Pe(e)rfectly Skilled: proficiently skilled in legal pleas, even without a teacher?:Students’ perceptions of the effectiveness, efficiency and attractiveness of feedback variants within an online skills training method in Higher Education

This paper reports results of a qualitative study on sophomore students’ online experiences with using the Pe(e)rfectly Skilled (PS-) method to train their pleading skills at two universities (regular and distance learning university). The PS-method is an online, interactive and practice-oriented method for complex skills training, facilitating formative assessment, reflection and (self-, peer and expert) feedback through the use of (video-enhanced) analytical rubrics and self-regulation support. This method facilitates more frequent and highly structured (peer)feedback, so that students can consciously focus their practicing efforts on the mastery of specific subskills. At the same time it intends to reduce teachers’ support burden. Participating students from two different Dutch universities received either both teacher and peer feedback (TP) or only peer feedback (P) while practicing their legal presentations (‘pleas’) with the PS-method. Afterwards, groupwise as well as individual interviews were conducted with a random selection of participating students (6 TP interviews (13 students), 9 P interviews (17 students ). In these interviews, students were asked about their experiences with the overall method, focusing on its perceived effectiveness, efficiency and attractiveness. Additionally, we explored whether students who didn’t receive teacher feedback perceived the method as effective, efficient and attractive as students receiving both teacher-and-peer feedback. Moreover, their suggestions for improvements of future versions of the method were collected. Transcripts of these interviews were analysed with a coding scheme, that was first validated through an inter-rater reliability test. Results showed that in general, students perceive and experience the PS-method both as effective as well as efficient, although teacher feedback is more readily accepted than peer feedback. Moreover, students overall also enjoy working with the method. Additionally, no important differences in perceived effectiveness and attractiveness were detected related to feedback variants, although for perceived efficiency both feedback variant as well as the type of university seemed to matter

Learnings From Longitudinal Patient-Reported and Clinical Outcomes in Palliative Head and Neck Cancer Care

Objective: Patients with palliative head and neck cancer experience many symptoms in a short period of time. Longitudinal data on patient-reported outcomes in this phase are lacking. The aim of this study is to use structurally obtained patient-reported outcome data combined with clinical patient data and obtain insight in patient-reported outcomes, survival, circumstances of death, and interventions and treatment during the palliative phase in order to improve the quality of end-of-life care and patient-centered counseling. Study Design: Longitudinal observational cohort study. Setting: Tertiary cancer center. Method: Quality of life was prospectively collected using the European Organization for Research and Treatment of Cancer QLQ-C15-PAL. Tumor- and patient-specific data were retrospectively collected. Descriptive statistics, linear mixed models, and regression analyses were performed. Results: A significant deterioration was found in global health status, physical functioning, fatigue, dyspnea, appetite loss, and constipation over time. However, emotional functioning improved. Median survival was 5.1 months, and only a low percentage of in-hospital death was observed (7.8%). Higher global health status at intake was associated with prolonged survival. Conclusion: Structural measurement of patient-reported outcome together with clinical outcomes provides unique insight, which enables improvement of patient-centered counseling and care.</p

Kinetoplastids:related protozoan pathogens, different diseases

Kinetoplastids are a group of flagellated protozoans that include the species Trypanosoma and Leishmania, which are human pathogens with devastating health and economic effects. The sequencing of the genomes of some of these species has highlighted their genetic relatedness and underlined differences in the diseases that they cause. As we discuss in this Review, steady progress using a combination of molecular, genetic, immunologic, and clinical approaches has substantially increased understanding of these pathogens and important aspects of the diseases that they cause. Consequently, the paths for developing additional measures to control these “neglected diseases” are becoming increasingly clear, and we believe that the opportunities for developing the drugs, diagnostics, vaccines, and other tools necessary to expand the armamentarium to combat these diseases have never been better

What is the biological basis of pattern formation of skin lesions?

Pattern recognition is at the heart of clinical dermatology and dermatopathology. Yet, while every practitioner of the art of dermatological diagnosis recognizes the supreme value of diagnostic cues provided by defined patterns of 'efflorescences', few contemplate on the biological basis of pattern formation in and of skin lesions. Vice versa, developmental and theoretical biologists, who would be best prepared to study skin lesion patterns, are lamentably slow to discover this field as a uniquely instructive testing ground for probing theoretical concepts on pattern generation in the human system. As a result, we have at best scraped the surface of understanding the biological basis of pattern formation of skin lesions, and widely open questions dominate over definitive answer. As a symmetry-breaking force, pattern formation represents one of the most fundamental principles that nature enlists for system organization. Thus, the peculiar and often characteristic arrangements that skin lesions display provide a unique opportunity to reflect upon – and to experimentally dissect – the powerful organizing principles at the crossroads of developmental, skin and theoretical biology, genetics, and clinical dermatology that underlie these – increasingly less enigmatic – phenomena. The current 'Controversies' feature offers a range of different perspectives on how pattern formation of skin lesions can be approached. With this, we hope to encourage more systematic interdisciplinary research efforts geared at unraveling the many unsolved, yet utterly fascinating mysteries of dermatological pattern formation. In short: never a dull pattern

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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