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Ongoing curriculum change in higher education is essential to enhance student learning and better prepare them for the job‐market. However, research shows that faculty are reluctant to implement such changes because students generally react adversely thereby negating any potential benefits, and moreover, sanction faculty through lower evaluations and future enrollment. Yet, understanding of the effect of curriculum changes on students' course and instructor perceptions is limited. In this article we attempt to fill this gap. Drawing on two empirical findings—students' motivation to attend college becoming increasingly extrinsic since the 1960s and their inability to recognize, ex ante, the value‐added by a curriculum change—and the norm life‐cycle theory, we argue that any effort‐increasing or grade‐threatening change is viewed as non‐normative and will lead to an adverse student reaction. However, this adverse reaction will dissipate over time once a critical mass of students is convinced of the merits of the new curriculum. We find support for our hypotheses by analyzing change in student perceptions following curriculum changes at a U.S. University. In addition, we also find that once the adverse reaction dissipates, students' perceptions of the new curriculum become more positive than the old curriculum, only to be reversed once the revised curriculum is accepted as the new norm. [ABSTRACT FROM AUTHOR]

Objective Since patients with dementia with Lewy bodies (DLB) tend to have greater impairment of attention and construction and better memory ability on neuropsychological tests than patients with Alzheimer's disease (AD), we determined if the items that measure attention, memory, and construction in the Mini-Mental State Examination (MMSE) help to distinguish DLB from AD early in the course of the dementia. Design We retrospectively studied the first available MMSE exam for each of our patients with DLB or AD and compared their MMSE subscores for attention, memory, and construction. Setting A university dementia brain bank in central Illinois, USA. Patients All patients with neuropathologically-proven DLB or AD with MMSE scores≥13. Results We identified 17 DLB and 27 AD patients for whom we had MMSE exams. The attention and construction subtest scores of the DLB group were worse (p =0.0071 and p =0.0038, respectively) than those of the AD group. The memory subscores of the DLB group were better, although the difference did not reach statistical significance (p =0.22). When a mathematical equation was used to combine the three subscores with equal weighting ($Attention-{5\over 3}\;Memory+5\cdot Construction$), the scores of the DLB group were worse (p =0.00007). Using this equation, a score less than 5 points was associated with DLB with a sensitivity of 0.82 (95% Confidence Interval (CI)=0.57–0.96) and a specificity of 0.81 (95% CI=0.62–0.94). Conclusions Our findings support the work of others regarding the relative neuropsychological impairments of DLB and AD and indicate that the MMSE may be helpful in the differentiation of DLB and AD. Copyright © 2002 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis Falls are the leading cause of morbidity and mortality for persons aged 65 years and older, with more than 2 million people falling and sustaining serious injury annually. This study compared computer dynamic posturography (CDP) and electronystagmography (ENG) results as predictors of falls. Study Design Retrospective. Methods Thirty-three patients over the age of 65 years who presented to a balance disorders and falls prevention clinic were used for this study (22 women and 11 men, with an average age of 78.0 y and a mean fall rate of 3.5 times). All had experienced at least one fall in the year before visiting the clinic and were tested with both CDP and ENG. The CDP results were divided into subcategories (sensory organization testing and limits of stability); ENG results were divided into four categories (ocular motor, rotational chair, positional, and caloric studies). Results Test findings were classified as normal or abnormal based on age-matched normative data. Of the patients in the study, 27.3% were normal for one type of testing and abnormal for the other. Twenty-six patients (78.8%) had abnormal results on CDP, and 20 individuals (60.6%) showed ENG abnormalities (42.4% for ocular motor, 28.6% for positional, 13.6% for caloric, and 11.2% for rotational chair studies). The limits of stability category was significant in predicting multiple falls. Conclusion For this population, CDP was determined to be a more sensitive test for identifying patients who have fallen, with limits of stability testing the most significant part of the CDP battery; for ENG studies, the best falls indicator was the ocular motor battery. [ABSTRACT FROM AUTHOR]

