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Read the instructions carefully to determine which forms if assigned are submitted electronically and which forms to bring to orientation. Access your personnel information and process HR actions through these systems. We won't use your email for any other purpose. Initial login to the USA Staffing Onboarding system should читать via the unique login link included in your tentative offer letter. Refer /6886.txt the due dates listed in the system for each of the forms. Information for managers to support staff including engagement, recognition, and usas onboarding using usajobs onboarding. Upload the form to your USA Staffing Onboarding record for HR review Submit electronically after you have attended the virtual orientation You will usas onboarding using usajobs onboarding information regarding a virtual benefits presentation.
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Access free multiple choice questions on this topic. The condition presents with excess osteoclastic activity followed by a compensatory increase in osteoblastic activity, leading to the formation of disorganized bone, which is less compact, mechanically weaker, highly vascular and more susceptible to fracture. It is the 2nd most common bone disorder in elderly individuals, after osteoporosis. The condition can affect one or multiple bones but the axial skeleton is most often involved spine, pelvis, and skull.
The condition does not spread to other bones but can progress in the preexisting site. A deadly complication of Paget disease is the development of pagetic sarcoma, which is fatal.
The cause of Paget disease remains unknown but there are both genetic and environmental associations. A number of viruses have been identified in the diseased bone but what their role is in the disease pathology remains a mystery. Some literary sources suggest that the family of paramyxoviruses solely causes Paget.
However, many studies have come to determine that the osteoclast generation of a unique cytokine found exclusively in the bone marrow of patients diagnosed with Paget disease may be the primary insult.
This cytokine is known as IL A genetic predisposition to the disorder appears to be strong based on population studies. Besides finding an association between HLA markers, siblings are at high risk for developing the disorder. Paget disease is usually seen in individuals older than 50 years. It is common in Caucasians of northern European descent. Paget disease is equally common in males and females. In the US, it is said to affect million people but most are asymptomatic.
The disorder is slightly more common in white males. The disorder usually presents in the decade of life but the diagnosis is often made a decade later.
Paget disease occurs when there's an increase in bone resorption that leads to a decrease in bone mass and lytic structures. This process gives rise to osteoblasts from the bone utilizing a sensing system that allows them to increase their activity. Paget disease pathological process occurs in four stages.
The third stage is where the osteoblastic activity is observed and culminates in the final stage, where malignant degeneration will be seen. The disease occurs in isolated pockets but is usually progressive. Often there is erythema and warmth over the involved bone due to hypervascularity, which in turn can also lead to high output heart failure.
The disease can affect almost every bone in the skeleton but has an affinity for the long bones, axial skeleton, and skull. The involvement of the feet and hands is very rare.
The key histopathological feature of Paget disease involveS the bone architecture and includes the three phases of the disease: mixed, osteolytic, and osteosclerotic. These phases may occur at the same time or separately. The osteolytic phase has areas of resorption due to a large increase in the number of abnormal osteoclasts that contain dozens of nuclei. The osteoblastic phase that follows is disorganized.
The bone development is fragmented and irregular. The presence of irregularly shaped bone particles appears like a jigsaw and is the hallmark feature of Paget disease. As the disorder advances, the osteoblastic phase becomes dominant, resulting in excessive bone formation which is fibrous and coarse. The marrow space is filled with vascularized fibrous tissue, which accounts for the persistent warmth and fever.
The bone in Paget disease does not have centralized blood vessels or Haversian systems. Once the osteoblastic phase subsides, the new bone is poorly mineralized and is devoid of any structural integrity.
Many patients that present to the clinic with pathognomonic features associated with Paget disease are usually asymptomatic. The majority of patients with the condition are often diagnosed by an incidental finding on an x-ray study.
The spine and pelvis are commonly affected and among the long bones, the femur is often involved. Symptomatic patients can present with the following:. The lumbar spine, sacrum, and skull are involved in most cases. Pain is a common feature and is worse with weight-bearing. The physical exam may show bone deformity or angulation, localized pain to palpation and increased warmth.
The gait may be altered and there may be balance problems. Incomplete fractures are common in Paget disease and seen in the tibia and femur. Even mild injuries can result in fractures. Femur fractures often involve the subtrochanteric region. Osteosarcoma is a rare complication but should be suspected in a patient with sudden increase in swelling or bone pain.
The disorder is fatal. Giant cell tumors may also arise in pagetic bone and involve the facial bones. With vertebral fractures, acute spinal cord compression can occur.
In addition, calcified aortic stenosis is also common in this population. This disease also may also present with the following findings:. Measurement of serum alkaline phosphatase is useful as well as urine levels of hydroxyproline, C-telopeptide, and N telopeptide. Bone scans can help document the extent of disease and should be used to follow treatment. In addition, a bone scan can pick up early changes in bone even before the patient develops symptoms. Some patients diagnosed with Paget disease may not require treatment.
There are several treatment regimens that aid in prophylactically preventing bone breakdown and the subsequent formation. Surgery is only offered as an option to patients diagnosed with Paget disease when there is a progression into osteosarcoma. The majority of patients diagnosed with osteosarcoma are often offered palliative options such as amputation of the affected limb. In many cases, clinicians are tasked with the job of making judgment calls about which treatment options to offer to the wide spectrum of patients that are diagnosed with Pagte disease.
For example, younger patients are usually offered a surgical procedure where they could potentially salvage the limb by resecting the tumor with wide margins.
This may not be a viable alternative for an elderly patient with multiple comorbidities and risk factors. Patients may also develop pathological fractures that may need radiation and internal fixation to relieve pain burden. Chemotherapy has been shown to be an ineffective option for patients diagnosed with a sarcoma. It is important to note that surgical failure rates are high in this group of patients.
Often, revision surgery is indicated. Patients with cauda equina and other nerve compression complications will frequently require laminectomy. The prognosis for patients who are treated is good, especially if the disease is in its early stages. There is no cure for Paget disease but the disorder can be controlled from progressing. Patients with polyostotic disease tend to have poor outcomes compared to monostotic disease.
The morbidity is usually due to fractures, chronic pain, bone deformity, and neurological complications. Once the patient develops sarcomatous degeneration, the survival rate is very poor. To date, there is no way to prevent Paget disease since the cause remains unknown. For family members of a patient with Paget disease, some physicians do recommend monitoring levels of alkaline phosphatase levels every 2 years.
If the levels are within the normal range, then imaging of the bone may also be performed. Paget disease is the second most common bone disorder in the elderly and is associated with very high morbidity and mortality.
There is no cure for the disorder and early diagnosis is key. The diagnosis and management of Paget disease are better made with an interprofessional team that consists of a rheumatologist or endocrinologist, neurologist, audiologist, internist, nurse practitioner, and a pathologist.
Asymptomatic patients do not require treatment. Patients need to be referred to a physical therapist as they will benefit from learning about body mechanics, proper posture and avoidance of trauma.
Because the patients have weak bones, they need to be educated about protected weight-bearing and the use of ambulatory devices. The nurse should reinforce education about safe ambulation to prevent fractures. Immobility should be avoided as it also increases morbidity. The pharmacist should educate the patient on medication compliance and potential adverse effects, and nursing should watch for signs of adverse drug effects and monitor treatment progress on subsequent visits, reporting any findings to the clinician staff.
Symptomatic patients usually can be managed by bisphosphonates, calcitonin and vitamin D supplements. The pharmacist should be involved in the decision of best medication and dosing choice to optimize the therapeutic effect. A pain specialist should also be involved as these patients have moderate to severe bony pain that is often disabling.
Indications for surgery are usually offered as an option to patients diagnosed with Paget disease when there is a progression into osteosarcoma. The majority of patients diagnosed with osteosarcoma are usually offered palliative options such as amputation of the affected limb. An analysis of archeological skeletons from Northern England — [ Rogers et al. The prevalence before was 1. The prevalence of PDB increases with age and is slightly more common in men.
PDB is rare under 25 years and unusual before 40 years of age [ Siris and Roodman, ]. In a survey of patients the mean age at diagnosis was 58 years [ Siris, ]. In Italy, the incidence has remained fairly stable [ Gennari et al. First-degree relatives of patients with PDB have an increased risk of PDB, particularly if the patient has an early age of diagnosis or deforming bone disease [ Siris et al. Familial PDB also tends to be diagnosed at a younger age and involve more of the skeleton than sporadic disease [ Seton et al.
These findings suggest that genetic and environmental factors are important in the development of this disease. PDB is a chronic, progressive disorder involving one or more bones. Skeletal lesions of PDB are characterized by increased osteoclastic bone resorption, increased but somewhat disorganized bone formation, and increased vascularity of bone [ Ralston et al. The osteoclasts are increased in number and size and may contain more nuclei than normal. The nuclei may contain inclusion bodies that resemble viral particles [ Roodman, ].
