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Learning in the arts is distinct from most other subjects for three reasons. First, the arts are centrally a representational domain and learning in the arts involves becoming aware of how representational choices communicate meaning to different audiences. Second, form and meaning are integrated; artistic representations are saturated with meaning, and subtle variations are consequential to that meaning. Third, work in the arts involves examining identify and culture, because artistic cognition is intertwined with both. This chapter argues that these three distinct features of arts learning have implications for our understanding of learning more generally. The chapter reviews four types of research: (1) how the arts have been studied in educational settings; (2) how learning occurs in different arts including music and visual arts; (3) the key features of arts learning: the role of the audience, critique, authentic assessment, and role taking; (4) how an arts-based perspective can contribute to our understanding of learning in all subjects.
Recently, artificial intelligence-powered devices have been put forward as potentially powerful tools for the improvement of mental healthcare. An important question is how these devices impact the physician-patient interaction.
Aims
Aifred is an artificial intelligence-powered clinical decision support system (CDSS) for the treatment of major depression. Here, we explore the use of a simulation centre environment in evaluating the usability of Aifred, particularly its impact on the physician–patient interaction.
Method
Twenty psychiatry and family medicine attending staff and residents were recruited to complete a 2.5-h study at a clinical interaction simulation centre with standardised patients. Each physician had the option of using the CDSS to inform their treatment choice in three 10-min clinical scenarios with standardised patients portraying mild, moderate and severe episodes of major depression. Feasibility and acceptability data were collected through self-report questionnaires, scenario observations, interviews and standardised patient feedback.
Results
All 20 participants completed the study. Initial results indicate that the tool was acceptable to clinicians and feasible for use during clinical encounters. Clinicians indicated a willingness to use the tool in real clinical practice, a significant degree of trust in the system's predictions to assist with treatment selection, and reported that the tool helped increase patient understanding of and trust in treatment. The simulation environment allowed for the evaluation of the tool's impact on the physician–patient interaction.
Conclusions
The simulation centre allowed for direct observations of clinician use and impact of the tool on the clinician–patient interaction before clinical studies. It may therefore offer a useful and important environment in the early testing of new technological tools. The present results will inform further tool development and clinician training materials.
Puumala virus (PUUV) causes many human infections in large parts of Europe and can lead to mild to moderate disease. The bank vole (Myodes glareolus) is the only reservoir of PUUV in Central Europe. A commercial PUUV rapid field test for rodents was validated for bank-vole blood samples collected in two PUUV-endemic regions in Germany (North Rhine-Westphalia and Baden-Württemberg). A comparison of the results of the rapid field test and standard ELISAs indicated a test efficacy of 93–95%, largely independent of the origin of the antigens used in the ELISA. In ELISAs, reactivity for the German PUUV strain was higher compared to the Swedish strain but not compared to the Finnish strain, which was used for the rapid field test. In conclusion, the use of the rapid field test can facilitate short-term estimation of PUUV seroprevalence in bank-vole populations in Germany and can aid in assessing human PUUV infection risk.
Maternal diet-induced obesity can cause detrimental developmental origins of health and disease in offspring. Perinatal exposure to a high-fat diet (HFD) can lead to later behavioral and metabolic disturbances, but it is not clear which behaviors and metabolic parameters are most vulnerable. To address this critical gap, biparental and monogamous oldfield mice (Peromyscus polionotus), which may better replicate most human societies, were used in the current study. About 2 weeks before breeding, adult females were placed on a control or HFD and maintained on the diets throughout gestation and lactation. F1 offspring were placed at weaning (30 days of age) on the control diet and spatial learning and memory, anxiety, exploratory, voluntary physical activity, and metabolic parameters were tested when they reached adulthood (90 days of age). Surprisingly, maternal HFD caused decreased latency in initial and reverse Barnes maze trials in male, but not female, offspring. Both male and female HFD-fed offspring showed increased anxiogenic behaviors, but decreased exploratory and voluntary physical activity. Moreover, HFD offspring demonstrated lower resting energy expenditure (EE) compared with controls. Accordingly, HFD offspring weighed more at adulthood than those from control fed dams, likely the result of reduced physical activity and EE. Current findings indicate a maternal HFD may increase obesity susceptibility in offspring due to prenatal programming resulting in reduced physical activity and EE later in life. Further work is needed to determine the underpinning neural and metabolic mechanisms by which a maternal HFD adversely affects neurobehavioral and metabolic pathways in offspring.
