Digital Commons Network^™

Sistema Cardiovascular- Manual De Enseñanza Para El Paciente Y La Familia Sobre Lesiones De La Médula Espinal, Thomas Jefferson University Hospital And Magee Rehabilitation

Manual de Lesión de la Médula Espinal (Español)

Introducción

Los problemas cardiovasculares afectan a todas las personas que tienen una lesión de la médula espinal. Se ha observado que son particularmente problemáticos para las personas mayores de 65 años y las personas que han tenido una lesión durante más de 30 años. Debido a que este problema afecta a muchas personas, debe abordarse en forma temprana en su proceso de rehabilitación, y durante toda su vida.

Descripción del sistema cardiovascular

El sistema cardiovascular está formado por el corazón y los vasos sanguíneos. El corazón es una bomba muscular que se encuentra en el pecho y que recibe sangre …

Nutrición- Manual De Enseñanza Para El Paciente Y La Familia Sobre Lesiones De La Médula Espinal, Thomas Jefferson University Hospital And Magee Rehabilitation

Manual de Lesión de la Médula Espinal (Español)

Introducción: por qué es importante la nutrición

La nutrición es importante para todas las personas, para mantener una buena salud. Después de una lesión de la médula espinal (SCI, por sus siglas en inglés), la nutrición puede ser incluso más importante para mejorar el bienestar general, alcanzar y mantener un peso saludable, y ayudar a regular la función intestinal y vesical. Seguir una dieta bien equilibrada puede ayudarlo a prevenir las complicaciones a largo plazo asociadas con una SCI, tales como el aumento de peso, el deterioro del estado físico y la escarificación cutánea.

Una dieta bien equilibrada puede proporcionarle …

Equipo- Manual De Enseñanza Para El Paciente Y La Familia Sobre Lesiones De La Médula Espinal, Thomas Jefferson University Hospital And Magee Rehabilitation

Manual de Lesión de la Médula Espinal (Español)

Introducción

Durante su estadía en el hospital, se le entregarán distintos equipos o se ordenarán equipos para usted. Sus terapeutas o enfermero le darán instrucciones sobre el uso, el cuidado y la reparación de estos equipos. Además, en esta sección, encontrará materiales relacionados con el equipo especializado que usted podría necesitar durante su estadía en el hospital y luego del alta hospitalaria. También hay material de referencia sobre los equipos que podría necesitar en el futuro.

Si tiene alguna pregunta sobre su equipo mientras se encuentra en el hospital, comuníquese con su terapeuta, enfermero o administrador de casos.

Como parte …

Cuestiones Psicológicas- Manual De Enseñanza Para El Paciente Y La Familia Sobre Lesiones De La Médula Espinal, Thomas Jefferson University Hospital And Magee Rehabilitation

Manual de Lesión de la Médula Espinal (Español)

Introducción

Un traumatismo súbito, como una lesión de la médula espinal, tendrá una repercusión significativa sobre usted y las personas que lo rodean. Posiblemente, algunas partes de su vida cambien mucho. Es posible que otras partes de su vida no cambien nada. Independientemente del alcance de su lesión e incapacidad, estar lesionado y tener una alteración en su vida puede plantear problemas o cambios imprevistos. Este capítulo proporciona información sobre los servicios de asistencia disponibles en Thomas Jefferson University Hospital, Magee Rehabilitation Hospital y en la comunidad.

Cómo sobrellevar una lesión de la médula espinal

Después de una lesión de …

Servicios Vocacionales- Manual De Enseñanza Para El Paciente Y La Familia Sobre Lesiones De La Médula Espinal, Thomas Jefferson University Hospital And Magee Rehabilitation

Manual de Lesión de la Médula Espinal (Español)

Introducción

Usted dispone de servicios vocacionales durante el transcurso de la rehabilitación, que lo ayudarán en el regreso al trabajo o la escuela, o le permitirán explorar opciones vocacionales y educativas. Puede comenzar a utilizar estos servicios mientras se encuentra en el hospital y puede continuar utilizándolos después de recibir el alta hospitalaria. Puede comenzar a recibir servicios vocacionales del consejero vocacional en Magee Rehabilitation Hospital y, al mismo tiempo, ser remitido al organismo estatal designado para brindar asistencia en la rehabilitación vocacional. En última instancia, podrá regresar al trabajo que realizaba antes de la lesión o emprender un nuevo …

