Implementing student centred learning in a traditional tertiary environment

Background A growing trend towards providing more student centred learning experiences in tertiary education is evident in Australia. Student centred learning (SCL) requires active rather than passive learning with an emphasis on building deep learning and understanding. This places increased responsibility and accountability on the part of the student fostering an increased sense of autonomy in the learner. Interdependence between teacher and learner and mutual respect within the learner-teacher relationship are central to SCL as is a reflexive approach to the learning and teaching process on the part of both teacher and learner. Many institutions are moving towards blended and flipped classroom models of instruction encouraging such active student engagement. However, there are considerable ingrained constraints to implementing student-centred learning in universities. The traditional teaching method in tertiary education is teacher-centred with a focus on the lecturer as expert controlling dissemination of transmission-style learning where coverage of content constitutes learning. The spatial environment of many university teaching spaces reflects authority and control of the lecturer/teacher for example; lecture theatres, classrooms with rows of desks facing the front of the room. Institutional and Faculty arrangements reinforce this teacher-centred approach including class timetabling, assessment policies (largely summative) and staff workload models based on the lecture/tutorial/exam structure. The modern institutional reality is ‘massification’ and corporatisation of universities leading to high enrolment numbers, large and diverse student cohorts with reduced government funding. Economic drivers for profit and increased funding lead to reduced student contact hours and higher student/staff ratios. We face the reality that formal study is only one of multiple student commitments. Students expect an instructivist teaching model and perceive lecturer as expert and only person qualified to disseminate knowledge and assess academic performance. Students are reluctant to take on a more active learning role. We face a shift to students as ‘clients’ of universities and the educational services they pay to access and hence their expectation of a ‘return’ on their investment. Aims Our aim was to explore if student centred learning could be effectively implemented within a teacher centred learning environment as defined by these acknowledged institutional constraints? On the basis of our diverse teaching backgrounds we argue that the tutorial is the ideal place to implement student centred learning in a university environment. We explore the notion and definition of tutorials and consider the teaching and learning commonalities across many university disciplines.We provide a list of activities and strategies which require a similar amount of preparation (and essentially the same type of preparation) as classical tutorials. These strategies and activities also fit within current university settings and their identified constraints. As such, tutorials offer a way to implement student-centred learning within institutional structures that are not otherwise orientated towards this learning approac

Unsupervised automatic tracking of thermal changes in human body

An automated system for detecting and tracking of the thermal fluctuation in human body is addressed. It applies HSV based k-means clustering which initialized and controlled the points which lie on the ROI boundary. Afterward a particle filter tracked the targeted ROI in the thermal video stream. There were six subjects have voluntarily participated on these experiments. For simulating the hot spots occur during the some medical tests a controllable heater utilized close to the subjects body. The results indicated promising accuracy of the proposed approach for tracking the hot spots. However, there were some approximations (e.g. the transmittance of the atmosphere and emissivity of the fabric) which can be neglected because of independency of the proposed approach for these parameters. The approach can track the heating spots efficiently considering the movement in the subjects which provided a confidence of considerable robustness against motion-artifact usually occurs in the medical tests

Legal situation and current practice of waste incineration bottom ash utilisation in Europe

Almost 500 municipal solid waste incineration plants in the EU, Norway, and Switzerland generate about 17.6 Mt/a of incinerator bottom ash (IBA). IBA contains minerals and metals. Metals are mostly separated and sold to the scrap market and minerals are either disposed of in landfills or utilised in the construction sector. Since there is no uniform regulation for IBA utilisation at EU level, countries developed own rules with varying requirements for utilisation. As a result from a cooperation network between European experts an up-to-date overview of documents regulating IBA utilisation is presented. Furthermore, this work highlights the different requirements that have to be considered. Overall, 51 different parameters for the total content and 36 different parameters for the emission by leaching are defined. An analysis of the defined parameter reveals that leaching parameters are significantly more to be considered compared to total content parameters. In order to assess the leaching behaviour nine different leaching tests, including batch tests, up-flow percolation tests and one diffusion test (monolithic materials) are in place. A further discussion of leaching parameters showed that certain countries took over limit values initially defined for landfills for inert waste and adopted them for IBA utilisation. The overall utilisation rate of IBA in construction works is approximately 54 wt.%. It is revealed that the rate of utilisation does not necessarily depend on how well regulated IBA utilisation is, but rather seems to be a result of political commitment for IBA recycling and economically interesting circumstances

A Belgian consensus on the definition of a treat‐to‐target outcome set in psoriasis management

