Risk factors for chest infection in acute stroke: a prospective cohort study

<p><b>Background and Purpose:</b> Pneumonia is a major cause of morbidity and mortality after stroke. We aimed to determine key characteristics that would allow prediction of those patients who are at highest risk for poststroke pneumonia.</p> <p><b>Methods:</b> We studied a series of consecutive patients with acute stroke who were admitted to hospital. Detailed evaluation included the modified National Institutes of Health Stroke Scale; the Abbreviated Mental Test; and measures of swallow, respiratory, and oral health status. Pneumonia was diagnosed by set criteria. Patients were followed up at 3 months after stroke.</p> <p><b>Results:</b> We studied 412 patients, 391 (94.9%) with ischemic stroke and 21 (5.1%) with hemorrhagic stroke; 78 (18.9%) met the study criteria for pneumonia. Subjects who developed pneumonia were older (mean±SD age, 75.9±11.4 vs 64.9±13.9 years), had higher modified National Institutes of Health Stroke Scale scores, a history of chronic obstructive pulmonary disease, lower Abbreviated Mental Test scores, and a higher oral cavity score, and a greater proportion tested positive for bacterial cultures from oral swabs. In binary logistic-regression analysis, independent predictors (P<0.05) of pneumonia were age >65 years, dysarthria or no speech due to aphasia, a modified Rankin Scale score ≥4, an Abbreviated Mental Test score <8, and failure on the water swallow test. The presence of 2 or more of these risk factors carried 90.9% sensitivity and 75.6% specificity for the development of pneumonia.</p> <p><b>Conclusions:</b> Pneumonia after stroke is associated with older age, dysarthria/no speech due to aphasia, severity of poststroke disability, cognitive impairment, and an abnormal water swallow test result. Simple assessment of these variables could be used to identify patients at high risk of developing pneumonia after stroke.</p&gt

Using video and multimodal classroom interaction analysis to investigate how information, misinformation, and disinformation influence pedagogy

Misinformation is accidentally wrong and disinformation is deliberately incorrect (i.e., deception). This paper uses the Pedagogy Analysis Framework (PAF) to investigate how information, misinformation, and disinformation influence classroom pedagogy. 95 people participated (i.e., one lesson with 7-year-olds, another with 10-year-olds, and three with a class of 13-year-olds). We used four video-based methods (lesson video analysis, teacher verbal protocols, pupil group verbal protocols, and teacher interviews). 35 hours of video data (recorded 2013-2020) were analysed using Grounded Theory Methods by the researchers, the class teachers, and groups of pupils (three girls and three boys). The methodology was Straussian Grounded Theory. We present how often participants used information, misinformation, and disinformation. We illustrate how the PAF helps understand and explain information, misinformation, and disinformation in the classroom by analysing video data transcripts. In addition, we discuss participant perceptions of the status of information; overlapping information, misinformation, and disinformation; and information communication difficulties

Multimodal classroom interaction analysis using video-based methods of the pedagogical tactic of (un)grouping

Grouping of people and/or things in school can involve challenging pedagogical problems and is a recurrent issue in research literature. Grouping of pupils sometimes aids learning, but detailed video-based analysis of how teachers (and pupils) group or ungroup (termed ‘(un)grouping’) in classrooms is rare. This multimodal classroom interaction analysis study builds on previous work by exploring how the Pedagogy Analysis Framework can help untangle complicated classroom interactions involving (un)grouping and identifies sixteen types of (un)grouping. The sample size is one class of thirty pupils (10-year-olds), their class teacher, and teaching assistant. Four research methods were used (lesson video analysis, teacher verbal protocols, pupil group verbal protocols, and individual teacher interviews). Six hours of data were video recorded (managed using NVivo). Data were analysed by two educational researchers, the class teacher, and two groups of pupils (three girls and three boys). The methodology is Straussian Grounded Theory. Data were recorded in 2019. We present how often participants (un)grouped during a lesson. We propose and use a grounded theory for (un)grouping which we call the ‘Exclusion, Segregation, Integration, and Inclusion (ESII) model’. Additionally, we discuss how misinformation and disinformation can complicate analysis of (un)grouping and examine different perspectives on (un)grouping

Science and RE teachers' perspectives on the purpose of RE on the secondary school curriculum in England

Renewed interest in curriculum in English schooling over the past decade has emanated from a particular focus on the place and role of knowledge in the classroom. Significant changes in policy and examination specifications have led to changes in religious education (RE). However, little is known about teachers' perspectives on the purpose of RE. We asked teachers of science and RE what they understood as the purpose of RE on the school curriculum. Data from 10 focus groups and a survey with 276 secondary teachers demonstrated that many secondary teachers of science have a different understanding to RE teachers of the purpose of RE on the school curriculum. Findings also show a lack of consensus from RE teachers on the purpose of RE, suggesting the impact of the knowledge turn in RE is not as strong as the Ofsted Research Review implies. Findings are significant as little is known about how knowledge works across disciplinary boundaries in schools. If students are to come to a full understanding of how knowledge works, teachers need to have some understanding of how knowledge is being constructed and utilised in other curriculum subjects. Knowledge of the intended purpose of RE is important for respectful co-existence of subjects on the curriculum and essential when RE is declining as a subject in secondary schools

