Didactic Discussion Research Articles

Holoprosencephaly spectrum: an up-to-date overview of classification, genetics and neuroimaging.

Holoprosencephaly (HPE) is a complex forebrain congenital malformation with widely variable outcomes. It represents a disorder of ventral induction, which begins in the fifth gestational week. Its main feature is forebrain cleavage failure, which prevents the brain complete division into right and left hemispheres, the normal development of midline structures, and the deep brain structure. Based on the severity of prosencephalic cleavage failure, three classic forms (lobar, semilobar, and alobar) were described, and subsequently, interhemispheric variant (syntelencephaly) and septopreoptic variants were proposed. This review proposes a practical imaging approach to diagnosing HPE spectrum disorders, allowing an easier recognition and earlier diagnosis, which is essential for prenatal care and adequate parental counseling. In addition, we intend to simplify the understanding of HPE through a didactic discussion, schematic illustrations, and descriptions of each entity's current classification and critical neuroimaging features, as well as the main differential diagnosis of HPE.

The Effects of Orthography on the Pronunciation of Nasal Vowels by L1 Japanese Learners of L3 French: Evidence from a Longitudinal Study of Speech in Interaction

In recent decades, a vast literature has documented crosslinguistic influences on the acquisition of L2 phonology and in particular the effects of spelling on pronunciation. However, articulating these research findings in terms of taking into account the effects of L1 phonology and spelling on L2 pronunciation in language teaching remains to be examined. These studies are based on experimental cross-sectional methods and mainly focus on L2 English learning by speakers of languages with an alphabetic system. In French, there are few studies on crosslinguistic influences on the acquisition of the nasal vowels (/ɑ~/, /ↄ~/ and /ε~/) and few experimental studies that point to a possible effect of orthography on the pronunciation of these phonemes. The results of experimental studies are difficult to transpose to the language classroom because they are based on word or sentence reading and writing activities, which are quite far-removed from the conversational activities practised in the classroom in interaction with peers and the teacher. Hence, we opted here for a case study of the effect of spelling on the production of nasal vowels in interaction tasks. We conducted a longitudinal study during the first year of extensive learning of French (4 hrs 30 per week). The results of a perceptive analysis by expert listeners show that (i) learners spell nasal vowels with an <n> or <m> in 98% of the obligatory contexts; (ii) most nasal vowels are perceived as nasal vowels in speech (72%), the others being perceived as vowels followed by a nasal consonant (19, 5%) or as oral vowels (8.5%); (iii) consonantisation is stronger when the learner spontaneously produces a word than when (s)he repeats it, (iv) which decreases with time (learning effect) and varies (v) according to the consonant, /ε~/ being less consonantised than /ↄ~/ and /ɑ~/. Finaly, we propose a didactic discussion in the light of intelligibility and influence of orthography.

Organ Shortage, Waiting Lists, and Mortality: Inadequate or Discussed Social Education?

Amongst the significant advances in current medicine, the successful transplantation of organs is undoubtedly of particular social interest. However, the increase in patients on waiting lists, as well as the consistent and sometimes frequent mortality of those patients, hoping for an organ that, unfortunately, will not arrive, has caused a health crisis called the “organ shortage”. This severe health emergency requires a deep analysis of the potential reasons for the social ambivalence toward organ donation, particularly in the case of the death of a loved one. The possibility that misinformation and the lack of public knowledge are fundamental barriers to consent requires an analysis of the current educational programs with the aim of improving the awareness of the general population. Negative consent to donation is particularly frequent in cases of the death of a loved one. Considering the significant social importance of consent, mainly in the case of deceased donors, the review of social programs should prioritize all the potential alternatives to improve people’s acknowledgment of the organ shortage crisis. New proposals, which might create further doubt and produce complex reactions at all levels of society, should be presented correctly in transplantation program reviews. Every proposal requires a didactic discussion by experts in social sciences on people’s consent in the case of deceased organ donation.

