The use of hybrid learning (a blend of face-to-face and distance learning) is rapidly increasing in higher education. However, educational leaders have raised concerns about the proliferation of hybrid programming as an efficiency measure without appropriate attention to learning. This study examined the relationship between social, teaching and cognitive presence, pedagogical design, and students' perspectives on hybrid learning effectiveness. Data from thirty-nine undergraduate courses representing 1,886 students were analyzed to identify indicators of best hybrid practice. Aspects of social and teaching presence significantly influenced students' perceptions of learning, including facilitation of student interactions, assignment feedback and guidance, effective use of class time, and organizational integration of course concepts. Recommendations for hybrid institutional initiatives and programming include attention to framing "presence" in hybrid settings, using integrated inquiry to encourage integrated course design, and encouraging communities of inquiry to promote cross-institutional investigation of hybrid effectiveness.

A 28-year-old female patient with active and difficult-to-treat systemic lupus erythematosus (SLE) was diagnosed with liver-dominant diffused large B-cell lymphoma. Repeated response 18F-FDG-PET studies showed persistently high, and, despite intensified immunochemotherapy, further increasing metabolic activity of one of the hepatic lymphoma residuals, whereas all other initial lymphoma manifestations had achieved complete metabolic remission. As biopsy of the 18F-FDG-PET-positive liver residual turned out to be inconclusive, complete resection was performed. Subsequent histopathological examination, however, revealed only necrotic tissue. Thus, no further lymphoma treatment was scheduled. The patient undergoes regular surveillance and is disease-free 13 months after resection. Similarly, treatment of SLE is no longer required due to lack of activity already after the first two cycles of lymphoma treatment. The case shows how closely SLE and diffused large B-cell lymphoma can be connected and stresses the importance of interdisciplinary treatment approaches. In the future, artificial intelligence may help to further classify 18F-FDG-PET-positive lymphoma residuals. This could lead to an increase of the positive predictive value of interim- and end-of-treatment 18F-FDG-PET. The patient’s point of view enables another instructive perspective on the course of treatment, which often remains hidden to treating physicians due to lack of time in clinical routine.

No description available.

No description available.

Environmental education (EE) as an approach to all education is needed to be incorporated in all the subjects of the school curriculum. In Namibia, there are Ministerial documents that support the incorporation of education About, In/ Through and For the environment within the curriculum. Even though there are documents that support this, EE continues to suffer barriers that hinder its effective incorporation into the curriculum. The findings reveal that EE in Namibia is incorporated into the traditional environmental subject homes only. The barriers that prevent the incorporation of EE into the Namibian broad curriculum for secondary schools are, amongst others, the lack of adequate teacher education programmes and the lack of interdepartmental collaboration at school level. These barriers and many others have been identified and discussed in detail in this investigation. Measures are recommended to ensure effective incorporation of EE in the Namibian broad curriculum for secondary schools. / Educational Studies / M. Ed. (Environmental Education)

The purposes of the study were to design an Arts Based/Language Arts curriculum in one elementary school at the K-3 level, and (1) determine whether this curriculum was effective in improving academic achievement, (2) determine whether teachers would be comfortable teaching such a curriculum, and (3) determine whether parents perceived their children as successful in learning arts and language arts. Samples of K-3 children were selected in one elementary school during 1986 and treated with an exploratory Arts Based/Language Arts curriculum for the 1986-87 school year. Pretest and posttest achievement data were collected with the Iowa Tests of Basic Skills and a Student Achievement Survey instrument constructed especially for the study. Pretest and posttest cognitive and creative skills data were collected with the Silver Test of Cognitive and Creative Skills. Teacher and parent perceptions of the curriculum were measured with instruments constructed especially for the study. Analysis consisted of testing for differences in pretest and posttest measures of cognitive and creative skills, ITBS test scores, and teacher's ratings on the Arts Based/Language Arts Survey. Comparisons were made on pretest to posttest differences with the Wilcoxon T-statistic, and comparisons of the differences for male and female groups were made with the Mann-Whitney U-statistic. Statistics were tested for significance at the 0.05 level. As a result Arts Based/Language Arts curriculum student cognitive and creative skills and student achievement in language arts did not improve, however teachers perceived improvement in motivation, language arts, and the arts. Findings and conclusions support the continuance of the Arts Based/Language Arts curriculum for a longer duration during which the instrument for measuring teacher perceptions could be revised and scores correlated with standardized test scores.

