In the LEAP-On follow-up study, after 12 months of avoiding peanuts, only 4.8% of the original peanut consumers were discovered to be allergic, compared with 18.6% of the original peanut avoiders. Full details of the studies and results were published in The New England Journal of Medicine and can be found in the following articles. Case Management Comprehensive Assessment 1 Form 470-4694 (Rev. Ad free audio capture 2 2 0 download. 1 /10) Section A: Consumer Information Consumer Name: (First, M.I., Last) Medicaid State ID#. Leap Introduction! 3 Very quick manual for people in a hurry! 3 A few more quick pointers! 4 Example Search! 4 A more detailed manual! 6 The Crumb Trail! 6 The Orange Source Menu! 8 By File Type Group! 8 The Location menu! 9 Preferred Places! 9 Standard Places! 10 Saved Places! 10 Recent Places! 10 The Date menu!
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In the current Portfolio API implementation (as at time of writing, May 2009), we're missing support for any of the available Portfolio standards. The reason for this is that during the development phase of that project (mid 2008) there wasn't a clear front runner. Autodesk flame 2020 system requirements. As I understand it, the IMS Portfolio standard is not mature and very complicated and it would have been far out of the scope of the Portfolio API project to support IMS eP.
However, the landscape has changed somewhat over the last year and LEAP2A has emerged as a very strong candidate. Mahara's upcoming 1.2 release will support importing from LEAP2A, as well as as well as other Portfolio vendors, and therefore it makes sense for Moodle to be able to export LEAP2A in order to be really useful. This doesn't mean that Moodle will never support any other Portfolio standard, it just means that it's a logical first choice.
A note on Moodle's current Portfolio export formats
At the present time, Moodle's Portfolio API exports Moodle content to a HTML respresentation. Files that have been uploaded into Moodle are kept in their native format. This is important as the 'fallback case', because HTML and files (eg PDF, etc) are supported everywhere, however, it is not actually necessarily the most useful end format to import into portfolio systems. For example, a forum post in Moodle will be exported to HTML, and become a HTML 'file' artefact in Mahara, which is essentially a non editable, rastered 'snapshot' of the content. It allows for much richer use, for a forum post in Moodle to (optionally) appear as a blog post artefact in Mahara, for example. In order to achieve this, we must export the forum post to some sort of common standard that Mahara can read. It is then up to Mahara to make decisions about what that content means inside Mahara. This takes away the impetus for Moodle to have to make decisions about what Moodle content becomes when it appears in a Portfolio application, and places it in the realm of the Portfolio application to decide (or ask the user). This is important because the same Moodle content might appear differently in different Portfolio applications.
Background to LEAP2A
LEAP2A is a simple ATOM Based standard that is well positioned as a low-barrier standard to combat some of the heavier standards out there. The basic premis is that every item is an entry, with some additional LEAP specific metadata. Content is not just defined by metadata, but also largely gains meaning based on its relation to other items.
LEAP2A is being championed by JISC in the UK and adopted by a number of Portfolio vendors.
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It is relatively simple to add LEAP2A support into Moodle.
What needs to happen in Moodle
- Agreement on a generic way to write XML, and an implementation
- LEAP2A writing library. We should keep this as simple as possible. Mahara's implementation uses Smarty and is quite specific to Mahara's infrastructure, a good end goal would be to consolidate these two libraries but it's a bit more work.
- Evaluation of the existing export locations in Moodle (canonical list here) and what the content maps to in LEAP2A if at all
- Interface between all the existing export locations in Moodle, and the LEAP2A writing library
- Support for the Mahara portfolio plugin in Moodle to send LEAP2A content to Mahara
What needs to happen in Mahara
- Changes to the Mahara import infrastructure to import LEAP2A over mnet. Mahara already supports importing files over MNET, and LEAP2A from uploade files. This does imply some refactoring of the interface between the Import plugins and the ImportTransport mechanisms.
