Single Course Research Articles

The Effects of Problem-Based, Project-Based, and Case-Based Learning on Students’ Motivation: a Meta-Analysis

In this meta-analysis, we examined the effects on students’ motivation of student-centered, problem-driven learning methods compared to teacher-centered/lecture-based learning. Specifically, we considered problem-based (PBL), project-based (PjBL), and case-based learning (CBL). We viewed motivation as a multifaceted construct consisting of students’ beliefs (competence and control beliefs), perceptions of task value (interest and importance), and reasons for engaging in tasks (intrinsic or extrinsic). In addition, we included students’ attitudes toward school subjects (e.g., science). We included 139 subsamples from the 132 included reports (83 PBL, 37 PjBL, and 19 CBL subsamples). Overall, PBL, PjBL, and CBL had a small to moderate, heterogeneous positive effect (d = 0.498) on motivation. Moderator analyses revealed that larger effect sizes were found for students’ beliefs, values, and attitudes compared to students’ reasons for studying. No differences were found between the three instructional methods on motivation. However, effect sizes were larger when problem-driven learning was applied in a single course (when compared to a curriculum-level approach). Larger effects were also found in some academic domains (i.e., healthcare and STEM) than in others. While the impact of problem-driven learning on motivation is generally positive, the intricate interplay of factors such as academic domain and implementation level underscores the need for a nuanced approach to leveraging these instructional methods effectively with regard to increasing student motivation.

The safety and feasibility of transcranial direct current stimulation for patients with chronic severe traumatic brain injury in Japan, a phase I study

BackgroundDespite evidence regarding the benefits of transcranial direct current stimulation (tDCS) in patients with severe traumatic brain injury, few trials have examined the treatment safety. Therefore, we created a phase I trial in Japan to investigate the safety of tDCS after severe brain injury. MethodsWe verified the safety of tDCS through constant left frontal anodal stimulation at 2 mA for 20 min for 5 consecutive days. Additionally, we added a variable stimuli period to explore the effects of stimulus intensity, location, and duration. We adapted a traditional 3 + 3 study design. We assessed the rate of adverse effects, including skin burns and clinical seizure. Changes in neurological symptoms were evaluated using the Glasgow Coma Scale, Coma Recovery Scale-Revised, and 4 states of consciousness (coma, unresponsive wakefulness syndrome, minimally conscious state, and severe disability). ResultsSix patients completed the study. No obvious adverse events were observed during the constant stimulation period or the variable stimulation period (right frontal anodal stimulation, stimulation frequency 2–4 mA, 1 or 5 times per week for a period of 4 weeks). Regarding the Coma Recovery Scale-Revised, patients in 4 out of 6 instances (66.7 %) improved by more than 1 point. ConclusionOur phase I safety study indicated that a single course of tDCS was safe in patients with severe traumatic brain injury. The next step is a phase II trial to investigate the preliminary efficacy and safety of tDCS at 2 mA (in comparison with sham stimulation).

The effects of prenatal azithromycin exposure on offspring ovarian development at different stages, doses, and courses

Azithromycin, a commonly used macrolide antibiotic for treating chlamydial infections during pregnancy, has sparked investigations into its potential effects on offspring development. Despite these inquiries, there remains uncertainty about the specific impact of prenatal azithromycin exposure (PAzE) on offspring ovarian development and the precise "effect window". Pregnant mice, following clinical guidelines for azithromycin dosing, were orally administered azithromycin at different gestational stages [(gestational day, GD) 10–12 or GD 15–17], doses (50, 100, or 200 mg/kg·d), and courses (single or multiple). On GD 18, we collected offspring blood and ovaries to examine changes in fetal serum estradiol (E2) levels, fetal ovarian morphology, pre-granulosa cell function, and oocyte development. Multiple courses of PAzE resulted in abnormal fetal ovarian morphological development, disorganized germ cell nests, enhanced ovarian cell proliferation, and reduced apoptosis. Simultaneously, multiple courses of PAzE significantly increased fetal serum E2 levels, elevated ovarian steroidogenic function (indicated by Star, 3β-hsd, and Cyp19 expression), disrupted oocyte development (indicated by Figlα and Nobox expression), and led to alterations in the MAPK signal pathway in fetal ovaries, particularly in the high-dose treatment group. In contrast, a single course of PAzE reduced fetal ovarian cell proliferation, decreased steroidogenic function, and inhibited oocyte development, particularly through the downregulation of Mek2 expression in the MAPK signal pathway. These findings suggest that PAzE can influence various aspects of fetal mouse ovarian cell development. Multiple courses enhance pre-granulosa cell estrogen synthesis function and advance germ cell development, while a single terminal gestation dose inhibits germ cell development. These differential effects may be associated with changes in the MAPK signal pathway.