Introdução: Doenças crônicas não transmissíveis representam as principais morbidades da atualidade, dentre estas o diabetes mellitus (DM) tipo 2 e a depressão, as quais encontram-se frequentemente associadas. Ambas contribuem para complicações cardiovasculares e mortalidade. Há evidências de que intervenções comportamentais trazem benefícios cardiometabólicos e psicológicos. Objetivos: Para avaliar intervenção no estilo de vida, este estudo incluiu: 1) revisão sistemática e metanálise destinada a investigar os efeitos de intervenções no estilo de vida na melhora da depressão em indivíduos de risco ou com diabetes mellitus tipo 2; 2) comparação do efeito de duas intervenções no estilo de vida sobre o risco cardiometabólico e na retenção dos indivíduos ao programa; 3) análise do papel da depressão na resposta cardiometabólica às intervenções, mediada pela inflamação e; 4) avaliação do efeito residual 9 meses após término das intervenções quanto às respostas de variáveis clínicas, qualidade de vida (QV) e depressão. Métodos: Para revisão sistemática os principais bancos de dados bibliográficos foram pesquisados, sendo a meta-análise conduzida por modelos de efeito aleatório. O estudo longitudinal incluiu adultos pré-diabéticos, submetidos a 18 meses de intervenção tradicional (TRD) ou interdisciplinar com psicoeducação (INT) para mudanças em hábitos de vida, sendo os dados coletados (antropometria, pressão arterial, perfil bioquímico e marcadores de inflamação PCR, TNF-, adiponectina) no momento basal, 9 e 18 meses, bem como 9 meses após o término do acompanhamento (27 meses). Dieta foi avaliada por recordatórios de 24h, atividade física pelo Questionário Internacional de Atividade Física , depressão pelo Inventário de Beck e a QV pelo Medical Outcome Study Short Form 36 itens. Os momentos e os tipos de intervenção foram comparados por modelos lineares de efeitos mistos. Teste t Student foi aplicado para comparações entre médias, qui-quadrado para avaliar frequências e coeficientes de Pearson ou Spearman para correlações, complementados por análise de regressão múltipla. Resultados: Revisando sistematicamente o efeito na depressão de intervenções, encontrou-se na meta-análise, que em indivíduos com DM, mudanças no 10 estilo de vida reduzem significativamente os escores de depressão (SMD=-0.151; IC: - 0.253, -0.049). Entre os 183 indivíduos que compuseram nossa amostra, 46 por cento tinham sintomas depressivos, e eram predominantemente do sexo feminino, com maior adiposidade e menores escores de QV. Após 18 meses de ambas as intervenções, houve redução nos escores de depressão. Comparada à TRD, a INT provocou maior redução no consumo energético, adiposidade, níveis de pressão arterial, e maior aumento na atividade física e concentrações de adiponectina. Desistentes aos 18 meses apenas da TRD apresentaram pior perfil de saúde e maior escore de depressão, comparados aos que se mantiveram neste subgrupo. Em regressão linear múltipla, a depressão apenas nas mulheres associou-se a não melhora metabólica ao longo de 18 meses e tal associação não foi mediada pela inflamação. Aos 27 meses, apenas a adiposidade diferiu entre as intervenções. A QV e depressão mantiveram-se com melhora aos 27 meses em ambas. Discussão: 1) A metanálise sugere que intervenções no estilo de vida para manejar o DM são efetivas na melhora da depressão. É essencial que este grupo de risco seja rastreado regularmente. 2) Intervenção interdisciplinar com abordagem psicoeducativa mostrou-se útil em atenuar o risco cardiometabólico e na retenção de indivíduos com pior perfil de saúde. 3) Presença de depressão pode predizer menor chance de melhora no perfil cardiometabólico em longo prazo, particularmente entre as mulheres. Maior atenção ao diagnóstico e manejo da depressão deve ser dada a este subgrupo de maior risco. 4) Intervenção interdisciplinar melhorou a QV e reduziu depressão, bem como manteve o peso dos participantes após 9 meses da interrupção do programa, contribuindo para melhora continuada das condições de saúde biopsicossociais. Conclusão: Em geral, intervenção no estilo de vida é eficaz para melhorar o perfil metabólico e depressão, além de ser capaz de manter em tratamento indivíduos com pior estado de saúde. Não se pode comprovar ou afastar que a inflamação media tais benefícios. Esta estratégia é promissora para motivar indivíduos de maior risco na adoção de hábitos saudáveis em longo prazo. Profissionais da saúde e gestores de políticas públicas devem conhecer os efeitos deletérios da depressão no manejo de indivíduos de risco cardiometabólico. Diagnóstico e tratamento da depressão devem contribuir para otimizar o tratamento de distúrbios cardiometabólicos. / Introduction: Nowadays non-communicable chronic diseases, such as diabetes mellitus and depression, are major public health problems worldwide. These conditions are commonly associated and contribute to cardiovascular complications and mortality. Previous studies showed that motivational interviews may improve cardiometabolic and psychological aspects. Objectives: In order to assess lifestyle intervention this study includes: 1) Systematic review and meta-analysis to verify effect of lifestyle interventions on depression; 2) to compare effects of two lifestyle interventions in the cardiometabolic risk and in retention of at-risk individuals; 3) to analyze influence of depression in cardiometabolic response to interventions mediated by inflammation and, 4) to assess residual effect at 9 months after completion of interventions according to clinical variables, quality of life and depression. Methods: In the systematic review major bibliographic databases were searched. Meta-analysis was conducted by random-effects model. The effect of method, duration, and frequency of the interventions were determined via subgroup analyses. Our longitudinal study includes prediabetic adults, submitted to one of two lifestyle interventions (TRD:Traditional or INT:Interdisciplinary). Data were collected (anthropometry, blood pressure, biochemical profile and inflammation markers CRP, TNF-, adiponectin) at baseline, 9th and 18th month, as well as 9 months after completion of interventions (observational phase). Diet was evaluated by 24h recalls and physical activity by IPAQ. Depression was measured by Beck Inventory and quality of life (QOL) by SF-36. Linear mixed-models were applied for longitudinal analysis. Student t-test was used to compare means and chi-square for frequencies. Pearson coefficient was used to select variables for multiple regression analysis. Results: Through systematic review and meta-analysis, we found that lifestyle interventions to manage diabetes reduce depression scores (SMD= -0.151; IC: -0.253, -0.049). Among 183 individuals, 46 per cent had depression, 12 mostly women, with greater adiposity and lower QOL scores. After 18 months of both interventions, depression scores were reduced. Compared to TRD, the INT had greater reductions in energy intake, adiposity, blood pressure levels, likewise higher adiponectin and physical activity levels. Only in the TRD individuals who dropped out showed worse health profile and increased depression scores, compared to those who non dropped out. In multiple regressions, depression in women increased the chances of non-improvement in blood pressure and glucose levels. This association was not mediated by inflammation. In the observational phase, adiposity, but not other parameters, differed between groups over time. QOL and depression were maintained improved with both interventions. Discussion: 1) This meta-analysis suggests that lifestyle interventions intended to manage DM were effective in improving depression. Regular screening for depression is essential for this at-risk subset; 2) The interdisciplinary psychoeducation-based intervention proved to be useful for reducing cardiometabolic risk profile, and improving retention of individuals with worse profile. This approach represents a feasible strategy for motivating at-risk individuals to adopt a long-term healthy lifestyle; 3) Depression predicted a lower chance of improving long-term cardiometabolic risk, particularly in women. We suggest that screening and management of depression as part of lifestyle interventions can potentially improve cardiometabolic responses. 4) Interdisciplinary intervention improved QOL and reduced depression scores, as well as maintained weight loss 9 months after interruption of intervention, which may contributes to the sustained improvement. Conclusion: In general, interdisciplinary intervention was effective to improve cardiometabolic risk and depression, likewise to retain individuals with worse health status. It was not found benefits mediated by inflammation reduction. This strategy may motivate individuals at high risk to adopt healthier life habits. Health professionals must be aware about deleterious effects of depression to manage individuals at risk. Diagnosis and treatment of depression may contribute to optimize treatments of cardiometabolic diseases.