Professional learning tasks and mathematical knowledge involving the algebraic structure of Groups: an experience in the degree in Mathematics teaching

Considering the teacher education of prospective teachers, the objective of this article is to understand how professional learning tasks are carried out in classes of a course of Algebra in the teacher education. Using Design-Based Research cycles, documents and video recordings were collected throughout the course of the classes. Data were analyzed in order to interpret how future teachers mobilize School-Related Content Knowledge and how teacher educators generate professional learning opportunities for them. The results indicate the possibility of approaching academic mathematics in specific-content disciplines of the teacher education, focusing on teacher training and the changes that future teachers’ knowledge may undergo during training. It is concluded that the use of resources that explore connections between academic and school mathematics, as was the case with formative tasks, seems to be a way to promote mathematical and didactic discussions in the teaching degree.

Online Training Process Groups for Therapists: A Proposed Model

ABSTRACT The article proposes a new model for online experiential training groups for therapists. Experiential groups are an essential part of training for group therapists. The article summarizes the requirements for becoming a group therapist, reviews the literature about training-process groups for therapists, and discusses the dilemmas that are part of these groups. Ethical questions and the difference between training-process groups and therapy groups are presented. This training model uses weekly online process group sessions that include a 10-minute didactic discussion at the end of each session, combined with an annual in-person intensive meeting. Group vignettes are included to illustrate group processes. The advantages and disadvantages of the model are discussed, as well as important areas for future research.

Integration of transgender health: A multi-modal approach

The lesbian, gay, bisexual, transgender, queer, and intersexed (LGBTQI+) community can benefit from access to evidence-based health care, social services, justice, and equality. A significant challenge that nurses and educators have is a lack of knowledge, enlightenment, and clinical experience necessary to provide equitable and evidenced based healthcare, specifically to transgender and gender diverse individuals. As this population continues to flourish, Associates Degree (ADN) prepared nurses will be called upon to render care frequently, so curricula must be adjusted. The objective of this quality improvement project was to emphasize how a multimodal education approach can expand knowledge and ease in caring for this community. The methodology included one in-class presentation and a Success Coaching Event that presented a didactic education module, a lived experience speaker, a film depicting bad versus good communication during a clinical encounter, and a post didactic discussion panel. The quasi-experimental design supported the success of the intervention, evaluated by comparing pre- and post-test survey scores as well as results from a final exam. This new curricular framework can be implemented in all ADN programs where nurses learn basics communication and assessment.

Firearm Injury and Mortality Prevention in Pediatric Health-care Settings.

Firearm Injury and Mortality Prevention in Pediatric Health-care Settings.

Enhancing cancer prevention and survivorship care with a videoconferencing model for continuing education: a mixed-methods study to identify barriers and incentives to participation.

ObjectiveTo enhance cancer prevention and survivorship care by local health care providers, a school of public health introduced an innovative telelearning continuing education program using the Extension for Community Healthcare Outcomes (ECHO) model. In ECHO’s hub and spoke structure, synchronous videoconferencing connects frontline health professionals at various locations (“spokes”) with experts at the facilitation center (“hub”). Sessions include experts’ didactic presentations and case discussions led by spoke site participants. The objective of this study was to gain a better understanding of the reasons individuals choose or decline to participate in the Cancer ECHO program and to identify incentives and barriers to doing so.Materials and methodsStudy participants were recruited from the hub team, spoke site participants, and providers who attended another ECHO program but not this one. Participants chose to take a survey or be interviewed. The Consolidated Framework for Implementation Research guided qualitative data coding and analysis.ResultsWe conducted 22 semistructured interviews and collected 30 surveys. Incentives identified included the program’s high-quality design, supportive learning climate, and access to information. Barriers included a lack of external incentives to participate and limited time available. Participants wanted more adaptability in program timing to fit providers’ busy schedules.ConclusionAlthough the merits of the Cancer ECHO program were widely acknowledged, adaptations to facilitate participation and emphasize the program’s benefits may help overcome barriers to attending. As the number of telelearning programs grows, the results of this study point to ways to expand participation and spread health benefits more widely.