The student voice on integrative teaching and learning of academic literacy at a South African university of technology

Academic literacy skills are universally considered as a valuable and integral part of academic development in higher education, yet they often remain peripheral to or are completely absent from many qualifications. At the presently selected institution, there is little consensus on the most effective model to design for and implement as far as academic literacy is concerned, and whether this should be embedded within core curricula, or as a stand-alone, credit-bearing subject. Conspicuously absent in conversations on this matter however, is the student voice, which is what the present study seeks to draw on. An analysis of students’ reflections on an integrated model of learning and teaching of academic literacy was evaluated, where the skills are taught within the context of an academic discipline. The academic literacy component was embedded within a single course taught in a Biotechnology qualification. Upon completion of the learning activities, ten students were interviewed, and a questionnaire was administered to a further fifteen students, to gauge feedback on the usefulness of the integrated model of academic literacy. We report that the pedagogy improved and enriched the overall learning experience. Students reflected that the approach enabled better access to Biotechnology content and made the discourse of the discipline more explicit, as they unlocked academic literacy skills, compared to if an academic literacy course was taken alone. More broadly, the study highlights the need to draw on student reflection and experiences in the design and implementation of pedagogies and the value of remaining responsive to student voices.

Evaluation of cost-effectiveness of single-credit traffic safety course based on Kirkpatrick model: a case study of Iran

BackgroundTraining plays a role in reducing traffic accidents, and evaluating the effectiveness of training programs in managers’ decision-making for training continuation is important. Thus, the present study aimed to evaluate the cost-effectiveness of a single-credit traffic safety course based on the four levels of the Kirkpatrick model in all Iranian universities.MethodsThis interventional study aimed to evaluate the cost-effectiveness of a single-credit traffic safety course based on the Kirkpatrick model from 2016 to 2020 in Iran. The data were collected in three stages: (1) calculating the costs of offering traffic safety courses, (2) determining the effectiveness of providing such courses based on the levels of the Kirkpatrick model, and (3) evaluating the cost-effectiveness of administering traffic safety courses. Data were collected through researcher-made and standardized questionnaires. The research population included traffic safety course instructors and university students who could take this course. Finally, the data were analyzed with SPSS v. 23 and also calculations related to ICER, which shows the cost effectiveness of providing single credit course.ResultsScores of the students’ reaction level to the traffic safety course was 41.8% before the course; this score was estimated at 67% after the course. At the level of learning, students’ knowledge was 43.6% before the training course, which reached 73% after the course. At the level of behavior, the state of students’ desirable traffic behaviors was 54% before the course, which reached 66.1% after the course. The educational effectiveness of the course presentation at the level of results was 58.2% before and 74.8% after the course. While assuming that the weights of all model levels were constant, the cost of a 1% increase in the overall educational effectiveness by using the Kirkpatrick model, compared to not providing the course (not administering the intervention) was 486.46 USD.ConclusionThe results showcased the effectiveness of the traffic safety course in all four levels of The Kirkpatrick model. Therefore, policy-makers and officials in charge of delivering this program should strengthen it and resolve its deficiencies to realize all its educational goals at the highest level.