Viajes Y Transporte- Manual De Enseñanza Para El Paciente Y La Familia Sobre Lesiones De La Médula Espinal, Thomas Jefferson University Hospital And Magee Rehabilitation

Manual de Lesión de la Médula Espinal (Español)

Introducción

El concepto de viajes y transporte incluye manejar o viajar como pasajero en un automóvil o una camioneta, o viajar en avión, autobús, tren o barco. Después de sufrir una disfunción de la médula espinal, realizar viajes de negocios o de placer puede ser una experiencia agobiante. Estar bien preparado de antemano disminuirá la tensión y hará que pueda disfrutar de su viaje.

Este capítulo le brinda sugerencias con respecto a los viajes con silla de ruedas eléctrica o manual, la compra o el alquiler de equipo médico duradero, el uso de medicamentos, cuestiones del intestino y la vejiga, …

Sistema De Atención De Seguimiento De Lesiones De La Médula Espinal, Thomas Jefferson University Hospital And Magee Rehabilitation

Manual de Lesión de la Médula Espinal (Español)

Introducción

El Sistema de Atención de Seguimiento de Lesiones de la Médula Espinal es un programa que le asistirá en su atención de por vida, una vez que se le dé el alta hospitalaria. El sistema de atención de seguimiento está estructurado con miembros de un equipo primario, que son usted y su familia, el fisioterapeuta (médico que se especializa en fisioterapia), el enfermero clínico y el administrador de casos. Los miembros del equipo disponibles para consultas incluyen fisioterapeutas, terapeutas ocupacionales, terapeutas recreativos, terapeutas del habla, dietistas, urólogos, ginecólogos, cirujanos plásticos y podólogos.

En la Clínica de Atención de Seguimiento …

Comentarios Y Opiniones- Manual De Enseñanza Para El Paciente Y La Familia Sobre Lesiones De La Médula Espinal, Thomas Jefferson University Hospital And Magee Rehabilitation

Manual de Lesión de la Médula Espinal (Español)

El personal del centro ha dedicado recientemente mucho tiempo y esfuerzo para revisar este manual. No obstante, sabemos que las personas que leen y utilizan el manual en forma activa pueden mejorarlo. Como parte de nuestro programa de mejora continua de la calidad, le solicitamos que ayude a guiar nuestros esfuerzos para mejorar el manual.

En la próxima sección del capítulo hay dos formularios. El primer formulario es un resumen por capítulo que intenta identificar aquellas áreas del manual que podrían mejorarse con un poco más de trabajo. También intentamos identificar cualquier inquietud importante que no haya sido abordada.

La …

Tabla De Contenidos- Manual De Enseñanza Para El Paciente Y La Familia Sobre Lesiones De La Médula Espinal, Thomas Jefferson University Hospital And Magee Rehabilitation

Manual de Lesión de la Médula Espinal (Español)

Tabla de contenidos para Manual de enseñanza para el paciente y la familia sobre lesiones de la médula espinal.

(41 páginas,416Kb)

Near Fatal Posterior Reversible Encephalopathy Syndrome Complicating Chronic Liver Failure And Treated By Induced Hypothermia And Dialysis: A Case Report., Rashmi Chawla, Daniel Smith, Paul E Marik

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

INTRODUCTION: Posterior reversible encephalopathy syndrome is a clinico-neuroradiological entity characterized by headache, vomiting, altered mental status, blurred vision and seizures with neuroimaging studies demonstrating white-gray matter edema involving predominantly the posterior region of the brain. CASE PRESENTATION: We report a 47-year-old Caucasian man with liver cirrhosis who developed posterior reversible encephalopathy syndrome following an upper gastrointestinal hemorrhage and who was managed with induced hypothermia for control of intracranial hypertension and continuous veno-venous hemodiafiltration for severe hyperammonemia. CONCLUSION: We believe this is the first documented case report of posterior reversible encephalopathy syndrome associated with cirrhosis as well as the first report …

Osteoarthritis Associated With Estrogen Deficiency., Jorge A Roman-Blas, Santos Castañeda, Raquel Largo, Gabriel Herrero-Beaumont