The initial lesion is believed to be a focal increase in osteoclastic bone resorption. This is followed by accelerated bone formation. Because of the accelerated bone turnover, new collagen fibers are not laid down in an orderly linear fashion but rather in a disorganized manner.
The resultant bone is a mosaic of woven and lamellar bone [ Siris and Roodman, ] that is mechanically insufficient and at increased risk for fracture or deformity. PDB is considered to be a disease of the osteo-clasts [ Wirfel et al. Bone marrow and circulating osteoclast precursors demonstrate increased sensitivity to factors known to stimulate bone resorption such as 1,25 dihydroxy vitamin D and receptor activator of NF-kB ligand RANKL [ Roodman and Windle, ]. Increased interleukin-6 IL-6 expression and signaling may contribute to increased osteo-clastic activity [ Roodman et al.
RANKL which stimulates osteo-clastic differentiation expression is increased in pagetic marrow cells [ Menaa et al. Osteoblasts are increased in numbers at pagetic sites, however, they are morphologically normal and are not considered to be a primary pathophysiologic factor in PDB by most authorities [ Singer et al. Several potential environmental factors have been associated with the development of PDB.
Viral infection has been suggested because the nuclear inclusion bodies in osteoclasts appear to represent viral nucleo-capsids [ Mills and Singer, ]. Paramyxovirus, and in particular canine distemper virus and measles virus are the most extensively studied environmental agents, however controversy remains whether viruses play a role in the development of PDB.
Some studies suggest an association between PDB and dog ownership [ O'Driscoll and Anderson, ] and in particular dogs not vaccinated for canine distemper [ Khan et al.
Other studies refute this association [ Siris et al. Another study found an association between prior dog and possibly prior cat ownership and PDB in patients younger than 60 years [ Holdaway et al.
In situ hybridization ISH [ Basle et al. Furthermore, transfection of measles virus nucleocapsid gene into osteoclast precursors produces a pagetic-like phenotype [ Kurihara et al. Infection of osteo-clast precursors with canine distemper virus induces osteoclastogenesis [ Selby et al.
Addition of canine distemper virus to canine bone marrow cultures results in an increase in multinucleated osteoclast-like cell formation [ Mee et al. Other studies using RT-PCR, ISH, and immunocytochemistry do not find evidence of measles or canine distemper virus in bone biopsies, bone marrow, or peripheral blood mononuclear cells from PDB patients [ Ralston et al. In a study of bone marrow cultures from patients with PDB, measles virus and canine distemper virus transcripts were not found [ Ooi et al.
The reasons that some studies find viral transcripts and others do not are unclear, however, this difference does not appear to be due to assay sensitivity [ Ralston et al. The possibility of contamination as a cause for false positive results has been raised [ Ralston et al.
Of note is that serologic evidence of canine distemper virus is absent in patients with PDB and PDB is rare in some regions where canine distemper virus is common [ Cundy and Bolland, ]. The issue of whether or not viral infections are related to PDB is not resolved.
Other environmental exposures have been postulated to increase the risk of PDB. Arsenic used as pesticides in the cotton industry from to has been hypothesized to contribute to the high regional incidence of PDB in Lancashire, United Kingdom in and decline in this region by [ Lever, ].
This system regulates osteoclast function [ Boyle et al. Rank ligand RANKL , which is expressed in the marrow stroma and on osteo-blasts, binds RANK on osteoclast precursors promoting osteoclast proliferation and differentiation. OPG, therefore, inhibits osteoclast differentiation. Biology of the osteoclast in bone metabolism as a model for drug discovery. When bone is resorbed, growth factors in the bone matrix are released, often stimulating osteoclasts, which secrete resorption products into the circulation.
Osteoblastic stromal mesenchymal cells and maturing osteoclasts express a soluble version of the osteokine-receptor activator of the nuclear factor KB ligand sRANKL , its cell-bound receptor RANK, and osteoprotegerin OPG , which sustain osteoclastogenesis. Bisphosphonates concentrated under the osteoclasts inhibit resorptive function and promote osteoclast apoptosis.
The incorporation of bisphosphonates into bone may increase resistance to resorption. Current therapies for hyperresorptive states can be accommodated by this model; the pathways outlined here suggest additional targets, for which therapies are under development: bone growth factor antagonists; guanine nucleotide exchange factors GEFs , which inhibit cell migration; arginine—glycine—aspartic acid peptides, which act on integrins; carbonic anhy-drase inhibitors, which block the generation of hydrochloric acid; cathepsin K and matrix metalloproteinase 9 MMP-9 inhibitors; and antibodies to parathyroid hormone-related protein PTHrP and RANKL.
With permission from Deftos LJ. Treatment of Paget's disease — taming the wild osteoclast. N Engt J Med — OPG mutations not appear to be a common cause of classical Paget's disease, however, common polymorphisms of this gene may be associated with PDB in women [ Daroszewska et al.
The genetics of classical PDB have been reviewed elsewhere [ Lucas et al. These loci are PDB1 chromosome 6 [ Tilyard et al. Some of these loci may be false positives and others may represent genes that interact with other genes to cause or modify PDB [ Ralston, ].
The rare syndrome of PDB inclusion body myo-pathy and frontotemporal dementia is caused by mutations in valosin-containing protein VCP [ Watts et al. Mutations in this gene do not appear to be the cause of common familial or sporadic PDB [ Lucas et al. Complications of PDB are listed in Table 1. PDB is often asymptomatic and is frequently discovered incidentally when an elevated serum alkaline phosphatase SAP is found on routine laboratory testing, or radiographically on x-rays performed for unrelated reasons.
Seventy-two percent of these patients had polyostotic disease. Skeletal complications included bowing deformity in 7. Neurologic symptoms were uncommon. Overall survival was slightly better than predicted. PDB appears to have an adverse effect on some domains of quality of life [ Gold et al.
The most commonly involved bones include the pelvis, femur, spine, skull, and tibia [ Siris, ]. The upper extremities, clavicles, ribs and scapulae are less frequently affected and the hands and feet are rarely involved [ Siris, ]. This disease may involve one or more bones, however, it is unusual for a new bone to become involved after initial diagnosis [ Cundy and Bolland, ].
PDB may be associated with osteoarthritis [ Altman and Collins, ; Altman, ] in large joints such as the hip and knee, particularly when PDB involvement is adjacent to the joint or when bone deformity is present. Bone pain may be present and may be worse at night.
Bone pain may be worse with weight-bearing if there is an osteolytic lesion [ Whyte, ]. Bone enlargement or deformity may be present. There may be enlargement of the skull or frontal bossing and long bones may be bowed [ Siris and Roodman, ]. When bowed, the femur and tibia typically bow anteriorly and laterally. Bowing of a femur or tibia can lead to pain due to gait abnormalities and arthritis [ Siris and Roodman, ]. Painful fissure fractures may occur [ Redden et al.
For example, fissure fractures of the femur are usually found laterally, unlike Looser zones of osteomalacia which are typically seen in the medial aspect of the proximal femur. Pain that increases dramatically may represent a fracture.
Patients may note warmth of the skin over pagetic lesions due to increased vascularity. Dilated scalp veins may be present when there is skull involvement. Some symptoms and neurologic complications may be related to skull involvement. Patients with skull involvement may have headaches [ Siris and Roodman, ]. Cranial nerve deficits have been reported but appear to be rare. Optic atrophy, ophthalmoplegia, anosmia, trigeminal neuralgia, and facial palsy have been reported [ Rubin and Levin, ].
Hearing loss may occur when the temporal bone is involved. Presbycusis and PDB affect similar populations and it may be difficult to differentiate presbycusis from pagetic hearing loss [ Bone, ]. The hearing loss appears to be caused by loss of bone density in the cochlear capsule [ Monsell et al. Some patients may have tinnitus. Another neurologic complication resulting from skull involvement is basilar invagi-nation from softening of the skull base which may cause cause hydrocephalus with headache and dizziness.
This basilar invagination can result in syringomyelia and compression of the brainstem. This neurologic syndrome is usually slowly progressive and symptoms may include ataxia, vertigo, tinnitus, dysphagia, and dysarthria [ Rubin and Levin, ]. Spinal involvement may cause pain, neurologic symptoms, and even paralysis.
Peripheral neuropathies such as ulnar, median, sciatic, and posterior tibial have been reported [ Rubin and Levin, ]. Neurologic symptoms may improve with calcitonin [ Chen et al. High output heart failure is rare but may occur with extensive PDB, particularly when underlying cardiac disease is present [ Siris, ].