Science religion encounters, epistemic trespass, neighbourliness and overlapping domains: theorisation and quantitative evidence of extent

This study advances a concept of science religion encounter (SRE), with preliminary theorisation and shares findings on the extent and nature of such encounters reported by secondary religious education and science teachers. SREs are interdisciplinary engagements in classrooms involving subject knowledge from more than one subject. The researchers hypothesised they may arise unexpectedly, when a pupil asks a question, or be teacher-planned and intended. This article further elaborates the concept of SRE with reference to the concepts of ‘epistemic trespassing’ (ET), epistemic neighbourliness, and overlapping domains, introducing these to the field of education. The study is contextualised in the school classroom with quantitative data gathered among beginning and experienced teachers measuring whether this ET in SRE topics enter the classroom via ‘spontaneity’ or via a ‘deliberateness’. This clarifies the different roles a teacher may play and offers considerations for teacher development when navigating an SRE in ways that potentially reduce lost learning

Making sense of big questions that require multiple subjects: preliminary theorisation of an integrative philosophy of knowledge and empirical indications of a lack of subject connection within school curricula

This paper provides theorisation about a novel concept for education: an integrative philosophy of knowledge (IPK). This is proposed for school curricula to relate multiple subjects to big questions of personal and existential importance. Critical contemporary issues such as climate change education require multiple subject contributions but there is little clarity in the English education guidance on this drawing together, beyond the encouragement to do so in priority areas. Leading British thinkers have engaged the idea of the unity of knowledge, not without difficulty and criticism. The paper identifies reasons for a practical approach to consilience in school curricula. In addition to preliminary theorisation, in methodological ‘harmony’, this paper adds tentative empirical findings from a related research project that provides quantitative indications that such multi-subject connection is likely not happening. The findings are not definitive, but the perceptions of three groups of beginning and experienced teachers (secondary Religious Education (RE), secondary science and primary teachers) indicate that school curricula do not reflect an integrative approach to climate change education, and sex and relationships education, despite policy priority. A significant national survey could not detect many signs of connection. The paper speculates that RE could have a key epistemic role for the curriculum as a whole in this regard

Barriers and attitudes influencing non-engagement in a peer feedback model to inform evidence for GP appraisal

<p>Abstract</p> <p>Background</p> <p>The UK general practitioner (GP) appraisal system is deemed to be an inadequate source of performance evidence to inform a future medical revalidation process. A long-running voluntary model of external peer review in the west of Scotland provides feedback by trained peers on the standard of GP colleagues' core appraisal activities and may 'add value' in strengthening the robustness of the current system in support of revalidation. A significant minority of GPs has participated in the peer feedback model, but a clear majority has yet to engage with it. We aimed to explore the views of non-participants to identify barriers to engagement and attitudes to external peer review as a means to inform the current appraisal system.</p> <p>Methods</p> <p>We conducted semi-structured interviews with a sample of west of Scotland GPs who had yet to participate in the peer review model. A thematic analysis of the interview transcriptions was conducted using a constant comparative approach.</p> <p>Results</p> <p>13 GPs were interviewed of whom nine were males. Four core themes were identified in relation to the perceived and experienced 'value' placed on the topics discussed and their relevance to routine clinical practice and professional appraisal: 1. Value of the appraisal improvement activity. 2. Value of external peer review. 3. Value of the external peer review model and host organisation and 4. Attitudes to external peer review.</p> <p>Conclusions</p> <p>GPs in this study questioned the 'value' of participation in the external peer review model and the national appraisal system over the standard of internal feedback received from immediate work colleagues. There was a limited understanding of the concept, context and purpose of external peer review and some distrust of the host educational provider. Future engagement with the model by these GPs is likely to be influenced by policy to improve the standard of appraisal and contractual related activities, rather than a self-directed recognition of learning needs.</p

Efficacy of Online Training for Improving Camp Staff Competency

Preparing competent staff is a critical issue within the camp community. This quasi-experimental study examined the effectiveness of an online course for improving staff competency in camp healthcare practices among college-aged camp staff and a comparison group (N = 55). We hypothesized that working in camp would increase competency test scores due to opportunities for staff to experientially apply knowledge learned online. Hierarchical linear modeling was used to analyse the cross-level effects of a between-individuals factor (assignment to experimental or comparison group) and within-individual effects of time (pre-test, post-test #1, and post-test #2) on online course test scores. At post-test #2, the difference in average test scores between groups was ~30 points, with the treatment group scoring lower on average than the comparison group. Factors that may have influenced these findings are explored, including fatigue and the limited durability of online learning. Recommendations for research and practice are discussed