Evidence-based practice in teaching: an information perspective.

Purpose The purpose of this research is to explore UK teachers' use of research-based information, with a particular focus on issues relating to access to information in schools, information literacy, and the role of the school librarian and school library services. Design/methodology/approach The study adopts a mixed methodology. In-depth qualitative data gathered through vignette interviews ( n=28), group exercises (four groups of between three and five teachers) and a discussion forum were supplemented by quantitative data gathered through surveys of teachers ( n=312), head teachers ( n=78), school librarians ( n=78) and school library services ( n=26). Findings Teachers' professional use of research information reflects a preference for predigested information and informal sources. Although professional bodies and government departments promote the use of research by teachers and provide a range of customised web sites for information, lack of ready local access to information and lack of time were cited as major barriers to the use of research information. Teachers also revealed uncertainties and lack of confidence in their own ability to find and evaluate such information. The findings suggest scope for more targeted provision by school librarians of both information and skills to support the professional development of teachers. However, this raises issues of priorities and resources, and needs to be seen in the context of a wider change in ethos supported by senior management. The study also raises questions about teachers' own experiences and approaches to the use of information in professional learning, and how this might impact on the provision of support for their pupils and the potential for collaborative working between librarians and teachers. Research limitations/implications The qualitative aspects of the study provided a rich source of data from teachers with varying levels of experience and involvement with the use of research information. However, a low response to the teacher questionnaire survey (10.9 per cent, overall, 312 teachers) resulted in a bias towards more research-oriented teachers in that particular data set. While the data from research-oriented teachers do appear to triangulate, it is difficult to generalise to other teachers. Therefore teacher survey data have been treated with some caution and drawn on only to aid further understanding of the issues raised in interviews and group exercises. Originality/value In focusing attention on teachers' information behaviour and information literacy, this paper provides a new perspective on the issues affecting the lack of uptake of research evidence within the teaching profession, contributes to the literature on information behaviour and information literacy in professional contexts, and contributes to the understanding of factors which may have a bearing on the development of student information literacy in schools

Impact of school library services on achievement and learning in primary schools: Critical literature review of the impact of school library provision on achievement and learning in primary level students.

This critical literature review examines research linking educational attainment and school library use at primary level, and complements a review examining the links between educational achievement and school library provision at secondary level, completed at the end of 2001. The study was funded by Resource: The Council for Museums, Archives and Libraries to inform the work of the Department for Education and Skills Task Group set up to implement actions contained in the Government's response to "Empowering the Learning Community". The aim of the literature review was to examine evidence from research conducted in the UK and abroad linking learning in its widest sense, encompassing processes and attitudes, with library provision, including the type of resources, nature of access and staffing. The evidence was then analysed in relation to: its applicability to primary school libraries and Schools Library Services in England; methodologies that could be used to assess impact of library provision on learning; and any gaps in the research. There was a body of research supporting the view that primary school libraries can have a positive impact on academic achievement particularly when accompanied by appropriate action to ensure the service delivery is efficient and effective. However, much of this evidence was from countries where school librarians have a teaching qualification and more research is needed to determine the extent to which the evidence is transferable to England. There is limited research demonstrating the view that school libraries have the potential to impact on the broader aspects of learning, including vulnerable or special needs students. Where there is evidence of impact on learning, there are associated key factors of collection levels, library staffing levels and collaboration between the librarian and teacher. Training of teachers and librarians is demonstrated to raise mutual understanding of each other's contribution and roles within the school library setting. Training should include information skills development, collection mapping, planning and evaluation. There is no clear evidence to indicate the contribution made to learning by the various models of school library provision, although flexible scheduling appears to be an important factor in encouraging student use and to be effective this requires a full-time qualified librarian managing the resources. The presence of a librarian and the quality and frequency of their instructional input has an impact on learning but the relationship between this and qualifications and personal attributes and experience is less clear. School librarians who take a professional and proactive approach to their role within the school can cite evidence of their impact on teaching and learning; and are more able to reflect, self-evaluate and develop the service further. The report makes the following recommendations. 1) Research should be conducted to establish the extent of the existence of different models of library provision in primary schools. 2) Research should be conducted into the impact of the different models of library provision on student learning. 3) Research related to the National Literacy Strategy should be reviewed in relation to the use and management of library collections, selection of resources by teachers, and how such issues impact on learning. 4) Consideration needs to be given to ensure pre-service training and professional development training of both teachers and librarians addresses the need for greater understanding of their professional contributions to learning in school libraries. 5) Consideration should be given to identifying and piloting process and outcome standards appropriate for use in primary school library provision. 6) Ideally all primary schools should have the funds to support the service of a qualified full-time librarian to manage well-resourced school libraries. As the situation stands, priority should be given to identifying appropriate models for: a) training for teachers in library management and resource integration within the curriculum; b) training in curricular issues and resource integration for librarians working in Schools Library Services, Public Libraries and volunteers working in school libraries; c) ensuring that all primary schools have the support of a Schools Library Service; d) establishing close relations between Schools Library Services and education departments. 7) Once some of the above measures have been put in place, it would become more appropriate to undertake the kind of longitudinal study of impact of primary library provision on learning, based on the implementation of appropriate standards, as recommended in the previous secondary report: a) adapt the quantitative studies used in the USA for use with KS1 and KS2 SATs and pilot to establish whether the methodology is transferable to the English primary education; b) implement appropriate intervention(s) related to training and standards (see above); c) apply a qualitative evaluation of the intervention using the standards and any indicators developed. Apply the adapted Lance model again after intervention(s) to identify any impact on learning