Decreased peripheral vascular resistance and increased stroke volume was found in echocar-diographic study of PDB [ Morales-Piga et al. Increased frequencies of aortic stenosis [ Strickberger et al. Increased calcification of the vasculature has also been reported [ Laroche and Delmotte, ]. Osteosarcomas or other sarcomas chondrosar-coma, fibrosarcoma are the most serious complications of PDB. Sarcomas may present with worsening pain, lytic lesion on x-ray, fracture, a new mass, or rising SAP [ Hansen et al.
The most common bones involved in pagetic osteosarcoma include pelvis, femur, humerus, tibia, and skull [ Hansen et al. Interestingly, despite being frequently involved by PDB, osteosarcoma is uncommon in the pagetic spine [ Hansen et al.
Patients with pagetic sarcomas have a poor prognosis and most patients die from local extension of disease or pulmonary metastases within 3 years [ Siris and Roodman, ].
The mean age at presentation of sarcoma after was The median survival remained poor at 0. Skeletal or extraskeletal benign giant cell tumors or osteoclastomas [ Singer and Mills, ; Ziambaras et al.
There appears to be geographic clustering with many of these patients being descendents of four residents of Avellino, Italy [ Rendina et al. The serum calcium and phosphorus are usually normal. In untreated patients, the serum total and bone specific alkaline phosphatase BSAP levels are usually elevated [ Whyte, ]. The elevation in totalor BSAP reflects both the extentofthe disease and the associated increased osteoblastic activity.
The SAP may be normal in patients with minimal skeletal involvement or monostotic PDB, inactive disease, or after specific antipagetic treatment. Other markers of bone formation and bone resorption may also be elevated [ Alvarez et al. The serum uric acid is sometimes elevated [ Siris and Roodman, ] but gout has not been proven to occur more frequently in patients with PDB than the general population [ Siris and Roodman, ].
Although hypercalcemia may complicate extensive PDB during periods of immobilization or dehydration, hypercalcemia usually reflects a coexisting condition such as primary hyperparathyroidism PHPT. The presence of hypercalcemia should prompt an evaluation for an underlying cause and should not be assumed to be related to PDB.
Hypercalciuria may occur due to increased bone resorption particularly with immobilization [ Kanis, b ]. It is probably prudent to measure the serum hydroxy vitamin D level to exclude vitamin D deficiency as a contributing factor to an elevated SAP.
Furthermore, vitamin D deficiency should always be corrected prior to initiating bisphospho-nate therapy. In many of these patients, the elevation of parathyroid hormone is believed to represent secondary PHPT occurring at times of active pagetic bone formation. Secondary PHPT can also occur after suppression of bone resorption with bisphosphonate therapy [ Siris et al.
Inadequate vitamin D stores and age-related declines in renal function could also contribute to secondary PHPT. A total body bone scan or a radiographic skeletal survey is often performed to assess the extent of disease. I prefer radionuclide bone scanning followed by targeted X-ray imaging of the bones that demonstrate abnormal radionuclide uptake. The enhanced skeletal uptake of radionuclide reflects increased bone formation and increased blood flow and may detect PDB before X-ray findings can be appreciated.
Alternatively, some lesions in which osteoblastic activity has become inactive will be negative on bone scanning despite findings of PDB on plain radiographs. Treatment of PDB may render the radionuclide scan normal. On plain radiographs the earliest lesions are lytic due to increase osteoclastic activity.
Lytic lesions may progress at a rate of about 1 cm yearly [ Whyte, ]. In response to increased bone resorption, bone formation is increased, resulting in a picture of mixed lytic and sclerotic areas. Bony enlargement, cortical thickening, increased trabecular pattern, and deformity or bowing may be seen. Involved vertebrae may have coarsened trabecular patterns and are sometimes osteosclerotic ivory vertebra.
The posterior elements are usually involved [ Cushing and Bone, ]. Compression deformities may occur [ Cushing and Bone, ]. Anterior, posterior, or lateral enlargement of verterbral bodies may be seen [ Kanis, a ]. Radiographic examples are shown in Figure 2. Radiographic appearance of Paget's disease of bone PDB.
Acetaminophen, aspirin, or nonsteroidal anti-inflammatory drugs may be used for secondary degenerative joint disease [ Siris and Roodman, ] and mild bone pain. Physical therapy is sometimes helpful. For the most part, indications are based on clinical experience rather than outcomes from clinical trials of significant size and duration.
Clinically significant progressive deformity has been observed in untreated patients [ Siris and Feldman, ]. Indications for treatment [ Lyles et al. Neurologic symptoms due to spine or skull involvement are also indications for treatment. Patients with hearing loss due to temporal bone involvement should be treated in an attempt to prevent further hearing loss. Preoperative treatment is indicated in patients scheduled for elective surgery involving pagetic bone such as a total hip arthroplasty or tibial osteotomy in an attempt to decrease blood loss.
Hypercalcemia related to immobilization in a patient with polyostotic PDB is another indication for treatment. While treatment to prevent complications in asymptomatic patients seems reasonable, this remains an area of controversy.
This includes treatment of patients with involvement adjacent to large joints to avoid arthritis, treatment of patients who may be at risk for bowing of long bones, treatment of patients with temporal bone involvement to avoid hearing loss, and treatment of patients with significant skull or spine involvement to avoid neurologic problems.
Specific antipagetic drugs inhibit osteoclastic activity. Salmon calcitonin has been available for many years. Improved bone pain, healing of osteolytic lesions, and improvement in neurologic complications have been reported. The maintenance dose is often subsequently decreased to 50—IU three times weekly. This drug is less effective than the more potent bisphosphonates and resistance due to antibody formation against calcitonin may occur [ Levy et al.
Side effects include nausea and flushing in some patients [ Siris and Roodman, ]. Calcitonin is now used much less frequently than the more potent bisphosphonates and is primarily used in patients who cannot take or tolerate oral or intravenous IV bispho-sphonate therapy.
Bisphosphonates are nonbiodegradable synthetic analogs of inorganic pyrophosphate. These drugs adhere to mineralized surfaces, inhibit osteoclastic bone resorption Figure 1 and have very long skeletal half-lives [ Licata, ].
These drugs are often divided into two classes; simple bispho-sphonates such as etidronate and tiludronate and the more potent nitrogen-containing bispho-sphonates such as pamidronate, alendronate, risedronate, and zoledronic acid ZA [ Licata, ]. The simple bisphosphonates appear to inhibit osteoclastic function by forming toxic analogues of ATP in osteoclasts [ Frith et al.
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Taro Pharmaceuticals Inc. History and Physical Many patients that present to the clinic with pathognomonic features associated with Paget disease are usually asymptomatic. Symptomatic patients can present with the following: Pain involving the bones and joints. Evaluation Tests to assist in the diagnosis of Paget disease include: Bone scan. Bisphosphonates that have been approved as the first-line treatment option, secondary to its influence in bone remodeling. Supplements such as calcium and vitamin D that have been known to provide some symptomatic benefit.
Differential Diagnosis The differential diagnosis includes: Osteomalacia. Prognosis The prognosis for patients who are treated is good, especially if the disease is in its early stages.
Complications Complications include: Secondary osteoarthritis. Pearls and Other Issues Diet and Activity While there is no specific diet for patients with Paget disease, those who are prescribed bisphosphonates should ensure adequate intake of calcium and vitamin D.
Aggressive physical activity is not recommended, as the risk of fracture is high. However, muscle-strengthening exercise at a low level is recommended. Patients at risk for complications like fracture should be started on bisphosphonates with Alendronate 40mg daily being the first choice in the oral category.
Another easy option is a single 5 mg dose of intravenous zoledronate if there are no contraindications. If a patient has normal alkaline phosphatase levels, monitor disease with a specific marker for bone formation. One can follow patients with serial bone scans to assess the disease if bone markers are all normal. Use of bisphosphonates is effective in slowing down the progression of the disease or the hearing loss.
If patients with Paget disease need surgery, should consider pre-treatment with bisphosphonates. Enhancing Healthcare Team Outcomes Paget disease is the second most common bone disorder in the elderly and is associated with very high morbidity and mortality.
Review Questions Access free multiple choice questions on this topic. Comment on this article. Figure Abnormal uptake in the left hemipelvis on bone scan representing Paget's Disease. Figure Paget Disease of the long bone. Figure Paget Disease pelvis. Figure Paget Disease skull. References 1. Female Pelvic Med Reconstr Surg. J Bone Miner Res. Reviewing vulvar Paget's disease molecular bases. Int J Gynecol Cancer. Paget's disease of bone. Adams C, Banks KP.