A new day in higher ed: HyFlex Universities

ABSTRACT As COVID-19 continues to impact various business sectors, university administrators have steadily pushed for all academic units to resume on campus operations and activities; conversely, faculty and students have expressed increased interest in continuing online teaching/learning. We aim to mitigate this “tug-of-war” between administrators, faculty and students and develop an academic ecosystem that accommodates varying preferences. We piloted a hybrid flexible (HyFlex) Business Statistics class that combined face-to-face, synchronous online, and asynchronous online delivery modes into a single course. Survey results revealed that the majority of the respondents found access to recorded lectures and flexible ways to attend class extremely useful. We also analyzed enrollment trends to ascertain the potential impact of offering HyFlex courses at one of the authors' institutions. In spring 2022, over 64% of course enrollments and 72% of overcapacity classes were offered asynchronously online. Conversely, 89% of on campus classes were under capacity. Additionally, we examined tuition/fees for online vs. face-to-face courses for 50 universities in the US. Seventy eight percent of the schools had varying tuition/fees for online vs. face-to-face students, which led to revenue deficits ranging between −171,683,736.00 to 22,727,259.00. The adoption of HyFlex courses could positively impact the aforementioned issues.

Evaluating pharmacological THRomboprophylaxis in Individuals undergoing superficial endoVEnous treatment across NHS and private clinics in the UK: a multi-centre, assessor-blind, randomised controlled trial—THRIVE trial

IntroductionEndovenous therapy is the first choice management for symptomatic varicose veins in NICE guidelines, with 56–70 000 procedures performed annually in the UK. Venous thromboembolism (VTE), including deep vein thrombosis...

Liver toxicity following reirradiation and multiple-target SBRT for primary hepatocellular carcinoma.

514 Background: Stereotactic body radiation therapy (SBRT) is increasingly used to treat hepatocellular carcinoma (HCC), but its safety in the treatment of multiple synchronous or recurrent lesions is underreported. We aim to better characterize SBRT-related hepatic toxicity in this population. Methods: We conducted a retrospective analysis of patients with primary HCC who underwent SBRT for 2 or more synchronous or recurrent liver lesions. We collected patient characteristics and dosimetric data (mean liver dose, cumulative effective volume [Veff], cumulative volume of liver receiving 15Gy [V15Gy], and cumulative planning target volume [PTV]) along with liver-related toxicity (measured by albumin-bilirubin [ALBI] and Child-Pugh [CP] scores). We employed a linear mixed-effects model to assess the effect of multi-target SBRT on changes in ALBI. Results: There were 25 patients and 56 lesions with median follow-up of 29 months. Eleven patients had synchronous lesions and 14 had recurrent lesions treated with separate SBRT courses. Eight local failures occurred at a median of 8 months (range: 4 – 25 months) after SBRT. Among those receiving multiple SBRT courses, there were 7 lesions with overlap of V15Gy (median V15Gy overlap: 35mL, range: 0.5 – 388mL). There was no association between cumulative Veff, V15Gy, or PTV and change in ALBI. Four of 25 patients an increase of Child-Pugh (CP) score by ≥ 2 points, within 3 to 6 months after SBRT. Neither increase in CP nor ALBI were associated with cumulative Veff, V15Gy, and PTV. Comparing the groups that received SBRT in a single course versus multiple courses revealed no statistically significant differences in liver toxicity. Conclusions: LiverSBRT for multiple lesions in a single or in separate courses results in worsening of CP scores or ALBI in a small percentage of patients, suggesting a low risk of RILD. Prospective studies with a larger cohort are needed to better characterize safety in this population.