Jefferson Institute of Molecular Medicine Papers and Presentations

Osteoarthritis (OA) affects all articular tissues and finally leads to joint failure. Although articular tissues have long been considered unresponsive to estrogens or their deficiency, there is now increasing evidence that estrogens influence the activity of joint tissues through complex molecular pathways that act at multiple levels. Indeed, we are only just beginning to understand the effects of estrogen deficiency on articular tissues during OA development and progression, as well as on the association between OA and osteoporosis. Estrogen replacement therapy and current selective estrogen receptor modulators have mixed effectiveness in preserving and/or restoring joint tissue in OA. Thus, a …

Actividades De La Vida Diaria- Manual De Enseñanza Para El Paciente Y La Familia Sobre Lesiones De La Médula Espinal, Thomas Jefferson University Hospital And Magee Rehabilitation

Manual de Lesión de la Médula Espinal (Español)

Introducción

Las actividades de la vida diaria (ADL, por sus siglas en inglés) incluyen comer, beber, bañarse, asearse, vestirse e ir al baño. También incluyen los traslados funcionales, la ayuda electrónica para la vida diaria (EADL, por sus siglas en inglés) y el manejo en el hogar.

En cuanto sea adecuado, se le recomendará que realice por sí mismo tantas ADL como pueda. Es posible que necesite aprender nuevas técnicas, utilizar dispositivos de asistencia para compensar la disminución en la fuerza muscular y la amplitud de movimiento, o para compensar la disminución en la resistencia.

El entrenamiento para las ADL …

Sexualidad- Manual De Enseñanza Para El Paciente Y La Familia Sobre Lesiones De La Médula Espinal, Thomas Jefferson University Hospital And Magee Rehabilitation

Manual de Lesión de la Médula Espinal (Español)

Introducción

En esta sección, aprenderá cómo las disfunciones de la médula espinal pueden afectar la forma en que se siente respecto de usted mismo, como hombre o como mujer, y la forma en que las disfunciones de la médula espinal pueden afectar su funcionamiento en el aspecto sexual. Es posible que, en este momento, recibir información sobre la sexualidad, el funcionamiento sexual, el control de la natalidad, la disfunción eréctil y la posibilidad de tener un bebé sea importante para usted, o es posible que prefiera dejar de lado estas cuestiones y pensar al respecto en otro momento. En cualquier …

Movilidad- Manual De Enseñanza Para El Paciente Y La Familia Sobre Lesiones De La Médula Espinal, Thomas Jefferson University Hospital And Magee Rehabilitation

Manual de Lesión de la Médula Espinal (Español)

Introducción

La movilidad se define como las actividades que se requieren para pasar desde la cama hasta la silla de ruedas, moverse en la silla de ruedas, pararse y caminar. Esto se logra, en primer lugar, estabilizando la columna vertebral a través de la cirugía, la inmovilización externa (mediante ortesis, tracción o yesos) o ambas, de manera que pueda moverse en forma segura sin causar mayores daños a la médula espinal. Una vez producida la disfunción de la médula espinal, su capacidad para moverse se verá limitada debido a debilidad muscular, dispositivos para inmovilización, reposo en cama o una combinación …

Quality Improvement In Small Office Settings: An Examination Of Successful Practices., Daniel Wolfson, Elizabeth Bernabeo, Brian Leas, Shoshanna Sofaer, Gregory Pawlson, Donna Pillittere

College of Population Health Faculty Papers

BACKGROUND: Physicians in small to moderate primary care practices in the United States (U.S.) (<25>physicians) face unique challenges in implementing quality improvement (QI) initiatives, including limited resources, small staffs, and inadequate information technology systems 23,36. This qualitative study sought to identify and understand the characteristics and organizational cultures of physicians working in smaller practices who are actively engaged in measurement and quality improvement initiatives.

METHODS: We undertook a qualitative study, based on semi-structured, open-ended interviews conducted with practices (N = 39) that used performance data to drive quality improvement activities.