Bone Scan. Kravets I. Paget's Disease of Bone: Diagnosis and Treatment. Am J Med. Lancet Haematol. Diagnosis and treatment of Paget's disease of bone : A clinical practice guideline. Wien Med Wochenschr. Development of a molecular test of Paget's disease of bone. Clinical Guidelines on Paget's Disease of Bone. Tuck SP. Adult Paget disease of bone: a tale of two guidelines. Rheumatology Oxford.
Indian J Endocrinol Metab. Paget Disease. Get Involved. Stay Connected Join our community to learn more about osteoporosis, or connect with others near you who are suffering from the disease. Sign Up Now Donate today!
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Command and Control. Command and control C2 information is encoded using a standard data encoding system. Several foundational concerns, however, can be raised about this emerging field. The differences between neuroscience and education are many, including differences in their histories,…. Vision and art: an interdisciplinary approach to neuroscience education. Undergraduate institutions are increasingly adopting neuroscience within their curricula, although it is unclear how best to implement this material given the interdisciplinary nature of the field, which requires knowledge of basic physics, chemistry, biology and psychology.
This difficulty is compounded by declines over recent decades in the amount of physics education that students receive in high school, which hinders students' ability to grasp basic principles of neuroscience. The course capitalizes on students' prior interest in visual art to motivate an understanding of the physiological and computational neural processes that underlie vision; our aim is that the learning strategies that students acquire as a result of the format and interdisciplinary approach of the course will increase students' critical thinking skills and benefit them as they pursue other domains of inquiry.
The course includes both expert lectures on central themes of vision along with a problem-based learning PBL laboratory component that directly engages the students as empirical scientists. We outline the syllabus, the motivation for using PBL, and describe a number of hands-on laboratory exercises, many of which require only inexpensive and readily available equipment. We have developed a website that we hope will facilitate student-driven inquiry beyond the classroom and foster inter-institutional collaboration in this endeavor.
We conclude the paper with a discussion of the potential limitations of the course and how to evaluate the success of the course and the website. Grisham, William; Brumberg, Joshua C. Speakers provided overviews of open datasets that could be used in teaching undergraduate courses.
Other resources, such as NeuroData presented by William R. Linda Lanyon further elaborated on the current state and challenges in educating students to deal with Big Data and described some training resources provided by the International Neuroinformatics Coordinating Facility.
Neuroinformatics is a subfield of neuroscience that deals with data utilizing analytical tools and computational models. The feasibility of offering neuroinformatics programs at primarily undergraduate institutions was also discussed. As part of a series of workshops on teaching neuroscience at the Society for Neuroscience annual meetings, William Grisham and Richard Olivo organized the workshop on "Teaching Neuroscience with Big Data.
Higher Education and the Society for Neuroscience : a website proposal that helped catalyze a change in policy. In the spring of , the Society for Neuroscience SfN did not include support for higher education as a priority in its strategic plan. By the spring of , its priorities had changed. One catalyst for that change was a proposal for a website that would list, review, and rate resources for teaching neuroscience at the graduate and undergraduate level. The proposal was sent to and accepted by SfN Council in August ; by spring , SfN had taken initial steps to implement it.
The Future of Educational Neuroscience. The primary goal of the emerging field of educational neuroscience and the broader movement called Mind, Brain, and Education is to join biology with cognitive science, development, and education so that education can be grounded more solidly in research on learning and teaching. To avoid misdirection, the growing worldwide movement needs to avoid…. Neuroscience , Education and Special Education.
The discipline of neuroscience draws from the fields of neurology, psychology, physiology and biology, but is best understood in the wider world as brain science. Of particular interest for education is the development of techniques for imaging the brain as it performs different cognitive functions.
Cognitive neuroimaging has already led to…. Neuroscience and Special Education. The purpose of this document is to provide a brief overview of how links are being developed between the rapidly expanding field of neuroscience and the practice of special education.
The first part of the document introduces definitions and terminology, provides an overview of how findings from neuroscience are being applied to the field of…. Philosophy, Neuroscience and Education. This short note takes two quotations from Snooks' recent editorial on neuroeducation and teases out some further details on the philosophy of neuroscience and neurophilosophy along with consideration of the implications of both for philosophy of education.
Neuroscience and education. Neuroscience is a relatively new discipline encompassing neurology, psychology and biology. It has made great strides in the last years, during which many aspects of the physiology, biochemistry, pharmacology and structure of the vertebrate brain have been understood.
Understanding of some of the basic perceptual, cognitive, attentional, emotional and mnemonic functions is also making progress, particularly since the advent of the cognitive neurosciences , which focus specifically on understanding higher level processes of cognition via imaging technology.
Neuroimaging has enabled scientists to study the human brain at work in vivo, deepening our understanding of the very complex processes underpinning speech and language, thinking and reasoning, reading and mathematics. It seems timely, therefore, to consider how we might implement our increased understanding of brain development and brain function to explore educational questions.
Written pain neuroscience education in fibromyalgia: a multicenter randomized controlled trial. Mounting evidence supports the use of face-to-face pain neuroscience education for the treatment of chronic pain patients. This study aimed at examining whether written education about pain neuroscience improves illness perceptions, catastrophizing, and health status in patients with fibromyalgia.
A double-blind, multicenter randomized controlled clinical trial with 6-month follow-up was conducted. Written pain neuroscience education comprised of a booklet with pain neuroscience education plus a telephone call to clarify any difficulties; the relaxation group received a booklet with relaxation education and a telephone call.
The revised illness perception questionnaire, Pain Catastrophizing Scale, and fibromyalgia impact questionnaire were used as outcome measures. Both patients and assessors were blinded. Repeated-measures analyses with last observation carried forward principle were performed.
Cohen's d effect sizes ES were calculated for all within-group changes and between-group differences. The results reveal that written pain neuroscience education does not change the impact of FM on daily life, catastrophizing, or perceived symptoms of patients with FM. Compared with written relaxation training, written pain neuroscience education slightly improved illness perceptions of patients with FM, but it did not impart clinically meaningful effects on pain, catastrophizing, or the impact of FM on daily life.
Face-to-face sessions of pain neuroscience education are required to change inappropriate cognitions and perceived health in patients with FM. Attitudes toward neuroscience education in psychiatry: a national multi-stakeholder survey. The objective of this study is to assess the attitudes of chairs of psychiatry departments, psychiatrists, and psychiatry trainees toward neuroscience education in residency programs and beyond in order to inform future neuroscience education approaches.
This multi-stakeholder survey captured data on demographics, self-assessments of neuroscience knowledge, attitudes toward neuroscience education , preferences in learning modalities, and interests in specific neuroscience topics. In , the authors distributed the surveys: by paper to US psychiatry department chairs and electronically through the American Psychiatric Association to 3, of its members 1, psychiatrists and 2, trainees.
A large majority of respondents agreed with the need for more neuroscience education in general and with respect to their own training. Most respondents believed that neuroscience will help destigmatize mental illness and begin producing new treatments or personalized medicines in years. Only a small proportion of trainees and psychiatrists, however, reported a strong knowledge base in neuroscience. This study demonstrates the opportunity and enthusiasm for teaching more neuroscience in psychiatry among a broad range of stakeholder groups.
A high level of interest was also found for transdiagnostic topics and approaches. We suggest that a transdiagnostic framework may be an effective way to deliver neuroscience education to the psychiatric community and illustrate this through a case example, drawing the similarity between this neuroscience approach and problem-based formulations familiar to clinicians.
Neuroscience : viable applications in education? As a relatively young science, neuroscience is still finding its feet in potential collaborations with other disciplines. One such discipline is education , with the field of neuroeducation being on the horizon since the s. However, although its achievements are now growing, the partnership has not been as successful as first hopes suggested it should be.
Here the authors discuss the theoretical barriers and potential solutions to this, which have been suggested previously, with particular focus on levels of research in neuroscience and their applicability to education. Moreover, they propose that these theoretical barriers are driven and maintained by practical barriers surrounding common language and research literacy. They propose that by overcoming these practical barriers through appropriate training and shared experience, neuroeducation can reach its full potential.
Case studies have been the cornerstone of many discoveries in neurology and continue to be an indispensable source of knowledge. This article describes the value of the case study methodology and its advantages as a pedagogical approach.
It also illustrates how the seminal case of H. Three exercises are described for incorporating case studies into neuroscience courses. The first exercise requires students to conduct a literature review regarding their assigned case and then design an experiment to address a lingering question regarding that neurological disorder. Survey results of 90 students provide quantitative and qualitative support for this approach.
The vast majority of students indicated this exercise was a valuable learning experience; sparked interest in the topic and in biopsychology; increased their knowledge and stimulated critical thinking.