To determine chemical composition, physical characteristics and standardized ileal digestibility (SID) of CP and amino acids (AA) in eight current hulled barley genotypes, an experiment with growing pigs has been conducted. These genotypes included Yool, Campanile, Lomerit, Travira, Anisette, Canberra, Metaxa and Fridericus. Growing barrows with an average initial BW of 30±2 kg were surgically fitted with simple T-cannulas at the distal ileum, and allotted to an 8×9 Youden square design with eight periods of 6 days each and nine pigs. Barley was the sole dietary source of CP and AA. On average, the eight genotypes contained on as-fed basis 10.7% CP, 15.2% total non-starch polysaccharides (NSP), 17.1% NDF and 4.1% β-glucan, and had a mean test weight (TW) of 72.2 kg/hl. The SID of CP in the barley genotypes varied from 69% to 74%, and was greater (P<0.01) for genotypes Travira, Anisette and Metaxa compared to Yool and Campanile. Standardized ileal digestibility of Lys, Met and Trp (P<0.05) but not of Thr differed between genotypes. Moreover, barley genotypes differed in their standardized ileal digestible content (cSID) of CP and AA. Furthermore, SID and cSID of CP and most AA linearly decreased (P<0.05) with increasing NDF and total sugar content. Standardized ileal digestibility of CP and some AA and cSID of CP and most AA decreased linearly with increasing TW (P<0.05). Additionally, SID and cSID of CP and AA of most barley genotypes were lower when compared to tabulated values. In conclusion, a comprehensive database on chemical composition and SID of CP and AA in eight current barley genotypes has been made available. However, as present SID values are lower compared to feed tables, adjustments are required to minimize the risk of overestimating the actual protein value of barley for pigs.
Initial infection with the sentinel respiratory pathogen in children with cystic fibrosis (CF), Pseudomonas aeruginosa (Pa), is generally with environmental strains of this ubiquitous organism. The purpose of this study was to evaluate the associations between meteorological and geographical factors and risk of initial Pa acquisition in young children with CF. Using the U.S. Cystic Fibrosis Foundation Patient Registry from 2003 to 2009, 3463 patients met inclusion criteria, of which 48% (n = 1659) acquired Pa during follow-up. From multivariable Weibull regression, increased risk of Pa acquisition was associated with increasing temperature [hazard ratio (HR) per 1 °C: 1·13; 95% confidence interval (CI) 1·08–1·13], dew point (HR per 1 °C: 1·10, 95% CI 1·07–1·13), rainfall (HR per cm: 1·10, 95% CI 1·07–1·12), latitude (HR per 1 °C northing: 1·15, 95% CI 1·11–1·20), longitude (HR per 1 °C easting: 1·01, 95% CI 1·01–1·02) and elevation (HR per 100 m: 1·05, 95% CI 1·03–1·07). These results suggest that environmental factors may play a previously unrecognized role in the aetiology of initial Pa acquisition.
