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Reflections on the learning sciences
\"This volume offers a historical and critical analysis of the emerging field of the learning sciences, which takes an interdisciplinary approach to understanding and improving how children and adults learn. It features a wide range of authors, including established scholars who founded and guided the learning sciences through the initial turbulence of forming a new line of academic inquiry, as well as newcomers who are continuing to shape the field. This diversity allows for a broad yet selective perspective on what the learning sciences is, why it came to be, and how contributors conduct their work. Reflections on the Learning Sciences serves both as a starting point for discussion among scholars familiar with the discipline and as an introduction for those interested in learning more. It will benefit graduate students and researchers in computer science, educational psychology, instructional technology, science, engineering, and mathematics\"-- Provided by publisher.
Bordetella pertussis in School-Age Children, Adolescents and Adults: A Systematic Review of Epidemiology and Mortality in Europe
2021
Pertussis (whooping cough) epidemics persist globally despite high vaccine coverage among infants and young children. The resurgence of pertussis in high-income countries is partly due to waning vaccine immunity, resulting in a pool of unprotected adolescents and adults. However, pertussis is generally less severe in adolescents and adults, and this difference in presentation means it can often be unrecognised by healthcare professionals, meaning that it is largely under-diagnosed in older populations. A systematic search of MEDLINE, EMBASE and BIOSIS was undertaken to identify studies published between 1 January 1990 and 17 June 2019, with information on pertussis epidemiology and mortality in school-aged children, adolescents and adults in Europe. A formal statistical comparison (e.g. using meta-analyses) was not possible because of the mix of methodologies reported. There were 69 epidemiological studies and 19 mortality studies identified for review. Over the past decade, the reported incidence of notified pertussis cases varied widely between European countries, which is likely associated with differences in surveillance systems, diagnostic techniques and reporting regulations. However, several studies show that pertussis is circulating among adolescents and adults in Europe, and although pertussis-related morbidity and mortality are highest in infants, there is evidence that adults aged > 50 years are at increased risk. For example, in a hospital-based surveillance study in Portugal, between 2000 and 2015, 94% of hospitalised pertussis cases were infants aged < 1 year, with a case fatality rate (CFR) of 0.8%; however, among hospitalised adult cases of pertussis, the CFRs were 11.5% (aged 18–64 years) and 17.4% (aged > 65 years). Very few European countries currently include pertussis boosters for adults in the national immunisation strategy. In addition to increasing pertussis vaccination coverage in adolescents and adults, mitigation strategies in European countries should include improved diagnosis and treatment in these populations.
Journal Article
The new music industries : disruption and discovery
\"This research-based book outlines career models for artists, methods of creative engagement, artistic options including individuality and branding, production practices, the realities of being a musician in the new industries, and implications for popular music education. Due to the profound effects of the digitisation of music, the music industries have undergone rapid transformation. The former record label dominated industry has been supplanted by new industries, including digital aggregators, strategists and online platforms. These new music industries now facilitate direct access to both artists and their music. While such accessibility and the potential for artist exposure have never been greater, the challenge to stand out or to even navigate a musical career pathway is formidable. A useful resource for musicians and educators, this text highlights the ways in which the new music industries facilitate increased opportunities for 21st century popular musicians to collaborate, communicate and interact with others interested in their music.\"--Back cover.
