Significant unexplained and unintentional weight loss was found in 45 elderly patients who were identified by computer search of the diagnostic files of seven family practice centers. We performed a case series chart review study which revealed that 24% of the 45 cases had no definitive etiology for the weight loss after two years of extensive clinical investigation. Depression was found to be the most common diagnosis made (18%) followed by cancer (16%). Only four patients died during the study period and all had cancer. The most prevalent diagnosis in this group of ambulatory elderly patients did not prove to be cancer, as often though, but rather "unexplained weight loss." CT scans were not found to be helpful as screening tests in the evaluation of weight loss. Using the data from this study, the diagnostic evaluations of elderly patients with unexplained weight loss may be more efficiently directed.
Aim/Purpose: The aim of the study was to investigate how the facilitation of a vocational lecturer (teacher) influenced the engagement of fifteen carpentry students during their learning. This facilitation occurred while the students used smartphones and mobile applications to create visual assessment ePortfolios. Background: To encourage independence and peer collaboration, when creating their visual ePortfolios, the lecturer decided to get his students to use BYOD mobile devices, and social media applications to record their learning of technical skills. His intention was to make use of the devices they brought to class, and to enable greater autonomy and flexibility in the learning process by eliminating the need for digital cameras and proprietary software they had previously been using. The lecturer also saw this as an opportunity to provide more frequent and immediate formative feedback, and to encourage students to share their work. Methodology: A Participatory Action Research design was used with fifteen certificate level students. They were guided in the use of three social media applications (apps) – Facebook, Evernote and Google Plus (G+) that they could use on their Smartphones to develop ePortfolios for assessment. Both quantitative and qualitative data was collected during four Action Cycles, and the outcomes are portrayed as a case study. Several sampling methods were used: a student pre-survey, and post-survey, observations and reflections by the lecturer, focus group interviews with students and an individual interview with the lecturer. For this article, a framework based on established factors of student engagement was used to examine the findings to establish the impact of the teacher. Contribution: This paper extends the body of research about student engagement with a focus on the importance of the teacher in supporting 21st Century vocational learning and ePortfolio assessment using mobile technologies. Findings: The majority of students were comfortable with the learning approach using the three applications and their mobile phones, and felt confident with the technologies. Overall, they found the learning approach was more convenient and made the experience easier, as well as enjoyable and fun. Students believed that mobile learning helped their learning and assisted them to connect with others. All three apps were considered easy to access. Facebook was the most preferred app with Google Plus (G+) the least liked. Evernote was favoured for its image editing and annotation features. Students responded well to the lecturer's teaching methods and the learning environment he created. He was found to be pivotal to the learning process. As a result of the lecturer’s learning and assessment design, students enhanced their achievement rates. He scaffolded their use of mobile technologies through: demonstrating and modelling each app at the start of the cycle of use, use of technologies during their learning, and by providing prompt, frequent and timely feedback on their ePortfolio work. Since he enabled them to use devices familiar to them, that is, smartphones, he helped them to develop autonomy and confidence. The lecturer was supportive and enthusiastic and encouraged students through structured and well-designed collaborative activities to engage in active learning that challenged them, and encouraged collaboration. He guided them in their learning through regularly interacting with them to provide feedback, and he also added an aspect of competitiveness to the activities to motivate them. Recommendations for Practitioners: Teaching staff are advised to seek guidance when designing learning activities using mobile technologies, and to access technical support. Cochrane’s (2014) six critical success factors for designing learning using mobile devices would assist. Also, it would be useful to carry out a needs analysis with students and other stakeholders beforehand. Recommendation for Researchers: Participatory Action Research is a robust methodology for trialling innovative learning strategies because when using this approach, researchers can be immediately responsive to the needs of the participants. Impact on Society: An understanding of the factors associated with student engagement and high self-efficacy for using mobile technologies is essential for teachers tasked with designing contemporary learning activities in today’s higher education learning environments. Encouraging the use of mobile devices that students own, and have familiarity using, helps to make learning and teaching more sustainable. Future Research: Further research is needed to measure the impact of factors associated with student engagement, on the design of student-centred learning using contemporary technologies. It would also be helpful to examine the implications of student engagement measures as predictors of excellence in teaching, and in the development of learner capability (e.g., critical thinking, social justice awareness, reasoning, etc.).
Lemierre's syndrome is an anaerobic suppurative thrombophlebitis involving the internal jugular vein secondary to oropharyngeal infection. There is only one previous case report in pregnancy which was complicated by premature delivery of an infant that suffered significant neurological damage. We present an atypical case diagnosed in the second trimester with a live birth at term. By reporting this case, we hope to increase the awareness of obstetricians to the possibility of Lemierre's syndrome when patients present with signs of unabating oropharyngeal infection and pulmonary symptoms.
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