Endocrine disrupting chemicals (EDC) have received considerable attention as potential obesogens. Past studies examining obesogenic potential of one widespread EDC, bisphenol A (BPA), have generally focused on metabolic and adipose tissue effects. However, physical inactivity has been proposed to be a leading cause of obesity. A paucity of studies has considered whether EDC, including BPA, affects this behavior. To test whether early exposure to BPA and ethinyl estradiol (EE, estrogen present in birth control pills) results in metabolic and such behavioral disruptions, California mice developmentally exposed to BPA and EE were tested as adults for energy expenditure (indirect calorimetry), body composition (echoMRI) and physical activity (measured by beam breaks and voluntary wheel running). Serum glucose and metabolic hormones were measured. No differences in body weight or food consumption were detected. BPA-exposed females exhibited greater variation in weight than females in control and EE groups. During the dark and light cycles, BPA females exhibited a higher average respiratory quotient than control females, indicative of metabolizing carbohydrates rather than fats. Various assessments of voluntary physical activity in the home cage confirmed that during the dark cycle, BPA and EE-exposed females were significantly less active in this setting than control females. Similar effects were not observed in BPA or EE-exposed males. No significant differences were detected in serum glucose, insulin, adiponectin and leptin concentrations. Results suggest that females developmentally exposed to BPA exhibit decreased motivation to engage in voluntary physical activity and altered metabolism of carbohydrates v. fats, which could have important health implications.
Emotional symptomatology data on 78 obese females treated for 3 weeks with fenfluramine, dextroamphetamine, or placebo were evaluated. These obese females were shown to be considerably less emotionally disturbed than neurotic females, and similar in emotional symptomatology to other females seeing physicians for nonpsychiatric complaints. Even within these marginally symptomatic patients, fenfluramine and dextroamphetamine were significantly more effective than placebo in reducing anxious, depressive, and anxious-depressive symptomatology. Fenfluramine was particularly effective in alleviating anxiety in patients who were initially higher in anxiety. Most important, fenfluramine produced significantly greater weight loss than dextroamphetamine in patients with higher levels of anxiety and depression, while dextroamphetamine was an especially effective anorexic in low anxious patients. Differences in initial anxiety and depression, even within relatively normal patients, may well affect results obtained with fenfluramine and dextroamphetamine in the short-term treatment of obesity.
In this work the thermocapillary-induced motion of partially engulfed compound drops is considered. This phenomenon occurs in many natural and technological processes in which heat is exchanged between such hybrid drops and the medium around them through the interfaces. Two types of thermal fields and the resulting motions are studied; flow induced by an external temperature gradient and spontaneous thermocapillary motion. For the first flow type, it was found that, in general, the motion is induced in the direction of the temperature gradient. However, under certain physical conditions and drops' configuration a motion against the temperature gradient may be observed. In the second case, spontaneous thermocapillary motion, the compound drop moves due to surface tension gradients which result from the geometric non-uniformity of the system. Results are presented for several parameters such as configuration of the compound drop, viscosity, thermal conductivity ratio, the dependence of the various interfacial tensions on temperature and the volume ratio of the phases within the drop.
The purpose of this study is to analyse the transport and stirring of fluid that occurs owing to the formation and growth of a laminar vortex ring. Experimental data was collected upstream and downstream of the exit plane of a piston-cylinder apparatus by particle-image velocimetry. This data was used to compute Lagrangian coherent structures to demonstrate how fluid is advected during the transient process of vortex ring formation. Similar computations were performed from computational fluid dynamics (CFD) data, which showed qualitative agreement with the experimental results, although the CFD data provides better resolution in the boundary layer of the cylinder. A parametric study is performed to demonstrate how varying the piston-stroke length-to-diameter ratio affects fluid entrainment during formation. Additionally, we study how regions of fluid are stirred together during vortex formation to help establish a quantitative understanding of the role of vortical flows in mixing. We show that identification of the flow geometry during vortex formation can aid in the determination of efficient stirring. We compare this framework with a traditional stirring metric and show that the framework presented in this paper is better suited for understanding stirring/mixing in transient flow problems. A movie is available with the online version of the paper.