A Novel Simulation-Based Multidisciplinary Verbal De-escalation Training.

BackgroundAgitated or aggressive patients pose a high risk of emotional and physical harm to hospital staff. Healthcare associates have the highest rate of workplace violence among studied fields. Learning to effectively de-escalate a patient who is a danger to self or others is key to reducing these incidents. This course was designed to improve education and communication among staff on a hospital surgical floor when verbal de-escalation is needed.MethodsA ninety-minute simulation-based multidisciplinary curriculum was developed. This included a 30-minute didactic discussion, 10-minute simulation, and 50-minute debrief. Learners included nurses, patient service associates, and protective services officers from a medical/surgical unit. Data were collected using a validated return on investment in learning protocol and the Management of Aggression and Violence Attitude Scale (MAVAS) tool.ResultsOur return on investment in learning showed that more than 97% of learners felt safer in managing agitated patients after participating in the training. The MAVAS tool was used in pre- and post-format and showed a significant trend toward the importance of clear communication and role clarity when de-escalating a patient.ConclusionsA combination of didactic teaching and simulated experience allowed for greater confidence, communication, and teamwork in de-escalating an agitated patient in a community hospital surgical unit.

973. Utilization of Project ECHO for COVID-19 Medical Knowledge and Best Practices for Health Professionals serving an Underserved Population

BackgroundDuring the global COVID-19 pandemic, the release of research and data particularly to guide clinical care evolved rapidly and highlights the critical need for timely, and equitable access to medical knowledge and best practices. Specialized medical knowledge has historically been confined to specialists in academic medical centers and disconnected from healthcare professionals in underserved areas. It is important to bridge this gap and democratize knowledge through a model that supports rapid dissemination of best practices to build capacity in areas of need.MethodsA Project ECHO partnership was implemented between academic infectious diseases specialists and local healthcare professionals involved in COVID-19 screening, diagnosis and management serving an underserved population. BCM COVID-19 ECHO supported the Access2Health SmartPod COVID-19 clinical operations staffed by a charitable community organization. The SmartPod clinical team were engaged in weekly one-hour ECHO sessions with didactic presentations and case discussions on diverse COVID-19 topics. The program was evaluated at 6 months.COVID 19 ECHO Model BCM COVID-19 ECHO Telementoring Program with the United Health Partners in the communityBCM COVID-19 ECHO Telementoring Session Topics Curriculum developed for the health professionals seeing patients in the SmartPOD and clinics in underserved communities.ResultsIn Fall 2020, BCM COVID-19 ECHO facilitated 10 sessions with an average attendance of 8 healthcare professionals per session. Evaluation results indicated high levels of satisfaction with session content and telementoring partnerships, with 80% expressing intent to apply the knowledge and skills acquired from the sessions to their clinical practice.ConclusionThe Project ECHO model successfully engaged healthcare professionals in a continuous learning loop. With the rapid and vast amount of information during the COVID-19 pandemic, it is important to ensure health professionals have equitable access to medical knowledge and feel empowered to implement best practice changes.Disclosures All Authors: No reported disclosures

Abstract 53: Promoting WHO's Cervical Cancer Elimination Goals ‘90-70-90' by Developing, Implementing, and Evaluating the ECHO Latin America (ECHO ELA) Program

