Challenging endocrinology students with a critical-thinking workbook

A central goal of science education is to help students develop higher order thinking skills to enable them to face the challenges of life. Accordingly, science instructors are now urged to craft their classrooms such that they serve as not only spaces for disseminating information, but also an arena through which students are encouraged to think scientifically and develop critical-thinking skills. This project aimed to develop a workbook that helps postsecondary students learn endocrinology and engages them in critical thinking. Each of the five chapters focuses on a different topic rooted within core biological concepts relevant to endocrinology. Such topics were identified on cross-referencing seminal reports on science education. Tenants of Numrich’s Sequence of Critical-Thinking Tasks were used to guide the development of chapter sections with the intent of engaging students in critical thinking over time by way of practice and scaffolded guidance. Chapter sections of modeling, event sequencing, clinical application, research and communication, and simulation, target different skills presented in Numrich’s framework. Students’ learning, experiences, and behaviors were used to evaluate the workbook and inform the revision of the workbook into the publicly available second edition.

Vision beyond Pixels: Visual Reasoning via Blocksworld Abstractions

Deep neural networks trained in an end-to-end fashion have brought about exceptional advances in computer vision, especially in computational perception. We go beyond perception and seek to enable vision modules to reason about perceived visual entities such as scenes, objects and actions. We introduce a challenging visual reasoning task, Image-Based Event Sequencing (IES) and compile the first IES dataset, Blocksworld Image Reasoning Dataset (BIRD). Motivated by the blocksworld concept, we propose a modular approach supported by literature in cognitive psychology and children's development. We decompose the problem into two stages - visual perception and event sequencing, and show that our approach can be extended to natural images without re-training.

Reference Values for Healthy Swallowing Across the Range From Thin to Extremely Thick Liquids

Purpose Thickened liquids are frequently used as an intervention for dysphagia, but gaps persist in our understanding of variations in swallowing behavior based on incremental thickening of liquids. The goal of this study was to establish reference values for measures of bolus flow and swallowing physiology in healthy adults across the continuum from thin to extremely thick liquids. Method A sex-balanced sample of 38 healthy adults underwent videofluoroscopy and swallowed 20% weight-to-volume concentration barium prepared in thin and slightly, mildly, moderately, and extremely thick consistencies using a xanthan gum thickener. Participants took comfortable sips and swallowed without a cue; sip volume was measured based on presip and postsip cup weights. A standard operating procedure (the ASPEKT method: Analysis of Swallowing Physiology: Events, Kinematics and Timing) was used to analyze videofluoroscopy recordings. Results The results clarify that, for thin liquid sips (10–14 ml), a single swallow without clearing swallows is typical and is characterized by complete laryngeal vestibule closure, complete pharyngeal constriction, and minimal postswallow residue. Aspiration was not seen, and penetration was extremely rare. Bolus position at swallow onset was variable, extending as low as the pyriform sinuses in 37% of cases. With thicker liquids, no changes in event sequencing, laryngeal vestibule closure, pharyngeal constriction, or postswallow residue were seen. The odds of penetration were significantly reduced. A longer timing interval until onset of the hyoid burst movement was seen, with an associated higher bolus position at swallow onset. Other timing measures remained unaffected by changes in bolus consistency. Conclusion The results include new reference data for swallowing in healthy adults across the range from thin to extremely thick liquids.

Identity, Contingency, and Interaction: Historical Research and Social Science Analysis of Nation-State Proliferation

Scholars of nation-building and secession tend to prioritize elite or broader nationalist activism when explaining the proliferation of nation-states. Yet, recent historical research reveals a major finding: the influence of great powers tended to eclipse nationalist mobilization for new states in Latin America, the Balkans, Anatolia, and Central and Eastern Europe. Drawing on recent trends in historical research largely unknown in other fields, this article examines context, timing, and event sequencing to provide a new approach to multi-case research on nation-state proliferation. Major power recognition of new states in the Balkans also emerges as transformational for the post-World War I replacement of dynastic empires with nation-states in Europe. These findings suggest a shift of focus to the interplay of nationalist activism and great power policy for explaining the spread of nation-states.

School Nurses Increasing the Compliance of Hygiene Routines for Students With Autism Spectrum Disorder

School nurses are essential healthcare providers to children with autism spectrum disorder (ASD). In providing this care, school nurses may need to accommodate the unique challenges that children with ASD may face, including but not limited to sensory sensitivities, communicative and social difficulties, difficulties remembering event sequencing and directions, and poor time management skills. The aim of this article is to provide school nurses and healthcare providers evidence-based interventions and strategies that they may use to increase the compliance of hygiene behaviors and routines for children with ASD.

Understanding and improving chemotherapy ordering and delivery using process elicitation and validation.

89 Background: Chemotherapy order/administration consists of complex, interrelated processes where errors have potentially severe consequences. We report a study that quantitatively and qualitatively evaluated chemotherapy delivery employing a formal process definition language to elicit and describe rigorously the process, then applied mathematical validation techniques to confirm the description, analogously to how computer software development and other industries use accurate, precise process definitions to assure soundness through redundancy and correct event sequencing. Methods: The process, including exceptional situations and individuals’ recognition of and responses to these, was elicited through informal, unstructured interviews with members of an interdisciplinary team. The resulting process description (or process definition), written in a notation developed for software development process assessment, guided chemotherapy process validation consisting of rigorous process definition analysis, direct observations, and semi-structured interviews to confirm the elicited details for the treatment plan sub-process. Results: The overall process definition yielded 467 steps; 207 steps (44%) were dedicated to handling 59 exceptional situations. Validation yielded 82 unique process events (35 new expected but not yet described steps, 16 new exceptional situations, and 31 new steps in response to exceptional situations). Process participants actively altered the process as ambiguities and conflicts were discovered by the elicitation and validation components of the study. Chemotherapy error rates (evaluated by our safety reporting system) declined during and after the project (p <.001). Conclusions: The initial elicitation methods and subsequent validation discussions supported rapid adoption of changes, improved communication regarding the process, and yielded error reduction. A combination of rigorous elicitation and validation methods creates increasingly accurate descriptions of complex but repetitive medical processes, leading to identification and removal of existing process defects while avoiding the creation of new defects as processes evolve.