Previous studies have shown that levels of binding for the strychnine-sensitive glycine receptor in the cochlear nucleus (CN) of Fischer(F344) rats decrease with age. Given the major role glycine plays in normal CN function, changes in glycine-receptor activity may contribute to central presbycusis. To further evaluate the impact of age on glycine receptors, in situ hybridization was used to assess, in three age groups of F344 rats, changes in levels of gene expression for four of its subunits. When compared with the 3-month-old rats, expression of mRNAs for α1 and β subunits in the anteroventral CN decreased significantly in the 18- and 27-month-old age groups, while mRNA expression for the α2 subunit increased. If protein expressions are similar, these subunit changes may alter the function of glycine receptors, thereby affecting binding to its ligands. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: Reports of laryngeal response to denervation are inconsistent. Some document atrophy and fibrosis in denervated laryngeal muscles, whereas others indicate resistance to atrophy. Spontaneous reinnervation has also been documented. The goal of this study was to clarify the effects of nerve injury and reinnervation on thyroarytenoid (TA) and posterior cricoarytenoid (PCA) muscles. Study Design: Laboratory experiment. Methods: TA and PCA muscles of cats were harvested 5 to 6 months after transecting right or left recurrent laryngeal nerve (RLN). Images of muscle cross-sections were acquired and studied using an image analysis workstation. Cross-sectional areas as well as total cross-sectional area of randomly selected muscle fibers were recorded. Results: TA reinnervation was robust on both sides, but there was less reinnervation of the PCA muscle after left-sided RLN lesion than after right-sided injury. Conclusions: Differences in reinnervation after RLN injury could contribute to the higher clinical incidence of left- vs. right-sided laryngeal paralysis. [ABSTRACT FROM AUTHOR]

Objective: Compare the risk of bacterial contamination of allergy immunotherapy vials prepared in-office versus those mixed under a ventilation hood. Study Design: Prospective single-blinded study. Setting: Tertiary otolaryngology outpatient clinic. Results: Five hundred thirty-seven vials were prepared and cultured for aerobes and anaerobes over an 11-month period. Three hundred twenty vials were arbitrarily assigned to in-office preparation and 217 to under-hood preparation. A total of two positive cultures occurred in vials prepared in-office and one from under-hood preparation. Follow-up cultures of these three vials were all negative. No patients receiving injections had signs or symptoms of skin or systemic infections from the injections. Conclusion: Our results suggest that the risk of bacterial contamination in immunotherapy vials in both groups is rare. [Copyright &y& Elsevier]

Objective: To prospectively evaluate the risks of vial contamination after routine clinical use of multiple-dose vials for immunotherapy. Study Design: Prospective observational study of immunotherapy vial cultures from June 2007 to January 2008. Setting: Tertiary care outpatient otolaryngology clinic. Results: Over an 8-month period, 136 consecutive vials were cultured for aerobic and anaerobic bacteria at the 3-month expiration date after regular use in an outpatient allergy clinic and dispensation of multiple doses of injection immunotherapy from each vial. All vials had negative cultures. Conclusion: Immunotherapy vials are at low risk to undergo contamination in routine use. Important factors include aseptic technique, bacteriostatic agents, and expiration dating. [Copyright &y& Elsevier]

Summary Mice with targeted deletion of the growth hormone receptor (GHRKO mice) are growth hormone (GH) resistant, small, obese, hypoinsulinemic, highly insulin sensitive and remarkably long-lived. To elucidate the unexpected coexistence of adiposity with improved insulin sensitivity and extended longevity, we examined effects of surgical removal of visceral (epididymal and perinephric) fat on metabolic traits related to insulin signaling and longevity. Comparison of results obtained in GHRKO mice and in normal animals from the same strain revealed disparate effects of visceral fat removal (VFR) on insulin and glucose tolerance, adiponectin levels, accumulation of ectopic fat, phosphorylation of insulin signaling intermediates, body temperature, and respiratory quotient (RQ). Overall, VFR produced the expected improvements in insulin sensitivity and reduced body temperature and RQ in normal mice and had opposite effects in GHRKO mice. Some of the examined parameters were altered by VFR in opposite directions in GHRKO and normal mice, and others were affected in only one genotype or exhibited significant genotype × treatment interactions. Functional differences between visceral fat of GHRKO and normal mice were confirmed by measurements of adipokine secretion, lipolysis, and expression of genes related to fat metabolism. We conclude that in the absence of GH signaling, the secretory activity of visceral fat is profoundly altered and unexpectedly promotes enhanced insulin sensitivity. The apparent beneficial effects of visceral fat in GHRKO mice may also explain why reducing adiposity by calorie restriction fails to improve insulin signaling or further extend longevity in these animals. [ABSTRACT FROM AUTHOR]