Abstract
Higher education institutions are increasingly interested in infusing sustainability content into their curricula. This can be accomplished through general education programs, which the ...University of Vermont recently established. The implementation of this new requirement created a unique opportunity to investigate sustainability-related teaching and learning. The purpose of this study was to explore how instructors structured and taught sustainability learning outcomes and students' perceptions of learning within an assortment of general education courses. The variety of data collection methods (online survey, interviews, focus groups, observation, and document review) enabled the identification and triangulation of strong themes. Findings describe three course design approaches instructors used to incorporate sustainability. Instructors taught sustainability through class discussions, papers, readings, projects, guest speakers, and case studies. Students reported the following teaching practices as particularly helpful: experiencing real-world applications, discussing sustainability issues in class, exploring different perspectives, experiencing agency, and learning from peers and guest speakers. The following are recommended areas for skill development: (1) training instructors to align learning outcomes with assessment strategies to ensure that appropriate evidence is gathered, (2) encouraging instructors to reflect upon which teaching practices effectively supported student learning and consider improvements, and (3) using a variety of teaching practices and assessment strategies.
Many patients delayed health care during COVID-19. We assessed the extent to which patients managing multiple chronic conditions (MCC) delayed care in the first months of the pandemic, reasons for ...delay, and impact of delay on patient-reported physical and behavioral health (BH) outcomes.
As part of a large clinical trial conducted April 2016-June, 2021, primary care patients managing MCC were surveyed about physical and behavioral symptoms and functioning. Surveys administered between September 3, 2020, and March 16, 2021, included questions about the extent of and reasons for any delayed medical and BH care since COVID-19. Multivariable linear regression was used to assess health outcomes as a function of delay of care status.
Among patients who delayed medical care, 58% delayed more than once. Among those who delayed behavioral health care, 63% delayed more than once. Participants who delayed multiple times tended to be younger, female, unmarried, and reported food, financial, and housing insecurities and worse health. The primary reasons for delaying care were lack of availability of in-person visits and perceived lack of urgency. Participants who delayed care multiple times had significantly worse outcomes on nearly every measure of physical and mental health, compared with participants who delayed care once or did not delay.
Delay of care was substantial. Patients who delayed care multiple times were in poorer health and thus in need of more care. Effective strategies for reengaging patients in deferred care should be identified and implemented on multiple levels.
ClinicalTrials.gov NCT02868983. Registered on August 16, 2016.
Background/Purpose
: Calcitonin gene-related peptide (CGRP) has been proposed to influence migration and testicular descent by release from the genitofemoral nerve. The site of CGRP within the nerve ...has been controversial, with conflicting views on whether CGRP is synthesised and released from the motor nerves.
Methods
: The genitofemoral nerve (GFN) was retrogradely labelled by fluorescent dye (DAPI) in 25 Sprague-Dawley rats (days 5, 16, and 31, n = 8 in each group; day 35, n = 1). Spinal cords and dorsal root ganglia (DRG) were removed two to three days later and sectioned for immunofluorescence. Substance P and CGRP-containing cells were labelled with fluorescein-linked antibodies. Specimens were examined by double fluorescence to identify cells with both markers.
Results
: The motor nucleus of the GFN contained 119 cells on day 7 and 284 cells by days 19 through 34. A prominent band of CGRP-containing fibers, arising from the dorsal horn, synapsed with the GFN motor nucleus itself. CGRP-labelled GFN cells were found in the DRG by double labelling.
Conclusions
: CGRP from the GFN may affect gubernacular migration by release from the sensory nerves, rather than motor nerves as previously thought. The GFN motor nucleus receives CGRP-containing innervation from the dorsal horn, which may form part of the cremasteric reflex.
At the start of every school year, teachers typically wonder what their new students know coming into the grade level. Sometimes, though, they place too much emphasis on what children do not know or ...have forgotten over summer break. After all, those gaps can be glaring. Helping their students grow is like helping an acorn grow; they must watch for what is sprouting and tend to how the sprouts are growing. The process of looking at student work and asking probing questions provides the perfect starting place to discover what students already know and which strategies they use to figure things out. It is also in keeping with current research on student growth and learning (Boaler 2016; Carpenter et al. 2015; Huinker and Bill 2017). Questions should be used to both assess and advance student thinking toward the next potential growth spurt. Questioning allows teachers to elicit, interpret, and respond to student work
Three rat strains have been studied, using a sensitive apoptotic detection method for germ-cell degeneration, to resolve the controversy regarding the effect of cryptorchidism on the contralateral ...descended testis (CDT). Sprague Dawley and Buffalo rats were made cryptorchid by operation at 20-22 days of age, while trans-scrotal (T-S) rats were a congenitally unilateral cryptorchid strain. Sham operated rats or normal T-S littermates were used as controls. Experiments were performed over a period ranging from 2 weeks to 18 months. Testis weight was assayed, as was the detection of apoptosis by agarose gel laddering and immunohistochemistry by using the TUNEL method. Labeled cells in 150 cross-sectioned testis tubules were counted on the TUNEL stained slides and the mean number of labeled cells per tubule was calculated. Paternity studies on Sprague Dawley and T-S rats were carried out at 12 and 24 weeks of age to assess fertility by the resultant number of pregnancies and litter sizes. Both Sprague Dawley and T-S rat models showed a biphasic distribution of apoptosis levels. This biphasic distribution was not observed in Buffalo rats as they were only studied at later time points (12-20 weeks). A significant effect on either testis weight or apoptosis in the CDT compared with the control descended testis (P > or = 0.1) has not been found in these three cryptorchid models, and the present results are discussed with reference to observations of other researchers in rodents and humans. While the cryptorchid testis showed a high level of labeled apoptotic cells per tubule in all rat strains, fertility was not affected and remained the same as controls at 12 and 24 weeks. There was, however, a marked strain difference in fertility in T-S as compared with Sprague Dawley rats. After 24 weeks of cryptorchidism, both control and cryptorchid T-S rats had a 44% pregnancy incidence compared with a 90% pregnancy incidence in Sprague Dawley rats. In addition, litter size in T-S control and cryptorchid rats were small compared with those of Sprague Dawley rats at 12 and 24 weeks.
