Valuing what clients think: standardized clients and the assessment of communicative competence

An international and interdisciplinary team from the Glasgow Graduate School of Law (GGSL) and the Dundee Medical School - in Scotland - and the Georgia State University College of Law (GSU) - in the United States - has undertaken an ambitious project to change the way lawyer-client communication skills are taught and assessed. Medical education in both America and Great Britain has been transformed by a new methodology for assessing competence in patient communication: the use of intensively-trained lay persons who present standardized patient scenarios to medical candidates and then assess the candidates' performance. GGSL is the site for a series of pilot projects testing whether a similar methodology using standardized clients (SCs) would be as valid, reliable and cost-effective as the current GGSL approach, which is widely used by many law schools, of having client roles played by students with assessment based on law teacher review of the interview videotape. These projects culminated in January 2006 with a graded interviewing exercise that GGSL students must pass in order eventually to he eligible for a law license. Over 250 GGSL students conducted this exercise with SCs, and the SC assessments were analyzed and com- pared with law teachers' evaluations of the interview videotapes. The results strongly indicated that assessment by SCs was sufficiently valid and reliable to be used for a high-stakes examination in legal education. As a direct result of this project, the way lawyer skills are taught and assessed is undergoing fundamental change not only at GGSL but elsewhere in Great Britain

The Making of \u3ci\u3eAlways Coming Home\u3c/i\u3e

Transcript of panel discussion from 1988 Mythopoeic Conference. Author, illustrator, composer, and cartographer/ researcher discuss the genesis of Always Coming Home

Validation Testing of Hydrogen Generation Technology

This report describes the results of testing performed by ORNL for Photech Energies, Inc. The objective of the testing was to evaluate the efficacy of Photech's hydrogen generation reactor technology, which produces gaseous hydrogen through electrolysis. Photech provided several prototypes of their proprietary reactor for testing and the ancillary equipment, such as power supplies and electrolyte solutions, required for proper operation of the reactors. ORNL measured the production of hydrogen gas (volumetric flow of hydrogen at atmospheric pressure) as a function of input power and analyzed the composition of the output stream to determine the purity of the hydrogen content. ORNL attempted measurements on two basic versions of the prototype reactors-one version had a clear plastic outer cylinder, while another version had a stainless steel outer cylinder-but was only able to complete measurements on reactors in the plastic version. The problem observed in the stainless steel reactors was that in these reactors most of the hydrogen was produced near the anodes along with oxygen and the mixed gases made it impossible to determine the amount of hydrogen produced. In the plastic reactors the production of hydrogen gas increased monotonically with input power, and the flow rates increased faster at low input powers than they did at higher input powers. The maximum flow rate from the cathode port measured during the tests was 0.85 LPM at an input power of about 1100 W, an electrolyte concentration of 20%. The composition of the flow from the cathode port was primarily hydrogen and water vapor, with some oxygen and trace amounts of carbon dioxide. An operational mode that occurs briefly during certain operating conditions, and is characterized by flashes of light and violent bubbling near the cathode, might be attributable to the combustion of hydrogen and oxygen in the electrolyte solution

Estimating the burden of minor ailment consultations in general practices and emergency departments through retrospective review of routine data in North East Scotland

Minor ailment attendances in general practices and emergency departments (EDs) place significant burden on health care resources

Effect of scavenger receptor BI antagonist ITX5061 in patients with hepatitis C virus infection undergoing liver transplantation