Abstract Purpose: Cervical cancer is one of the leading causes of cancer deaths among women in some countries in the Region of the Americas.1 Cervical cancer is preventable through HPV vaccination, screening and treatment of precancerous lesions, and can be effectively treated if diagnosed early.2 Methods: Under the framework of the Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem, the US National Cancer Institute (NCI), the University of Texas MD Anderson Cancer Center (MD Anderson) and the Pan American Health Organization/World Health Organization (PAHO/WHO) partnered to develop ECHO Latin America (ECHO ELA). ECHO ELA is modeled on Project ECHO® (Extension of Community Healthcare Outcomes) a hub-and-spoke knowledge-sharing approach where expert teams lead virtual didactic lectures and case discussions, amplifying the capacity for participants to deliver best practice programs to their regions. ECHO ELA consists of monthly, Spanish-language telementoring conferences about cervical cancer prevention and control. The program targets Ministries of Health, Immunization Program Managers and key cervical cancer stakeholders in Latin American (LA) countries. Its primary goal is to assist countries in reaching their WHO cervical cancer elimination goals “90-70-90:” vaccinating 90 percent of girls against HPV by the age of 15, screening 70 percent of women for cervical cancer at ages 35 and 45, and treating 90 percent of women diagnosed with pre-invasive cervical lesions or cervical cancer. Results: To date, 222 participants from 21 countries have registered. Seven sessions have been held averaging 93 participants per session. 85 participants completed the baseline survey addressing priorities, capacity, and desired outcomes. Baseline, mid-year evaluation results, within the COVID-19 context, and learned lessons will be presented. Conclusion: ECHO ELA is potentially an effective tool to convene participants from multiple countries to enhance collaboration and support countries' progress towards the elimination of cervical cancer in the Americas. Citation Format: Sandra L. San Miguel-Majors, Edward L. Trimble, Doug Lowy, Melissa Lopez-Varon, Ellen Baker, Kathleen Schmeler, Silvina Arrossi, Maria Tereza da Costa Oliveira, Mauricio Maza, Jane R. Montealegre, Mila P. Salcedo, Lucia Helena de Oliveira, Silvana Luciani. Promoting WHO's Cervical Cancer Elimination Goals ‘90-70-90' by Developing, Implementing, and Evaluating the ECHO Latin America (ECHO ELA) Program [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 53.

Blcfa: An R Package for Bayesian Model Modification in Confirmatory Factor Analysis

ABSTRACT In confirmatory factor analysis (CFA), post hoc model modification (PMM) indexes are often used to adjust for possible residual correlations between items. Although the approach is useful for improving model goodness-of-fit, it requires an iterative, one-item-pair-at-a-time procedure that can be tedious and prone to error. This paper provides a didactic discussion in the form of a tutorial of a more efficient and practical alternative and its implementation using an R-based package. The tutorial contains (1) the Bayesian covariance Lasso (least absolute shrinkage and selection operator) approach as an alternative to the PMM method, and (2) the R package blcfa, which implements the Bayesian covariance lasso and directly interfaces with Mplus. It adopts a two-step approach by first estimating the entire residual covariance matrix, and then identifying the nonzero entries and seamlessly feeding them into Mplus. Two examples were used to illustrate package implementation.

Методика обучения третьеклассников умению различать и составлять монологические тексты разного типа

Using the example of conducting a Russian language lesson in the third grade, the article reveals the methodology of forming the ability of younger students to independently construct monologue texts. The author has demonstrated the effectiveness of using a set of methodological techniques that contribute to the development of students’ ability to analyze and distinguish between texts of different types: narration, description, reasoning. This allows third graders to create their own texts, taking into account the characteristics of the type to which they belong. Taking into account the tendency of primary school children to play, research activities and dialogue with peers, the teacher offers them didactic play, educational dialogue and discussion during the lesson.

