Inspiratory Muscle Training in Patients with Heart Failure: A Systematic Review

Purpose

The purpose of this review was to assess the quality of evidence on inspiratory muscle training (IMT) in patients with heart failure and to provide an overview on subject selection, training protocols, and outcome achieved with IMT.

Methods

Literature search was first performed via the PubMed database, and additional references were identified from the Scopus citation index. Articles of the review type and of clinical trials published in English were included. Quality of the articles was assessed using Sackett''s levels of evidence and rigor of methodology was assessed using PEDro (Physiotherapy Evidence Database) criteria for randomized controlled trials and the Downs & Black tool for cohort studies.

Results

Twelve articles of clinical trials were included. Typical training protocols involved daily training with intensity greater than 30% of maximal inspiratory pressure (PImax), duration of 20 to 30 minutes (continuous or incremental) and using a pressure threshold muscle trainer. The effect sizes of PImax, walk test distance, and dyspnea were moderate to large across these studies. Effects on quality of life scores were inconsistent.

Conclusion

Inspiratory muscle training is beneficial for improving respiratory muscle strength, functional capacity, and dyspnea in patients with stable heart failure and respiratory muscle weakness.Key Words: inspiratory muscle training, heart failure, maximal inspiratory pressure     

Cloud computing as an innovation: Percepetion,attitude, and adoption

Cloud computing is a current trend that reveals the next-generation application architecture and it is estimated that by 2013 the cloud market will have reached $8.1bn. While cloud services such as webmail, Flickr and YouTube have been widely used by individuals for some time, it not until relatively recently that organisations have began to use cloud services as a tool for meeting their IT needs. This study aims to investigate how cloud computing is understood by IT professionals and the concerns that IT professionals have in regard to the adoption of cloud services. The study was carried out in Taiwan and used a survey by interview approach to understand IT professionals’ understandings and concerns about cloud computing. The findings of the study suggest that while the benefits of cloud computing such as its computational power and ability to help companies save costs are often mentioned in the literature, the primary concerns that IT managers and software engineers have are compatibility of the cloud with companies’ policy, IS development environment, and business needs; and relative advantages of adopting cloud solutions. The findings also suggest that most IT companies in Taiwan will not adopt cloud computing until the uncertainties associated with cloud computing, e.g. security and standardisation are reduced and successful business models have emerged.     

Young Children’s Representations of Spatial and Functional Relations Between Objects

Three experiments investigated changes from 15 to 30 months of age in children’s (N = 114) mastery of relations between an object and an aperture, supporting surface, or form. When choosing between objects to insert into an aperture, older children selected objects of an appropriate size and shape, but younger children showed little selectivity. Further experiments probed the sources of younger children’s difficulty by comparing children’s performance placing a target object in a hole, on a 2‐dimensional form, or atop another solid object. Together, the findings suggest that some factors limiting adults’ object representations, including the difficulty of comparing the shapes of positive and negative spaces and of representing shapes in 3 dimensions, contribute to young children’s errors in manipulating objects.     

Distinguishing between knowledge and beliefs: students’ epistemic criteria for differentiating

“I believe that he/she is telling the truth”, “I know about the solar system”: what epistemic criteria do students use to distinguish between knowledge and beliefs? If knowing and believing are conceptually distinguishable, do students of different grade levels use the same criteria to differentiate the two constructs? How do students understand the relationship between the two constructs? This study involved 219 students (116 girls and 103 boys); 114 were in 8th grade and 105 in 13th grade. Students had to (a) choose which of 5 graphic representations outlined better the relationship between the two constructs and to justify their choice; (b) rate a list of factual/validated, non-factual/non-validated and ambiguous statements as either knowledge or belief, and indicate for each statement their degree of truthfulness, acceptance and on which sources their views were based. Qualitative and quantitative analysis were performed. The data showed how students distinguish knowledge from belief conceptually and justify their understanding of the relationship between the two constructs. Although most students assigned a higher epistemic status to knowledge, school grade significantly differentiated the epistemic criteria used to distinguish the two constructs. The study indicates the educational importance of considering the notions of knowledge and belief that students bring into the learning situation.     

Complicating Culture and Difference: Situating Asian American Youth Identities in Lisa Yee’s <Emphasis Type="Italic">Millicent Min,Girl Genius</Emphasis> and <Emphasis Type="Italic">Stanford Wong Flunks Big-Time</Emphasis>

This review situates how culture, difference, and identity are discursively constructed in Millicent Min, Girl Genius and Stanford Wong Flunks Big-Time, two award-winning books written by critically acclaimed Asian American author Lisa Yee. Using contextual literacy approaches, the characters, cultural motifs, and physical settings in these texts are deconstructed to explore the nuances of Asian American youth identities that intersect along the lines of class, gender, and race. This review ends by offering teaching strategies for explicating Asian American young adult literature to critically investigate the representations of Asian American counter-narratives, experiences, and youth cultures. Rachel Endo is a Ph.D. Candidate in the College of Education at the University of Illinois at Urbana-Champaign. Her current research interests are comparative multicultural education, immigrant/refugee experiences in post-1965 contexts, teacher education, and transnational studies of Asian America.     