Growing out of the college retention research of Alexander Astin (1993) and Vincent Tinto (1975), this study examined differences in academic achievement and persistence of first-semester college freshmen who participated in Freshman Learning Communities (FLC), including a Living-Learning Community (LLC), and students who did not participate in a university-sponsored learning community. This study also explored variables that may moderate the relationship of learning community participation with academic achievement and persistence. Variables explored included: entry-level readiness for self-directed learning, gender, ethnicity, high school GPA, and SAT or equivalent ACT scores. Data was collected from 544 students at XYZ University using a pre/post university-developed instrument, the College Assessment of Readiness for Entering Students Intended (CARES-I), College Assessment of Readiness for Entering Students- Actual (CARES-A) and the Self-Directed Learning Readiness Scale/Learning Preference Assessment. Demographic and academic data were collected through the institution's Office of Institutional Effectiveness and Analysis. There was a statistically significant difference in academic achievement for students enrolled in either a Freshman Learning Community or a Living Learning Community (df = 424, t = 2.32, p < .05) as compared to students not part of a freshman learning community. The learning community students had higher end-of-semester grades. Multiple regression analysis was used to explore the moderating variables that may influence the learning community effect on academic achievement. Only the pre-academic characteristic of students' entering high school GPA moderated the relationship of learning community participation and academic achievement (p < .05). / Chi-square analysis showed there was no relationship between participation in a learning community and enrollment in the second semester (p > .05).Logistic regression of variable relations determined that the variables of high school GPA and ethnicity were significant. In addition, there was an association between the variables of SDLRS scores, high school GPA, and end-of-semester GPA for students not part of a learning community. Finally, results from a paired samples t-test determined that there was a difference in the intended and actual social involvement for students enrolled in a learning community. / by Jodie Jae Koerner. / Thesis (Ph.D.)--Florida Atlantic University, 2008. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2008. Mode of access: World Wide Web.