Bordetella pertussis in School-Age Children, Adolescents, and Adults: A Systematic Review of Epidemiology, Burden, and Mortality in Asia
2021
Cyclic epidemics of pertussis (whooping cough) have been observed globally over the past twenty years despite high infant vaccine coverage. The resurgence of pertussis in high-income countries is partly due to waning vaccine immunity in older children and adults, as well as better surveillance and diagnostics. Moreover, in adolescents and adults, pertussis symptoms are mild and similar to common cough syndromes, meaning that it is under-diagnosed in older populations. A systematic search of MEDLINE, EMBASE, and BIOSIS was undertaken to identify studies published between 1 January 1990 and 17 June 2019, with information on pertussis epidemiology, burden of illness, and mortality in school-aged children, adolescents, and adults in Asia. Studies identified for inclusion were reviewed narratively because a statistical comparison was not possible due to the mix of methodologies used. The results showed that in East Asia, including Japan, South Korea, China, and Taiwan, pertussis is circulating in older children and adults. Diphtheria–tetanus–pertussis (DTP4) coverage is high in East Asia, yet outbreaks observed in Japan and South Korea suggest that vaccine-acquired immunity had waned in adolescents and adults. Several school outbreaks in China show that pertussis is circulating in young children, with continued circulation in adolescents and adults. There was a lack of information from Southeast/South Asian countries, although pan-Asian serosurveys showed that recent pertussis infection was common in adolescents and in adults with persistent cough. To conclude, the circulation of pertussis in Asian countries with high DTP4 coverage supports the expansion of routine vaccination to include booster doses for children at school entry and adolescents. However, surveillance is weak or absent in many countries, meaning that the true burden of pertussis, particularly among older populations, is unknown.
Journal Article
Real World Evidence: Can We Really Expect It to Have Much Influence?
2019
Introduction There has been a recent increase in interest in the concept of ‘real world’ evidence (RWE) with the increasing digitisation of health care records and the ability, through increased computing power and interconnectivity, to analyse what is known as ‘big data’. Current Use As pressure on healthcare budgets has increased payers are increasingly forced to restrict access to drugs, often citing the lack of clear and compelling data on clinical/cost-effectiveness as the justification for their decisions. The potential of RWE to impact upon how we deliver healthcare has raised interest from a wide variety of groups, ranging from international and national regulatory bodies such as the European Medicines Agency (EMA) and the Food and Drug Administration (FDA), through to societies such as the American Society of Clinical Oncology (ASCO) down to the levels of individual health plans and patient groups. There is a recognition that payers are interested in using RWD/RWE not only as a basis for decision making (where RWE can address issues around the uncertainty of the evidence base) but also potentially increase its use in pricing and reimbursement A recent report published by Deloitte has highlighted the pharmaceutical industry’s belief in the value of using RWE and proposing a number of measures against which its use can be judged.
Journal Article
Invasive meningococcal disease in older adults in North America and Europe: is this the time for action? A review of the literature
by
Guedes, Sandra
,
Oster, Philipp
,
Bertrand-Gerentes, Isabelle
in
Aged
,
Atypical Presentation
,
Biostatistics
2022
Background
Neisseria meningitidis
is an encapsulated Gram-negative diplococcus that asymptomatically colonises the upper respiratory tract in up to 25% of the population (mainly adolescents and young adults). Invasive meningococcal disease (IMD) caused by
Neisseria meningitidis
imposes a substantial public health burden,. The case fatality rate (CFR) of IMD remains high. IMD epidemiology varies markedly by region and over time, and there appears to be a shift in the epidemiology towards older adults. The objective of our review was to assess the published data on the epidemiology of IMD in older adults (those aged ≥ 55 years)in North America and Europe. Such information would assist decision-makers at national and international levels in developing future public health programmes for managing IMD.
Methods
A comprehensive literature review was undertaken on 11 August 2020 across three databases: EMBASE, Medline and BIOSIS. Papers were included if they met the following criteria: full paper written in the English language; included patients aged ≥ 56 years; were published between 1/1/2009 11/9/2020 and included patients with either suspected or confirmed IMD or infection with
N. meningitidis in
North America or Europe
.
Case studies/reports/series were eligible for inclusion if they included persons in the age range of interest. Animal studies and letters to editors were excluded. In addition, the websites of international and national organisations and societies were also checked for relevant information.
Results
There were 5,364 citations identified in total, of which 76 publications were included in this review. We identified that older adults with IMD were mainly affected by serogroups W and Y, which are generally not the predominant strains in circulation in most countries. Older adults had the highest CFRs, probably linked to underlying comorbidities and more atypical presentations hindering appropriate timely management. In addition, there was some evidence of a shift in the incidence of IMD from younger to older adults.
