Confidence assessment in the teaching of basic science

A scheme is described for including information about confidence in the computer‐based assessment of students. After each answer, students declare a confidence level of 1, 2, or 3. If the answer is correct, then this is the mark awarded. If not, marks of 0, ‐2, or ‐6 are awarded Students do well on this scheme if they can discriminate between when they are sure of correct answers and when they are partly guessing. In self‐assessment, students are trained to reflect on their reasoning, and to develop the skills of correct confidence judgement. The task of writing tests is simplified, since it becomes less important to ask complex questions. Simple direct questions discriminate better between students than they do with ordinary marking. Good students answer correctly with high confidence, while weak students moderate their confidence level if they know they are uncertain, or else lose heavily when they make mistakes. Preliminary data are presented from self‐assessment trials amongst medical students

Localist representation can improve efficiency for detection and counting

Almost all representations have both distributed and localist aspects, depending upon what properties of the data are being considered. With noisy data, features represented in a localist way can be detected very efficiently, and in binary representations they can be counted more efficiently than those represented in a distributed way. Brains operate in noisy environments, so the localist representation of behaviourally important events is advantageous, and fits what has been found experimentally. Distributed representations require more neurons to perform as efficiently, but they do have greater versatility

Reasonable doubt : uncertainty in education, science and law

This chapter champions the elicitation and use of probabilistic measures of uncertainty. It compares two different views (roughly corresponding, respectively, to the Bayesian and frequentist approaches to statistical inference) as to how probabilities should be used as evidence. It argues that, while the former may be a logical ideal, the latter may be more appropriate in the special circumstances of the courtroom.</p

The effectiveness of a multidisciplinary foot care program for children and adolescents with juvenile idiopathic arthritis: an exploratory trial

Objectives: To evaluate the effectiveness of multidisciplinary foot-care, and to evaluate the methodological considerations of a trial of multidisciplinary care in juvenile idiopathic arthritis. Design: Exploratory randomised controlled trial. Subjects/Patients: Children/adolescents with juvenile idiopathic arthritis and inflammatory joint disease affecting the foot/ankle. Methods: Standard medical care was compared with a 12 month program of multidisciplinary foot-care informed by musculoskeletal ultrasound. This program was centred on strict disease control through rigorous examination and interventions delivered by a team comprised of a paediatric rheumatologist, podiatrist, physiotherapist and musculoskeletal ultrasonographer. Patients were assessed on foot impairment and disability scores using the Juvenile Arthritis Foot Disability Index. Results: Forty-four participants, aged 3-17 years were randomly assigned to receive the experimental (n = 21) or usual care (n = 23) interventions. There was an overall improvement in levels of foot related impairments in both groups over 12 months. Between-group differences in change scores for the Juvenile Arthritis Foot Disability Index were not statistically significant at 6 or 12 month follow-ups. Conclusion: The integrated multidisciplinary foot care interventions described in this trial were safe, but did not improve foot impairment levels relative to usual care. This trial identified several methodological challenges including recruitment/retention, difficulties with outcome tools and potential confounders.</p

T-cell activation without proliferation in juvenile idiopathic arthritis

A study was done to determine if the differentiation and activation phenotype of T cells in synovial fluid (SF) from patients with juvenile idiopathic arthritis (JIA) is associated with T-cell proliferation in situ. Mononuclear cells were isolated from 44 paired samples of peripheral blood and SF. Differentiation and activation markers were determined on CD4 and CD8 T cells by flow cytometry. Cell-cycle analysis was performed by propidium iodide staining, and surface-marker expression was also assessed after culture of the T cells under conditions similar to those found in the synovial compartment. The majority of the T cells in the SF were CD45RO+CD45RBdull. There was greater expression of the activation markers CD69, HLA-DR, CD25 and CD71 on T cells from SF than on those from peripheral blood. Actively dividing cells accounted for less than 1% of the total T-cell population in SF. The presence or absence of IL-16 in T-cell cultures with SF or in a hypoxic environment did not affect the expression of markers of T-cell activation. T cells from the SF of patients with JIA were highly differentiated and expressed early and late markers of activation with little evidence of in situ proliferation. This observation refines and extends previous reports of the SF T-cell phenotype in JIA and may have important implications for our understanding of chronic inflammation