One of the key challenges in Information Literacy (IL) teaching in higher education is ensuring student engagement. As such, active learning approaches are encouraged in order to maximise student participation and interaction with the teaching. The use of audience response systems (ARSs) is one active learning approach which is being used increasingly in IL teaching. The purpose of this study is to investigate the effectiveness of ARSs in terms of increased engagement and student learning. Previous research has explored the use of ARSs as an active learning approach in comparison to traditional lectures, but this study aims to specifically examine the effectiveness of these tools as part of an active learning pedagogy. Most existing studies have looked at a single ARS, usually clickers. With an increase in availability and functionality of online tools, and discussions at a university level about moving to a single system which makes use of students’ own devices, this study also aims to compare the effectiveness of clickers and online ARSs. A controlled study was carried out on two cohorts of medical students at Queen Mary University of London comparing the use of clickers, online response tools, or a mixture of the two, to teaching without ARSs. Class observation and student evaluation were used to measure student engagement, and quizzes and student confidence levels to measure student learning. Results of the study showed that ARSs, when used as part of an active learning pedagogy, are an effective tool in terms of increasing student engagement, and have a generally positive impact on student learning, with online tools being slightly more effective than clickers. The study provides evidence which can be used by IL practitioners to help integrate ARSs into their teaching as well as inform institutional decisions on the use of these tools.

Variants of inflammatory and immune response genes have been associated with adverse respiratory outcomes following exposure to air pollution. However, the genes involved and their associations are not well characterized, and there has been no systematic review. Thus, we conducted a review following the guidelines of the Human Genome Epidemiology Network. Six observational studies and 2 intervention studies with 14,903 participants were included (2001-2010). Six studies showed at least 1 significant gene-pollutant interaction. Meta-analysis was not possible due to variations in genes, pollutants, exposure estimates, and reported outcomes. The most commonly studied genes were tumor necrosis factor α (TNFA) (n = 6) and toll-like receptor 4 (TLR4) (n = 3). TNFA -308G>A modified the action of ozone and nitrogen dioxide on lung function, asthma risk, and symptoms; however, the direction of association varied between studies. The TLR4 single-nucleotide polymorphisms rs1927911, rs10759931, and rs6478317 modified the association of particulate matter and nitrogen dioxide with asthma. The transforming growth factor β1 (TGFB1) polymorphism -509C>T also modified the association of pollutants with asthma. This review indicates that genes controlling innate immune recognition of foreign material (TLR4) and the subsequent inflammatory response (TGFB1, TLR4) modify the associations of exposure to air pollution with respiratory function. The associations observed have biological plausibility; however, larger studies with improved reporting are needed to confirm these findings.

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ConclusionIn severe AS, there is microvascular rarefaction and loss of endothelium, which is more pronounced in patients with the most severe aortic valve narrowing. This appears to be an underlying mechanism for reduced myocardial perfusion reserve, which may be reversible post AVR.