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The authors investigate how conversational routines, or the practices by which groups structure work-related talk, function in teacher professional communities to forge, sustain, and support learning and improvement. Audiotaped and videotaped records of teachers’ work group interactions, supplemented by interviews and material artifacts, were collected as part of a 2-year project centered on teacher learning and collegiality at two urban high schools. This analysis focuses on two teacher work groups within the same school. While both groups were committed to improvement and shared a common organizational context, their characteristic conversational routines provided different resources for them to access, conceptualize, and learn from problems of practice. More specifically, the groups differed in the extent to which conversational routines supported the linking of frameworks for teaching to specific instances of practice. An analysis of the broader data set points to significant contextual factors that help account for the differences in the practices of the two groups. The study has implications for fostering workplace learning through more systematic support of professional community.

Heart rate variability (HRV) is an accepted method for determining autonomic nervous system activity and cardiovascular risk in various populations. This study assessed the validity and reliability of a commercially available finger photoplethysmography (PPG) system for measuring pediatric HRV in a real-world setting. Sixteen healthy children (4.06 ± 0.58 years) were recruited. The PPG system was compared to the Polar H10 heart rate (HR) sensor validated against ECG (gold standard) for HRV measurement. Seated short-term resting R-R intervals were recorded simultaneously using both systems. Recordings were performed on 3 days at the participants’ school. Paired t-tests, effect sizes and Bland–Altman analyses determined the validity of the PPG system. The relative and absolute reliability of both systems were calculated. No HRV parameters were valid for the PPG system. Polar H10 yielded moderate (0.50–0.75) to good (0.75–0.90) relative reliability with R-R intervals and the standard deviation of instantaneous and continuous R-R variability ratio showing the best results (ICCs = 0.84). Polar H10 displayed better absolute reliability with the root mean square of successive differences, R-R intervals and HR showing the lowest values (TEM% < 12%). The use of the Polar H10 and not the PPG system is encouraged for HRV measurement of young children in an educational real-world setting.

ObjectiveTo evaluate the efficacy differentials among corticosteroid regimens by type, dosage and duration, we conducted a systematic review and network meta-analysis of randomised controlled trials (RCTs).MethodsWe searched four databases from their inception to March 2024 and included RCTs that evaluated oral corticosteroids for asthma exacerbations in young people aged <21 years. We compared six regimens (dexamethasone (DEXA) 0.3 mg/kg/day administered for 1 day, DEXA 0.6 mg/kg/day for 1 day, DEXA 0.6 mg/kg/day for 2 days, prednisolone (PSL) 1.0 mg/kg/day for 3 days, PSL 1.0–1.5 mg/kg/day for 5 days and PSL 2.0 mg/kg/day for 5 days). Primary outcome was relapse within 14 days, defined as unplanned visit to an emergency department or primary care physician.ResultsEleven studies involving 2353 patients were analysed in our quantitative synthesis. There were no significant differences in the relapse rates among 15 comparisons of six regimens. As part of the results, the network estimate showed that DEXA (0.3 mg/kg/day×1 day) compared with PSL (1.0 mg/kg/day for 3 days) had a risk ratio (RR) of 0.99 (95% CI 0.56 to 1.74), and DEXA (0.6 mg/kg/day for 2 days) compared with PSL (1.0–1.5 mg/kg/day×5 days) had an RR of 1.29 (95% CI 0.84 to 1.98). The certainty of the evidence for the included comparisons was low to very low.ConclusionIn this network meta-analysis, there were no significant differences in the efficacy of commonly used corticosteroid regimens for acute exacerbations in childhood asthma. Short-term oral DEXA may be an acceptable alternative to a longer course of PSL.PROSPERO registration numberCRD 42023449189.

