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ObjectiveTo describe the evolution of perioperative opioid management in gynecologic oncology patients after open surgeries and determine current opioid over-prescription rates.MethodsPart one of this two-part study was a retrospective chart review of adult patients who underwent laparotomy by a gynecologic oncologist from July 1, 2012 to June 30, 2021, comparing changes in clinical characteristics, pain management and discharge opioid prescription sizes between fiscal year 2012 (FY2012) and 2020 (FY2020). In part two, we prospectively surveyed patients after laparotomy in 2021 to determine opioid use after hospital discharge.Results1187 patients were included in the chart review. Demographic and surgical characteristics remained stable from FY2012 to FY2020 with differences notable for increased rates of interval cytoreductive surgeries for advanced ovarian cancer and decreased rates of full lymph node dissection. Median inpatient opioid use decreased by 62 % from FY2012 to FY2020. Median discharge opioid prescription size was 675 oral morphine equivalents (OME) per patient in FY2012 and decreased by 77.7 % to 150 OME in FY2020. Of 95 surveyed patients in 2021, median self-reported opioid use after discharge was 22.5 OME. Patients had an excess of opioids equivalent to 1331 doses of 5-milligram oxycodone tablets per 100 patients.ConclusionInpatient opioid use in our gynecologic oncology open surgical patients and post-discharge opioid prescription size significantly decreased over the last decade. Despite this progress, our current prescribing patterns continue to significantly overestimate patients' actual opioid use after hospital discharge. Individualized point of care tools are needed to determine an appropriate opioid prescription size.

Because of decreased prices, increased convenience, and wireless access, an increasing number of college and university students are using laptop computers in their classrooms. This recent trend has forced instructors to address the educational consequences of using these mobile devices. The purpose of the current study was to analyze and assess beneficial and challenging laptop behaviours in higher education classrooms. Both quantitative and qualitative data were collected from 177 undergraduate university students (89 males, 88 females). Key benefits observed include note-taking activities, in-class laptop-based academic tasks, collaboration, increased focus, improved organization and efficiency, and addressing special needs. Key challenges noted include other student's distracting laptop behaviours, instant messaging, surfing the web, playing games, watching movies, and decreased focus. Nearly three-quarters of the students claimed that laptops were useful in supporting their academic experience. Twice as many benefits were reported compared to challenges. It is speculated that the integration of meaningful laptop activities is a critical determinant of benefits and challenges experienced in higher education classrooms. (Contains 6 tables.)

The purpose of this study was to examine individual differences in attitudes toward Audience Response Systems (ARSs) in secondary school classrooms. Specifically, the impact of gender, grade, subject area, computer comfort level, participation level, and type of use were examined in 659 students. Males had significantly more positive attitudes toward ARSs than female students. Students who were more comfortable with computers had significantly more positive attitudes than students who were less comfortable. Students who did not actively participate in class before ARSs were used were more positive about this tool than students who regularly participated. Finally, students were significantly more positive about ARSs when they were used for formative (not for grades) as opposed to summative (for grades) assessment. There were no significant differences observed for grade level or subject area taught. (Contains 7 tables.)

The current study offers a formative analysis of the impact of learning objects in middle school mathematics and science classrooms. Five reliable and valid measures of effectiveness were used to examine the impact of learning objects from the perspective of 262 students and 8 teachers (14 classrooms) in science or mathematics. The results indicate that teachers typically spend 1-­2 hours finding and preparing for learning-­object based lesson plans that focus on the review of previous concepts. Both teachers and students are positive about the learning benefits, quality, and engagement value of learning objects, although teachers are more positive than students. Student performance increased significantly, over 40%, when learning objects were used in conjunction with a variety of teaching strategies. It is reasonable to conclude that learning objects have potential as a teaching tool in a middle school environment.

