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Our institution underwent a curricular revision to change the course approach for introductory anatomy and physiology courses from separate, discipline-specific human anatomy and human physiology courses to an integrated A&P I and A&P II course approach. Through a mixed-methods exploratory study, this research sought to determine undergraduate student perceptions of anatomy through this curricular revision. Data was collected through word associations, open-ended surveys, and course evaluation data. Our results indicate that undergraduate student perceptions of anatomy changed between the first course and the second course in the sequence, rather than between course approaches. Students in both course approaches reported similar interests, confusions, and difficulties related to anatomy education, and an awareness of the explicit and implicit curriculum was evident in student responses. However, some specific evaluation prompts exhibited a significant difference between course approaches. Results from this perception study can guide practitioners to consider the curricular context and unique challenges of anatomy and physiology students in meeting the expectations of the health care field.

We describe the outcome of a large international interlaboratory study of the measurement of particle number concentration of colloidal nanoparticles, project 10 of the technical working area 34, "Nanoparticle Populations" of the Versailles Project on Advanced Materials and Standards (VAMAS). A total of 50 laboratories delivered results for the number concentration of 30 nm gold colloidal nanoparticles measured using particle tracking analysis (PTA), single particle inductively coupled plasma mass spectrometry (spICP-MS), ultraviolet-visible (UV-Vis) light spectroscopy, centrifugal liquid sedimentation (CLS) and small angle X-ray scattering (SAXS). The study provides quantitative data to evaluate the repeatability of these methods and their reproducibility in the measurement of number concentration of model nanoparticle systems following a common measurement protocol. We find that the population-averaging methods of SAXS, CLS and UV-Vis have high measurement repeatability and reproducibility, with between-labs variability of 2.6%, 11% and 1.4% respectively. However, results may be significantly biased for reasons including inaccurate material properties whose values are used to compute the number concentration. Particle-counting method results are less reproducibile than population-averaging methods, with measured between-labs variability of 68% and 46% for PTA and spICP-MS respectively. This study provides the stakeholder community with important comparative data to underpin measurement reproducibility and method validation for number concentration of nanoparticles.

Introductory anatomy and physiology courses are either taught as discipline-specific courses (human anatomy and human physiology) or integrated sequences [combined human anatomy and physiology (A&P I and A&P II)]. This variation suggests there is no agreed upon pedagogical standard for teaching introductory anatomy and physiology. We surveyed undergraduate students enrolled in human anatomy, human physiology, A&P I, and A&P II to determine their course approach preference, either discipline-specific or an integrated A&P sequence, and the underlying reasons for their preferences. The literature suggests that understanding students' preferred learning environment influences learner satisfaction, level of achievement, and socioemotional adjustment in the classroom. Our qualitative analysis revealed students prefer an integrated A&P course approach to a discipline-specific sequence with "building on prior knowledge," "easier," and "increased understanding" emerging as the top reasons for their preferences. Our findings have implications for course design and curricular reforms.

High-quality lexical representations are important for reading comprehension; however, prior research has focused primarily on the verbal aspects of these lexical representations. In this article, the authors argue for the importance of considering nonverbal representational elements of lexical knowledge and for more systematic attention to how nonverbal supports, such as gestures, pictures, and sounds, contribute to the acquisition of word knowledge. Drawing from various theoretical perspectives, the authors argue that the semantic content and the attention-directing attributes of nonverbal supports are critical in assisting primary-grade students in building high-quality multimodal lexical representations. The authors examined the use of nonverbal supports in vocabulary studies for young learners and present implications about the role of nonverbal supports in students' vocabulary acquisition. Results suggest that nonverbal scaffolds can help refine and deepen students' knowledge of words for a variety of word types, including abstract words.