PARQUES EÓLICOS OFFSHORE NO BRASIL E OS POTENCIAIS IMPACTOS SOCIAIS: APLICAÇÃO DE MATRIZES SWOT

Com o constante aumento dos investimentos no setor elétrico, surgiram iniciativas internacionais para introdução de turbinas eólicas em ambientes marinhos (offshore). No Brasil, tem-se articulado três iniciativas distintas para a construção de parques eólicos marinhos. Estima-se que surjam diferentes impactos sociais envolvendo as populações costeiras que fazem uso dos recursos oceânicos e marítimos próximos. O objetivo da pesquisa foi analisar, de forma participativa, a introdução de um projeto de parque eólico offshore emáguas litorâneas da costa oeste cearense. Utilizou-se a elaboração de Matrizes SWOT com os pescadores das comunidades próximas ao projeto como ferramenta para a realização do diagnóstico participativo local. Foram indicadas 36 forças, 27 fraquezas, 20 oportunidades e 13 ameaças. Foi possível entender que garantir a inserção social promove consideráveis ganhos. O efetivo engajamento público deve seguir métodos que permitam transparecer as informações relevantes aos moradores, promovendo discussões fluidas e didáticas e tomadas de decisão de forma participativa, garantindo o diálogo entre empreendedores,Estado e comunidades atingidas.
 Palavras-chave: avaliação de impacto social, Matrizes SWOT, participação pública, parque eólico offshore.

Didactic discussions during ESL/EFL English teacher training courses

ABSTRACT During teacher training courses, pre-service teachers acquire not only aspects regarding specific content they must teach, in this case English as a Second and Foreign Language, they also analyse different pedagogical approaches and reflect on their practical implementations. At present, student-centred approaches are being implemented in educational systems and they demand complex perspectives focused on interaction and reflective practices. One way of promoting these approaches is by incorporating didactic discussions based on the meta-analysis of recorded lessons that are presented as case studies. By watching and examining specially chosen video-recorded lessons, prospective teachers reflect upon and discuss different teaching and learning approaches, classroom management strategies, ways of interacting, and classroom arrangements. A mixed research approach, based on interviews and a classroom survey, was carried out during two consecutive years in an English teacher training programme in Uruguay to evaluate the effectiveness of didactic discussions based on the observation of video-recorded lessons. All of the pre-service teachers stated that the discussions and debates the video-recorded lessons triggered, helped them understand and acquire important pedagogical notions that helped them teach in more confident and effective ways.

Not Positive Definite Correlation Matrices in Exploratory Item Factor Analysis: Causes, Consequences and a Proposed Solution

ABSTRACT Least-squares exploratory factor analysis based on tetrachoric/polychoric correlations is a robust, defensible and widely used approach for performing item analysis, especially in the first stages of scale development. A relatively common problem in this scenario, however, is that the inter-item correlation matrix fails to be positive definite. This paper, which is largely intended for practitioners, aims to provide a didactic discussion about the causes, consequences and remedies of this problem. The discussion is more applied than statistical and based on the factor analysis model, and the problem is linked to that of improper solutions. Solutions for preventing the problem from occurring, and the smoothing corrections available at present are described and discussed. A new smoothing algorithm is also proposed.

FitFirms: A wellness option for oncology trainees.

10537 Background: Burnout in oncologists has been rising over the past decade. Burnout leads to poor patient outcomes and poor physician health. Younger oncologists are at higher risk for burnout. The Firm System was designed by Victor McKusick at the Johns Hopkins hospital in 1975 to integrate faculty and trainees into clinical and psychologically supportive cohorts. Here we describe an adapted Firm System called the FitFirms, which focused on social connectivity and altruistic service as means to combat burnout in oncology trainees. Methods: We divided the Hematology and Oncology Division of an academic Comprehensive Cancer Care center into four cohorts of faculty-fellow teams called FitFirms. Each FitFirm was named after a notable local or national female leader in the field of cancer medicine—The Henrietta Lacks Firm, The Jane Wright Firm, The Padmini Iyer Firm, and The Rita Mehta Firm. The faculty and fellows interacted on an at-minimum quarterly basis in casual social events and/or community service-oriented events for 15 months. The social events included group dinners, bowling, paint and game nights. The service events included participation in 5K walk/run fundraiser for our institution’s cancer center and support of a National Cancer Survivors Day event for US Veterans. A didactic discussion series was created to explore concepts of resiliency, work-life balance, and the role of art in medicine—mentored by faculty across the spectrum of oncologic disciplines (Surgical Oncology, Gynecologic Oncology, Palliative Care, and Health Communication). The Maslach Burnout Inventory survey was used to survey the oncology trainees before and after the interventions. Results: Nine pre-intervention surveys were collected with 78% of trainees describing themselves as on the burnout spectrum of feeling either ineffective, overextended, disengaged, or burned out (22% engaged). After 15 months, 10 post-intervention surveys were collected in which 60% of trainees described themselves on the burnout spectrum (40% engaged). Conclusions: The FitFirms are a novel system using social capital to reduce the problem of burnout in oncology trainees by engaging in social connectivity and altruistic service through faculty-mentored, historically-named divisional cohorts.