The following paper is based on a review of 68 referred journal articles that focused on introducing technology to preservice teachers. Ten key strategies emerged from this review, including delivering a single technology course; offering mini-workshops; integrating technology in all courses; modeling how to use technology; using multimedia; collaboration among preservice teachers, mentor teachers and faculty; practicing technology in the field; focusing on education faculty; focusing on mentor teachers; and improving access to software, hardware, and/or support. These strategies were evaluated based on their effect on computer attitude, ability, and use. The following patterns emerged: First, most studies looked at programs that incorporated only one to three strategies. Second, when four or more strategies were used, the effect on preservice teacher's use of computers appeared to be more pervasive. Third, most research examined attitudes, ability, or use, but rarely all three. Fourth, and perhaps most important, the vast majority of studies had severe limitations in method: poor data collection instruments, vague sample and program descriptions, small samples, an absence of statistical analysis, or weak anecdotal descriptions of success. It is concluded that more rigorous and comprehensive research is needed to fully understand and evaluate the effects of key technology strategies in preservice teacher education. The following are appended: (1) Details of Studies Reviewed; and (2) Variables and Criteria Used to Code Studies. (Contains 2 tables and 1 figure.)

Abstract Background Phenotypic and molecular genetic data often provide conflicting patterns of intraspecific relationships confounding phylogenetic inference, particularly among birds where a variety of environmental factors may influence plumage characters. Among diurnal raptors, the taxonomic relationship of Buteo jamaicensis harlani to other B. jamaicensis subspecies has been long debated because of the polytypic nature of the plumage characteristics used in subspecies or species designations. Results To address the evolutionary relationships within this group, we used data from 17 nuclear microsatellite loci, 430 base pairs of the mitochondrial control region, and 829 base pairs of the melanocortin 1 receptor (Mc1r) to investigate molecular genetic differentiation among three B. jamaicensis subspecies (B. j. borealis, B. j. calurus, B. j. harlani). Bayesian clustering analyses of nuclear microsatellite loci showed no significant differences between B. j. harlani and B. j. borealis. Differences observed between B. j. harlani and B. j. borealis in mitochondrial and microsatellite data were equivalent to those found between morphologically similar subspecies, B. j. borealis and B. j. calurus, and estimates of migration rates among all three subspecies were high. No consistent differences were observed in Mc1r data between B. j. harlani and other B. jamaicensis subspecies or between light and dark color morphs within B. j. calurus, suggesting that Mc1r does not play a significant role in B. jamaicensis melanism. Conclusions These data suggest recent interbreeding and gene flow between B. j. harlani and the other B. jamaicensis subspecies examined, providing no support for the historical designation of B. j. harlani as a distinct species.

Learning objects are interactive online tools that support the acquisition of specific concepts. Limited research has been conducted on factors that affect the use of learning objects in K-12 mathematics classrooms. The current study examines the influence of student characteristics (gender, age, computer comfort level, subject comfort level, and mathematics grade), instructional design (structured vs. open ended), and teaching strategy (teacher led vs. student based) on student attitudes toward the use of learning objects and learning performance. Data in the form of surveys and pre- and posttests were collected from 286 middle and secondary school students. Higher computer and subject area comfort ratings were significantly correlated with more positive student attitudes about learning objects. Older students in higher grades learned more than younger students in lower grades after using learning objects. Learning performance was significantly higher for students who used structured (vs. open-ended) learning objects and participated in teacher-led (vs. student-based) lessons. It is speculated that younger students might need more scaffolding when using mathematics-based learning objects. (Contains 5 tables.)

Over the past 18 years, a number of large scale reviews of the literature have documented that gender differences in computer attitudes, ability, and use tend to favor males. Since the use of laptops in higher education classrooms is increasing, it is important to examine whether this use is disproportionally advantageous to males and disadvantageous to females. The purpose of this study was to explore gender differences in the use of laptops in higher education classrooms. Two key areas were examined: on-task behaviors (note-taking, academic activities, instant messaging) and off-task behaviors (e-mail, instant messaging, games, movies, distractions). With respect to on-task behaviors, females reported significantly more note-taking and participation in academic laptop-based activities. No gender differences were observed with respect to instant messaging for academic purposes. Regarding off-task behaviors, females were more distracted by their peers' use of laptops than males, whereas males reported that they played significantly more games during class. Recommendations for future research include expanding the breadth of off- and on-task behaviors assessed, exploring the role of teaching strategies, and focusing on learning performance. (Contains 6 tables.)