The second exercise discusses how students might conduct their own case studies. The third exercise emphasizes the use of case studies as a platform to examine competing hypotheses regarding neurological conditions and their treatment.
A table listing case studies appropriate for undergraduate neuroscience courses is included. Cases are categorized by the type of neurological disorder and notes regarding the nature of and content of each case are provided. The past decade has seen major advances in cognitive, affective and social neuroscience that have the potential to revolutionize educational theories about learning. The importance of emotion and social learning has long been recognized in education , but due to technological limitations in neuroscience research techniques, treatment of these….
Educational neuroscience represents a concerted interdisciplinary effort to bring the fields of cognitive science, neuroscience and education to bear on classroom practice. This article draws attention to the current and potential implications of importing biological ideas, language and imagery into education.
By analysing examples of brain-based…. Neuroscience continues to enjoy a renaissance of study and a range of responses, both in explorations of religious experience and in educational practice. Neuroscience , as an interdisciplinary field, attained a new ascendancy at the end of the 20th century, known as the decade of the brain. New insights continue to influence education and public….
Optimising, generalising and integrating educational practice using neuroscience. Practical collaboration at the intersection of education and neuroscience research is difficult because the combined discipline encompasses both the activity of microscopic neurons and the complex social interactions of teachers and students in a classroom. Taking a pragmatic view, this paper discusses three education objectives to which neuroscience can be effectively applied: optimising, generalising and integrating instructional techniques.
These objectives are characterised by: 1 being of practical importance; 2 building on existing education and cognitive research; and 3 being infeasible to address based on behavioural experiments alone. The focus of the neuroscientific aspect of collaborative research should be on the activity of the brain before, during and after learning a task, as opposed to performance of a task. The objectives are informed by literature that highlights possible pitfalls with educational neuroscience research, and are described with respect to the static and dynamic aspects of brain physiology that can be measured by current technology.
Neuroscience and education : myths and messages. For several decades, myths about the brain - neuromyths - have persisted in schools and colleges, often being used to justify ineffective approaches to teaching.
Many of these myths are biased distortions of scientific fact. Cultural conditions, such as differences in terminology and language, have contributed to a 'gap' between neuroscience and education that has shielded these distortions from scrutiny.
In recent years, scientific communications across this gap have increased, although the messages are often distorted by the same conditions and biases as those responsible for neuromyths. In the future, the establishment of a new field of inquiry that is dedicated to bridging neuroscience and education may help to inform and to improve these communications.
As neuroscience knowledge grows in its scope of societal applications so does the need to educate a wider audience on how to critically evaluate its research findings. Efforts at finding teaching approaches that are interdisciplinary, accessible and highly applicable to student experience are thus ongoing. The article describes an interdisciplinary undergraduate health course that combines the academic study of contemplative neuroscience with contemplative practice, specifically yoga.
The class aims to reach a diverse mix of students by teaching applicable, health-relevant neuroscience material while directly connecting it to first-hand experience. Finally, students in their written work applied neuroscience course content to their personal and professional lives.
Such results indicate that this approach could serve as a model for the interdisciplinary, accessible and applied integration of relevant neuroscience material into the undergraduate health curriculum. Towards an Understanding of Neuroscience for Science Educators. Advances in neuroscience have brought new insights to the development of cognitive functions. These data are of considerable interest to educators concerned with how students learn. This review documents some of the recent findings in neuroscience , which is richer in describing cognitive functions than affective aspects of learning.
A brief…. The principles and practices of educational neuroscience : Comment on Bowers In his recent critique of Educational Neuroscience , Bowers argues that neuroscience has no role to play in informing education , which he equates with classroom teaching. Neuroscience , he suggests, adds nothing to what we can learn from psychology.
In this commentary, we argue that Bowers' assertions misrepresent the nature and aims of the work in this new field.
We suggest that, by contrast, psychological and neural levels of explanation complement rather than compete with each other. Bowers' analysis also fails to include a role for educational expertise-a guiding principle of our new field. On this basis, we conclude that his critique is potentially misleading. We set out the well-documented goals of research in Educational Neuroscience , and show how, in collaboration with educators , significant progress has already been achieved, with the prospect of even greater progress in the future.
There has been a marked increase in interest, research, and publications exploring ways in which educational practices might be influenced by neuroscience.
The idea that a greater understanding of how the brain works can improve teaching and learning is very seductive, but what can teachers and other professionals working in education learn from…. This paper outlines an initiative in mathematics education research that aims to augment qualitative methods of research into mathematical cognition and learning with quantitative methods of psychometrics and psychophysiology.
Background and motivation are provided for this initiative, which is coming to be referred to as educational neuroscience. Extending the seductive allure of neuroscience explanations effect to popular articles about educational topics. The seductive allure of neuroscience explanations SANE is the finding that people overweight psychological arguments when framed in terms of neuroscience findings.
This study extended this finding to arguments concerning the application of psychological findings to educational topics. We developed eight articles that orthogonally varied two processes learning vs. We increased neuroscience framing across four levels: psychological finding alone, with an extraneous neuroscience finding verbal , with an extraneous neuroscience finding verbal and graph, and with an extraneous neuroscience finding verbal and brain image.
Participants were randomly assigned to one level of neuroscience framing and rated the credibility of each article's argument. Seductive allure of neuroscience explanations effects were not ubiquitous. Extraneous verbal neuroscience framings, either alone or accompanied by graphs, did not influence the credibility of the application of psychological findings to educational topics. However, there was a SANE effect when educational articles were accompanied by both extraneous verbal neuroscience findings and brain images.
This effect persisted even after controlling for individual differences in familiarity with education , attitude towards psychology, and knowledge of neuroscience. The results suggest that there is a SANE effect for articles about educational topics among the general public when they are accompanied by both extraneous verbal neuroscience findings and brain images.
A distance education in undergraduate dietetic education. Distance education is an exploding phenomenon that allows people to pursue higher education on their own time, at a pace that meets their needs, in locations where there are no colleges and universities, or where there is not a desired program of study.
This study examined the use of distance education in undergraduate dietetic education programs and the opportunities for obtaining an undergraduate degree in dietetics solely via distance education. Institutions that offer nondietetics distance education courses were more likely to offer dietetics distance education courses.
From the data of courses offered, or permitted to be transferred, it would not be possible for a student to complete an undergraduate degree in dietetics solely via distance education methodologies at the time this study was conducted. Neuroscience , Education and Mental Health.
The following article presents a series of investigations, reflections, and quotes about neuroscience , education , and psychology. Each area is specialized in some matters but at some point they share territory and mutually benefit one another, and help us to increasingly understand the complex world of learning, the brain, and human behavior. Both short excerpts from, and full-length presentation of feature films have been used with success in undergraduate instruction. Studies of such use of films has revealed that incorporation of film viewing within courses can promote both content mastery and the development of critical thinking skills.
This article discusses and provides examples of successful use of two methods that may be used to incorporate a variety of full-length feature films into neuroscience instruction. The second, a neuroscience film series, features group discussion of movies of perhaps more limited relevance to neuroscience. An additional goal of this article is provide the reader with initial resources for the selection of potential film titles for use in neuroscience education.
Chronic pain is a widespread problem in the field of pediatrics. Many interventions to ameliorate pain-related dysfunction have a biobehavioral focus.
As treatments for chronic pain e. Most pain treatment interventions incorporate psychoeducation, or pain neuroscience education PNE , as an essential component, and in some cases, as a stand-alone approach. The current topical review focuses on the state of pain neuroscience education and its application to pediatric chronic pain.
As very little research has examined pain neuroscience education in pediatrics, we aim to describe this emerging area and catalyze further work on this important topic. As the present literature has generally focused on adults with chronic pain, pain neuroscience education merits further attention in the realm of pediatric pain in order to be tailored and implemented in this population.
Does Neuroscience Matter for Education? In this review essay, Francis Schrag focuses on two recent anthologies dealing completely or in part with the role of neuroscience in learning and education : The "Jossey-Bass Reader on the Brain and Learning", edited by Jossey-Bass Publishers, and "New Philosophies of Learning", edited by Ruth Cigman and Andrew Davis. Schrag argues that…. A competency-based longitudinal core curriculum in medical neuroscience.
Current medical educational theory encourages the development of competency-based curricula. The Accreditation Council for Graduate Medical Education 's 6 core competencies for resident education medical knowledge, patient care, professionalism, interpersonal and communication skills, practice-based learning, and systems-based practice have been embraced by medical schools as the building blocks necessary for becoming a competent licensed physician.
Many medical schools are therefore changing their educational approach to an integrated model in which students demonstrate incremental acquisition and mastery of all competencies as they progress through medical school.