Background: Unconscious bias of the clinician favors the diagnosis of carpal tunnel syndrome (CTS) in patients with median paresthesia. We hypothesized that more patients in this cohort would be diagnosed with proximal median nerve entrapment (PMNE) by strengthening our cognitive awareness of this alternative diagnosis. We also hypothesized that patients with PMNE may be successfully treated with surgical release of the lacertus fibrosus (LF). Methods: In this retrospective study, cases of median nerve decompression at the carpal tunnel and in the proximal forearm for the 2-year periods before and after adopting strategies to mitigate cognitive bias for CTS were enumerated. Patients diagnosed with PMNE and treated by LF release under local anesthesia were evaluated to determine surgical outcome at minimum 2-year follow-up. Primary outcome measures were changes in preoperative median paresthesia and proximal median-innervated muscle strength. Results: There was a statistically significant increase in PMNE cases identified after our heightened surveillance was initiated (z = 3.433, P <.001). In 10 of 12 cases, the patient had previous ipsilateral open carpal tunnel release (CTR) but experienced recurrent median paresthesia. In 8 cases evaluated an average of 5 years after LF release, there was improvement in median paresthesia and resolution of median-innervated muscle weakness. Conclusions: Owing to cognitive bias, some patients with PMNE may be misdiagnosed with CTS. All patients with median paresthesia, particularly those with persistent or recurrent symptoms after CTR, should be assessed for PMNE. Surgical release limited to the LF may be an effective treatment for PMNE. [ABSTRACT FROM AUTHOR]

Undergraduate introductory human anatomy and human physiology courses are either taught as discipline‐specific or integrated anatomy and physiology (A&P) sequences. An institution underwent a curricular revision to change the course approach from discipline‐specific Human Anatomy and Human Physiology to an integrated A&P I and II sequence, allowing the unique opportunity to explore the potential role of contextual learning in academic achievement and content retention. Mediation and moderation analysis was used to evaluate lecture examinations, laboratory practical examinations, and anatomical content retention between the different course approaches. Undergraduate students in the integrated A&P I course approach performed significantly better on lecture assessments and had a higher anatomy content retention rate at the end of the year than students enrolled in the standalone Human Anatomy course. The lecture examination averages between Human Physiology and A&P II (the second course in the sequence), as well as the anatomy laboratory practical examinations, were not significantly different between discipline‐specific and integrated course approaches. The results suggest contextual learning—providing physiological context to anatomical structures—increases the anatomical content retention and academic achievement overall. [ABSTRACT FROM AUTHOR]

This qualitative study explores networked collaborative learning in the context of an online undergraduate education course, analyzing the talk, thinking, and media that students jointly produced during a discussion hosted via video conference. Our work speaks to recent interest in online instruction, particularly in post-secondary institutions, as well as the challenge of making online courses engaging, critical, and inclusive educational spaces. Working from a sociocultural frame on learning and development, we demonstrate how synchronous engagement online with multiple digital technologies facilitated students' knowledge construction and analysis of assignment content. Additionally, we illustrate how the students and the technologies influenced each other, co-functioning reciprocally as elements within a broader "actor-network". Human and non-human "actants" worked together, affording small but noteworthy shifts in students' perspectives and thinking. We offer a definition of networked collaborative learning, positing that it is constituted by the dynamic convergence of actants working toward multiple and competing goals, and we discuss its potential for teaching and learning in online spaces.

Early vocabulary knowledge is vital for later reading comprehension and academic success. Studies have found that augmenting explicit teaching of word meanings with nonverbal visual aids, particularly pictures and gestures, assists young learners in building rich lexical representations. Research has focused on the effects of visual supports in fostering word knowledge but has not considered the effectiveness of using sound-based supports. Working from a semiotics perspective, the authors used a music instructional strategy known as a sound story to examine the impact of using sound effects to teach words to first-grade students. Words were taught with explicit instruction in combination with sound effects or no sound effects during music class. All sound effects were created and performed using musical instruments in the classroom. Students' receptive and productive definitional word knowledge were assessed. The productive measure was used as a measure of depth of word knowledge. The authors found that students had deeper knowledge of words that were taught with an associated sound effect compared with words taught with no sound effect. Analysis of the types of information students provided about words showed that students gave more contextual information and gestural responses for words that were taught with sound compared with words taught with no sound. These results provide evidence that vocabulary learning can be fostered during specialist music classes using methods familiar to music educators.