RESULTS: Physicians indicated that benefits to performing measurement and …

Reactive Oxygen And Nitrogen Species Induce Protein And Dna Modifications Driving Arthrofibrosis Following Total Knee Arthroplasty., Theresa A Freeman, Javad Parvizi, Craig J Della Valle, Marla J Steinbeck

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Arthrofibrosis, occurring in 3%-4% of patients following total knee arthroplasty (TKA), is a challenging condition for which there is no defined cause. The hypothesis for this study was that disregulated production of reactive oxygen species (ROS) and nitrogen species (RNS) mediates matrix protein and DNA modifications, which result in excessive fibroblastic proliferation. RESULTS: We found increased numbers of macrophages and lymphocytes, along with elevated amounts of myeloperoxidase (MPO) in arthrofibrotic tissues when compared to control tissues. MPO expression, an enzyme that generates ROS/RNS, is usually limited to neutrophils and some macrophages, but was found by immunohistochemistry to be expressed …

Feeding The Fledgling Repository: Starting An Institutional Repository At An Academic Health Sciences Library., Ann E. Koopman, Am, Daniel G. Kipnis, Msi

Academic Commons and Scott Memorial Library Staff Papers and Presentations

In 2005, the Scott Memorial Library at Thomas Jefferson University started an institutional repository (IR), the Jefferson Digital Commons (JDC) . Originally intended as a showcase for faculty scholarship, it has evolved to serve also as a university press for original journals and newsletters, and as an institutional archive. Many lessons have been learned about marketing techniques, common IR issues, and advantages of an IR for a library. IR recruitment has come to be viewed as yet another form of collection development and has been integrated into all forms of the Library's outreach. Jefferson's academic health sciences environment has proven …

Learning Resources Classroom Schedules

Learning Resources

No abstract provided.

The Interaction Of Hab18g/Cd147 With Integrin Alpha6beta1 And Its Implications For The Invasion Potential Of Human Hepatoma Cells., Jing-Yao Dai, Ke-Feng Dou, Cong-Hua Wang, Pu Zhao, Wayne Bond Lau, Ling Tao, Ya-Mei Wu, Juan Tang, Jian-Li Jiang, Zhi-Nan Chen

Department of Emergency Medicine Faculty Papers

BACKGROUND: HAb18G/CD147 plays pivotal roles in invasion by hepatoma cells, but the underlying mechanism remains unclear. Our previous study demonstrated that overexpression of HAb18G/CD147 promotes invasion by interacting with integrin alpha3beta1. However, it has never been investigated whether alpha3beta1 is solely responsible for this process or if other integrin family members also interact with HAb18G/CD147 in human hepatoma cells. METHODS: Human SMMC-7721 and FHCC98 cells were cultured and transfected with siRNA fragments against HAb18G/CD147. The expression levels of HAb18G/CD147 and integrin alpha6beta1 were determined by immunofluorescent double-staining and confocal imaging analysis. Co-immunoprecipitation and Western blot analyses were performed to examine …

Activity Loss Is Associated With Cognitive Decline In Age-Related Macular Degeneration., Barry W. Rovner, Robin J. Casten, Benjamin E. Leiby, William S. Tasman

Department of Psychiatry and Human Behavior Faculty Papers

BACKGROUND/METHODS: The objective of this study was to determine whether relinquishing cognitive, physical, and social activities is associated with an increased risk of cognitive decline in patients with age-related macular degeneration (AMD). We conducted a 3-year longitudinal study of 206 nondemented patients with AMD.

RESULTS: Twenty-three subjects (14.4%) declined cognitively. Age, sex, education, decline in visual acuity, and number of dropped activities were associated with cognitive decline; each additional dropped activity increased the risk by 58%. Subjects who relinquished three activities were 3.87 times (95% confidence interval, 1.95-7.76) more likely to become demented than subjects who relinquished no activities; those …

Unusual Fibrosclerotic Lesion Of The Laryngotracheal Complex Presenting As Subglottic Stenosis., Douglas R. Johnston, Joseph M. Curry, Raphael Rubin, Marc R. Rosen

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

We present a case report that describes the pathology, presentation, and management complexities of an unusual, destructive fibrosclerotic lesion of the laryngotracheal complex. An otherwise healthy 21-year-old man presented with a 1-year history of progressive shortness of breath and stridor. The initial examination revealed a 3-cm, grade III subglottic stenosis. Nodular fibrosis of the strap muscles, laryngotracheal cartilages, and trachea was evident. Biopsies revealed dense peritracheal desmoplastic reaction with focal erosion of cartilage. However, features diagnostic for relapsing polychondritis, desmoid tumor, or orbital pseudotumor were absent. The disease progressed to involve severe stenosis and thickening of the trachea and main …