Challenges to medical schools include integration of preclinical and clinical studies as well as development of learning objectives and assessment measures for each competency. The Undergraduate Education Subcommittee UES of the American Academy of Neurology AAN assembled a group of neuroscience educators to outline a longitudinal competency-based curriculum in medical neuroscience encompassing both preclinical and clinical coursework.
In development of this curriculum, the committee reviewed United States Medical Licensing Examination content outlines, Liaison Committee on Medical Education requirements, prior AAN-mandated core curricula for basic neuroscience and clinical neurology, and survey responses from educators in US medical schools. The newly recommended curriculum provides an outline of learning objectives for each of the 6 competencies, listing each learning objective in active terms.
Documentation of experiences is emphasized, and assessment measures are suggested to demonstrate adequate achievement in each competency. These guidelines, widely vetted and approved by the UES membership, aspire to be both useful as a stand-alone curriculum and also provide a framework for neuroscience educators who wish to develop a more detailed focus in certain areas of study.
Taking an educational psychology course improves neuroscience literacy but does not reduce belief in neuromyths. Educators are increasingly interested in applying neuroscience findings to improve educational practice. However, their understanding of the brain often lags behind their enthusiasm for the brain. We propose that educational psychology can serve as a bridge between basic research in neuroscience and psychology on one hand and educational practice on the other. We evaluated whether taking an educational psychology course is associated with increased neuroscience literacy and reduced belief in neuromyths in a sample of South Korean pre-service teachers.
The results showed that taking an educational psychology course was associated with the increased neuroscience literacy, but there was no impact on belief in neuromyths. We consider the implications of these and other findings of the study for redesigning educational psychology courses and textbooks for improving neuroscience literacy. Neuroscience education of undergraduate medical students. Part II: outcome improvement. Because of political and economic pressures, primary care physicians are now charged with greater responsibility for the care of patients with disease processes definitively managed by neurosurgeons.
The goal of this study was to establish the feasibility and efficacy of a neurosurgical curriculum designed to teach future primary care physicians about these diseases. A compact, seven-lecture curriculum was developed to teach 3rd-year medical students about degenerative spine disease, stroke, tumor- and hydrocephalus-related raised intracranial pressure, head and spine injury, and subarachnoid hemorrhage.
This curriculum was given as part of a 6-week pilot course that included neurology, neurosurgery, ophthalmology, and rehabilitation medicine components. This course was administered to two groups of 18 medical students, and an examination was administered at the end of the pilot course. The same examination was administered to an additional 19 students immediately after their completion of the neurology course currently required.
Students enrolled in the pilot neuroscience course performed significantly better p neuroscience course significantly improved student performance on an examination focusing on the recognition and management of common neurosurgical disorders.
Because primary care physicians are responsible for the initial recognition and management of these disorders, the knowledge gained may lead to improved patient care. Research and innovation in undergraduate chemistry education has been done for many years, and one goal of this….
As the brain sciences make advances in our understanding of how the human brain functions, many educators are looking to findings from the neurosciences to inform classroom teaching methodologies. This paper takes the view that the neurosciences are an excellent source of knowledge regarding learning processes, but also provides a warning….
Building a functional multiple intelligences theory to advance educational neuroscience. A key goal of educational neuroscience is to conduct constrained experimental research that is theory-driven and yet also clearly related to educators ' complex set of questions and concerns. However, the fields of education , cognitive psychology, and neuroscience use different levels of description to characterize human ability. An important advance in research in educational neuroscience would be the identification of a cognitive and neurocognitive framework at a level of description relatively intuitive to educators.
I argue that the theory of multiple intelligences MI; Gardner, , a conception of the mind that motivated a past generation of teachers, may provide such an opportunity. I criticize MI for doing little to clarify for teachers a core misunderstanding, specifically that MI was only an anatomical map of the mind but not a functional theory that detailed how the mind actually processes information.
In an attempt to build a "functional MI" theory, I integrate into MI basic principles of cognitive and neural functioning, namely interregional neural facilitation and inhibition.
In so doing I hope to forge a path toward constrained experimental research that bears upon teachers' concerns about teaching and learning. With the emergence of a wealth of research-based information in the field of educational neuroscience , educators are now able to make more evidence-based decisions in the important area of curriculum design and construction.
By viewing from the perspective of educational neuroscience , we can give a more meaningful and lasting purpose of leading to…. This article considers the extent to which neuroscience is being applied to education , both on a classroom level and also on the level of curricular reform in Northern Ireland.
The article reviews recent research in the area of neuroscience and education and examines a number of popular "neuromyths. Cognitive Neuroscience and Education : Unravelling the Confusion. This paper critically examines the application of research into cognitive neuroscience to educational contexts. It first considers recent warnings from within the neuroscientific community itself about the limitations of current neuroscientific knowledge and the urgent need to dispel popular "neuromyths" which have become accepted in….
The journal IMPULSE offers undergraduates worldwide the opportunity to publish research and serve as peer reviewers for the submissions of others. However, integration of scientific publication into an undergraduate laboratory classroom setting has been lacking.
The syllabus allowed for the laboratory research to coincide with the background research and writing of the manuscript. Students completed their projects on the impact of drugs on the Daphnia magna nervous system while producing manuscripts ready for submission by week 7 of the course. Findings from a survey completed by the students and perceptions of the faculty member teaching the course indicated that students spent much more time writing, were more focused on completing the assays, completed the assays with larger data sets, were more engaged in learning the scientific concepts and were more thorough with their revisions of the paper knowing that it might be published.
Incorporating journal submission into the course stimulated an in depth writing experience and allowed for a deeper exploration of the topic than students would have experienced otherwise. This case study provides evidence that IMPULSE can be successfully used as a means of incorporating scientific publication into an undergraduate laboratory science course. This requirement challenges program resources, and the demand for faculty attention is high.
Thus, we developed an intentional 3-step peer mentoring system that encourages our students to collaborate with and learn from, not only faculty, but each other.
Peer mentoring occurs in the curriculum, faculty research labs, and as students complete their senior theses. As the program has grown with over 80 current majors, we have developed a new Neuroscience Methods course to train students on the safety, ethics, and practice of research in the neuroscience laboratory space.
Students in this course leave with the skills and knowledge to assist senior level students with their theses and to begin the process of developing their own projects in the laboratory. New knowledge from the rapidly growing field of neuroscience has important implications for our understanding of human behavior in the social environment, yet little of this knowledge has made its way into social work education.
This article presents a model for integrating neuroscience into instruction on human development, the bio psychosocial…. The Vision and Change in Undergraduate Biology Education reports cite the critical role of professional societies in undergraduate life science education and, since , have called for the increased involvement of professional societies in support of undergraduate education.
Our study explored the level of support being provided by societies for undergraduate education and documented changes in support during the Vision and Change era. Society representatives responded to a survey on programs, awards, meetings, membership, teaching resources, publications, staffing, finances, evaluation, and collaborations that address undergraduate faculty and students.
A longitudinal comparison group of societies responded to surveys in both and Societies are devoting funding and staff to these efforts and engaging volunteer leadership. Longitudinal comparison group responses indicate there have been significant and quantifiable expansions of undergraduate efforts in many areas since These indicators can serve as a baseline for defining, aligning, and measuring how professional societies can promote sustainable, evidence-based support of undergraduate education initiatives.
When and How Neuroscience Applies to Education. In this reply, the author agrees with Eric Jensen on several important points, among them: that neuroscientific data are relevant to educational research, that these data have already proved useful, and that neuroscience alone should not be expected to generate classroom-ready prescriptions.
He sharply disagrees with him, however, on the prospects…. Tackling student neurophobia in neurosciences block with team-based learning. Traditionally, neurosciences is perceived as a difficult course in undergraduate medical education with literature suggesting use of the term "Neurophobia" fear of neurology among medical students. Instructional strategies employed for the teaching of neurosciences in undergraduate curricula traditionally include a combination of lectures, demonstrations, practical classes, problem-based learning and clinico-pathological conferences.
Recently, team-based learning TBL , a student-centered instructional strategy, has increasingly been regarded by many undergraduate medical courses as an effective method to assist student learning. In this study, students of year-three neuroscience block were divided into seven male and seven female groups, comprising students in each group. TBL was introduced during the 6 weeks of this block, and a total of eight TBL sessions were conducted during this duration.
We evaluated the effect of TBL on student learning and correlated it with the student's performance in summative assessment. Moreover, the students' perceptions regarding the process of TBL was assessed by online survey. We found that students who attended TBL sessions performed better in the summative examinations as compared to those who did not. Furthermore, students performed better in team activities compared to individual testing, with male students performing better with a more favorable impact on their grades in the summative examination.
