Using Flipped Classroom Modules to Facilitate Higher Order Learning in Undergraduate Organic Chemistry.

In an ongoing effort to incorporate active learning and promote higher order learning outcomes in undergraduate organic chemistry, a hybrid ("flipped") classroom structure has been used to facilitate a series of collaborative activities in the first two courses of the lower division organic chemistry sequence. An observational study of seven classes over a five-year period reveals there is a strong correlation between performance on the in-class activities and performance on the final exam across all classes; however, a significant number of students in these courses continue to struggle on both the in-class activities and final exam. The Activity Engagement Survey (AcES) was administered in the most recent course offering included in this study, and these preliminary data suggest that students who achieved lower scores on the in-class activities had lower levels of emotional and behavioral/cognitive engagement and were less likely to work in collaborative groups. In total, these findings suggest that if students can be guided to engage more successfully with the in-class activities, they are likely to be more successful in carrying out the higher order learning required on the final exam. In addition to the analyses of student performance and engagement in the in-class activities, the implementation of the flipped classroom structure and suggestions for how student engagement in higher order learning might be improved in future iterations of the class are described herein.

A fatal respiratory complication of malaria caused by Plasmodium vivax.

BACKGROUND: Malaria is endemic and represents an important public health issue in Brazil. Knowledge of risk factors for disease progression represents an important step in preventing and controlling malaria-related complications. Reports of severe forms of Plasmodium vivax malaria are now becoming a common place, but respiratory complications are described in less than 3% of global literature on severe vivax malaria. CASE PRESENTATION: A severe respiratory case of imported vivax malaria in a previously healthy 40-year-old woman has been reported. The patient died after the fifth day of treatment with chloroquine and primaquine due to acute respiratory distress syndrome. CONCLUSIONS: Respiratory symptoms started 48 h after the initiation of anti-malarial drugs, raising the hypothesis that the drugs may have been involved in the genesis of the complication. The concept that vivax malaria is a benign disease that can sometimes result in the development of serious complications must be disseminated. This report highlights, once more, the crucial importance of malaria early diagnosis, a true challenge in non-endemic areas, where health personnel are not familiar with the disease and do not consider its diagnosis promptly.

Fatal Brazilian spotted fever in a healthy military man during field training in Rio de Janeiro city, southeastern Brazil.

Brazilian spotted fever, a zoonotic disease transmitted by ticks, is caused by Rickettsia rickettsii. We report a fulminant case of this zoonosis in a healthy 46-year-old military man in the urban region of Rio de Janeiro city, in October, 2021. Ticks and capybaras (Amblyomma sculptum, Hydrochoerus hydrochaeris, respectively) were identified in the military fields, pointing to the participation of this large synanthropic rodent, recognized as an efficient amplifier host of Rickettsia rickettsii in Brazil. As the military population is considered a risk group for spotted fever, it is necessary to alert health professionals to the importance of the early detection of the disease and its adequate management, mainly in populations that are particularly at risk of exposure to ticks, in order to avoid fatal outcomes.

Fatal Brazilian spotted fever in a healthy military man during field training in Rio de Janeiro city, southeastern Brazil

ABSTRACT Brazilian spotted fever, a zoonotic disease transmitted by ticks, is caused by Rickettsia rickettsii. We report a fulminant case of this zoonosis in a healthy 46-year-old military man in the urban region of Rio de Janeiro city, in October, 2021. Ticks and capybaras (Amblyomma sculptum, Hydrochoerus hydrochaeris, respectively) were identified in the military fields, pointing to the participation of this large synanthropic rodent, recognized as an efficient amplifier host of Rickettsia rickettsii in Brazil. As the military population is considered a risk group for spotted fever, it is necessary to alert health professionals to the importance of the early detection of the disease and its adequate management, mainly in populations that are particularly at risk of exposure to ticks, in order to avoid fatal outcomes.

Implementation of a standardised sign-up process to increase MyChart enrolment among HIV-positive patients.

Interactive patient portals are a valuable tool for engaging patients in their healthcare, with various functionalities including viewing laboratory results, refilling prescriptions and communicating directly with nurses, physicians and other healthcare providers via electronic messaging. The utility of patient portals is limited primarily from lack of patient uptake and enrolment due to a variety of factors including lack of awareness, low health literacy, poor technology mastery, lack of availability of a smartphone or computer and distrust of the security of their personal health information. We aimed to increase enrolment in the Epic (O2) MyChart patient portal among patients receiving HIV care through our Infectious Diseases clinic via a standardised sign-up protocol during their clinic visits. This intervention resulted in a modest increase in enrolled patients. However, the factors preventing a more dramatic increase in patient uptake remain unclear.

Redes alimentarias alternativas de Medellín y el Oriente de Antioquia: espacios de construcción de confianza / Alternative Food Networks in Medellin and Eastern Antioquia: Building Spaces of Trust

Antecedentes: el abastecimiento de alimentos en las ciudades es mayoritariamente dirigido por empresas transnacionales; usa circuitos largos, estimula el uso de agroquímicos en la producción de alimentos y con frecuencia no genera precios justos. Estas características han llevado a la construcción de un sector alternativo que articule nuevos mecanismos de producción, distribución y consumo de alimentos. Objetivo: describir las principales características de las redes alimentarias alternativas de Medellín y la subregión Oriente del departamento de Antioquia, sus actores, procesos y relacionamiento entre productores, distribuidores y consumidores. Materiales y métodos: estudio cualitativo de casos colectivos; se entrevistaron personas relacionadas con 15 redes alimentarias alternativas, se realizaron entrevistas semiestructuradas, observación participante en espacios de distribución y no participante en zonas de producción. Resultados: se halló en estas iniciativas el cimiento de un sistema alimentario alternativo, fundamentado en la agroecología, el comercio justo y el consumo saludable. Al ser analizadas desde los constructos teóricos del capital social, se halló que estas redes trabajan por tender puentes entre productores y consumidores y reforzar lazos entre los primeros eslabones del sistema; sin embargo, un posicionamiento más fuerte requiere fortalecer la asociatividad. Conclusiones: el naciente sector alternativo representa una oportunidad para consolidar sistemas alimentarios que contribuyan a generar capital social como bien público colectivo

Background: Food supply in cities is largely managed by multinational companies using widespread systems, promoting the use of agrochemicals in food production, and generating unfair pricing and access. These factors have led to the creation of an alternative sector highlighting new mechanisms of production, distribution, and consumption of foods. Objective: Describe the principle characteristics of alternative food networks in Medellin and the eastern sub-region of the state of Antioquia, highlighting the actors, processes, and relationships among producers, distributors, and consumers of said food products. Materials and Methods: Qualitative collective case study in which the participants were selected for interviews given their ties to 15 alternative food networks and systems. Semi-structured interviews were conducted, as well as active observation in distribution areas and passive observation in production zones. Results: The basis for healthy food systems was found in these alternative initiatives, which are based on agro-ecology, fair trade, and healthy consumption and consumerism. When analyzed from the theoretical constructs of social capital, it's seen that these networks help build ties between producers and consumers, and reinforce the bonds between the first links of these systems; however, stronger positioning is needed to strengthen these association. Conclusions: The recent advent of alternative food systems represents an opportunity to consolidate food sectors that contribute to the generation of social capital for the collective good of the population.