Conclusions
The use of meningococcal vaccines that include coverage against serogroups W and Y in immunization programs for older adults needs to be evaluated to inform health authorities’ decisions of the relative benefits of vaccination and the utility of expanding national immunization programmes to this age group.
Journal Article
Pertussis in Individuals with Co-morbidities: A Systematic Review
2021
Pertussis is a highly contagious disease of the respiratory tract caused by Bordetella pertussis. Although the burden of pertussis is highest in children, available data suggests that pertussis in the elderly and those with underlying chronic conditions or illnesses can result in significant morbidity, mortality and costs. We undertook a comprehensive review to assess the association between pertussis and chronic conditions/illnesses. A search was undertaken on 17 June 2019 across EMBASE, Medline and BIOSIS. Citations were limited to those in English, in humans and published since 1 January 1990. There were 1179 papers identified with an additional 70 identified through a review of the reference lists. Of these, 34 met the inclusion criteria. Papers included were categorised in groups, those which reported: associations between prior pertussis and subsequent chronic conditions or illnesses; a link between chronic conditions/illnesses and subsequent risk of pertussis; and those which reported on the effect of the chronic conditions/illnesses on pertussis complications or exacerbations. Pertussis appears to increase the likelihood of developing some chronic conditions/illnesses, but also appears to decrease the likelihood of developing some haematological cancers. There were several chronic conditions/illnesses where the study results were mixed, and several studies that found no association with previous pertussis. There were also studies which showed that having some comorbid health condition(s) might increase the risk of developing pertussis. Three studies showed pertussis can lead to increased exacerbations of chronic conditions/illnesses and associated hospitalisations, although one study showed it reduced the effects of chronic bronchitis. Previous pertussis appears to contribute to the increased likelihood of developing some respiratory conditions like asthma, and conversely those with asthma or COPD are at increased risk of severe pertussis requiring further intervention. Further research is required to confirm or disprove these associations, and to characterise the pathophysiological mechanisms behind the potential associations with pertussis.Plain Language SummaryPertussis, or whooping cough as it is more commonly known, is a respiratory disease that mainly affects young children, although it can be caught at any age. An increasing number of cases are being identified in older adults. This is concerning since older people typically have other underlying health conditions that can increase the risk of severe outcomes leading to increased mortality. We assessed 34 published studies that examined the link between whooping cough and some health conditions. Several studies found that prior whooping cough was more likely in those with an underlying health condition, and this was particularly true in those with respiratory conditions like asthma and chronic obstructive pulmonary disease, whilst there were also studies which showed that having some health condition(s) might increase the risk of developing severe whooping cough which might require medical attention or hospitalisation. There was also some evidence that previous whooping cough might be protective against some blood cancers. Whooping cough was shown to exacerbate several underlying health conditions, although a single study found that it may reduce the risk of chronic bronchitis exacerbations. More research is required to corroborate these findings.
Journal Article
Thermomechanical forcing of deep rock slope deformation: 2. The Randa rock slope instability
by
Evans, Keith F.