Aim: This study aimed to identify differences in the parameters of swimming skills development among prize-winning swimmers of varying ages and genders, based on the results of the 21st World Aquatics Championships, held on February 2-18, 2024, in Doha, Qatar. Material: Achievements of 111 men and 111 women prize-winning swimmers were analyzed across 50 events in both sport and marathon swimming. Methods: The study used a theoretical analysis of the specialized literature and practical experience, along with a preliminary experiment, generalization of documentary materials and mathematical statistics. Results: A total of 31 countries won medals at the 21st World Aquatics Championships (Doha 2024). The USA recorded the most successful performances with 20 medals in swimming, followed by Australia with 16 medals in swimming and 2 marathon swimming medals, Italy (12+2), China (11), the Netherlands (6+2), Great Britain (7+1), Canada (7), Germany (6), France (2+3) and New Zealand (4). Countries in the second tier of rankings included Sweden (4 medals), South Korea (3), Portugal (2+1), Spain (2+1), Hong Kong (3), Hungary (1+2), Poland (3), Ireland (2), Lithuania (2), Japan (2) and Austria (2). Each one of the remaining countries, including Ukraine, Switzerland, Denmark, Israel, South Africa, Greece, Belarus, Bosnia and Herzegovina, Egypt and Brazil, won a single medal. Age-related differences were identified across distances. Men had a 1-7-year age advantage at seven distances, while no age difference was observed at five distances. Women had a 1-6-year age advantage at 13 distances. The overall average age of both groups was similar (men = 24.24 ± 1.88 years, women = 24.44 ± 2.04 years; t = 0.747; p >0.05). Regarding swimming speed, the largest differences between men and women were observed in relay events (0.21 m/s), short-distance freestyle (50 m: 0.215 m/s; 100 m: 0.196 m/s), backstroke (0.196 m/s), butterfly (0.176 m/s) and breaststroke (0.176 m/s). The smallest differences were noted in long-distance freestyle events (400-800-1500 m: 0.135 m/s) and mixed relays (4x100 m freestyle and medley: 0.12 m/s). The overall difference in average swimming speed across all events was 0.16 m/s (men = 1.84 ± 0.16 m/s; women = 1.68 ± 0.14 m/s; t = 2.225; p < 0.05). Conclusion: The 21st World Swimming Championships highlighted the dominance of top-performing countries, with the USA, Australia and Italy leading in both quality and quantity of medals. Gender-based analysis revealed significant disparities in average swimming speed, particularly at shorter distances and relay events, with men demonstrating consistently higher speeds. However, smaller differences were observed in long-distance and mixed relay events, indicating the decreasing performance gap in endurance-based disciplines. So, these findings underscore the continuous evolution of competitive swimming performance across genders and distances.

Purpose: This article examines use of language sample analysis (LSA) by school-based speech-language pathologists (SLPs), including characteristics of language samples, methods of transcription and analysis, barriers to LSA use, and factors affecting LSA use, such as American Speech-Language-Hearing Association certification, number of years' experience, and caseload characteristics. Method: School-based SLPs responded to an invitation to complete an electronic survey related to LSA. Results: One third of respondents indicated they did not use LSA during the 2012-2013 school year. SLPs who served middle and high school students were less likely to use LSA. Most respondents reported using conversation to analyze fewer than 10 samples and transcribing in real time. Additional analyses revealed that SLPs who had 3 or fewer years of experience and who analyzed fewer than 20 language samples per year were statistically less likely to report using real-time transcription. The most frequently cited barrier to using LSA was \"LSA is too time-consuming.\" Conclusion: Many school-based SLPs do not routinely use LSA. Further, many did not report engaging in evidence-based practices, such as recording samples, using established protocols, or using tasks designed to elicit complex syntax. These results indicate a continued need for professional development regarding evidenced-based practices relative to LSA use.

Purpose The repair of cleft lip is a highly intricate and challenging surgical procedure in plastic surgery. Consequently, it is also a pivotal and difficult subject in clinical education. Problem-based learning (PBL) is a student-centered teaching methodology that facilitates students in solving complex, practical, or real-world problems collaboratively. Given that the 3D-printed simulator features high-fidelity, multi-layer structures, including skin, muscle, and mucosa layers, we have incorporated it into the conventional PBL approach to address the limitations of traditional PBL in the teaching of cleft lip repair. The primary objective of this study is to investigate the application of the 3D-printed simulator in conjunction with PBL in the instruction of cleft lip repair and to enhance teaching quality. Methods A total of 40 senior stomatological undergraduates were randomly divided into two groups: the 3D-printed PBL group and the traditional PBL group (each group, n  = 20). The 3D-printed group underwent instruction using the 3D-printed simulator in conjunction with the PBL teaching methodology, while the traditional PBL group utilized conventional teaching tools in conjunction with the PBL methodology. Subsequently, both groups of students were subjected to separate assessments to evaluate the outcomes, including theoretical examinations, operational assessments, and questionnaires. Results Compared with the traditional PBL group, the 3D-printed PBL group demonstrated significantly higher theoretical assessment scores ( P  < 0.05). In operative skill evaluations, the 3D-printed PBL group outperformed the traditional PBL group in incision design, correction of columellar deformities, and upper lip symmetry restoration ( P  < 0.001). Furthermore, the questionnaire results indicated a positive impact of the 3D-printed simulator combined with PBL on the learning experiences of stomatological undergraduates. Conclusions 3D-printed simulators combined with PBL have proven to be highly effective in enhancing the educational outcomes for cleft lip repair courses.

