Integrated cardiovascular physiology: a laboratory exercise

Chronic, complete cervical6-7 cord transection: distinct autonomic and cardiac deficits

Spinal cord injury (SCI) resulting in tetraplegia is a devastating, life-changing insult causing paralysis and sensory impairment as well as distinct autonomic dysfunction that triggers compromised cardiovascular, bowel, bladder, and sexual activity. Life becomes a battle for independence as even routine bodily functions and the smallest activity of daily living become major challenges. Accordingly, there is a critical need for a chronic preclinical model of tetraplegia. This report addresses this critical need by comparing, for the first time, resting-, reflex-, and stress-induced cardiovascular, autonomic, and hormonal responses each week for 4 wk in 12 sham-operated intact rats and 12 rats with chronic, complete C_6-7 spinal cord transection. Loss of supraspinal control to all sympathetic preganglionic neurons projecting to the heart and vasculature resulted in a profound bradycardia and hypotension, reduced cardiac sympathetic and parasympathetic tonus, reduced reflex- and stress-induced sympathetic responses, and reduced sympathetic support of blood pressure as well as enhanced reliance on angiotensin to maintain arterial blood pressure. Histological examination of the nucleus ambiguus and stellate ganglia supports the profound and distinct autonomic and cardiac deficits and reliance on angiotensin to maintain cardiovascular stability following chronic, complete cervical_6-7 cord transection. NEW & NOTEWORTHY For the first time, resting-, reflex-, and stress-induced cardiovascular, autonomic, and hormonal responses were studied in rats with chronic, complete C_6-7 cord transection. Loss of supraspinal control of all sympathetic preganglionic neurons reduced cardiac sympathetic and parasympathetic tonus, reflex and stress-induced sympathetic responses, and sympathetic support of blood pressure as well as enhanced reliance on angiotensin to maintain arterial blood pressure. Histological examination supports the distinct deficits associated with cervical cord injury.

Continuous and noninvasive recording of cardiovascular parameters with the Finapres finger cuff enhances undergraduate student understanding of physiology

The Finapres finger cuff recording system provides continuous calculations of beat-to-beat variations in cardiac output (CO), total peripheral resistance, heart rate (HR), and blood pressure (BP). This system is unique in that it allows experimental subjects to immediately, continuously, and noninvasively visualize changes in CO at rest and during exercise. This study provides evidence that using the Finapres system improves undergraduate student engagement, understanding, and learning of how the cardiovascular system responds to exercise. Second-year science students undertaking a physiology practical class in 2009 (n = 243) and 2010 (n = 263) used the Finapres system to record CO, BP, and HR during graded exercise on a cycle ergometer. Student experiences with the Finapres was evaluated with a survey (a 5-point scale from strongly disagree to strongly agree). This indicated that students appreciated the immediacy of the recordings (88% of students agreed or strongly agreed, average for 2009 and 2010), gained an understanding of how to record physiological data (84%), enjoyed the practical (81%), and would recommend the Finapres to other students (81%). To determine if the practical enhanced student learning of cardiovascular physiology, identical tests were given to the students at the beginning (pretest) and end (posttest) of the class. There was a significant improvement from the pretest to the posttest (4% in 2009 and 20% in 2010). In summary, the ability of the Finapres to continuously display CO, BP, and HR during experimental protocols provides students with immediate feedback and improves their understanding of cardiovascular physiology.

Assessing Fit of Nontraditional Assistive Technologies

There is a variety of brain-based interface methods which depend on measuring small changes in brain signals or properties. These methods have typically been used for nontraditional assistive technology applications. Non-traditional assistive technology is generally targeted for users with severe motor disabilities which may last long-term due to illness or injury or short-term due to situational disabilities. Control of a nontraditional assistive technology can vary widely across users depending upon many factors ranging from health to experience. Unfortunately, there is no systematic method for assessing usability of nontraditional assistive technologies to achieve the best control. The current methods to accommodate users through trial-and-error result in the loss of valuable time and resources as users sometimes have diminishing abilities or suffer from terminal illnesses. This work describes a methodology for objectively measuring an individual’s ability to control a specific nontraditional assistive technology, thus expediting the technology-fit process.

Case studies in a physiology course on the autonomic nervous system: design, implementation, and evaluation

The introduction of case studies on the autonomic nervous system in a fourth-semester physiology course unit for Pharmacy students is described in this article. This article considers how these case studies were developed and presents their content. Moreover, it reflects on their implementation and, finally, the reception of such a transformation among the students as well as the tutor's perception. Specifically, the following issues were addressed. First, how were the course unit and, within the course unit, case study components organized? Second, how was the transformation of the course unit from an originally interactive but rather teacher-centered lecture to an interactive course module achieved? Third, how were the case studies structured, what questions were asked, and what were the answers expected from the students; what additional information was provided by the tutor? Fourth, how did the implementation of these case studies work out in the actual course, i.e., how did the tutor guide the students in this interactive session and how did the students tackle the problems? Finally, how was the integration of interactive modules received by the students and what was their learning experience (as assessed by questionnaires) and learning success (as assessed through the final course exam)? Equally, the tutor's perception of this transformation and its implementation is described.

Too much teaching, not enough learning: what is the solution?

The curriculum is packed with so much content that teachers resort to telling students what they know and students simply commit facts to memory. The packed curriculum leaves little time for students to acquire a deep understanding of the subject or to develop life-long skills such as critical thinking, problem solving, and communication. However, learning is not committing a set of facts to memory, but the ability to use resources to find, evaluate, and apply information. This paper addresses these concerns by discussing "how we learn" and reviewing the literature on what works to improve learning. It is clear that active processing of information, not passive reception of information, leads to learning. That is, students must construct their own understanding of concepts, relationships, and procedures. Teachers can encourage this process by carefully considering the type and organization of information as well as instructional strategies. Specifically, teachers should reduce the total amount of factual information students are expected to memorize, reduce our use of the passive lecture format, and devote much more effort to helping students become active, independent learners and problem solvers. Collaborative learning activities, interactive models, educational games, and establishing a culture of inquiry/scholarship are critical for achieving these goals.

Peer instruction enhanced meaningful learning: ability to solve novel problems

Students must be able to interpret, relate, and incorporate new information with existing knowledge and apply the new information to solve novel problems. Peer instruction is a cooperative learning technique that promotes critical thinking, problem solving, and decision-making skills. Therefore, we tested the hypothesis that peer instruction enhances meaningful learning or transfer, defined as the student's ability to solve novel problems or the ability to extend what has been learned in one context to new contexts. To test this hypothesis, our undergraduate exercise physiology class of 38 students was randomly divided into two groups: group A (n = 19) and group B (n = 19). A randomized crossover design in which students either answered questions individually or during peer instruction was used to control for time and order effects. The first factor that influences meaningful learning is the degree of mastery of the original material. Importantly, peer instruction significantly enhanced mastery of the original material. Furthermore, the student's ability to solve novel problems was significantly enhanced following peer instruction. Thus pausing two to three times during a 50-min class to allow peer instruction enhanced the mastery of the original material and enhanced meaningful learning, i.e., the student's ability to solve novel problems.