This article discusses important considerations for teachers who teach or may be thinking about teaching statistics online or in a hybrid/blended format. Suggestions from previous research and practical teaching experiences are examined. Moreover, the latest recommendations from the literature are considered in the context of teaching from a distance, which includes the 2014 curriculum guidelines published by the American Statistical Association (ASA Curriculum Undergraduate Guidelines Workgroup, 2014) and the Guidelines for Assessment and Instruction in Statistics Education (GAISE) College Report (2005; 2012). The paper concludes with suggestions about essential next steps to further advance our understanding of teaching and learning in this environment.
Urban centers are highly significant with limited space together with the rising urban population. Most of the houses and buildings are attached with some kind of a sewage disposal facility as central sewage disposal systems are limited. Urbanization is expected to create many problems in terms of black water disposal due to limitation of land. A study was done in Gampaha municipality area, an urban center, where there is no central sewage treatment facility. The objectives of the study were to analyze the current situation of the black water disposal system in the study area and to identify the shortcomings of the black water disposal system comparing with the standards. The study was conducted within the urban center in five GN divisions. Random samples of 44 households were selected to represent all the five GN divisions. Selected households were interviewed to collect basic data needed and physical measurements were also taken where necessary. The data categories collected are household information, toilet type and size, desludging interval and distance to nearest well. The code of practice for the design and construction of septic tanks reports that 80% of urban communities use septic tanks for sewage disposal, but this study reveals that only 18% of the population uses septic tanks. Over 82% uses typical soakage pits that are constructed with loosely constructed brick walls and bare bottom open to soil for their sewage disposal. Over 68% of the households have their toilet pits within 15m to the nearest well, which is below the recommended distance. Only 30% of the households comply with over 15m to the nearest well that is recommended for septic tanks. The recommended distance for the soakage pits to the nearest well is 30m and only 9% of the households meet this standard. The black water disposal pits are over sized in general, so that the desludging interval is more than 10 years. Recently constructed houses, due to limitation of space, have reduced the size of the pits reducing the size Journal of Environmental Professionals Sri Lanka, Vol. 2 – No. 2 – 2013, 1-12 2 of desludging interval. The construction and placement of septic tanks or soakage pits in the area have not complied with the standards.
CONTEXTPreventing posttraumatic stress disorder (PTSD) is a pressing public health need.OBJECTIVESTo compare early and delayed exposure-based, cognitive, and pharmacological interventions for preventing PTSD.DESIGNEquipoise-stratified randomized controlled study.SETTINGHadassah Hospital unselectively receives trauma survivors from Jerusalem and vicinity.PARTICIPANTSConsecutively admitted survivors of traumatic events were assessed by use of structured telephone interviews a mean (SD) 9.61 (3.91) days after the traumatic event. Survivors with symptoms of acute stress disorder were referred for clinical assessment. Survivors who met PTSD symptom criteria during the clinical assessment were invited to receive treatment.INTERVENTIONSTwelve weekly sessions of prolonged exposure (PE; n = 63), or cognitive therapy (CT; n = 40), or double blind treatment with 2 daily tablets of either escitalopram (10 mg) or placebo (selective serotonin reuptake inhibitor/placebo; n = 46), or 12 weeks in a waiting list group (n = 93). Treatment started a mean (SD) 29.8 (5.7) days after the traumatic event. Waiting list participants with PTSD after 12 weeks received PE a mean (SD) 151.8 (42.4) days after the traumatic event (delayed PE).MAIN OUTCOME MEASUREProportion of participants with PTSD after treatment, as determined by the use of the Clinician-Administered PTSD Scale (CAPS) 5 and 9 months after the traumatic event. Treatment assignment and attendance were concealed from the clinicians who used the CAPS.RESULTSAt 5 months, 21.6% of participants who received PE and 57.1% of comparable participants on the waiting list had PTSD (odds ratio [OR], 0.21 [95% CI, 0.09-0.46]). At 5 months, 20.0% of participants who received CT and 58.7% of comparable participants on the waiting list had PTSD (OR, 0.18 [CI, 0.06-0.48]). The PE group did not differ from the CT group with regard to PTSD outcome (OR, 0.87 [95% CI, 0.29-2.62]). The PTSD prevalence rates did not differ between the escitalopram and placebo subgroups (61.9% vs 55.6%; OR, 0.77 [95% CI, 0.21-2.77]). At 9 months, 20.8% of participants who received PE and 21.4% of participants on the waiting list had PTSD (OR, 1.04 [95% CI, 0.40-2.67]). Participants with partial PTSD before treatment onset did similarly well with and without treatment.CONCLUSIONSProlonged exposure, CT, and delayed PE effectively prevent chronic PTSD in recent survivors. The lack of improvement from treatment with escitalopram requires further evaluation. Trauma-focused clinical interventions have no added benefit to survivors with subthreshold PTSD symptoms. Trial Registration clinicaltrials.gov Identifier: NCT00146900.