Assessment Of Smoking Status Based On Cotinine Levels In Nasal Lavage Fluid., Mehmet Hakan Ozdener, Karen K Yee, Ryan Mcdermott, Beverly J Cowart, Aldona A Vainius, Pamela Dalton, Nancy E Rawson

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

ABSTRACT: Cotinine is a principal metabolite of nicotine with a substantially longer half-life, and cotinine levels in saliva, urine or serum are widely used to validate self-reported smoking status. The nasal cavity and olfactory system are directly exposed to tobacco smoke in smokers and in non-smokers who live with or work around smokers. However, despite the potential for a direct impact of tobacco smoke on the nasal epithelium and olfactory neurons, no prior studies have assessed cotinine levels in nasal mucus. We sought to determine whether cotinine levels in nasal lavage fluid (NLF) would provide a reasonable estimate of smoke …

Malignant Melanoma Metastatic To The Thyroid Gland: A Case Report And Review Of The Literature., Brian Kung, Md, Saba Aftab, Bs, Moira D. Wood, Md, David Rosen, Md

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

The thyroid gland is a relatively uncommon site for a secondary malignancy; even less common is a case of malignant melanoma metastatic to the thyroid. We describe the case of a 68-year-old man who presented with a neck mass in the posterior triangle. Fine-needle aspiration biopsy (FNAB) identified the mass as a malignant melanoma. The patient had had no known primary skin melanoma. He underwent a left modified radical neck dissection, and the mass was discovered to be a positive lymph node. Postoperatively, he declined to undergo radio- and chemotherapy. Eighteen months later, he returned with a diffusely enlarged thyroid. …

Microrna Expression Profiling Of Male Breast Cancer., Matteo Fassan, Raffaele Baffa, Juan P Palazzo, Joshua Lloyd, Marco Crosariol, Chang-Gong Liu, Stefano Volinia, Hannes Alder, Massimo Rugge, Carlo M Croce, Anne Rosenberg

Department of Urology Faculty Papers

INTRODUCTION : MicroRNAs (miRNAs) are a class of small noncoding RNAs that control gene expression by targeting mRNAs and triggering either translation repression or RNA degradation. Their aberrant expression may be involved in human diseases, including cancer. To test the hypothesis that there is a specific miRNA expression signature which characterizes male breast cancers, we performed miRNA microarray analysis in a series of male breast cancers and compared them with cases of male gynecomastia and female breast cancers. METHODS : Paraffin blocks were obtained at the Department of Pathology of Thomas Jefferson University from 28 male patients including 23 breast …

A Glycosylated Recombinant Human Granulocyte Colony Stimulating Factor Produced In A Novel Protein Production System (Avi-014) In Healthy Subjects: A First-In Human, Single Dose, Controlled Study., Roslyn Varki, Ed Pequignot, Mark C Leavitt, Andres Ferber, Walter K Kraft

Department of Pharmacology and Experimental Therapeutics Faculty Papers

BACKGROUND: AVI-014 is an egg white-derived, recombinant, human granulocyte colony-stimulating factor (G-CSF). This healthy volunteer study is the first human investigation of AVI-014. METHODS: 24 male and female subjects received a single subcutaneous injection of AVI-014 at 4 or 8 mcg/kg. 16 control subjects received 4 or 8 mcg/kg of filgrastim (Neupogen, Amgen) in a partially blinded, parallel fashion. RESULTS: The Geometric Mean Ratio (GMR) (90% CI) of 4 mcg/kg AVI-014/filgrastim AUC(0-72 hr) was 1.00 (0.76, 1.31) and Cmax was 0.86 (0.66, 1.13). At the 8 mcg/kg dose, the AUC(0-72) GMR was 0.89 (0.69, 1.14) and Cmax was 0.76 (0.58, …

Targeting The Cgmp Pathway To Treat Colorectal Cancer, Giovanni Mario Pitari

Department of Pharmacology and Experimental Therapeutics Faculty Papers

This presentation was given in 2009 for the Seminar Series of the Department of Molecular Physiology and Biophysics, Thomas Jefferson University (Philadelphia, PA, USA). It illustrates the role of the calcium-sensing receptor (CaR) and matrix metalloproteinase 9 (MMP-9) as critical downstream mediators of the anticancer GCC pathway in intestine.