Since many soils used for growing potatoes in the UK are likely to be close to their plastic limit for cultivation during early spring, there exists the potential for soil compaction to occur during planting which will restrict root penetration. A series of experiments showed that soil compaction delayed emergence, reduced rate of leaf appearance and ground cover expansion, shortened canopy cover duration and restricted light interception, which combined to reduce tuber yield. Rooting density and maximum depth of rooting were reduced, particularly where compaction was shallow. In some soils, irrigation helped alleviate some of the effects of compaction but in others it exacerbated their severity. Using a cone penetrometer, relationships between rate of root penetration and soil resistance (Ω) were established from a number of experiments and replicated blocks in commercial fields and an overall relationship of the form y=16·3–4·08Ω mm/day was produced. Root penetration rates of c. 20 mm/day were measured in the intensively-cultivated ridge zone but growth rates were halved at a Ω of 1·5 MPa. A survey of 602 commercial fields showed that two thirds of fields had Ωs ⩾3 MPa (where root growth rates would be <2 mm/day) within the top 0·55 m of the soil profile. Thus, rooting depth is likely to be considerably shallower than desirable and lead to inefficiency of water and nutrient utilization. The use of powered cultivators to separate stones and clods from beds or ridges and produce a fine seedbed is now almost universally adopted in the UK. However, the system is both time and energy inefficient and increases the risk of creating soil compaction, particularly at shallow depths. All cultivation equipment has been shown to cause compaction and it is suggested that the consequences of the shortening of the growing season from delaying planting by a few days to allow the soil to dry are far less than the yield and quality losses caused by compaction.
The possibility of phase manipulation and temporal tailoring of ultrashort laser pulses enables new opportunities for optimal processing of materials. Phase-manipulated ultrafast laser pulses allow adapting the laser energy delivery rate to the material properties for optimal processing laying the groundwork for adaptive optimization in materials structuring. Different materials respond with specific reaction pathways to the sudden energy input depending on the efficiency of electron generation and on the ability to release the energy into the lattice. The sequential energy delivery with judiciously chosen pulse trains may induce softening of the material during the initial steps of excitation and change the energy coupling for the subsequent steps. We show that this can result in lower stress, cleaner structures, and allow for a materialdependent optimization process.
Elaborate, religiously sanctioned relationships between people and place are one of the most distinctive features of Aboriginal Australia. In the Australian desert, rock paintings and engravings provide a tangible link to the totemic geography and allow us to examine both changes in the role of individual places and also the development of this system of relationships to land. In this paper we use rock-art to examine the changing history of Puritjarra rock shelter in western central Australia. The production of pigment art and engravings at the shelter appears to have begun by c. 13,000 BP and indicates a growing concern by people with using graphic art to record their relationship with the site. Over the last millennium changes in the surviving frieze of paintings at Puritjarra record fundamental changes in graphic vocabulary, style, and composition of the paintings. These coincide with other evidence for changes in the geographic linkages of the site. As Puritjarra's place in the social geography changed, the motifs appropriate for the site also changed. The history of this rock shelter shows that detailed site histories will be required if we are to disentangle the development of central Australian graphic systems from the temporal and spatial variability inherent in the expression of these systems.
The objective of this paper was to determine the effectiveness of combined steroid-antimicrobial therapy for otitis media with effusion (OME) of sufficient duration to justify tympanostomy tube insertion.
A consecutive sample of 122 children with bilateral OME of at least three months duration, or unilateral OME of at least six months duration, despite treatment with one or more beta-lactamase stable antibiotics was studied. The treatment group received prednisolone plus a beta-lactamase stable antibiotic for 10 days, with responders receiving an additional six weeks of chemoprophylaxis. The control group received no medication. The child's caregiver decided which group the child should be in.
Resolution of effusion in all affected ears occurred in 32 per cent of steroid-treated children and in 2 per cent of controls (p<0.001) at three to four weeks post-therapy. Relapse of effusion occurred in over 40 per cent of initial responders within six months, reducing the final resolution rate to 25 per cent (95 per cent CI: 15–36 per cent).
It was concluded that treatment with oral steroids should be considered in selected children with chronic OME prior to surgical intervention. One in every four children whose caregiver consents to this therapy may avoid or postpone surgery for at least six months.