Impact of school library services on achievement and learning: Critical literature review of the impact of school library services on achievement and learning to inform the work of the DfES Task Group set up to implement actions contained in the Governmen

This critical literature review examines research linking educational attainment and school library use at secondary level. The study was funded by Resource: The Council for Museums, Archives and Libraries to inform the work of the DfES Task Group set up to implement actions contained in the Government's response to "Empowering the Learning Community". The work was conducted during the last three months of 2001. The aims of the literature review were to examine evidence from research conducted in the UK and abroad linking learning in its widest sense, encompassing processes and attitudes, with library provision, including the type of resources, nature of access and staffing. The evidence was then analysed in relation to: its applicability to primary school libraries and Schools Library Services in England; methodologies that could be used to assess impact of library provision on learning; and any gaps in the research. There was a body of research supporting the view that school libraries can have a positive impact on academic achievement, particularly at the primary and early secondary level and with appropriate action to ensure the service delivery is efficient and effective. However, much of this evidence was from countries where school librarians also have teaching training and more research would be needed to determine the extent to which the evidence is transferable. There is limited but significant research demonstrating the view that school libraries have the potential to impact on the broader aspects of learning, including vulnerable or special needs students. Where there is evidence of impact on learning, there are associated key factors of collection levels, library staffing levels and collaboration between the librarian and teacher. Training of teachers and librarians is demonstrated to raise mutual understanding of each other's contribution and roles within the school library setting. Training should include information skills development, collection mapping, planning and evaluation. There is no clear evidence to indicate the contribution made to learning by the various models of school library provision, although flexible scheduling appears to be an important factor in encouraging student use. The presence of a librarian and the quality and frequency of their instructional input has an impact on learning but the relationship between this and qualifications and personal attributes and experience is less clear. However, school librarians who take a professional and proactive approach to their role within the school can cite evidence of their impact on teaching and learning; and are more able to reflect, self-evaluate and develop further. The report makes the following recommendations. 1) Consideration is given to the pre-service and professional development training of both teachers and librarians in order to develop greater understanding of the respective professional contributions to learning in school libraries, and to encourage reflection andincrease the ability to provide evidence. 2) Funds are made available to sustain the quality of collections. 3) Consideration should be give to whether the emphasis in developing the links between the school library and learning are more appropriately begun with the primary sector. 4) A longitudinal approach, in association with appropriate interventions, is taken to examine the impact of school libraries on learning

Neodymium isotope analyses after combined extraction of actinide and lanthanide elements from seawater and deep-sea coral aragonite

Author Posting. © American Geophysical Union, 2016. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Geochemistry, Geophysics, Geosystems 17 (2016): 232–240, doi:10.1002/2015GC006130.Isotopes of the actinide elements protactinium (Pa), thorium (Th), and uranium (U), and the lanthanide element neodymium (Nd) are often used as complementary tracers of modern and past oceanic processes. The extraction of such elements from low abundance matrices, such as seawater and carbonate, is however labor-intensive and requires significant amounts of sample material. We here present a combined method for the extraction of Pa, Th, and Nd from 5 to 10 L seawater samples, and of U, Th, and Nd from <1 g carbonate samples. Neodymium is collected in the respective wash fractions of Pa-Th and U-Th anion exchange chromatographies. Regardless of the original sample matrix, Nd is extracted during a two-stage ion chromatography, followed by thermal ionization mass spectrometry (TIMS) analysis as NdO+. Using this combined procedure, we obtained results for Nd isotopic compositions on two GEOTRACES consensus samples from Bermuda Atlantic Time Series (BATS), which are within error identical to results for separately sampled and processed dedicated Nd samples (εNd = −9.20 ± 0.21 and −13.11 ± 0.21 for 15 and 2000 m water depths, respectively; intercalibration results from 14 laboratories: εNd = −9.19 ± 0.57 and −13.14 ± 0.57). Furthermore, Nd isotope results for an in-house coral reference material are identical within analytical uncertainty for dedicated Nd chemistry and after collection of Nd from U-Th anion exchange chromatography. Our procedure does not require major adaptations to independently used ion exchange chromatographies for U-Pa-Th and Nd, and can hence be readily implemented for a wide range of applications.Funding that supported this work was received from the National Science Foundation (NSF 0752402), the Leverhulme Trust (RPG-398), the Natural Environmental Research Council (NE/J021636/1 and NE/N003861/1), the European Research Council (278705), and the Grantham Institute for Climate Change.2016-07-0

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Caring for patients with cancer in the COVID-19 era.

The current COVID-19 pandemic challenges oncologists to profoundly re-organize oncological care in order to dramatically reduce hospital visits and admissions and therapy-induced immune-related complications without compromising cancer outcomes. Since COVID-19 is a novel disease, guidance by scientific evidence is often unavailable, and impactful decisions are inevitably made on the basis of expert opinions. Here we report how the seven comprehensive cancer centers of Cancer Core Europe have organized their healthcare systems at an unprecedented scale and pace to make their operations 'pandemic proof'. We identify and discuss many commonalities, but also important local differences, and pinpoint critical research priorities to enable evidence-based remodeling of cancer care during the COVID-19 pandemic. Also, we discuss how the current situation offers a unique window of opportunity for assessing the effects of de-escalating anticancer regimens, which may fast-forward the development of more-refined and less-toxic treatments. By sharing our joint experiences, we offer a roadmap for proceeding and aim to mobilize the global research community to generate the data that are critically needed to offer the best possible care to patients