A majority of today's higher education students have been nurtured on a steady diet of technology and Internet access, leading to the increased presence of laptops in higher education classrooms. However, many instructors are unsure whether or how to assimilate this technology into their lessons. The purpose of the following study was to examine the impact of unstructured (limited use) vs. structured (active use) use of laptops for 177 university students (89 males, 88 females). Both on-task (note taking, academic activities) and off-task (email, instant messaging, games, movies) behaviours were examined by surveying students. Paired-t-tests revealed that structured use of laptops resulted in significantly more time spent on note taking and academic activities and significantly less time spent on sending personal emails, instant messages and playing games during class. It is concluded that future research needs to focus on evaluating specific strategies that maximize the benefits and minimize the distractions of using laptops. (Contains 2 tables.)

An interactive classroom communication system (ICCS) involves the use of remote devices that permit all students in a class to respond to multiple choice questions displayed on a LCD projector. After responses are clicked in, the results are instantly aggregated and displayed in chart form. The purpose of this study was to examine gender differences in attitudes toward ICCSs for 659 secondary school students. The initial results suggested that male students had significantly more positive attitudes than female students with respect to student involvement, assessment, and perceived learning. However, a number of these differences disappeared when computer comfort level and type of use were added as covariates. Male students still perceived that ICCSs improved the overall learning process more than female students regardless of computer comfort level or type of use. (Contains 4 tables.)

Learning objects are interactive web-based tools that support the learning of specific concepts by enhancing, amplifying, and/or guiding the cognitive processes of learners. Research on the impact, effectiveness, and usefulness of learning objects is limited, partially because comprehensive, theoretically based, reliable, and valid evaluation tools are scarce, particularly in the K-12 environment. The purpose of the following study was to investigate a Learning Object Evaluation Scale for Students (LOES-S) based on three key constructs gleaned from 10 years of learning object research: learning, quality or instructional design, and engagement. Tested on over 1100 middle and secondary school students, the data generated using the LOES-S showed acceptable internal reliability, face validity, construct validity, convergent validity and predictive validity.

An audience response system (ARS) permits students to respond to multiple choice questions using a remote control device. All responses are instantly displayed, usually in chart form, and subsequently reviewed and discussed by the instructor and the class. This paper offers a comprehensive review of teaching strategies used with ARS and includes a discussion of general, motivational, assessment based, and learning based approaches. Several promising strategies have been identified, particularly collecting formative assessment feedback and peer based instruction. More systematic, detailed research in a broader range of contexts is recommended. (Contains 1 table.)

Very few studies have systematically evaluated the effect of learning objects in secondary school classrooms. The vast majority of studies have focussed on higher education. The current study examined the impact of learning objects from the perspective of 850 students and 27 teachers (50 classrooms) of science, mathematics, or social science. The results suggest that teachers typically spend 1 to 2 h finding and preparing for learning object based lesson plans that focus on the review of previous concepts. Both teachers and students are positive about the learning benefits, quality, and engagement value of learning objects, although teachers are more positive than students. Student performance increased significantly--almost 30%--when learning objects were used in conjunction with a variety of teaching strategies. It is reasonable to conclude that learning objects are a viable teaching tool in a secondary school environment.

The purpose of this study was to examine individual differences in the effectiveness of learning objects in secondary school classrooms. Specifically, gender, age, grade, subject area, and computer comfort (self-efficacy) were examined in 850 students. Effectiveness was measured in terms of student attitude (learning, quality, and engagement) and student performance. No gender differences were observed between males and females with respect to student attitudes or performance. Age was significantly correlated with student attitudes and performance, however correlation coefficients were small. Grade 12 students were more positive about learning objects and performed better than grade 9 and 10 students. Science students had significantly more positive attitudes and performed better than mathematics students. Finally, students who were more comfortable about computers, appreciated learning objects more than their less confident peers, however performance was unaffected. (Contains 6 tables.)

Most computer users have to deal with major software upgrades every 6-18 months. Given the pressure of having to adjust so quickly and so often, it is reasonable to assume that users will express emotional reactions such as anger, desperation, anxiety, or relief during the learning process. To date, the primary emotion studied with respect to computer knowledge has been anxiety or fear. The purpose of the following study was to explore the relationship among a broader range of emotions (anger, anxiety, happiness, and sadness) and the acquisition of nine computer related skills. Pre- and post-surveys were given to 184 preservice education students enrolled in 8 month, integrated laptop program. Happiness was expressed most of the time--anxiety, anger, and sadness were reported sometimes. Anxiety and anger levels decreased significantly, while computer knowledge increased. All four emotions were significantly correlated with all nine computer knowledge areas at the beginning of the program, but happiness and anxiety were the only emotions significantly related to change in computer knowledge.