Enteral oxygen therapy: new approaches to rehabilitation for chronic gastroduodenal pathology in children

Purpose. Studying the effect of enteral oxygen therapy (EOT), in the process of rehabilitation, on the regenerative process of the mucous membrane of the gastrointestinal tract in children with chronic gastroduodenal pathology (CGDP). Methods. The clinical observation was based on a randomized study. We examined 286 children with CGDP. The research methods fibrogastroduodenoscopy (FGDS), and tests for Helicobacter pylori infection. Results. Based on the results of the FGDS, we developed a scoring scale for the regeneration process (SSRP) without morphological biopsy. According to the results of the SSRP, in patients with inflammatory processes, after a course of standard inpatient treatment, there was a 3rd degree of regeneration, with ulcerative lesions - 4th degree. After a single rehabilitation course, using EOT, a transition to 1-degree regeneration was noted (6.6±0.77 points), without the use of EOT for 2-degree (10.9±1.23 points). The data indicated a more than 63% increase in reparative-regenerative processes when using EOT. Against this background, there was up to a 2.5-fold decrease in Helicobacter pylori carriage. Conclusions. The use of EOT helps to accelerate regenerative mechanisms of the gastric mucosa by up to 63%, and the implementation of a comprehensive rehabilitation program using EOT contributes to a significant decrease in Helicobacter pylori carriage.

Success Story of Pakshagata

Vatavyadhi is one among the Ashtamahagada according to different Acharyas. Samprapti of any Vatavyadhi can be analysed in 2 ways namely Dhatukshaya and Margaavarana which are not only applicable to general Vatavyadhi but also extend to specific conditions like Pakshaghata. The disease Pakshaghata can be correlated with hemiplegia as there is close resemblance with the manifestation. Stroke affects 33 million individuals worldwide every year and two third of the stroke cases occur in developing countries. In India, community surveys have shown crude prevalence rate of hemiplegia in the range of 200 per 1,00,000 people. Material and Methods- This case study involves a 52 year old male, who is not a known case of hypertension and newly diagnosed with diabetes mellitus presented with loss of strength in left half of the body since 10 days. The condition was diagnosed as Kaphavaranajanya Pakshaghata and was treated with Agnilepa, Vacha shunti Avapeedaka Nasya and Dashamula niruha basti for 17days in total. Results- There was a remarkable improvement in the Barthel index from 30 to 95. Conclusion- Pakshaghata can occur due to Margaavarana or Dhatukshaya and the Chikitsa depends on the Dosha, Vyaadhi avastha and the Samprapti involved. In this case, characterized by Vatakaphaja lakshanas, treatment focused on addressing Kaphavarana and pacifying the aggravated Vata. As Vatavyadhi are Kruchrasadhya or Asadhya in nature, they demand prolonged treatment, this case exhibited significant improvement with a single course of Agnilepa, Nasya, and Basti, with observable symptomatic relief and radiological changes.

Biochemical Safety of SBRT to Multiple Intrahepatic Lesions for Hepatocellular Carcinoma.

We aim to better characterize stereotactic body radiation therapy (SBRT)-related hepatic biochemical toxicity in patients with multiple intrahepatic lesions from hepatocellular carcinoma (HCC). We conducted a retrospective analysis of patients with HCC who underwent SBRT for 2 or more synchronous or metachronous liver lesions. We collected patient characteristics and dosimetric data (mean liver dose [MLD], cumulative effective volume [Veff], cumulative volume of liver receiving 15 Gy [V15Gy], and cumulative planning target volume [PTV]) along with liver-related toxicity (measured by albumin-bilirubin [ALBI] and Child-Pugh [CP] scores). A linear mixed-effects model was used to assess the effect of multi-target SBRT on changes in ALBI. There were 25 patients and 56 lesions with median follow-up of 29 months. Eleven patients had synchronous lesions, and 14 had recurrent lesions treated with separate SBRT courses. Among those receiving multiple SBRT courses, there were 7 lesions with overlap of V15Gy (median V15Gy overlap: 35 mL, range: 0.5-388 mL). There was no association between cumulative MLD, Veff, V15Gy, or PTV and change in ALBI. Four of 25 patients experienced non-classic radiation-induced liver disease (RILD), due to an increase of CP score by ≥2 points 3 to 6 months after SBRT. Sixteen of 25 patients experienced an increase in ALBI grade by 1 or more points 3 to 6 months after SBRT. Comparing the groups that received SBRT in a single course versus multiple courses revealed no statistically significant differences in liver toxicity. Liver SBRT for multiple lesions in a single or in separate courses is feasible and with acceptable risk of hepatotoxicity. Prospective studies with a larger cohort are needed to better characterize safety in this population.