The effects of laboratory-based and field-based practicum experience on pre-service teachers' self-efficacy

A well defined line of research has been conducted on the role of self-efficacy (Bandura, A. (1977). Self-efficacy: toward a unifying theory of behavioral change. Psychological Review, 84, 191–215.) in teaching and learning environments. The purpose of this study was to examine the effect of Laboratory-Based (LB) and Field-Based (FB) practicum experience on pre-service teachers' efficacy levels within one Physical Education Teacher Education program. The participants were 59 undergraduate students who were placed into two groups, LB design (n = 31) and FB design (n = 28). A quasi-experimental design with two levels of treatment and no control group was implemented. Both groups were administered a version of the Teacher Efficacy Scale (TES) adapted for physical education teachers at four stages of their preservice program: (1) at or near entry; (2) at the start of their methods course sequence; (3) at the end of the methods course sequence, just prior to student teaching; and (4) at program completion. Results from a Repeated Measures ANOVA indicated significant differences between groups on one facet of teacher efficacy at Stages 2 and 3. Those differences are attributed to the differing levels of authentic teaching practice between groups, and the challenges posed to each group of preservice teachers prior to student teaching. By the end of student teaching, both groups' efficacy levels were essentially equal, perhaps due to the similarly high level of authenticity across all subjects in that key experience. This study also highlights the importance of on-going, appropriate and authentic challenges in eventually establishing strong and stable efficacy levels among preservice teachers     

Brokering Community–University Engagement

Although substantial areas of agreement exist regarding the characteristics of effective community–university partnerships for research, there is little empirical research on the relationship between the characteristics of such partnerships and their outcomes. In this study, we explored the relationship between partnership characteristics and partnership outcomes. Analyses of the relationships between partnership dynamics and perceived benefits show that (1) effective partnership management is associated with increased research on a community issue, problem, or need; (2) co-creation of knowledge is associated with improved service outcomes for clients; and (3) shared power and resources are negatively associated with increased funding for community partners’ organizations. Our findings suggest that effective partnership management and opportunities for the co-creation of knowledge are practices that are worthy of deliberate cultivation within community–university partnerships for research. Miles McNall is the Assistant Director of the Community Evaluation and Research Center, University Outreach and Engagement, Michigan State University. He received his Ph.D. in sociology from the University of Minnesota. His research and scholarship focus on program evaluation and the evaluation of university–community partnerships. Celeste Sturdevant Reed is an evaluator with University Outreach and Engagement at Michigan State University. She has an M.S.W. from the University of Michigan and a Ph.D. in Interdisciplinary Social Science/Labor and Industrial Relations from Michigan State University. Her current evaluation projects focus on comprehensive early childhood services and out-of-school time (K-12) programs. Robert E. Brown is the Associate Director of University–Community Partnerships, Michigan State University Outreach and Engagement. He brokers, facilitates, and participates in university-community partnerships that are scholarly, community-based, collaborative, responsive, and capacity-building for the public good. He has a master’s degree in public administration from Western Michigan University. Angela Allen is an ABD Research Associate with the Charles F. Kettering Foundation. She is completing her Ph.D. in Higher, Adult, and Lifelong Education at Michigan State University. She holds an M.S.W from the University of Michigan-Ann Arbor and a B.S. in Urban and Regional Planning from Michigan State University. Her dissertation research is entitled, “Faculty and Community Collaboration in Sustained Community–University Engagement Partnerships”.     

The role of child gender and ethnicity in teacher–child relationship quality and children's behavioral adjustment in preschool

The present study examined the role of child gender, child ethnicity, and teacher–child ethnic match in moderating the association between teacher–child relationship quality and children's classroom behavioral adjustment. The study was conducted using data from an ethnically diverse sample of 301 Head Start children and their teachers. Teacher–child conflict was found to be a stronger predictor of hostile–aggressive behavior for boys than girls. In contrast, teacher–child closeness was found to be more predictive of school competence for girls than boys. Similar patterns of association were found between teacher–child relationship quality and school behavioral adjustment for Non-Hispanic, white children and those of Mexican-origin. Results also revealed that teacher–child ethnic match did not moderate the association between teacher–child relationship quality and child behavioral adjustment.     

The mediational role of posttraumatic stress in the relationship between domestic violence exposure and peer victimisation: a Cambodian sample

Research demonstrates that children exposed to domestic violence experience a myriad of internalising and externalising symptoms. The current study examines this pathway within a Cambodian sample, specifically determining if the effect of witnessing domestic violence on the child’s tendency to bully or to be bullied is mediated by symptoms of posttraumatic stress disorder (PTSD). The PTSD Checklist – Civilian Version, a revised version of a12-item bullying and victimisation questionnaire, and the Revised Conflict Tactics Scale were administered to 206 high school students in Phnom Penh. A significant mediational effect of PTSD symptoms was found for victimisation (being bullied); no such mediational model was supported for bullying as the outcome variable. However, controlling for emotional, physical, and sexual child abuse resulted in the mediation effect being non-significant. Implications and directions for future research are discussed.