Theory Competition and the Process of Change

The reasons why many educational change initiatives have little impact are often framed in terms of either a poorly designed process on the part of the change initiator, or in terms of problems with the attitudes, skills and/or knowledge of those responsible for implementation. In this paper, we seek to integrate these two perspectives more closely by focusing on their interface and the competing theories frequently held by the change initiators and implementers. This concept of theory competition is illustrated with a case of a national literacy initiative in New Zealand in which the change initiators wished to raise the achievement of low performing students through the development of “learning-centred” leadership in schools and evidence-based practice. The desired outcomes were not achieved because theories about what it means to be a successful leader in such a situation, the data needed to undertake the type of evidence-based analysis envisioned and school personnel beliefs about the target students were understood differently by those responsible for initiating the change and those responsible for implementing it.     

Curriculum Design of a Flipped Classroom to Enhance Haematology Learning

A common trend in higher education is the “flipped” classroom, which facilitates active learning during class. The flipped approach to teaching was instituted in a haematology ‘major’ class and the students’ attitudes and preferences for the teaching materials were surveyed. The curriculum design was explicit and involved four major components (1) the preparation of the students; (2) the weekly pre-class work; (3) the in-class active learning strategies and (4) closing the learning loop using formative quizzes. Each of these components is discussed in detail and was informed by sound pedagogical strategies. Several different sources of information and several freely available software tools to engage the students are discussed. Two iterations are reported here, with improved pass rate for the final examination from 47 to 48 % in the traditional class to 56–65 % in the flipped classroom approach. The majority of students (93 and 89 %) came to the class prepared, after viewing the screencasts and engaged fully with the activities within the face-to-face time. The students perceived that solving case studies (93 %) was the most beneficial activity for their learning and this was closely followed by the production of essay plans (71 %). The majority of students recommended that this approach be repeated the following year (69 and 75 %).     

Association of Elevated Serum Lipoprotein(a), Inflammation,Oxidative Stress and Chronic Kidney Disease with Hypertension in Non-diabetes Hypertensive Patients

Hypertension is the most common cardiovascular risk factor. Lipoprotein(a) [Lp(a)], inflammation, oxidative stress and chronic kidney disease (CKD) exacerbate the response to tissue injury and acts as markers of the vascular disease, especially in glomerulosclerosis. We compared the clinical characteristics of 138 non-diabetes hypertensive women (ndHT) patients with 417 non-diabetes normotensive subjects and tested the association of hypertension with Lp(a), inflammation, CKD and oxidative stress by using multiple logistic regression. BP, BMI, waist circumference, creatinine, Lp(a), inflammation and malondialdehyde levels were significantly higher and CKD state in the ndHT patients (p < 0.05). Multiple logistic regression showed hypertension associated with increased Lp(a), inflammation, ORs and 95 % CIs were 2.52 (1.33, 4.80), 2.75 (1.44, 5.27) after adjusting for their covariates. Elevated serum Lp(a) and inflammation levels concomitants with increased oxidative stress and CKD were the major risk factors associated with hypertension and implications for the increased risk of HT and vascular disease.     

The effect of extremely high glucose concentrations on 21 routine chemistry and thyroid Abbott assays: interference study

Introduction

Extremely high glucose concentrations have been shown to interfere with creatinine assays especially with Jaffe method in peritoneal dialysate. Because diabetes is the fastest growing chronic disease in the world, laboratories study with varying glucose concentrations. We investigated whether different levels of glucose spiked in serum interfere with 21 routine chemistry and thyroid assays at glucose concentrations between 17-51 mmol/L.

Materials and methods

Baseline (group I) serum pool with glucose concentration of 5.55 (5.44-5.61) mmol/L was prepared from patient sera. Spiking with 20% dextrose solution, sample groups were obtained with glucose concentrations: 17.09, 34.52, and 50.95 mmol/L (group II, III, IV, respectively). Total of 21 biochemistry analytes and thyroid tests were studied on Abbott c8000 and i2000sr with commercial reagents. Bias from baseline value was checked statistically and clinically.

Results

Creatinine increased significantly by 8.74%, 31.66%, 55.31% at groups II, III, IV, respectively with P values of < 0.001. At the median glucose concentration of 50.95 mmol/L, calcium, albumin, chloride and FT4 biased significantly clinically (-0.85%, 1.63%, 0.65%, 7.4% with P values 0.138, 0.214, 0.004, < 0.001, respectively). Remaining assays were free of interference.

Conclusion

Among the numerous biochemical parameters studied, only a few parameters are affected by dramatically increased glucose concentration. The creatinine measurements obtained in human sera with the Jaffe alkaline method at high glucose concentrations should be interpreted with caution. Other tests that were affected with extremely high glucose concentrations were calcium, albumin, chloride and FT4, hence results should be taken into consideration in patients with poor diabetic control.Key words: assay interference, glucose interference, preanalytical phase, creatinine, Jaffe kinetic assay, thyroid function tests     

IPv6: The next generation Internet Protocol

IPv4, the workhorse protocol of the currently popular TCP/ IP protocol suite, is fast becoming obsolete. The exponential growth of the Internet is the main reason that has required the creation of the next generation of Internet Protocol-IPv6. IPv6 is much more flexible and promises to take care of the address space and security issues in the foreseeable future. Part 1 of the paper lays the foundation of the various issues involved in designing the Internet Protocol and motivates the need for an upgraded version of this protocol.     

Experiences of Danish Business Expatriates in Russia: Power Distance in Organizational Communication

Rapid globalization of business processes stimulates many companies to dispatch their employees – business expatriates – on overseas assignments. Russia differs markedly from many other cultures in terms of specific communication norms and rules. Understanding such differences in organizational life is crucial for the success of business expatriates working there. This study employs in-depth interviews with eight Danish business expatriates who worked in Russia and examines the differences between the Danes and the Russians in terms of communication characteristics related to Hofstede’s cultural dimension power distance. This work enhances scholars’ empirical knowledge of power distance, which has rarely been investigated qualitatively.     

Electrical and mechanical response of skeletal muscle to electrical stimulation after acute passive stretching in humans: a combined electromyographic and mechanomyographic approach

Two mechanisms have been suggested to explain stretching-induced maximum force depression: a mechanical alteration in the stretched muscle and an impairment of neural activation. Electrical stimulation allows standardization of the level of muscle activation without being limited by neural control. The aim of this study was to evaluate the stretching-induced changes in the electrical and mechanical properties of muscle during electrically elicited contractions. Twelve participants (age 22 +/- 1 years; body mass 75 +/- 2 kg; stature 1.79 +/- 0.02 m; mean +/- standard error) underwent six electrical stimulations of the medial gastrocnemius muscle before and after stretching. During the contractions, surface electromyogram (EMG) and mechanomyogram (MMG) were recorded simultaneously together with force. After stretching we found: (i) no differences in EMG parameters; (ii) MMG amplitude decreased by 4 +/- 1% (P < 0.05); and (iii) the peak force, the peak rate of force development, and the acceleration peak of force development decreased by 12 +/- 3%, 14 +/- 1%, and 24 +/- 5%, respectively (P < 0.05). In conclusion, acute passive stretching did not change EMG properties but altered the mechanical characteristics of the contracting muscle. Indeed, muscle force-generating capacity and stiffness of the muscle-tendon unit were significantly impaired.