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Rationale:The technique used to provide continuous positive airway pressure (CPAP) to the newborn may influence lung function and breathing efficiency. Objectives: To compare differences in gas exchange physiology and lung injury resulting from treatment of respiratory distress with either bubble or constant pressure CPAP and to determine if the applied flow influences short-term outcomes. What This Study Adds to the FieldIn an ovine model of preterm lung disease, treatment with bubble CPAP immediately after birth enhances gas exchange, lung mechanics, gas mixing efficiency, and lung volume compared with constant pressure CPAP.in New York, where B-CPAP has been a cornerstone of clinical treatment practice since the 1970s. Despite the lengthy period over which B-CPAP has been used, surprisingly little is known about the importance or relevance of the bubble component of the CPAP treatment.During B-CPAP, the expiratory limb of the CPAP circuit vents through an underwater seal. The resulting bubbles create pressure oscillations that are transmitted back to the airway opening. The noisy nature of the pressure waveform delivered to the airway opening generates broadband frequency composition and oscillatory pressure amplitudes that are in the order of 4 cm H 2 O around the mean pressure. Although this noisy component may contribute to gas mixing in a similar fashion to mechanisms present during high-frequency oscillatory ventilation (4), only two previous studies have examined the effect of B-CPAP on gas exchange. Lee and colleagues (4) randomized a group of infants ready for extubation to receive either B-CPAP or ventilator-derived (constant pressure) CPAP (CP-CPAP) for a period of 15 minutes before crossover to the alternative treatment. Although there were no differences in Pa CO 2 between B-CPAP and CP-CPAP groups, the babies treated with B-CPAP had lower respiratory rates and lower minute volumes, suggesting more efficient ventilation. More recently, Morley and colleagues reported a crossover study of clinically stable infants treated with CPAP in the neonatal intensive care unit (5). They found no differences in transcutaneous measurements of arterial CO 2 or in oxygen saturation between CPAP with and without bubbles over the brief 30-minute study epochs. Both studies tested the effect of B-CPAP on clinically stable infants in the recovery stage of neonatal respiratory illness, and focused predominantly on the concept that the bubble component was likely to influence CO 2 clearance.

A wiki is able to provide a learning environment which is closely aligned with the social‐constructivist approach and is more natural than many tools where open collaboration and the exchange of ideas are important. This case study analyses and evaluates essential aspects for the successful deployment of a wiki in a higher education setting using Salmon's five‐stage e‐learning framework. Indicators of the learning benefits were determined by qualitative analysis of students' wiki contributions. Students' perceptions were captured through interviews and questionnaires at the start and end of the project, thereby providing indicators of their motivation towards this method of learning. Our results suggest that a wiki can promote effective collaborative learning and confidence in formative self and peer assessment by facilitating rapid feedback, vicarious learning through observing others' contributions and easy navigation and tracking facilities. Student authorship was also encouraged. Issues identified included providing easy access to the wiki, lack of personalisation, possible vandalism and plagiarism. Also, students with learning difficulties might require extra help and take longer to familiarise themselves with this new e‐learning environment

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Collaborative learning through case-based or problem-based learning (PBL) scenarios is an excellent way for students to acquire knowledge and develop decision-making skills. However, the process is threatened by the movement towards more self-directed learning and the migration of students from campus-based to workplace-based learning. Paper-based PBL cases can only proceed in a single direction which can prevent learners from exploring the impact of their decisions. The PREVIEW project, outlined in this article, trialled a replacement to traditional paper PBL with virtual patients (VPs) delivered through a virtual world platform. The idea was that an immersive 3D environment could provide (a) greater realism (b) active decision-making and (c) a suitable environment for collaboration amongst work-based learners meeting remotely. Five VP scenarios were designed for learners on a Paramedic Foundation Degree within the virtual world second life (SL). A player using the MedBiquitous VP international standard allowed cases to be played both within SL and on the web. Three testing days were run to evaluate the scenarios with paramedic students and tutors. Students unfamiliar with the SL environment worked through five PBL scenarios in small groups, shadowed by 'in-world' facilitators. Feedback indicated that the SL environment engages students effectively in learning, despite some technology barriers. Students believed SL could provide a more authentic learner environment than classroom-based PBL.