Objective: Treat-to-target (T2T) is an algorithm to reach a predefined outcome. Here, we define a T2T outcome for moderate-to-severe psoriasis vulgaris. Methods: Briefly, the study included a literature review, discussions with key opinion leaders, recruitment of additional dermatologists with experience in managing moderate-to-severe psoriasis, 3 eDelphi survey rounds and a patient focus group. Relevant topics were selected during discussions prior to the survey for the statements. Surveys were based on the eDelphi methodology for consensus-building using a series of statements. Consensus was defined as at least 80% of participants agreeing. A psoriasis patient focus group provided feedback on topic selection and outcome. Results: A total of 5 discussions were held, and 3 eDelphi rounds were conducted with an average of 19 participants per round. The T2T outcome was set assuming shared decision between patient and dermatologist, awareness and referral for comorbidities by the dermatologist and appropriate treatment adherence by the patient. We defined 'ideal' and 'acceptable' targets; the latter referring to conditions restricting certain drugs. The T2T outcome was multidimensional, including >= Delta PASI90/75 or PGA <= 1, itch VAS score <= 1, absence of disturbing lesions, DLQI <= 1/3, incapacity daily functioning VAS score <= 1, safety <= mild side-effects and full/mild tolerability of treatment for the ideal and acceptable target, respectively. Finally, time to achieve the T2T outcome was set at 12 weeks after initiation for all treatments. At all times, safety should not exceed the presence of mild side-effects. Conclusion: With this novel T2T composite outcome for psoriasis, clinicians and patients can make shared decisions on the treatment goals they envisage, as a guidance for future treatment steps - leading to a tight control management of the disease

A Systematic Review and Meta-Analysis of Patient Decision Aids for Socially Disadvantaged Populations:Update from the International Patient Decision Aid Standards (IDPAS)

International audienceBackground. The effectiveness of patient decision aids (PtDAs) and other shared decision-making (SDM) interventions for socially disadvantaged populations has not been well studied. Purpose. To assess whether PtDAs and other SDM interventions improve outcomes or decrease health inequalities among socially disadvantaged populations and determine the critical features of successful interventions. Data Sources. MEDLINE, CINAHL, Cochrane, Psy-cINFO, and Web of Science from inception to October 2019. Cochrane systematic reviews on PtDAs. Study Selection. Randomized controlled trials of PtDAs and SDM interventions that included socially disadvantaged populations. Data Extraction. Independent double data extraction using a standardized form and the Template for Intervention Description and Replication checklist. Data Synthesis. Twenty-five PtDA and 13 other SDM intervention trials met our inclusion criteria. Compared with usual care, PtDAs improved knowledge (mean difference = 13.91, 95% confidence interval [CI] 9.01, 18.82 [I 2 = 96%]) and patient-clinician communication (relative risk = 1.62, 95% CI 1.42, 1.84 [I 2 = 0%]). PtDAs reduced decisional conflict (mean difference = 29.59; 95% CI 218.94, 20.24 [I 2 = 84%]) and the proportion undecided (relative risk = 0.39; 95% CI 0.28, 0.53 [I 2 = 75%]). PtDAs did not affect anxiety (standardized mean difference = 0.02, 95% CI 20.22, 0.26 [I 2 = 70%]). Only 1 trial looked at clinical outcomes (hemoglobin A1C). Five of the 12 PtDA studies that compared outcomes by disadvantaged standing found that outcomes improved more for socially disadvantaged participants. No evidence indicated which intervention characteristics were most effective. Results were similar for SDM intervention trials. Limitations. Sixteen PtDA studies had an overall unclear risk of bias. Heterogeneity was high for most outcomes. Most studies only had short-term follow-up. Conclusions. PtDAs led to better outcomes among socially disadvantaged populations but did not reduce health inequalities. We could not determine which intervention features were most effective

Care Workers and Managers’ Experiences of Implementing Infection Control Guidance in an Epidemic Context: A Qualitative Study in the South East of England, during the COVID-19 Prevaccination Era

The national response to COVID-19 has had a severe impact on adult social care settings, with high mortality amongst people receiving and providing care in England. Care workers had to rapidly adapt to new infection control measures to protect themselves, their colleagues, and the people receiving care. Infection control in residential and domiciliary care is always complex, but COVID-19 infection control measures impacted exceptionally on care workers’ working and everyday lives. We undertook qualitative interviews with care workers and managers (n = 10) in residential and domiciliary care for older people in the Southeast England during the first wave of the pandemic to understand their experiences, solutions, and concerns to implement guidance in practice. Data were analysed using framework analysis, and the following eight themes were identified: (1) Increasing visibility and support for the sector; (2) the impact of negative messaging about the sector; (3) feelings of isolation; (4) accessibility and usability of guidance; (5) social care staff as agents in producing and sharing good practice; (6) managing expectations and the impact of conflicting messages in the media; (7) improving communication with hospitals; and (8) problems in the early pandemic. The findings reveal widespread concerns for the marginalisation of the sector in the policy response and the inadequacy of infection control guidance. Guidance would benefit from a better understanding of domiciliary and residential care settings. This might involve the following steps: (a) coproduction of guidance with adult social care stakeholders, including those in direct-care roles and (b) a shift away from a clinical model of infection control towards a more flexible approach that attends to the inherent variability of care settings