Background Bridge preparation skills are a vital component of dental education and require specific techniques. This study aimed to develop and evaluate 3D printed teeth for use in defect-oriented bridge preparation and pre-prosthetic exercises in dental training, addressing the limited customization and lack of integrated workflows found in commercial typodont teeth. The null hypothesis stated that 3D printed teeth offered no advantage over established typodont training methods for bridge preparation. Methods Custom 3D printed teeth were designed to support integrated workflows with defect-oriented preparation techniques and evaluated by fourth-year dental students in three sequential hands-on courses. Students had completed preclinical studies. Feedback was collected using a structured questionnaire comparing 3D printed teeth with conventional typodonts. Evaluation domains included pre-prosthetic exercise, preparation experience, learning process, learning success, and overall training, measured via Visual Analog Scales. Free-text responses captured perceived strengths and areas for improvement. Exercise complexity was reduced due to external factors and poor initial evaluations: pre-prosthetic exercises were omitted after the first course, and provisional bridge fabrication after the second. Results A total of 116 fourth-year students participated. Although student evaluations were subjective, they provided valuable insight into the usability and learning experience of the 3D printed teeth. 3D printed teeth were rated relatively low in perceived realism in caries excavation (mean 30.58 ± 24.74) and core build-up placement (mean 47.77 ± 26.22). Tactile feedback during preparation was rated comparably ( p  = 0.906) for 3D printed and typodont teeth. Ratings for 3D printed teeth improved significantly from the first to third courses in tactile feedback ( p  = 0.008), learning process ( p  < 0.001), learning success ( p  < 0.001), and suitability ( p  < 0.001). Interest in using 3D printed teeth increased ( p  < 0.001), though students were cautious about fully replacing typodonts. Internal consistency was high (Cronbach’s α = 0.772–0.857). Free-text feedback highlighted the need for greater hardness ( n  = 43). Cost-effectiveness ( n  = 43) and realism ( n  = 18) were identified as key advantages. Conclusions The 3D printed teeth allowed students to practice defect-oriented bridge preparation. Despite subjective data and methodological limitations, they show promise as a tool to support dental education.

Online discussions tend to be more effective when they are purposefully structured. In this article, we describe how the design of a photo-based protocol influenced community interactions within an online discussion in an undergraduate course. Students were asked to take and share a photo related to a course concept, respond to a peer’s photo, and reflect on the comments they received. Discussion posts were coded to identify the three presences (social, cognitive, and teaching) within the Community of Inquiry framework, and student feedback about the experience was analyzed. Findings indicated that the protocol supported all three presences among learners within the community. Cognitive presence was the most frequently exhibited presence, with students exploring concepts from the photos together. In the future, enhancements to the protocol design are proposed to elicit richer interactions and references to course materials.

Undocumented immigrants face barriers to and discrimination in healthcare, but those with Deferred Action for Childhood Arrivals (DACA) status may fare better. This analysis uses the cross-sectional BRAVE Study of young undocumented Latinx and Asian immigrants to examine differences in barriers to and discrimination in healthcare by DACA status. A majority of respondents experienced financial, language, and cultural barriers, and up to half experienced documentation status barriers, discrimination when seeking healthcare or by a health provider, and negative experiences related to documentation status. In multivariable analyses, DACA recipients have over 90% lower odds of language and cultural barriers, approximately 80% lower odds of discrimination when seeking healthcare and by a health provider, and approximately 70% lower odds of documentation status barriers and negative experience related to documentation status compared to nonrecipients. These findings indicate that DACA recipients experience fewer barriers to healthcare and discrimination in healthcare compared to nonrecipients.

Objective Standardized training for resident physicians in China has been carried out for 10 years, and various new teaching methods have been widely applied in it. The quality of internal medicine teaching is directly related to whether the trainees can master the corresponding clinical skills well and become qualified clinical physicians. The purpose of this study is to systematically evaluate the effectiveness of all teaching methods in Chinese standardized training of internal medicine residents. Methods This study was registered in Inplasy. A comprehensive search of databases, including English and Chinese, was conducted from inception to 30 July 2023. Eligible studies included cohort study and randomized controlled trials (RCT) of all teaching methods in Chinese standardized training of internal medicine residents. A network meta-analysis (NMA) was performed using STATA 16.0. Statistical analysis was done using the mean and standard deviation. The literature quality and risks of bias was assessed using RevMan 5.3. Results A total of 74 articles including 5004 Chinese participants were retrieved, involving 13 interventions, of which 65 were RCT and 9 were cohort studies. This study demonstrated that, in comparison to lecture-based learning (LBL), the integration of problem-based learning (PBL) with WeChat significantly enhanced students' theoretical scores (SMD = 2.3; 95% CI 1.19–3.42; P  < 0.05; Sucra = 88%) and decreased the number of dissatisfied students (OR = 0.06; 95% CI 0.01–0.27; P  < 0.05; Sucra = 89%). Team-based learning (TBL) was beneficial in improving practical performance (SMD = 2.32; 95% CI 0.74–3.9; P  < 0.05; Sucra = 80.1%). Additionally, the PBL combined with clinical practice (PBL + CP) teaching method significantly enhanced students' performance in medical record analysis (SMD = 4.84; 95% CI 3.08–6.59; P  < 0.05; Sucra = 99.9%). Furthermore, PBL effectively improved students' self-directed learning abilities (SMD = 1.98; 95% CI 0.05–3.91; P  < 0.05; Sucra = 75.8%). Conclusion New teaching methods represented by PBL + Wechat, CBL + Wechat, PBL + CBL are more effective in improving the academic performance of Chinese resident physicians in standardized training compared to control therapy, and have gained more recognition from students.