The clinical years of medical student education are an ideal time for students to practise and refine ethical thinking and behaviour. We piloted a new clinical ethics teaching activity this year with ...undergraduate medical students within the Rural Clinical School at the University of New South Wales. We used a modified teaching ward round model, with students bringing deidentified cases of ethical interest for round-table discussion. We found that students were more engaged in the subject of clinical ethics after attending the teaching sessions and particularly appreciated having structured time to listen to and learn from their peers. Despite this, we found no change in student involvement in managing or planning action in situations that they find ethically challenging. A key challenge for educators in clinical ethics is to address the barriers that prevent students taking action.
An increasing number of faculty are seeing the need for integrative teaching that is relevant for the grand challenges of our times. Faculty professional development can provide an effective avenue ...to support innovative pedagogy and curricular leadership related to sustainability. The University of Vermont (UVM) Sustainability Faculty Fellows Program (SFF) was developed by a group of academic and community partners to address this challenge. Over the course of 6 years, the program grew from a handful of faculty funded by one-time competitive funds to just over 100 faculty and staff participants with base level funding from the Provost’s Office. Through the leadership efforts of sustainability faculty fellows, a sustainability general education requirement was developed and approved through the UVM Faculty Senate in 2015. Drawing on data sets prepared by Rowse (
2013
) and Natkin (
2015
), this paper reports findings of three assessment efforts evaluating the long-term impacts of the SFF program to develop faculty leadership in sustainability curricula. In 2013, a 4-year report analyzed course and faculty information (i.e., enrollment, course level, type of course, faculty rank, and disciplinary field). In 2014, interviews of program alumni revealed benefits of participating in a professional learning community, common challenges in teaching sustainability concepts, and examples of changes in fellows’ teaching strategies. A 2015 survey of SFF alums provided further data about fellows’ leadership in campus sustainability initiatives and their needs related to implementation of UVM’s new sustainability general education requirement. The paper concludes with reflections on the stages of leadership development generated through faculty engagement in sustainability curricular initiatives.
Just as an acorn contains everything it needs to grow into a mighty tree, our students possess understandings hidden right beneath the surface that can be nurtured to support their growth into mighty ...mathematicians.
Chronic diseases that drive morbidity, mortality, and health care costs are largely influenced by human behavior. Behavioral health conditions such as anxiety, depression, and substance use disorders ...can often be effectively managed. The majority of patients in need of behavioral health care are seen in primary care, which often has difficulty responding. Some primary care practices are providing integrated behavioral health care (IBH), where primary care and behavioral health providers work together, in one location, using a team-based approach. Research suggests there may be an association between IBH and improved patient outcomes. However, it is often difficult for practices to achieve high levels of integration. The Integrating Behavioral Health and Primary Care study responds to this need by testing the effectiveness of a comprehensive practice-level intervention designed to improve outcomes in patients with multiple chronic medical and behavioral health conditions by increasing the practice's degree of behavioral health integration.
Forty-five primary care practices, with existing onsite behavioral health care, will be recruited for this study. Forty-three practices will be randomized to the intervention or usual care arm, while 2 practices will be considered "Vanguard" (pilot) practices for developing the intervention. The intervention is a 24-month supported practice change process including an online curriculum, a practice redesign and implementation workbook, remote quality improvement coaching services, and an online learning community. Each practice's degree of behavioral health integration will be measured using the Practice Integration Profile. Approximately 75 patients with both chronic medical and behavioral health conditions from each practice will be asked to complete a series of surveys to measure patient-centered outcomes. Change in practice degree of behavioral health integration and patient-centered outcomes will be compared between the two groups. Practice-level case studies will be conducted to better understand the contextual factors influencing integration.
As primary care practices are encouraged to provide IBH services, evidence-based interventions to increase practice integration will be needed. This study will demonstrate the effectiveness of one such intervention in a pragmatic, real-world setting.
ClinicalTrials.gov NCT02868983 . Registered on August 16, 2016.
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