Optical and Near-IR Microwave Kinetic Inductance Detectors (MKIDs) in the 2020s

Optical and near-IR Microwave Kinetic Inductance Detectors, or MKIDs, are superconducting photon counting detectors capable of measuring the energy and arrival time of individual OIR photons without read noise or dark current. In this whitepaper we will discuss the current status of OIR MKIDs and MKID-based instruments.Comment: Astro2020 APC Whitepaper. 16 pages, 10 figure

Tepotinib in Non–Small-Cell Lung Cancer with MET Exon 14 Skipping Mutations

BACKGROUND: A splice-site mutation that results in a loss of transcription of exon 14 in the oncogenic driver MET occurs in 3 to 4% of patients with non-small-cell lung cancer (NSCLC). We evaluated the efficacy and safety of tepotinib, a highly selective MET inhibitor, in this patient population. METHODS: In this open-label, phase 2 study, we administered tepotinib (at a dose of 500 mg) once daily in patients with advanced or metastatic NSCLC with a confirmed MET exon 14 skipping mutation. The primary end point was the objective response by independent review among patients who had undergone at least 9 months of follow-up. The response was also analyzed according to whether the presence of a MET exon 14 skipping mutation was detected on liquid biopsy or tissue biopsy. RESULTS: As of January 1, 2020, a total of 152 patients had received tepotinib, and 99 patients had been followed for at least 9 months. The response rate by independent review was 46% (95% confidence interval [CI], 36 to 57), with a median duration of response of 11.1 months (95% CI, 7.2 to could not be estimated) in the combined-biopsy group. The response rate was 48% (95% CI, 36 to 61) among 66 patients in the liquid-biopsy group and 50% (95% CI, 37 to 63) among 60 patients in the tissue-biopsy group; 27 patients had positive results according to both methods. The investigator-assessed response rate was 56% (95% CI, 45 to 66) and was similar regardless of the previous therapy received for advanced or metastatic disease. Adverse events of grade 3 or higher that were considered by investigators to be related to tepotinib therapy were reported in 28% of the patients, including peripheral edema in 7%. Adverse events led to permanent discontinuation of tepotinib in 11% of the patients. A molecular response, as measured in circulating free DNA, was observed in 67% of the patients with matched liquid-biopsy samples at baseline and during treatment. CONCLUSIONS: Among patients with advanced NSCLC with a confirmed MET exon 14 skipping mutation, the use of tepotinib was associated with a partial response in approximately half the patients. Peripheral edema was the main toxic effect of grade 3 or higher. (Funded by Merck [Darmstadt, Germany]; VISION ClinicalTrials.gov number, NCT02864992.)

SOX2 Drives Bronchial Dysplasia in a Novel Organotypic Model of Early Human Squamous Lung Cancer

Rationale Improving the early detection and chemoprevention of lung cancer are key to improving outcomes. The pathobiology of early squamous lung cancer is poorly understood. We have shown that amplification of SOX2 is an early and consistent event in the pathogenesis of this disease but its functional oncogenic potential remains uncertain. We tested the impact of deregulated SOX2 expression in a novel organotypic system that recreates the molecular and microenvironmental context in which squamous carcinogenesis occurs. Objectives 1) To develop an in vitro model of bronchial dysplasia that recapitulates key molecular and phenotypic characteristics of the human disease 2) To test the hypothesis that SOX2 deregulation is a key early event in the pathogenesis of bronchial dysplasia 3) To use the model for studies on pathogenesis and chemoprevention Methods We engineer the inducible activation of oncogenes in immortalised bronchial epithelial cells. We use 3-dimensional tissue culture to build an organotypic model of bronchial dysplasia. Measurements and Main Results We recapitulate human bronchial dysplasia in vitro. SOX2 deregulation drives dysplasia, and loss of TP53 is a co-operating genetic event that potentiates the dysplastic phenotype. Deregulated SOX2 alters critical genes implicated in hallmarks of cancer progression. Targeted inhibition of AKT prevents the initiation of the dysplastic phenotype. Conclusion In the appropriate genetic and microenvironmental context acute deregulation of SOX2 drives bronchial dysplasia. This confirms it’s oncogenic potential in human cells and affords novel insights into the impact of SOX2 deregulation. This model can be used to test therapeutic agents aimed at chemoprevention.This work is supported by the Wellcome Trust. FM is a Wellcome Trust Intermediate Clinical Fellow (WT097143MA). TDL and GIE are supported by Cancer Research UK (C4750/A12077 and C4750/A19013). This work was also supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. PL is supported by MRC Programme Grant G1100238. RCR and DMR are supported in part by the NIHR Biomedical Research Centre in Cambridge and the Cambridge Cancer Centre