Research utilization competence of postgraduate nursing students: A cross-sectional study

Previous studies of research utilization competence of master's level nursing students have mostly focused on evaluations after a single evidence-based practice course. In this study, research utilization is defined as the process of acquisition, critical reading, and implementation of research knowledge. The aim of the study was to analyze the research utilization competence of postgraduate nursing students at the beginning and end of master's degree studies in Finland. Data were collected online from two groups of students ( n = 33 and n = 60) with the structured Competence in Research Utilization-2 instrument and analyzed statistically. The study was reported using the STROBE guidelines. The students’ attitudes towards research utilization were positive. Students’ knowledge of research utilization was excellent and their skills were good at the end of their studies; they were higher than at the beginningof their studies. The study suggests that theoretically oriented nursing science education, including studies on conducting research, strengthens the research utilization competence needed for evidence-based practice.

Varied etiology in patients presenting with non-puerperal mastitis: an observational study

Abstract Introduction: The etiology of nonpuerperal mastitis is more diverse varying from infections to autoimmune disorders. Most of them are misdiagnosed as pyogenic mastitis and are treated with routine antibiotics. In this study the various causes of nonpuerperal mastitis which required surgical intervention were evaluated. It was observed that some of the pre-malignant and malignant conditions were also presented as nonpuerperal mastitis. Materials and methods: All non-lactating women who presented with symptoms and signs of mastitis and did not respond to single course of antibiotics (active against staphylococcus) treated in tertiary care Hospital and in private practice of primary author between June 2021 to December 2022 and in those in whom the ultrasound of breast was also suggestive of inflammatory breast disease were included in the study and rest were excluded from study. The final etiological diagnosis of these patients is given by the histopathological examination of tissue taken from the wall of abscess cavity or of breast mass. Results: Total 21 patients were included in the study of which 7 patients had nonspecific infection, 3 patients were diagnosed to have tuberculous mastitis, 3 patients with idiopathic granulomatous mastitis, 2 patients with periductal mastitis, 1 patient with fat necrosis, 3 patients with atypical ductal hyperplasia and 2 patients were diagnosed to have invasive duct cell carcinoma. Conclusion: The etiology of nonpuerperal mastitis is diverse. Not only the benign conditions but premalignant conditions like ADH, DCIS and even invasive carcinoma can present with clinical symptoms and signs of inflammatory breast disease.

Effects of azithromycin exposure during pregnancy at different stages, doses and courses on testicular development in fetal mice

Azithromycin is a commonly used antibiotic during pregnancy, but some studies have suggested its potential developmental toxicity. Currently, the effects and mechanisms of prenatal azithromycin exposure (PAzE) on fetal testicular development are still unclear. The effects of prenatal exposure to the same drug on fetal testicular development could vary depending on different stages, doses, and courses. Hence, in this study, based on clinical medication characteristics, Kunming mice was administered intragastrically with azithromycin at different stages (mid-/late-pregnancy), doses (50, 100, 200 mg/kg·d), and courses (single-/multi-course). Fetal blood and testicular samples were collected on GD18 for relevant assessments. The results indicated that PAzE led to changes in fetal testicular morphology, reduced cell proliferation, increased apoptosis, and decreased expression of markers related to Leydig cells (Star), Sertoli cells (Wt1), and spermatogonia (Plzf). Further investigation revealed that the effects of PAzE on fetal testicular development were characterized by mid-pregnancy, high dose (clinical dose), and single course having more pronounced effects. Additionally, the TGFβ/Smad and Nrf2 signaling pathways may be involved in the changes in fetal testicular development induced by PAzE. In summary, this study confirmed that PAzE influences fetal testicular morphological development and multicellular function. It provided theoretical and experimental evidence for guiding the rational use of azithromycin during pregnancy and further exploring the mechanisms underlying its developmental toxicity on fetal testicles.