Questa presentazione e’ stata effettuata per il Seminar Series del Dipartimento di Fisiologia Molecolare e Biofisica dell’Universita’ del Thomas Jefferson (Filadelfia, USA). La presentazione illustra l’importante ruolo del CaR ed MMP-9 come mediatori della soppressione del processo tumorale dell’intestino da parte del recettore GCC.

Elongation Factor 1 Alpha Interacts With Phospho-Akt In Breast Cancer Cells And Regulates Their Proliferation, Survival And Motility., Luisa Pecorari, Oriano Marin, Chiara Silvestri, Olivia Candini, Elena Rossi, Clara Guerzoni, Sara Cattelani, Samanta A Mariani, Francesca Corradini, Giovanna Ferrari-Amorotti, Laura Cortesi, Rita Bussolari, Giuseppe Raschellà, Massimo R Federico, Bruno Calabretta

Kimmel Cancer Center Faculty Papers

BACKGROUND: Akt/PKB is a serine/threonine kinase that has attracted much attention because of its central role in regulating cell proliferation, survival, motility and angiogenesis. Activation of Akt in breast cancer portends aggressive tumour behaviour, resistance to hormone-, chemo-, and radiotherapy-induced apoptosis and it is correlated with decreased overall survival. Recent studies have identified novel tumor-specific substrates of Akt that may provide new diagnostic and prognostic markers and serve as therapeutic targets. This study was undertaken to identify pAkt-interacting proteins and to assess their biological roles in breast cancer cells. RESULTS: We confirmed that one of the pAkt interacting proteins is …

Isolated Polyethylene Exchange Versus Acetabular Revision For Polyethylene Wear, Camilo Restrepo, Elie Ghanem, Carrie Houssock, Mathew Austin, Javad Parvizi, William J. Hozack

Department of Orthopaedic Surgery Faculty Papers

Polyethylene wear and osteolysis are not uncommon in THA mid- and long-term. In asymptomatic patients the dilemma faced by the orthopaedic surgeon is whether to revise the cup and risk damage to the supporting columns and even pelvic discontinuity or to perform isolated polyethylene exchange and risk a high rate of postoperative recurrent instability and dislocation that will necessitate further surgery. We retrospectively reviewed 62 patients (67 hips) who underwent revision arthroplasty for polywear and osteolysis. Thirty-six hips had isolated polyethylene exchange, while 31 had full acetabular revision. The minimum followup was 2 years (mean, 2.8 years; range, 2-5 years). …

Combined Effects Of Hyperglycemic Conditions And Hiv-1 Nef: A Potential Model For Induced Hiv Neuropathogenesis., Edward A Acheampong, Cassandra Roschel, Muhammad Mukhtar, Alagarsamy Srinivasan, Mohammad Rafi, Roger J Pomerantz, Zahida Parveen

Department of Neurology Faculty Papers

Hyperglycemic conditions associated with diabetes mellitus (DM) or with the use of antiretroviral therapy may increase the risk of central nervous system (CNS) disorders in HIV-1 infected patients. In support of this hypothesis, we investigated the combined effects of hyperglycemic conditions and HIV-1 accessory protein Nef on the CNS using both in vitro and in vivo models. Astrocytes, the most abundant glial cell type required for normal synaptic transmission and other functions were selected for our in vitro study. The results show that in vitro hyperglycemic conditions enhance the expression of proinflammatory cytokines including caspase-3, complement factor 3 (C3), and …

Fostering Community Of Relationships Via Online Discussion, Kellie Smith, Rn, Msn

College of Nursing Faculty Papers & Presentations

Background:

Statistics reveal that online education continues to expand in significant numbers throughout higher education. Nursing education must evolve and incorporate instructional technologies to meet the needs of the new era of tech-savvy students. An important aspect to consider for online and nursing education is creating and fostering a strong sense of community among students. Establishing a sense of community builds relationships among nursing students, assists in developing a comfort level with online course technology, is conducive to learning, and encourages reflection on learning possibilities. It has been established that online threaded discussions can encourage the growth of a learning …