ObjectiveMost investigations of pharmacotherapy for treating Alzheimer's disease focus on patients with mild-to-moderate symptoms, with little evidence to guide clinical decisions when symptoms become severe. We examined whether continuing donepezil, or commencing memantine, is cost-effective for community-dwelling, moderate-to-severe Alzheimer's disease patients.MethodsCost-effectiveness analysis was based on a 52-week, multicentre, double-blind, placebo-controlled, factorial clinical trial. A total of 295 community-dwelling patients with moderate/severe Alzheimer's disease, already treated with donepezil, were randomised to: (i) continue donepezil; (ii) discontinue donepezil; (iii) discontinue donepezil and start memantine; or (iv) continue donepezil and start memantine.ResultsContinuing donepezil for 52 weeks was more cost-effective than discontinuation, considering cognition, activities of daily living and health-related quality of life. Starting memantine was more cost-effective than donepezil discontinuation. Donepezil-memantine combined is not more cost-effective than donepezil alone.ConclusionsRobust evidence is now available to inform clinical decisions and commissioning strategies so as to improve patients' lives whilst making efficient use of available resources. Clinical guidelines for treating moderate/severe Alzheimer's disease, such as those issued by NICE in England and Wales, should be revisited. © 2016 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd.

High rates of exposure to violence and other adversities among Latino/a youth contribute to health disparities. The current article addresses the ways in which community-based participatory research (CBPR) and human-centered design (HCD) can help engage communities in dialogue and action. We present a project exemplifying how community forums, with researchers, practitioners, and key stakeholders, including youths and parents, integrated HCD strategies with a CBPR approach. Given the potential for power inequities among these groups, CBPR + HCD acted as a catalyst for reciprocal dialogue and generated potential opportunity areas for health promotion and change. Future directions are described.

Background and Aims Contrast-induced nephropathy (CIN), also known as contrast-associated acute kidney injury (CA-AKI) underlies a significant proportion of the morbidity and mortality following coronary angiographic procedures in high-risk patients and remains a significant unmet need. In pre-clinical studies inorganic nitrate, which is chemically reduced in vivo to nitric oxide, is renoprotective but this observation is yet to be translated clinically. In this study, the efficacy of inorganic nitrate in the prevention of CIN in high-risk patients presenting with acute coronary syndromes (ACS) is reported. Methods NITRATE-CIN is a double-blind, randomized, single-centre, placebo-controlled trial assessing efficacy of inorganic nitrate in CIN prevention in at-risk patients presenting with ACS. Patients were randomized 1:1 to once daily potassium nitrate (12 mmol) or placebo (potassium chloride) capsules for 5 days. The primary endpoint was CIN (KDIGO criteria). Secondary outcomes included kidney function [estimated glomerular filtration rate (eGFR)] at 3 months, rates of procedural myocardial infarction, and major adverse cardiac events (MACE) at 12 months. This study is registered with ClinicalTrials.gov : NCT03627130. Results Over 3 years, 640 patients were randomized with a median follow-up of 1.0 years, 319 received inorganic nitrate with 321 received placebo. The mean age of trial participants was 71.0 years, with 73.3% male and 75.2% Caucasian; 45.9% had diabetes, 56.0% had chronic kidney disease (eGFR <60 mL/min) and the mean Mehran score of the population was 10. Inorganic nitrate treatment significantly reduced CIN rates (9.1%) vs. placebo (30.5%, P <.001). This difference persisted after adjustment for baseline creatinine and diabetes status (odds ratio 0.21, 95% confidence interval 0.13–0.34). Secondary outcomes were improved with inorganic nitrate, with lower rates of procedural myocardial infarction (2.7% vs. 12.5%, P =.003), improved 3-month renal function (between-group change in eGFR 5.17, 95% CI 2.94–7.39) and reduced 1-year MACE (9.1% vs. 18.1%, P =.001) vs. placebo. Conclusions In patients at risk of renal injury undergoing coronary angiography for ACS, a short (5 day) course of once-daily inorganic nitrate reduced CIN, improved kidney outcomes at 3 months, and MACE events at 1 year compared to placebo. [ABSTRACT FROM AUTHOR]