,
Amann, Florian
,
Loew, Simon
in
Heat transfer
,
Mathematical models
,
progressive failure
2011
Deformation monitoring between 2004 and 2011 at the rock slope instability above Randa (Switzerland) has revealed an intriguing seasonal trend. Relative dislocation rates across active fractures increase when near‐surface rock temperatures drop in the fall and decrease after snowmelt as temperatures rise. This temporal pattern was observed with different monitoring systems at the ground surface and at depths up to 68 m, and represents the behavior of the entire instability. In this paper, the second of two companion pieces, we interpret this seasonal deformation trend as being controlled by thermomechanical (TM) effects driven by near‐surface temperature cycles. While Part 1 of this work demonstrated in a conceptual manner how TM effects can drive deep rock slope deformation and progressive failure, we present here in Part 2 a case study where temperature‐controlled deformation trends were observed in a natural setting. A 2D discrete‐element numerical model is employed, which allows failure along discontinuities and successfully reproduces the observed kinematics of the Randa instability. By implementing simplified ground surface temperature forcing, model results were able to reproduce the observed deformation pattern, and TM‐induced displacement rates and seasonal amplitudes in the model are of the same order of magnitude as measured values. Model results, however, exhibit spatial variation in displacement onset times while field measurements show more synchronous change. Additional heat transfer mechanisms, such as fracture ventilation, likely create deviations from the purely transient‐conductive temperature field modeled. We suggest that TM effects are especially important at Randa due to the absence of significant groundwater within the unstable rock mass. Key Points Displacement monitoring at Randa exhibit increased rates in winter Temporal behavior at Randa is not related to ground water Thermomechanical effects drive progressive failure at Randa
Journal Article
Bordetella pertussis in School-Age Children, Adolescents, and Adults: A Systematic Review of Epidemiology, Burden, and Mortality in Africa
2021
The Global Pertussis Initiative recommends diphtheria–tetanus–pertussis (DTP3) vaccination of infants aged < 1 year for all African countries, and recommends the vaccination of pregnant women as a primary prevention strategy. However, the role of older children and adults in the transmission of pertussis in Africa is not clear. A systematic search of MEDLINE, EMBASE, and BIOSIS was undertaken to identify studies published between 1 January 1990 and 17 June 2019, with information on pertussis epidemiology, burden of illness, and mortality in school-aged children, adolescents, and adults in Africa. Studies identified for inclusion were reviewed narratively because a statistical comparison was not possible because of the mix of methodologies used.Studies from North Africa (Morocco, Tunisia, and Algeria) reported that although DTP4 vaccine coverage is high, severe pertussis-related complications persist in young children, vaccine-acquired immunity wanes in adolescents, and household contacts are important transmitters of infection. A serosurvey in Gambia showed that 6% of the general population had pertussis antibody levels suggesting recent infection, and studies from Senegal showed that pertussis infection was endemic despite high DTP3 coverage. During a pertussis outbreak in Ethiopia, the case fatality rate was 3.7% overall, and 6.3% among children aged 5–9 years. In a case-surveillance study in South Africa, the incidence of pertussis among hospitalized children was 526/100,000, and infection rates were higher in HIV-exposed and -infected children compared with uninfected children. In conclusion, the highest burden of pertussis in Africa is among infants, and surveillance is lacking in many African countries meaning that the burden of pertussis among infants and infection rates among older children and adults are not well reported, and likely underestimated.
Journal Article
Bordetella pertussis in School-Age Children, Adolescents, and Adults: A Systematic Review of Epidemiology, Burden, and Mortality in the Middle East
2021
Despite modern diphtheria-tetanus-pertussis (DTP) vaccines and high vaccine coverage, a resurgence of pertussis (whooping cough) has been observed globally. In North America and Europe, high vaccine coverage in children has led to a shift in the age-specific peak incidence of infection away from infants and towards older children and adolescents. However, much less is known about the prevalence of pertussis in older children and adults in the Middle East. A systematic search of MEDLINE, EMBASE, and BIOSIS was undertaken to identify studies published between 1 January 1990 and 17 June 2019, with information on pertussis epidemiology, burden of illness, and mortality in school-aged children, adolescents, and adults in the Middle East. Studies identified for inclusion were reviewed narratively because a statistical comparison was not possible because of the mix of methodologies used. The results showed that surveillance data are weak or missing in most Middle Eastern countries, and among 24 epidemiological studies identified, most were from Iran (14), Israel (4), and Turkey (3), with single studies from the United Arab Emirates and Iraq. Despite various surveillance periods, clinical definitions, and antibody cut-off values used across the studies, the reported seroprevalence of pertussis antibodies suggested that adolescents and adults are commonly exposed to pertussis in the community and that vaccine-acquired immunity from childhood wanes. Few countries in the Middle East include a diphtheria-tetanus-acellular pertussis (Tdap) booster for adolescents on the national schedule. Israel was the only country with epidemiological data in a population that received Tdap, and the study showed that after the introduction of the adolescent booster dose, there was decrease in pertussis among children aged 5–14 years. To conclude, results from the Middle East suggest that in common with other regions, pertussis is widely circulating and that it might be shifting towards older age groups.
Journal Article