Hepatitis C virus (HCV) entry inhibitors have been hypothesized to prevent infection of the liver after transplantation. ITX5061 is a Scavenger Receptor B-I (SR-BI) antagonist that blocks HCV entry and infection in vitro. We assessed the safety and efficacy of ITX5061 to limit HCV infection of the graft. The study included 23 HCV infected patients undergoing liver transplantation. The first 13 "control" patients did not receive drug. The subsequent 10 patients received ITX5061 150 mg immediately pre- and post-transplant, and daily for 1 week thereafter. ITX5061 pharmacokinetics and plasma HCV RNA were quantified. Viral genetic diversity was measured by ultradeep pyrosequencing. ITX5061 was well tolerated with measurable plasma concentrations during therapy. Whilst the median HCV RNA reduction was greater in ITX treated patients at all time points in the first week after transplantation there was no difference in the overall change in the area over the HCV RNA curve in the 7-day treatment period. However, in genotype 1 infected patients treatment was associated with a sustained reduction in HCV RNA levels compared to the control group (area over the HCV RNA curve analysis, p=0.004). Ultradeep pyrosequencing revealed a complex and evolving pattern of HCV variants infecting the graft during the first week. ITX5061 significantly limited viral evolution where the median divergence between day 0 and day 7 was 3.5% in the control group compared to 0.1% in the treated group.CONCLUSIONS: ITX5061 reduces plasma HCV RNA post transplant notably in genotype 1 infected patients and slows viral evolution. Following liver transplantation the likely contribution of extrahepatic reservoirs of HCV necessitates combining entry inhibitors such as ITX5061 with inhibitors of replication in future studies. Clinicaltrials.gov NCT01292824. This article is protected by copyright. All rights reserved.</p

Rapid Wolff–Kishner reductions in a silicon carbide microreactor

Wolff–Kishner reductions are performed in a novel silicon carbide microreactor. Greatly reduced reaction times and safer operation are achieved, giving high yields without requiring a large excess of hydrazine. The corrosion resistance of silicon carbide avoids the problematic reactor compatibility issues that arise when Wolff–Kishner reductions are done in glass or stainless steel reactors. With only nitrogen gas and water as by-products, this opens the possibility of performing selective, large scale ketone reductions without the generation of hazardous waste streams.Novartis-MIT Center for Continuous ManufacturingNatural Sciences and Engineering Research Council of Canada (post-doctoral fellowship

Correspondence: Are Cognitive Functions Localizable? Colin Camerer et al. versus Marieke van Rooij and John G. Holden

The Fall 2011 issue of this journal published a two-paper section on “Neuroeconomics.” One paper, by Ernst Fehr and Antonio Rangel, clearly and concisely summarized a small part of the fast-growing literature. The second paper, “It’s about Space, It’s about Time, Neuroeconomics, and the Brain Sublime,” by Marieke van Rooij and Guy Van Orden, is beautifully written and enjoyable to read, but misleading in many critical ways. A number of economists and neuroscientists working at the intersection of the two fields shared our reaction and have signed this letter, as shown below. Some of the paper’s descriptions of empirical findings and methods in neuroeconomics are incomplete, badly out of date, or flatly wrong. In studies the authors describe in detail, their skeptical interpretations have often been refuted by published data, old and new, that they overlook

Statistical colocalization of monocyte gene expression and genetic risk variants for type 1 diabetes

One mechanism by which disease-associated DNA variation can alter disease risk is altering gene expression. However, linkage disequilibrium (LD) between variants, mostly single-nucleotide polymorphisms (SNPs), means it is not sufficient to show that a particular variant associates with both disease and expression, as there could be two distinct causal variants in LD. Here, we describe a formal statistical test of colocalization and apply it to type 1 diabetes (T1D)-associated regions identified mostly through genome-wide association studies and expression quantitative trait loci (eQTLs) discovered in a recently determined large monocyte expression data set from the Gutenberg Health Study (1370 individuals), with confirmation sought in an additional data set from the Cardiogenics Transcriptome Study (558 individuals). We excluded 39 out of 60 overlapping eQTLs in 49 T1D regions from possible colocalization and identified 21 coincident eQTLs, representing 21 genes in 14 distinct T1D regions. Our results reflect the importance of monocyte (and their derivatives, macrophage and dendritic cell) gene expression in human T1D and support the candidacy of several genes as causal factors in autoimmune pancreatic beta-cell destruction, including AFF3, CD226, CLECL1, DEXI, FKRP, PRKD2, RNLS, SMARCE1 and SUOX, in addition to the recently described GPR183 (EBI2) gene