SECONDARY SCHOOL CURRICULAR RIGOR AND COGNITIVE FUNCTION AT AGE 81

Abstract A current goal is to identify how and for whom years of educational attainment translate into high cognitive function in later life. Recent work has found effects of school quality factors such as teacher experience and racial integration of schools. In this project, I examine secondary school curriculum. Not only is there variation in curriculum across school districts, but also adolescents within a single secondary school select different courses. Curricular opportunities and selections may change the developing brain in lasting ways, and/or may place the student on a path towards future academic and career opportunities that shape risk and resilience. I hypothesize that a rigorous secondary school curriculum positions students to attend college, which in turn promotes lifelong cognitive health. I tested this hypothesis by estimating multilevel structural equation models in data from the Wisconsin Longitudinal Study (WLS), which follows a randomly-selected one-third of all students who graduated from Wisconsin high schools in 1957 (N = 10,317). I created a latent measure of curricular rigor out of participants’ highest secondary school math course and number of semesters of English, science, and foreign language. In 2020 (most participants were age 81), participants completed a phone-based cognitive screening (Telephone Interview for Cognitive Status-Modified; TICS-m). Net of school-level factors, parental socioeconomic status, and academic achievement, higher curricular rigor predicted higher cognitive function at age 81. Educational attainment significantly mediated this effect, and a significant direct effect also remained. Both educational attainment and curricular rigor are desirable targets for policy interventions.

Scenarios of Building Information Modelling-Based Design Education in Architecture Schools

Due to the rapid development of computer technologies and trends in digital design, including building information modeling (BIM) and its diffusion into architectural design practice, it was necessary to introduce BIM into architectural curricula in order to prepare students for practice. This article therefore aims to identify scenarios for teaching BIM to architecture students worldwide. To achieve this objective, a thematic analysis of BIM teaching experiences in several selected academic institutions was conducted. The data studied included published articles and official university websites dealing with BIM teaching. A theoretical framework for BIM education was determined, comprising two aspects: pedagogical methods for BIM education and specifications for BIM courses in architecture programs. The document identified several scenarios for teaching BIM in multidisciplinary or architecture-specific courses. BIM teaching can be offered as part of a single course integrated with other courses, or as a separate course. It may be taught as part of related or unrelated courses. Related courses can be organized in parallel with an academic semester, or over several semesters. In addition, there are different types of input to project-based BIM teaching, such as a new design project, the results of a previous design course or an actual project. These scenarios can serve as a reference for universities wishing to integrate BIM into their programs.

Development and Use of the Competency-Based Veterinary Education (CBVE) Assessment Toolkit.

The Competency-Based Veterinary Education (CBVE) Analyze Working Group of the American Association of Veterinary Medical Colleges (AAVMC) Council on Outcomes-based Veterinary Education (COVE) has developed a CBVE assessment toolkit. The toolkit is designed to provide curriculum committees and individual instructors with an opportune intersection of the CBVE domains of competence and various assessment techniques. College-wide curriculum committees can use the toolkit to guide programs of assessment in the larger unit, ensuring that assessment methods are aligned with intended learning outcomes throughout the curriculum. On a smaller unit basis, the toolkit allows a single instructor or team of instructors to identify domains of interest for evaluation and then to identify various assessment tools appropriate to those domains. For each of 21 different assessment tools, the toolkit provides information that includes: a description; appropriate CBVE domains and competencies; examples; documented uses; evidence of efficacy; references; and links to illustrations if available. Because the toolkit is published online, periodic updates can be made as more data become available on the efficacy of various assessment tools relative to the CBVE domains in veterinary education. From programmatic assessment to single course examinations, the toolkit is intended to assist both administrators and faculty alike in understanding how different assessment approaches can support a variety of competency domains.