There was an increase in the number of students achieving higher grades grade B and above in this block when compared to the previous block Moreover, the number of students at risk for lower grades Grade B- and below decreased in this block when compared to the previous block Students generally elicited a favorable response regarding the TBL process, as well as expressed satisfaction with the content covered and felt that such activities led to improvement in communication and.
In this review, we lay the groundwork for an interdisciplinary conversation between literacy education research and relevant neuroscience research. We review recent neuroscience research on correlates of proposed cognitive subprocesses in text decoding and reading comprehension and analyze some of the methodological and conceptual challenges of…. As the field of Mind, Brain, and Education seeks new ways to credibly bridge the gap between neuroscience , the cognitive sciences, and education , various connections are being developed and tested.
This article presents a framework and offers examples of one approach, predictive modeling within a virtual educational system that can include…. Collaborative and international scientific efforts continue to be of increasing importance in the development of successful educational and research programs. The goal of our study abroad program, Neuroscience Seminar in Germany, is to bring this fact to light for undergraduates and make them aware of the global opportunities that exist in the neurosciences and related biological sciences.
This course combined the historical foundations of neuroscience in Germany with current research programs at these two prominent German research universities. Two weeks were spent at each location and faculty members from the participating universities provided seminars, laboratory exercises, demonstrations and tours. Students were presented with background reading and lecture material prior to the seminars and activities.
Additionally, they were responsible for leading seminar-style class discussions through brief presentations and submitting written critical analyses of primary research papers associated with the laboratory exercises.
These assignments provided a means to assess learning outcomes, coupled with course evaluations. Overall, this experience may serve as a template for those interested in study abroad course development and research opportunities in the neurosciences.
Neuroscience study abroad: developing a short-term summer course. The "Vision and Change in Undergraduate Biology Education " reports cite the critical role of professional societies in undergraduate life science education and, since , have called for the increased involvement of professional societies in support of undergraduate education. Our study explored the level of support being provided by…. Within the emerging field of educational neuroscience , concerns exist that the impact of neuroscience research on education has been less effective than hoped.
In seeking a way forward, it may be useful to consider the problems of integrating two complex fields in the context of disciplinary boundaries. Here, a boundary perspective is used as a…. Matyas et al. This article is distributed by The American Society for Cell Biology under license from the author s.
It is available to the public under an Attribution—Noncommercial—Share Alike 3. Competence, competency-based education , and undergraduate dental education : a discussion paper. The aim of undergraduate dental education is to provide competent dentists to serve societal needs and improve population oral healthcare. Competency-based education has influenced the development of dental education for decades but this term is problematic.
This article explores components of competency-based undergraduate health professional education in order to help the dental profession have a better understanding of the context and purposes of undergraduate dental education.
This is a discussion paper based on a wide reading of the literature on the education of health professionals with a specific focus on competency-based undergraduate education. Competence comprises an integration of knowledge, skills and attitudes indicating a capability to perform professional tasks safely and ethically. The process of becoming a competent practitioner is complex. Four characteristics of competency-based education are: curriculum components and content shaped by societal needs; focused on student-centred learning; learning achievement; and limited attention to time-based training and numerical targets.
Alongside a competency-based approach, undergraduate dental education can be influenced by institutional features and external factors but these receive little consideration in the literature. Understanding competence, competency-based education , and institutional and external factors will help to improve educational quality, define roles and professional development for the dental educator , and inform further research. Recently, an interest in creativity education has increased globally.
Cognitive neuroscience research of creativity has provided possible implications for education , yet few literary reviews that bridge the brain and education studies have been published. This article first introduces the definitions and behavioral measures of creativity from…. Humanities in undergraduate medical education : a literature review.
Humanities form an integral part of undergraduate medical curricula at numerous medical schools all over the world, and medical journals publish a considerable quantity of articles in this field. The aim of this study was to determine the extent to which the literature on humanities in undergraduate medical education seeks to provide evidence of a long-term impact of this integration of humanities in undergraduate medical education.
Medline was searched for publications concerning the humanities in undergraduate medical education appearing from January to December All articles were manually sorted by the authors. Two hundred forty-five articles were included in the study. Following a qualitative analysis, the references included were categorized as "pleading the case," "course descriptions and evaluations," "seeking evidence of long-term impact," or "holding the horses. Only 9 articles provided evidence of attempts to document long-term impacts using diverse test tools, and 10 articles presented relatively reserved attitudes toward humanities in undergraduate medical education.
Evidence on the positive long-term impacts of integrating humanities into undergraduate medical education is sparse. This may pose a threat to the continued development of humanities-related activities in undergraduate medical education in the context of current demands for evidence to demonstrate educational effectiveness.
Physical education PE undergraduate programs in higher education in China have evolved over the last years.
The large number of students who have completed a physical education…. The Neuroscience of Mathematical Cognition and Learning. The synergistic potential of cognitive neuroscience and education for efficient learning has attracted considerable interest from the general public, teachers, parents, academics and policymakers alike.
This review is aimed at providing 1 an accessible and general overview of the research progress made in cognitive neuroscience research in…. Much attention has been given to "bridging the gap" between neuroscience and educational practice. In order to gain better understanding of the nature of this gap and of possibilities to enable the linking process, we have taken a boundary perspective on these two fields and the brain-based learning approach, focusing on….
Neuropsychiatry and neuroscience education of psychiatry trainees: attitudes and barriers. The American Association of Directors of Psychiatric Residency Training AADPRT Task Force on Neuropsychiatry and Neuroscience Education of Psychiatry Residents was established in with the charge to seek information about what the field of psychiatry considers the core topics in neuropsychiatry and neuroscience to which psychiatry residents should be exposed; whether there are any "competencies" in this area on which the field agrees; whether psychiatry departments have the internal capacity to teach these topics if they are desirable; and what the reception would be for "portable curricula" in neuroscience.
The task force reviewed the literature and developed a survey instrument to be administered nationwide to all psychiatry residency program directors. In , adult and child and adolescent psychiatry residency program directors responded to the survey, representing over half of all US adult and child psychiatry training directors.
Ninety-two percent were interested in access to portable neuroscience curricula. There is widespread agreement among training directors on the importance of neuropsychiatry and neuroscience knowledge to general psychiatrists but barriers to training exist, including some programs that lack faculty resources and a dearth of portable curricula in these areas.
The system used the method of adaptive exploration, in which exploration in a high fidelity graphical environment is integrated with immediate testing and feedback in repeated cycles of learning. The results of this study were that students considered the graphical learning environment to be superior to typical classroom materials used for learning neuroanatomy. Students managed the frequency and duration of study, test, and feedback in an efficient and adaptive manner.
There was a wide range of student opinion regarding the choice between a simpler and a more graphically compelling program for learning sectional anatomy.
Course outcomes were predicted by individual differences in the use of the software that reflected general work habits of the students, such as the amount of time committed to testing. The results of this introduction into the classroom are highly encouraging for development of computer-based instruction in biomedical disciplines. The growing neuroscientific understanding of the biological basis of behaviors has profound social and ethical implications. To address the need for public awareness of the consequences of these advances, we developed an undergraduate neuroethics course, Neuroscience and Society, at the University of Minnesota.
Course evolution, objectives, content, and impact are described here. To engage all students and facilitate undergraduate ethics education , this course employed daily reading, writing, and student discussion, case analysis, and team presentations with goals of fostering development of moral reasoning and judgment and introducing application of bioethical frameworks to topics raised by neuroscience.
Pre- and post-course Defining Issues Test DIT scores and student end-of-course reflections demonstrated that course objectives for student application of bioethical frameworks to neuroethical issues were met.
The active-learning, student-centered pedagogical approaches used to achieve these goals serve as a model for how to effectively teach neuroethics at the undergraduate level. Neuromyths are misconceptions about brain research and its application to education and learning. Previous research has shown that these myths may be quite pervasive among educators , but less is known about how these rates compare to the general public or to individuals who have more exposure to neuroscience. This study is the first to use a large sample from the United States to compare the prevalence and predictors of neuromyths among educators , the general public, and individuals with high neuroscience exposure.
Neuromyth survey responses and demographics were gathered via an online survey hosted at TestMyBrain. The two most commonly endorsed neuromyths across all groups were related to learning styles and dyslexia. More accurate performance on neuromyths was predicted by age being younger , education having a graduate degree , exposure to neuroscience courses, and exposure to peer-reviewed science.
These findings suggest that training in education and neuroscience can help reduce but does not eliminate belief in neuromyths. We discuss the possible underlying roots of the most prevalent neuromyths and implications for classroom practice. These empirical results can be useful for developing comprehensive training modules for educators that target general. Anwar, Khurshid; Shaikh, Abdul A.
