The use of digital technologies is now widespread and increasing, but is not always optimized for effective learning. Teachers in higher education have little time or support to work on innovation and improvement of their teaching, which often means they simply replicate their current practice in a digital medium. This paper makes the case for a learning design support environment to support and scaffold teachers' engagement with and development of technology‐enhanced learning, based on user requirements and on pedagogic theory. To be able to adopt, adapt, and experiment with learning designs, teachers need a theory‐informed way of representing the critical characteristics of good pedagogy as they discover how to optimize learning technologies. This paper explains the design approach of the Learning Design Support Environment project, and how it aims to support teachers in achieving this goal.
Five horses were examined because of signs of muscle stiffness, colic, or both. All 5 had been exposed to Streptococcus equi within 3 weeks prior to examination or had high serum titers of antibodies against the M protein of S equi. Horses had signs of unrelenting colic-like pain and focal areas of muscle swelling. Four horses were euthanatized. The fifth responded to treatment with penicillin and dexamethasone; after 3 weeks of treatment with dexamethasone, prednisolone was administered for an additional 10 weeks. Common hematologic and serum biochemical abnormalities included neutrophilia with a left shift and toxic changes, hyperproteinemia, hypoalbuminemia, and high serum creatine kinase and aspartate transferase activities. Necropsy revealed extensive infarction of the skeletal musculature, skin, gastrointestinal tract, pancreas, and lungs. Histologic lesions included leukocytoclastic vasculitis in numerous tissues and acute coagulative necrosis resembling infarction. These horses appeared to have a severe form of purpura hemorrhagica resembling Henoch-Schönlein purpura in humans and characterized by infarction of skeletal muscles. Early recognition of focal muscle swelling, abdominal discomfort, neutrophilia, hypoalbuminemia, and high serum creatine kinase activity combined with antimicrobial and corticosteroid treatment may enhance the likelihood of a successful outcome.
Non-attendance in chronic disease clinics: a matter of non-compliance? Aim. To identify the personal, contextual and mediating factors that influence nonattendance in specialty chronic disease clinics. Background. Non-attendance in chronic disease clinics is an ongoing problem that can increase patients' vulnerability to serious complications, affect continuity of care, contribute to long wait times, engender negative patient-provider relationships, and increase costs to the health system. Methods. Literature for this review was obtained by an extensive search of health and social science computerised bibliographic databases using the search terms participation, attendance, non-attendance, attrition, dropout, missed appointment, no show with diabetes, chronic disease and chronic illness care. Results. Twenty-eight research studies met our criteria for inclusion in the review. Analyses revealed that non-attendance at chronic disease clinics is influenced by a myriad of factors encompassed as personal and clinical factors, and factors pertaining to the nature and operations of the clinic. Conclusions. The factors that influence attendance are complex and multifactoral. A range of strategies are needed to address the myriad of patient-related and health-system factors to increase attendance rates and ultimately improve health outcomes. Relevance to clinical practice. A critical analysis of factors that affect attendance is important to begin to develop a greater awareness and understanding among health providers of the implications and reasons for missed appointments. The results can help to improve patient-provider relationships and deliver services that better meet patients' needs and expectations.
This paper reports on an iterative design‐based research project to develop an online design tool (the Learning Designer) to support “teachers as designers.” The aim is to evaluate the potential of the tool to develop and support a knowledge‐building teaching professional community. The Learning Designer was embedded and evaluated through international online “design challenge” events, and a series of MOOCs, providing both quantitative and qualitative data. Findings indicate that the Learning Designer enables an online community of teachers from across the K‐12, further and higher education sectors (~400 per day) to build and share their developing knowledge of learning design, and that this would be strengthened by further functionality to support collaboration and peer review of the learning designs created. The research shows how digital technology could bring about large‐scale improvements in teacher professional development of TEL. The paper concludes with users’ priorities for new features to mobilise community knowledge via large‐scale professional development of teachers as innovative TEL designers.
IntroductionThe environmental scan has been described as an important tool to inform decision-making on policy, planning and programme development in the healthcare sector. Despite the wide adoption of environmental scans, there is no consensus on a working definition within the health services delivery context and methodological guidance on the design and implementation of this approach is lacking in the literature. The objectives of this study are to map the extent, range and nature of evidence that describe the definitions, characteristics, conceptualisations, theoretical underpinnings, study limitations and other features of the environmental scan in the health services delivery literature and to propose a working definition specific to this context.Methods and analysisThis protocol describes a scoping review based on the methodology outlined by Khalil and colleagues. A comprehensive search strategy was developed by experienced health science librarians in consultation with the research team. A Peer Review of Electronic Search Strategies (PRESS) was completed. Two reviewers will independently screen titles, abstracts and full-text articles and select studies meeting the inclusion criteria from seven electronic databases: Academic Search Premier, Canadian Business & Current Affairs (CBCA), CINAHL, ERIC, Embase, MEDLINE and PsycINFO. The grey literature and reference lists of included articles will also be searched. The data will be analysed and presented in tabular format, and will include a descriptive numerical summary as well as a qualitative thematic analysis.Ethics and disseminationThis protocol provides an audit trail for a scoping review that will advance understanding about the environmental scan and its application in the health services delivery context. The review will propose a working definition and will inform future research to explore the development of a conceptual framework in this context. Findings will be disseminated through a peer-reviewed journal and conference presentations. The scoping review does not require ethics approval.
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