The effectiveness of team-based flipped learning on a vocational high school economics classroom

ABSTRACTThe purpose of this study is to explore the effectiveness of team-based flipped learning classes on students’ learning achievement and motivation. Eighty-two students in two economics classes at a vocational high school participated in the study. This study adopted a pre-test and post-test quasi-experiment design with two teaching approaches taught by the same instructor. In the experimental group, the instructor assigned students into group and used team-based flipped learning; and in the control group, students learned from didactic teaching and unstructured small group discussion. The study employed achievement test, readiness assurance test, and Motivational Strategies Learning Questionnaire to assess students’ learning strategies and outcomes. Results of this study indicated a significant difference in students’ knowledge test and motivation scores between the two groups. Students in the team-based flipped learning class showed better performance and were more motivated. Meanwhile, the delayed post-test also indicated that the experimental group outperformed the control group. Based on the findings, this study proposed implications and suggestions for future research and teaching practice.

Resolution-enhanced Kendrick mass defect plots for the data processing of mass spectra from wood and coal hydrothermal extracts

The Kendrick mass defect (KMD) analysis conveniently turns a complex high-resolution mass spectrum into a compositional map with informative clustering of points depending on the elemental composition of the associated ions. It has nevertheless been left unchanged for thirty years with the use of chemical moieties such as methylene as base units for the computation of “regular” mass defects displayed in condensed plots regardless of the samples. The concept of “resolution-enhanced” KMD analysis using the mass of the repeating unit divided by an integer as the new fractional base unit has been recently introduced for the computation of expanded plots from polymeric mass spectral data with a dramatically improved separation of ion series. This user-friendly data processing is extended to the case of carbonaceous samples for the first time with the analysis of water-insoluble organic microspheres recovered from the hydrothermal extraction of wood and coals. In a didactic discussion with illustrative examples, the direct resolution-enhanced KMD analysis, the consecutive resolution-enhanced analysis of a part of a regular KMD plot or the systematic slicing of plots in a multistep procedure are shown to produce simple resolution-enhanced KMD plots or resolution-enhanced zooming from complex mass spectra. The combination of these techniques in a unique “advanced KMD analysis” toolkit is expected to revolutionize the data processing of high-resolution mass spectra with unprecedented separating and unraveling capabilities.

“They weren no thyng ydel”: Noblemen and Their Supporters in Chaucer's Knight's Tale

Abstract In Chaucer's Knight's Tale, chivalric heroism depends on a knight's ability to exercise both prowess and lordship. This article analyzes chivalry in Chaucer's romance alongside medieval didactic texts and modern historical discussions of the English nobility to suggest that the medieval imagination considered noble social status, and the personal control of men that status implied, to be an integral aspect of knighthood. As Theseus, Palamon, and Arcite call upon attendants in preparation for combat and prestigious displays, they demonstrate Chaucer's interest in interdependent relationships between noblemen and their supporters. The tale characterizes chivalry as an organizing principle that links men together with bonds of mutual loyalty.