Methods In this study, students of year-three neuroscience block were divided into seven male and seven female groups, comprising 11—12 students in each group. Results We found that students who attended TBL sessions performed better in the summative examinations as compared to those who did not. Students generally elicited a favorable response regarding the TBL process, as well as expressed satisfaction with the content covered and felt that such activities led to.
Scientific writing is an important communication and learning tool in neuroscience , yet it is a skill not adequately cultivated in introductory undergraduate science courses.
Proficient, confident scientific writers are produced by providing specific knowledge about the writing process, combined with a clear student understanding about how to think about writing also known as metacognition. We developed a rubric for evaluating scientific papers and assessed different methods of using the rubric in inquiry-based introductory biology classrooms. Students were either 1 given the rubric alone, 2 given the rubric, but also required to visit a biology subject tutor for paper assistance, or 3 asked to self-grade paper components using the rubric.
Students who were required to use a peer tutor had more negative attitudes towards scientific writing, while students who used the rubric alone reported more confidence in their science writing skills by the conclusion of the semester. Overall, students rated the use of an example paper or grading rubric as the most effective ways of teaching scientific writing, while rating peer review as ineffective.
Our paper describes a concrete, simple method of infusing scientific writing into inquiry-based science classes, and provides clear avenues to enhance communication and scientific writing skills in entry-level classes through the use of a rubric or example paper, with the goal of producing students capable of performing at a higher level in upper level neuroscience classes and independent research.
Internationalizing undergraduate psychology education : Trends, techniques, and technologies. How can we best internationalize undergraduate psychology education in the United States and elsewhere? This question is more timely than ever, for at least 2 reasons: Within the United States, educators and students seek greater contact with psychology programs abroad, and outside the United States, psychology is growing apace, with educators and students in other nations often looking to U.
In this article, we outline international developments in undergraduate psychology education both in the United States and abroad, and analyze the dramatic rise of online courses and Internet-based technologies from an instructional and international point of view.
Building on the recommendations of the APA Working Group on Internationalizing the Undergraduate Psychology Curriculum, we then advance 14 recommendations on internationalizing undergraduate psychology education --for students, faculty, and institutions. Background: The "seductive allure of neuroscience explanations" SANE is the finding that people overweight psychological arguments when framed in terms of neuroscience findings. Aim: This study extended this finding to arguments concerning the application of psychological findings to educational topics.
Pathways program usafa blackboard mdc. The Collection of Papers - The Higher Learning Commission
The results of this study were that students considered the graphical learning environment to be superior to typical classroom materials used for learning neuroanatomy. We hypothesised that using seminal research papers as a teaching tool in a flipped classroom setting would model for neuroscience students what it means to think like a research scientist, would provide an opportunity for them to develop their causal reasoning skills and allow them to become more comfortable with the nature of professional practice i.
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It may have happened at the rate of molasses, but maple syrup is now known and loved far beyond the pocket of the northeast. Food rations during WWII give cause for northeasterners to substitute their normal sweeteners for maple syrup and maple sugar. A multitude of technological advances in this decade increases the efficiency of the maple syrup production process. First feared as an instance of chemical warfare, the mysterious appearance of the smell of maple syrup in the streets of New York City is found to originate from a nearby food processing factory in New Jersey.
While you might use maple syrup throughout the year in and over your foods, make it a tradition to mix it up by mixing it into teas, coffees, or even mugs of hot chocolate!
You can even try out different grades with different drinks to mix it up year-to-year. While not everyone may have the privilege to do this, it is serendipitous than National Maple Syrup Day falls very close to the Christmas holidays. Approximately 40 gallons of maple sap are required to produce just one gallon of maple syrup! In , 6 millions pounds of maple syrup was stolen from the syrup stockpile held by the Federation of Quebec Maple Syrup Producers.
While authorities managed to track down dozens of people responsible for the theft, about one-third of their take is still to be recovered. Canada is the largest producer of maple syrup! Within the country, the province of Quebec is responsible for the majority of syrup output.
Pure maple syrup is produced by first extracting the somewhat sweet sap of the sugar maple tree and then concentrating the sap through a process of heating and evaporation. It depends on your flavor preference! There are four categorizations of Grade A maple syrup, and they range between golden, amber, dark, and very dark colorings with distinct flavors to match. Pure, natural maple syrup is a thinner substance; thicker syrups that some are familiar with are denser due to the use of corn syrup in the mixture with additional maple flavoring.
You can find plenty of maple syrup tapping and processing kits online! Get out there, find a tree, and collect that liquid gold! For those of you lucky enough to live in a state that produces maple syrup from native trees, get out and support your local maple syrup producers by buying a nice big jug of their finest batch!
Sure, you've tried it on your pancakes, waffles, and french toast — but have you ever let maple syrup make its way to your bacon? Don't just limit yourself to breakfast, though. Maple syrup makes an awesome glaze for all sorts of root vegetables, bringing out flavors you might have never noticed. There aren't many foods that would seem worthwhile to stage a heist around. But with barrels of maple syrup valued at over a thousand dollars each, it's easy to see why a truckload might be worth a boatload of cash.
While you might be wise to brush your teeth after having those maple syrup-soaked pancakes, it's hard not to love something that's mostly sugar! We keep track of fun holidays and special moments on the cultural calendar — giving you exciting activities, deals, local events, brand promotions, and other exciting ways to celebrate.
Holiday survey data is powered by TOP Agency. Skip to content View the calendar. Today Thursday. Any other local stamps will also be unlocked at the same time. Browse wiki. List of stamps on Slowly Location-based stamps National Flag stamps Region exclusive stamp sets Region exclusive Commemorative stamps Region exclusive Premium stamps Achievements stamps. Recent blog posts Site Staff. Explore Wikis Community Central. Don't have an account? They started complaining about the people of their country who were becoming too lazy to hunt or farm or engage in other activities.
All they wanted was to drink maple syrup directly from the maple trees. So the god cursed them. He told them that the people would only be able to enjoy maple syrup if they worked hard. That is why it takes a season to form the sap before it is extracted. The production of maple syrup can be traced back thousands of years to the northeastern region of the United States.
Maple syrup is generally extracted from the xylem sap of either sugar maple, red maple, or black maple trees. However, the process is not limited to these maple species.
These trees that store maple syrup grows in cold climate regions. Due to the weather conditions, the trees store starch in their trunk and roots.
Surya Chandrasekaran. Trevor Lawrence. Vaughn Raines Jr. Special Interest. Menu National Today. Log in Sign up. History of Canadian Maple Syrup Day There are many stories revolving around the origins of maple syrup.
Canadian Maple Syrup Day timeline. Indigenous Indian tribes of North America use maple sap for hydration instead of water. French explorer Andre Thevet documents maple syrup in his writings. Maple sap is stored in wooden buckets instead of hollow wooden logs. Canadian Maple Syrup Day recognizes the diversity of the ingredient. Will maple syrup production ever cease? What is the difference between Canadian and American maple syrup?
Share it on social media Let everyone know that you're celebrating this day. Learn more about Canadian maple syrup Use this day to improve your knowledge. Quebec is the largest producer With an annual production of 7,, gallons, Quebec is the largest producer of maple syrup globally.
Not all maple trees can produce syrups Not all species of maple trees in Canada can be used for maple syrup production. Why We Love Canadian Maple Syrup Day It allows us to appreciate this tasty syrup Maple syrups are used in almost all households as an accompaniment to breakfast.
It gives us a chance to try out something new This day gives us a chance to do something different from our monotonous daily routine. It gives us a chance to improve our knowledge This is also a day of learning. View all December holidays. Want to sponsor this holiday? Learn more. Holidays Straight to Your Inbox Every day is a holiday! Receive fresh holidays directly to your inbox. Log In With Google. About us Our Mission Our Story. Upcoming Today Tomorrow Monday.
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- National maple syrup day canada goosebumps
Just the other day I was watching several groups of geese fly in from different directions and land on the lake. Once they were settled, they formed lines and. I do not drink but this commercial is so true it gives me goosebumps. I love this country with every fibre of my body it is beautiful it is free and it is. For the second day in a row, female sporting history was made at the Niagara Canada Summer Games. Newfoundland and Labrador's Jaida Lee.
National maple syrup day canada goosebumps
Take an epic road trip on a scenic drive For better or for worse, Canada is made for driving. Canoeing or kayaking is so popular in some parts of Canada that a boat is an essential hiking accessory. This is the chance to discover remote places and true Canadian wilderness. Experience true Islander life on picturesque Prince Edward Island PEI , complete with welcoming fishing villages, red-sand beaches and beautiful craggy coastlines.