Intermediate elementary students (grades 4 and 5) frequently struggle to become scientifically literate in their general education classrooms. Scientific literacy includes knowing how to access and use information found in science texts. Unfortunately, many students struggle to read and understand science texts (Michalsky, Mevarech, & Haibi, 2009, p. 363). Fortunately, elementary students have shown improvement in reading comprehension when explicitly instructed in cognitive and metacognitive strategies to comprehend expository text in settings that support collaboration and flexible application of comprehension strategies, and have meaningful opportunities for reading and writing (Mastropieri & Scruggs, 2004; Palincsar & Klenk, 1992). A method that includes these components is reciprocal teaching (RT; National Reading Panel, 2000). RT has been used during content area instruction to increase reading comprehension skills of intermediate elementary students without disabilities in general education classrooms (King & Johnson, 1999; Lederer, 2000; Lubliner, 2004). These reading comprehension gains have been maintained by students on follow-up tests after the RT intervention has been withdrawn (Palincsar & Brown, 1984; Westera & Moore, 1995). This study examined the effects of RT on the science literacy of intermediate elementary students (grades 4-5) participating in inclusive science classes. Students with learning disabilities (SWLD), students at-risk (AR), and students in general education (GE) participated in this study. General education teachers used RT with science texts to improve science literacy. Pre/post science quizzes were used to assess the effects of the RT intervention, and post/follow-up tests assessed potential maintenance of the RT. s / Analyses of the data showed that the RT intervention resulted in improved science comprehension overall, and for each student group. In addition, the results showed that the gains were maintained for the individual student grouping after the RT intervention was removed, although these gains were not found overall.The study demonstrated that the use of RT during science instruction in inclusive, intermediate elementary classes assisted students who are AR, SWLD, and students in GE to attain science knowledge using standard science texts and materials. These results extend the experimental literature on science literacy and reciprocal teaching, particularly among intermediate elementary students. / by Kim E. DiLorenzo. / Thesis (Ed.D.)--Florida Atlantic University, 2010. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2010. Mode of access: World Wide Web.