Qualitative research in Indian postgraduate psychology and social work programmes: a study on curriculum content coverage and graduates’ perspectives

ABSTRACTAlthough gaining prominence in recent years, the qualitative research paradigm appears less taught and minimally employed across disciplines. In this context, the present study attempted to understand whether the Indian postgraduate psychology and social work programmes adequately covered qualitative research content in their curriculum. In addition, we explored the experiences and perspectives of graduates on the curriculum and learning qualitative research during their Master’s. The study was conducted in two phases. First, we have undertaken an on-desk research involving content analysis of the curriculum of Master’s programmes in psychology and social work across 71 publically funded universities in India. The second phase included qualitative interviews with 33 graduates who had completed their Master’s degrees from the selected universities, and the data were analyzed thematically. Most universities did not have a separate course on qualitative research (N = 65), and the research methods were taught through a single course dominated by the quantitative approach. Qualitative content is minuscule in the course, covering basic topics across universities. Furthermore, four themes emerged from the perspectives of graduates: minimal qualitative content, lack of qualitative traditions, least experts, and misconceptions. This study implies the importance of a diversified curriculum with different research paradigms to strengthen students’ capabilities.

It isn’t sloppy language: exploring the discourse of Village English

Abstract In Alaska, as elsewhere in the United States, standardized American English is privileged over both local varieties of English and Indigenous languages. This privileged position is maintained, in part, through a deficit model of language acquisition and a model of school success which locates the source of underachievement among K-12 students within the child rather than within the broader sociopolitical context of school and schooling. Using a critical participatory action research approach, this article examines a single graduate course for K-12 teachers intended to address ideologies of linguistic deficit and demonstrate that the varieties of English spoken by adults and children in Southwest Alaska are systematic and rule-governed. Data are analyzed in terms of trajectories of learning, focusing on three distinct points within this trajectory: Pre-course questionnaire, Mid-point questionnaire and post-course artifacts (e.g., final projects for the master’s degree). Through the lens of discourse analysis (Gee, James Paul. 2010. An introduction to discourse analysis: Theory and method, 3rd edn. New York, NY: Routledge), we illustrate and discuss the tensions inherent in shifting discourse models as the teachers contend with course content that challenges broadly accepted explanations for school underachievement.

Evaluation of febrile seizures in children infected with SARS-CoV-2 Omicron variant in Yunnan, China: a multi-center, retrospective observational study.

The SARS-CoV-2 Omicron variant was reported to be linked to febrile seizures (FSs), but studies on FSs in children with Omicron infection remain relatively scarce, especially in the Chinese population. This study aimed to investigate the characteristics of children diagnosed with Omicron infection with FSs in Yunnan, China, and evaluate the potential association between FSs and Omicron infection. This study was conducted at four hospitals in Yunnan from December 8, 2022, to January 8, 2023, and consisted of 590 pediatric subjects. According to clinical characteristics, 85, 129 and 376 subjects were divided into the FS-only, Omicron-FS, and Omicron-only groups, respectively. Demographic, clinical and laboratory data were retrospectively collected for analysis. The incidence of FSs in children with Omicron infection was 25.5% (129/505). Older age, stronger male predominance, as well as lower proportions of prior history and family history of seizures were observed in Omicron-FS and Omicron-only groups than in FS-only group, but there were no differences in these four above-mentioned events between these two Omicron-related groups. Compared to FS-only group, Omicron-FS group also had a shorter fever-to-seizure onset duration and more frequent seizures during a single course of fever. Moreover, higher levels of IL-6, TNF-α and ferritin as well as decreased counts of leukocytes and lymphocytes were confirmed in Omicron-FS group than in FS-only and Omicron-only groups. Regarding COVID-19 vaccination status, Omicron-FS group revealed a higher proportion of unvaccinated children and a lower proportion of three-dose vaccination than Omicron-only group. As for clinical outcomes, proportions of mechanical ventilation and intensive care unit admission observed in the two Omicron-related groups were notably higher than those in FS-only group. Meanwhile, Omicron-FS group showed the longest length of hospital stay, followed by Omicron-only group and FS-only group, in order. Finally, all patients but one who died of fulminant myocarditis had been successfully discharged. The incidence of FSs in children with Omicron infection was 25.5% in Yunnan. FSs might be a clinical sign deserving more attention in children with Omicron infection. Furthermore, COVID-19 vaccination is likely to provide effective protection against Omicron-related FSs in children.