While discussion of the criteria needed to assess learning objects has been extensive, a formal, systematic model for evaluation has yet to be thoroughly tested. The purpose of the following study was to develop and assess a multi-component model for evaluating learning objects. The Learning Object Evaluation Metric (LOEM) was developed from a detailed list of criteria gathered from a comprehensive review of the literature. A sample of 1113 middle and secondary students, 33 teachers, and 44 learning objects was used to test this model. A principal components analysis revealed four distinct constructs: interactivity, design, engagement, and usability. These four constructs showed acceptable internal and inter-rater reliability. They also correlated significantly with student and teacher perceptions of learning, quality, and engagement. Finally, all four constructs were significantly and positively correlated with student learning performance. It is reasonable to conclude that the LOEM is reliable, valid, and effective approach to evaluating the effectiveness of learning objects in middle and secondary schools. (Contains 6 tables.)

Little research has been done examining the role of errors in learning computer software. It is argued, though, that understanding the errors that people make while learning new software is important to improving instruction. The purpose of the current study was to (a) develop a meaningful and practical system for classifying computer software errors, (b) determine the relative effect of specific error types on learning, and (c) examine the impact of computer ability on error behaviour. Thirty-six adults (18 males, 18 females), representing three computer ability levels (beginner, intermediate, and advanced), volunteered to think out loud while they learned the rudimentary steps (moving the cursor, using a menu, entering data) required to use a spreadsheet software package. Classifying errors according to six basic categories (action, orientation, knowledge processing, seeking information, state, and style) proved to be useful. Errors related to knowledge processing, seeking information, and actions were observed most frequently, however, state, style, and orientation errors had the largest immediate negative impact on learning. A more detailed analysis revealed that subjects were most vulnerable when observing, trying to remember, and building mental models. The effect of errors was partially related to computer ability, however beginner, intermediate and advanced users were remarkably similar with respect to the prevalence of errors.

A comprehensive review of the literature on the evaluation of learning objects revealed a number of problem areas, including emphasizing technology ahead of learning, an absence of reliability and validity estimates, over-reliance on informal descriptive data, a tendency to embrace general impressions of learning objects rather than focusing on specific design features, the use of formative or summative evaluation, but not both, and testing on small, vaguely described sample populations using a limited number of learning objects. This study explored a learning-based approach for evaluating learning objects using a large, diverse, sample of secondary school students. The soundness of this approach was supported by estimates of reliability and validity, using formal statistics where applicable, incorporating both formative and summative evaluations, examining specific learning objects features based on instructional design research, and testing of a range of learning objects. The learning-based evaluation tool produced useful and detailed information for educators, designers and researchers about the impact of learning objects in the classroom. A Learning object survey is appended. (Contains 7 tables.)

The use of online discussion boards has grown extensively in the past 5 years, yet some researchers argue that our understanding of how to use this tool in an effective and meaningful way is minimal at best. Part of the problem in acquiring more cohesive and useful information rests in the absence of a comprehensive, theory-driven metric to assess quality and effectiveness. Based on an extensive review of the research, the following variables were used to assess traditional discussion board use: thread, location of message within thread, author (student vs. educator), subject line clarity, time of posting, response time from previous message, number of times message was read, number of words, primary purpose, message quality, difficulty level of topic, knowledge level, processing level and use of external resources. These variables proved to be effective in assessing 12 key areas of discussion board use. It is argued that this kind of metric is essential if we wish to advance our understanding of online discussion boards for both educators and researchers.

The purpose of this study was to evaluate the effect of an integrated, laptop-based approach on pre-service teachers' computer attitudes, ability and use. Pre-post program analysis revealed significant differences in behavioural attitudes and perceived control (self-efficacy), but not in affective and cognitive attitudes. In addition, there was a significant improvement in all 10 computer ability areas (operating systems, communication, World Wide Web, word processing, spreadsheets, database, graphics, multimedia, web page design, and programming). Finally, pre-service teachers used laptop computers significantly more in a university setting than in their field placements. (Contains 5 tables.)