The shifting educational landscape: science teachers' practice during the COVID-19 pandemic through an activity theory lens.

In March 2020, the COVID-19 pandemic closed all educational institutions. Teachers were called upon to respond quickly to the needs of K-12 students. They had to learn how to navigate online learning systems while simultaneously delivering engaging inquiry-based activities in high-stakes school science courses. To understand how teachers navigated these dual tensions, we have drawn on Cultural-Historical Activity Theory (CHAT) to describe how teachers learned and mediated their professional practices to meet the educational needs of their students. We examine the rapidly changing school activity system and how these changes impacted teachers' epistemological beliefs about student engagement and evaluation. We report that teachers developed new styles and attitudes about teaching that reflected the new educational landscape imposed by the pandemic. We explore the pedagogical shifts that characterize this specific time and how the newly acquired pedagogies could find permanence in teachers' activities post-pandemic. This study reports on the experiences of ten teachers from two high schools as they adapt to change during the global pandemic. We followed the teachers' professional journey as they worked in a professional learning community to develop online practices. Professional learning meetings, semi-structured interviews, and participant journals captured teachers' successes and failures as they struggled to adapt inquiry-based science lessons to meet the challenges of teaching online. Their practices shifted as they engaged students in synchronous collaborative projects and laboratory activities, and they developed alternative formative and summative assessment practices. This study contributes to a growing body of research of teacher practice through a CHAT theoretical framework to understand teachers' professional learning during a time of change and upheaval.

From the Luttrell Psalter to the Lobster Boy: Split hand and foot awaken many facets of human nature.

A marginal illustration of a non-ambulatory child in the 14th Century Luttrell Psalter is the earliest currently identifiable image of an individual with Split Hand Split Foot with Long Bone Deficiency (SHFLD). Changes in portrayal of SHFLD over the centuries reflect changes in social perception of disabilities from pious sympathy to scientific curiosity and unfortunately also morbid fascination. Hopefully understanding of the past attitudes toward split hand and foot as reflected in art can help in moving toward acceptance of individuals with this highly visible malformation.

Delivering primary healthcare in conflict-affected settings: A review of the literature.

OBJECTIVE: Conflict is often destructive to existing services and exacerbates population health inequities and the vulner-abilities of existing healthcare. We undertook a scoping review of the literature concerning delivery of primary healthcare (PHC) in post-conflict settings. DESIGN: We undertook a scoping review of the peer-reviewed and gray literature to identify articles related to the development and delivery of PHC in post-conflict settings. We searched PubMed/Medline, Cochrane Library, Em-base/Ovid, CAB abstracts, POPLINE, and WHO.int. between January 1990 through the December end of 2017, for arti-cles in the English language. Two researchers independently assessed each article and applied inclusion criteria: refer-ring to post-conflict settings and a range of terms related to PHC or health system development. Search terms were selected by careful review of the World Health Organization's analytical framework for developing a strategy on univer-sal coverage and analysis according to the availability, accessibility, affordability, and acceptability of healthcare and further themes involving demand-side or user-side concerns. RESULTS: Findings were captured to reflect a range of conflict-affected settings and varied priorities and approaches to PHC reconstruction. Integrated immediate and longer-term strategies, involving needs-assessments, effective ad-ministration, development of institutions, and cost-efficient investment in human resources, infrastructure, and capacity building are needed to deliver expanded and equitable services, responsive to population health needs, critical to the delivery of equitable PHC. CONCLUSIONS: Scoping review of the literature may be formative in the generation of evidence-base to inform delivery of universal PHC, when applied according to context specificity of conflict-affected setting.

Qualitative study of the role of men in maternal health in resource-limited communities in western Kenya.

OBJECTIVE: To better understand the beliefs of men and women in western Kenya regarding the appropriate role of men in maternal health and to identify barriers to greater involvement. METHODS: Between June 1 and July 31, 2014, a cross-sectional qualitative study enrolled lay men, lay women, and community health workers from Kisumu and Nyamira counties in western Kenya. Semi-structured focus group discussions were conducted and qualitative approaches were utilized to analyze the transcripts and identify common themes. RESULTS: In total, 134 individuals participated in 18 focus group discussions. Participants discussed the role of men and a general consensus was recorded that it was a man's duty to protect women during pregnancy. When discussing obstacles to male involvement, female participants highlighted gender dynamics and male participants raised financial limitations. CONCLUSION: There was considerable discrepancy between how men described their roles and how they actually behaved, although educated men appeared to describe themselves as performing more supportive behaviors compared with male participants with less education. It is suggested that interventions aimed at increasing male involvement should incorporate the existing culturally sanctioned roles men perform as a foundation upon which to build, rather than attempting to construct roles that oppose prevailing norms.

Growth hormone and prolactin response to apomorphine in bipolar and unipolar depression.

BACKGROUND: It has been suggested that patients with bipolar disorder may have an increased sensitivity to dopaminergic (DA) compounds. This was investigated by measuring growth hormone (GH) or prolactin (PRL) response to apomorphine (APO), a dopamine receptor agonist, in patients with bipolar depression, unipolar depression and control subjects. METHODS: Fourteen patients in an episode of bipolar depression (BP), 15 in an episode of unipolar depression (UP) and 19 age- and gender-matched control subjects (C) participated. The growth hormone (GH) and prolactin (PRL) responses to subcutaneous administration of 0.005 or 0.008 mg/kg APO were measured over 2 h. RESULTS: The rise in GH was greater with the higher APO dose. Both the GH rise and the PRL fall following APO were similar in BP, UP and C. Neither the GH or PRL responses in BP and UP were affected by successful treatment of the depressive episode. CONCLUSION: Our findings do not indicate an altered sensitivity of DA neurones in the hypothalamic-pituitary system in either bipolar or unipolar depression.

Deep white matter hyperintensities in patients with bipolar depression, unipolar depression and age-matched control subjects.

OBJECTIVE: Hyperintensities in the white matter of the brain (DWH) and in the periventricular area (PVH) seen on magnetic resonance imaging (MRI) have been reported to be more frequent in patients with bipolar disorder (BP) than in normal subjects. To examine this further we compared MRI of patients with BP with age-matched patients with major depressive disorder (unipolar depression, UP) and healthy control subjects. METHODS: T2 weighted axial and coronal brain MRI scans were obtained from 13 patients in the depressive phase of BP, 11 with current UP and 19 age-matched control subjects. The degree of DWH and PVH present in each scan was determined using a standardized scoring method. RESULTS: The PVH ratings were similar in the three groups of subjects. However, proportionately more BP patients had higher DWH scores than either UP patients or controls. Although this difference did attain statistical significant, a main effect of age was noted. Further, subjects over the age of 50 were under-represented in the UP group. CONCLUSIONS: Notwithstanding the small total sample size and relative lack of older subjects in the UP group, the fact that almost twice as many BP patients showed more severe DWH suggests that patients with BP may be more vulnerable to develop these changes than UP patients and healthy controls.