A pesquisa tem como objeto de investigação a percepção climática, inserido o conceito de clima caracterizado como o ritmo de atuação dos tipos de tempo, e o conforto térmico. Os estudos mais conhecidos em conforto térmico quantificam os efeitos físicos e fisiológicos da ambiência atmosférica nas pessoas, baseados em índices, deixando lacunas no conhecimento tanto da dinâmica do clima, na qual se inserem as variáveis ambientais, como na subjetividade do fenômeno para o entendimento dessa realidade. Considerando essa problemática, a presente pesquisa questiona a insuficiência dos referidos índices por um viés exclusivamente positivista para o entendimento da percepção climática e do conforto térmico, especialmente em climas quentes como o de Palmas, Tocantins. No intuito de conhecer as essências do clima e do conforto térmico enquanto fenômenos vividos, a tese tem como objetivo contribuir com o entendimento de tais temas de forma interdisciplinar, enfocando de modo complementar seus aspectos objetivos e subjetivos. Para isso, a metodologia adotada compreendeu quatro etapas: (1) a análise rítmica anual em dois anos-padrão selecionados, um de padrão confortável e um de padrão desconfortável, 1997 e 2013, respectivamente, em conjunção com o Discomfort Index (DIT), proposto por Thom (1959); (2) a análise rítmica episódica, abarcando três episódios entre os anos 2015 e 2016, em conjunção com os índices de conforto PET e UTCI, aplicada em área externa na cidade; (3) a avaliação quali-quantitativa de dados pessoais dos moradores sobre sua percepção térmica, coletados por meio de questionários durante estes mesmos episódios; (4) e a análise dos dados subjetivos utilizando aplicação empírica do método fenomenológico, com as orientações operacionais de Giorgi (2012a). A tese procurou fornecer algumas contribuições metodológicas principais: um enfoque interdisciplinar da análise rítmica do clima (e do microclima medido in loco) com os índices de conforto térmico; uma abordagem interrelacional entre as análises climáticas e a percepção das pessoas sobre o clima e o conforto térmico, envolvendo seus aspectos objetivos e subjetivos; e o uso inédito de uma abordagem fenomenológica nos campos da climatologia e do conforto térmico. A dinâmica climática em Palmas demonstrou que a cidade apresenta altas temperaturas em todo o ano, com dois períodos distintos, chuvoso e seco, apresentando maior desconforto térmico na transição do período seco para o período chuvoso. Além disso, verificou-se que a cidade vem apresentando ampliação do desconforto térmico ao longo do período analisado (1995–2014). A avaliação quali-quantitativa apontou que as variáveis ligadas à experiência térmica, aos aspectos físico-fisiológicos e à experiência afetiva influenciaram na maioria das vezes parcialmente na percepção do conforto térmico das pessoas. A estrutura essencial revelada na análise fenomenológica demonstrou que o clima é somente mais um elemento em um vasto conjunto de aspectos naturais, sociais, econômicos, culturais etc., que interferem no bem-estar e na qualidade de vida dos sujeitos, e no seu conforto térmico, o que reforça a necessidade de uma abordagem menos parcial da realidade complexa da percepção climática. / The research has as its aim to investigate the climate perception, introduced the concept of climate characterized as the rhythm of the performance of the types of weather and thermal comfort. The better known studies on thermal comfort quantify the physical and physiological effects of the atmospheric ambience on people, based on indices, leaving gaps on the knowledge both in the climate dynamics, in which the environmental variables are inserted and in the phenomenon subjectivity for the understanding of this reality. Considering that issue, the present research enquires the insufficiency of the referred indices via an exclusively positivist bias for the comprehension of the climate perception and the thermal comfort, especially in warm climates like the one of Palmas, Tocantins, Brazil. With the purpose of learning about the essences of the climate and thermal comfort as lived phenomena, the thesis aims to contribute with the mastery of those themes in an interdisciplinary way, focusing their objective and subjective aspects in a complementary manner. To accomplish that, the method used complied four phases: (1) the annual rhythmic analysis in two selected standard-years, one of comfortable standard and one of uncomfortable standard, 1997 and 2013, respectively, in conjunction with the Discomfort Index (DIT), proposed by Thom (1959); (2) the episodic rhythmic analysis, involving three episodes within the years 2015 and 2016, in conjunction with the PET and UTCI comfort indices, applied in outer area of the city; (3) the quali-quantitative evaluation of personal data of the residents about their thermal perception, collected through questionnaires during those same episodes; (4) and the analysis of the subjective data utilizing empiric application of the phenomenological method, with the operational orientations of Giorgi (2012a). The thesis sought to provide some main methodological contributions: an interdisciplinary approach of the climate rhythmic analysis (and the microclimate measured in loco) with the thermal comfort indices; a inter-relational approach between the climate analyses and the people’s perception on the climate and thermal comfort, comprising their objective and subjective aspects; and the unprecedented use of a phenomenological focus on the climatology and thermal comfort. The climate dynamics in Palmas demonstrated that the city renders high temperatures throughout the year, with two distinct periods, rainy and dry, presenting greater thermal discomfort in the transition from the dry season to the rainy one. Furthermore, it was verified that the city has been presenting an expansion of the thermal comfort along the analyzed period (1995–2014). The quali-quantitative assessment pointed out that the variables linked to the thermal experience, to the physical-physiological aspects and to the affective experience most of the time influenced partially on the people’s thermal comfort perception. The essential structure unveiled in the phenomenological analysis showed that the climate is only one more element in a vast assembly of natural, social, economic and cultural aspects, which interfere on the well-being and the quality of life of the subjects and on their thermal comfort, what enhances the need of a less partial approach of the complex reality of the climate perception.