26Based on recent evidence (Thomas, Lane, & Kingston, 2011), this study identified 10 27 strategies advocated by sport psychology consultants as effective at developing and by sport psychology consultants. 52Self-confidence is frequently cited as an important part of successful sport 53 performance and has been shown to influence behaviors, attitudes, and sporting attainment 54 (Cox, Shannon, McGuire, & McBride, 2010). The two theoretical frameworks that have 55 predominantly been used to study self-confidence in sport are self-efficacy theory (Bandura, 56 1977(Bandura, 56 , 1986(Bandura, 56 , 1997 and sport-confidence (cf. Vealey & Chase, 2008). 57Self-efficacy is defined as a judgment of one's ability to organize and execute specific 58 actions needed to produce a certain level of performance, and is considered to be a fluctuating 59 state rather than a fixed trait (Bandura, 1986). It is thought that efficacy beliefs influence 60 one's behaviors (i.e., actions), cognitions (i.e., thoughts), and affect (i.e., feelings) and are 61 predicted by six main sources of information (Maddux & Gosselin, 2003). These sources are 62 enactive mastery experiences (i.e., gaining belief from mastery and successful experiences), 63vicarious experiences (i.e., gaining belief from observing the successful experiences of 64 others), verbal persuasion (i.e., gaining belief from the support of significant others including 65 themselves), physiological and emotional states (i.e., gaining belief from associations made 66 between performance and our physiological arousal and emotions), and imaginal experiences 67 (i.e., referring to people gaining belief from imagining themselves, or others, behaving 68 successfully). While Bandura's (1977Bandura's ( , 1986Bandura's ( , 1997) theory of self-efficacy was not developed 69 specifically for the context of competitive sport, it made an important contribution to the 70 study of self-confidence in sport as it tended to be the focal theory underpinning suggested 71 strategies for designing confidence interventions for athletes (Vealey, 2001). 72In order to develop a framework that more appropriately captured the context of 73 competitive sport, Vealey, Hayashi, Garner-Holman, and Giacobbi (1998) built on self-74 efficacy theory to develop the theory of sport-confidence. This term was defined as an 75Develop and maintain robust sport-confidence 3 individual's belief in their ability to succeed in sport (Vealey, 1986(Vealey, , 2001 84Initial research exploring the sources from which athletes derive their confidence identified 85 mental/physical preparation, mastery, and demonstration of ability to be salient sources 86 (Vealey et al., 1998;Wilson, Sullivan, Myers, & Feltz, 2004). sources and types of confidence will influence athletes' sport-confidence levels, and will also 103 vary depending on the organizational culture of the sport. 104The most recent model of sport-confidence (Vealey & Chase, 2008) retains the 105 original nine sources of confidence and also includes...

We present a statistical study of the distribution and physical properties of cold, dense material in and around the inner Galactic Plane near-infrared bubbles as cataloged by the Milky Way Project citizen scientists. Using data from the Atacama Pathfinder Experiment (APEX) Telescope Large Area Survey of the Galaxy 870 μmsurvey, we show that 48±2% of all cold clumps in the studied survey region) are found in close proximity to a bubble, and 25±2% appear directly projected toward a bubble rim. A two-point correlation analysis confirms the strong correlation of massive cold clumps with expanding bubbles. It shows an overdensity of clumps along bubble rims that grows with increasing bubble size, which shows how interstellar medium material is reordered on large scales by bubble expansion around regions of massive star formation. The highest column density clumps appear to be resistent to the expansion, remaining overdense toward the bubbles' interior rather than being swept up by the expanding edge. Spectroscopic observations in ammonia show that cold dust clumps near bubbles appear to be denser, hotter, and more turbulent than those in the field, offering circumstantial evidence that bubble-associated clumps are more likely to be forming stars. These observed differences in physical conditions persist beyond the region of the bubble rims.

This article reports the findings of a demonstrator project to evaluate how effectively Immersive Virtual Worlds (IVWs) could support Problem-based Learning. The project designed, created and evaluated eight scenarios within Second Life (SL) for undergraduate courses in health care management and paramedic training. Evaluation was primarily qualitative, using illuminative evaluation which provided multiple perspectives through interviews, focus groups and questionnaires with designers, facilitators, learning technologists and students. Results showed that SL provided a rich, engaging environment which enhanced authenticity of the scenarios, though there were issues of access and usability. The article concludes by drawing together the lessons learned which will inform educators who seek to design and develop learning scenarios in this medium.