Context: The US Food and Drug Administration issued a black box warning for antidepressants and suicidal thoughts and behavior in children and young adults.Objective: To determine the short-term safety of antidepressants by standard assessments of suicidal thoughts and behavior in youth, adult, and geriatric populations and the mediating effect of changes in depressive symptoms.Data Sources: All intent-to-treat person-level longitudinal data of major depressive disorder from 12 adult, 4 geriatric, and 4 youth randomized controlled trials of fluoxetine hydrochloride and 21 adult trials of venlafaxine hydrochloride.Study Selection: All sponsor-conducted randomized controlled trials of fluoxetine and venlafaxine.Data Extraction: The suicide items from the Children's Depression Rating Scale-Revised and the Hamilton Depression Rating Scale as well as adverse event reports of suicide attempts and suicide during active treatment were analyzed in 9185 patients (fluoxetine: 2635 adults, 960 geriatric patients, 708 youths; venlafaxine: 2421 adults with immediate-release venlafaxine and 2461 adults with extended-release venlafaxine) for a total of 53 260 person-week observations.Data Synthesis: Suicidal thoughts and behavior decreased over time for adult and geriatric patients randomized to fluoxetine or venlafaxine compared with placebo, but no differences were found for youths. In adults, reduction in suicide ideation and attempts occurred through a reduction in depressive symptoms. In all age groups, severity of depression improved with medication and was significantly related to suicide ideation or behavior.Conclusions: Fluoxetine and venlafaxine decreased suicidal thoughts and behavior for adult and geriatric patients. This protective effect is mediated by decreases in depressive symptoms with treatment. For youths, no significant effects of treatment on suicidal thoughts and behavior were found, although depression responded to treatment. No evidence of increased suicide risk was observed in youths receiving active medication. To our knowledge, this is the first research synthesis of suicidal thoughts and behavior in depressed patients treated with antidepressants that examined the mediating role of depressive symptoms using complete longitudinal person-level data from a large set of published and unpublished studies.
CONTEXTSmoking is a possible risk factor for dementia, although its impact may have been underestimated in elderly populations because of the shorter life span of smokers.OBJECTIVETo examine the association between smoking history and cognitive decline in the transition from midlife to old age.DESIGNCohort study.SETTINGThe Whitehall II study. The first cognitive assessment was in 1997 to 1999, repeated over 2002 to 2004 and 2007 to 2009.PARTICIPANTSData are from 5099 men and 2137 women in the Whitehall II study, mean age 56 years (range, 44-69 years) at the first cognitive assessment.MAIN OUTCOME MEASURESThe cognitive test battery was composed of tests of memory, vocabulary, executive function (composed of 1 reasoning and 2 fluency tests), and a global cognitive score summarizing performance across all 5 tests. Smoking status was assessed over the entire study period. Linear mixed models were used to assess the association between smoking history and 10-year cognitive decline, expressed as z scores.RESULTSIn men, 10-year cognitive decline in all tests except vocabulary among never smokers ranged from a quarter to a third of the baseline standard deviation. Faster cognitive decline was observed among current smokers compared with never smokers in men (mean difference in 10-year decline in global cognition=-0.09 [95% CI, -0.15 to -0.03] and executive function=-0.11 [95% CI, -0.17 to -0.05]). Recent ex-smokers had greater decline in executive function (-0.08 [95% CI, -0.14 to -0.02]), while the decline in long-term ex-smokers was similar to that among never smokers. In analyses that additionally took dropout and death into account, these differences were 1.2 to 1.5 times larger. In women, cognitive decline did not vary as a function of smoking status.CONCLUSIONSCompared with never smokers, middle-aged male smokers experienced faster cognitive decline in global cognition and executive function. In ex-smokers with at least a 10-year cessation, there were no adverse effects on cognitive decline.
CONTEXT Brain-derived neurotrophic factor (BDNF) is suspected of being a causative factor in psychiatric disorders based on case reports or studies involving large structural anomalies. OBJECTIVE To determine the involvement of BDNF in human psychopathology. DESIGN Case-control study. SETTING Microarray-based comparative genomic hybridization data from 7 molecular diagnostic centers including 38 550 affected subjects and 28 705 unaffected subjects. PATIENTS Subjects referred to diagnostic screening centers for microarray-based comparative genomic hybridization for physical or cognitive impairment. MAIN OUTCOME MEASURES Genomic copy number gains and losses. RESULTS We report 5 individuals with psychopathology and genomic deletion of a critical region including BDNF. The defined critical region was never disrupted in control subjects or diagnostic cases without developmental abnormalities. CONCLUSION Hemizygosity of the BDNF region contributes to variable psychiatric phenotypes including anxiety, behavioral, and mood disorders.