See also
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Retrieved from 'https://docs.moodle.org/dev/index.php?title=LEAP2A_Portfolio_Implementation&oldid=14237'
Studies: Learning Early About Peanut allergy (LEAP); Persistence of Oral Tolerance to Peanut (LEAP-On)
Sponsor: NIH-National Institute of Allergy and Infectious Diseases (NIAID)
Collaborator: Immune Tolerance Network (ITN)
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Prime: Rho
Project Status: Completed
Start and End Dates: LEAP: December 2006–May 2014; LEAP-On: May 2011–May 2015 Highdesign 2017 1 0 – professional cad application.
Disease: Peanut allergy is a food allergy that produces mild to severe reactions, including hives, coughing, choking, trouble breathing, and anaphylaxis, which can be fatal if not treated immediately. Peanut allergy prevalence has doubled over the past 10 years in countries that encourage avoiding peanuts during pregnancy, lactation, and infancy. Currently, no cure exists for peanut allergy, which affects about 1.5% of young children.
Objective: The LEAP study tested the hypothesis that early introduction of peanut in the diets of children at high risk for developing peanut allergy could lead to a reduction in peanut allergy at age 5. The LEAP-On follow-up study sought to determine whether the reduction in peanut allergy among those in the peanut-consuming group would be maintained if they avoided eating peanut for 12 months.
Study Information: The LEAP study enrolled 640 infants, 4 to 11 months of age, who were considered to be at high risk for developing peanut allergy due to the presence of severe eczema and/or egg allergy at screening. They were randomized to either avoid peanut completely, as per the pediatric guidelines in place at the time, or to consume approximately 6 grams of peanut protein each week given over the course of 3 meals until the age of 5. The LEAP-On follow-up study followed 556 of the original 640 children in LEAP (both peanut eaters and avoiders) for a 12-month period of peanut avoidance.
Rho served as the statistical and data coordinating center for the ITN, providing support for statistical analysis, safety monitoring, and data management, as well as supporting study protocol and manuscript development. Rho also supported the next phase of the study, LEAP-On, which sought to determine whether the reduction in peanut allergy among those in the peanut-consuming group would be maintained if they avoided eating peanut.
Results: For the LEAP study, at 5 years of age, the group randomized to consume peanut had a rate of peanut allergy 81% lower than that of the group that avoided peanut. In the LEAP-On follow-up study, after 12 months of avoiding peanuts, only 4.8% of the original peanut consumers were discovered to be allergic, compared with 18.6% of the original peanut avoiders.
Full details of the studies and results were published in The New England Journal of Medicine and can be found in the following articles:
- “Randomized Trial of Peanut Consumption in Infants at Risk for Peanut Allergy” (LEAP study details and results): http://www.nejm.org/doi/full/10.1056/NEJMoa1414850
- “Effect of Avoidance on Peanut Allergy after Early Peanut Consumption” (LEAP-On study details and results): http://www.nejm.org/doi/full/10.1056/NEJMoa1514209
Public Health Impact: LEAP study results indicate that high-risk infants who consumed a snack containing peanut prevents them from developing the allergy. The LEAP study was the first randomized trial that prevented food allergy in a large cohort of high-risk infants. The LEAP-On follow-up study demonstrated that peanut consumption could be stopped for at least one year without impacting a child’s ability to tolerate peanut.
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Five years prior to the publication of the LEAP results, an expert panel convened by NIAID of the NIH issued a report entitled Guidelines for the Diagnosis and Management of Food Allergy in the United States. Because of a lack of definitive studies at the time, the report did not offer strategies for the prevention of peanut allergy. However, in light of the results of the LEAP trial, another expert panel was convened in 2015 to review new evidence. After reviewing the evidence, the expert panel concluded that the “early introduction of peanut will result in the prevention of peanut allergy in a large number of infants.” The expert panel developed 3 addendum guidelines to the earlier report that provide guidance to healthcare providers on the early introduction of peanuts into the diets of infants. The final document entitled Addendum Guidelines for the Prevention of Peanut Allergy in the United States: Report of the NIAID–Sponsored Expert Panel was published in January 2017. The entire report may be found at https://www.niaid.nih.gov/sites/default/files/addendum-peanut-allergy-prevention-guidelines.pdf.
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