The processfolio: a critical action research intervention designed to mitigate negative impacts of writing assessment practices on agency in a UK EAP pre-sessional context

This thesis is concerned with the interaction between assessment and agency. The context in which the research took place is an English for Academic Purposes (EAP) department of a UK university, specifically its summer pre-sessional courses which prepare and assess postgraduate international students’ academic language for their degree programmes. The specific focus of this thesis is the negative impacts of academic writing assessment practices within this context on students’ ability to a) exercise agency in learning and assessment situations b) conceptualise themselves as developing writers. The research was underpinned by a critical realist perspective, which allowed educational assessment to be seen as a layer of societal structure with the potential to enable and constrain individual and social agency. An action research methodology in iterative cycles over three consecutive years was employed to investigate and intervene. As a response to the negative impacts identified in a reconnaissance cycle in 2013, I designed and implemented a processfolio assessment for academic writing to facilitate student agency around assessment. The first intervention took place in 2014 with my own class of 14 students; the second in 2015 widened the participation to three classes (46 students) and three teachers including myself. Due to the necessity for flexibility in methods of data collection in this context, a range of methods and analysis was employed in each cycle. Data sets generated through both intervention cycles were the processfolios themselves and interviews with students and teachers. Benefits deriving from the processfolio were that students both demonstrated and reported high levels of self-efficacy and awareness of writing as a both a social practice and an individual metacognitive process. In keeping with the aims of action research underpinned by a critical realist approach to agency, the students showed a growing critical consciousness of the potential of EAP assessment to constrain or enable their understandings of writing, and their relationships with themselves, peers, teachers, and the academy. Participating teachers’ tacit assumptions about assessment practices and EAP writing pedagogies were also disrupted. Moreover, through a reflexive process, my own understanding of the original intention of the processfolio shifted. For practical and philosophical reasons, it should not be a replacement assessment tool to foster better learning behaviours. Rather, I conclude that the processfolio should be used on the pre-sessional to mitigate the negative impacts of assessment by creating conditions for a continuous dialectic between agency and structure. These findings imply that this approach to action research in assessment writing in EAP can contribute to a greater understanding of the mediating conditions which shape assessment practices

Temperature acclimatisation of swimming performance in the European Queen Scallop

The phenotypic plasticity of muscle performance and locomotory physiology allows the maintenance of essential activity capacity in the face of environmental change, and has been demonstrated in a wide phylogenetic range of eurythermal vertebrates. This study used the scallop, Aequipecten opercularis, as a model eurythermal invertebrate. Animals caught in different seasons demonstrated marked differences in their swimming performance and the relationship between, temperature and performance. When stimulated to swim at natural ranges of temperature, Winter (cold acclimatised), animals accelerated faster than autumn collected animals swimming at the same temperature (x 2 at 11degreesC) and attained higher velocities during jetting. The effects of acclimatisation were confined to the jetting phase and may be a mechanism for the maintenance of acceleration during predator-prey interactions. This is the first demonstration of the thermal acclimatisation of muscle performance in a mollusc and one of very few studies in invertebrates

Acceptance of and Adherence to a Four-Dose RTS,S/AS01 Schedule: Findings from a Longitudinal Qualitative Evaluation Study for the Malaria Vaccine Implementation Programme

Background: The WHO recommended the use of the RTS,S/AS01 malaria vaccine (RTS,S) based on a pilot evaluation in routine use in Ghana, Kenya, and Malawi. A longitudinal qualitative study was conducted to examine facilitators and barriers to uptake of a 4-dose RTS,S schedule. Methods: A cohort of 198 caregivers of RTS,S-eligible children from communities where RTS,S was provided through the pilot were interviewed three times over a ≈22-month, 4-dose schedule. The interviews examined caregiver perceptions and behaviors. Children’s vaccination history was obtained to determine dose uptake. Results: 162 caregivers remained at round 3 (R3); vaccination history was available for 152/162 children. Despite early rumors/fears, the uptake of initial doses was high, driven by vaccine trust. Fears dissipated by R2, replaced with an enthusiasm for RTS,S as caregivers perceived its safety and less frequent and severe malaria. By R3, 98/152 children had received four doses; 34 three doses; 9 one or two doses; and 11 zero doses. The health system and information barriers were important across all under-dose cases. Fears about AEFIs/safety were important in zero-, one-, and two-dose cases. Competing life/livelihood demands and complacency were found in three-dose cases. Regardless of the doses received, caregivers had positive attitudes towards RTS,S by R3. Conclusions: Findings from our study will help countries newly introducing the vaccine to anticipate and preempt reasons for delayed acceptance and missed RTS,S doses

Processfolio: uniting Academic Literacies and Critical Emancipatory Action Research for practitioner-led inquiry into EAP writing assessment

This paper reports on the design and implementation of an alternative form of writing assessment on a UK English for Academic Purposes (EAP) presessional course. The assessment, termed processfolio, was a response to research inquiry into how writing assessment in a local context negated student agency and inculcated disempowering models of teaching and learning academic writing. The project merged an Academic Literacies approach to writing (Lea and Street, 1998) with a Critical Emancipatory Action Research (Carr and Kemmis, 1986) framework and a Critical Realist(Bhaskar, 1989) perspective. Data collected from the folios and interviews with students and teachers on their experiences of the processfolio found that a small scale intervention has potential for agency to be exercised within the highly constrained context of a UK EAP pre-sessional. New directions in research are proposed which can engage students and teachers to work for change in UK EAP assessment within their internal and external constraints

Is local alcohol outlet density related to alcohol-related morbidity and mortality in Scottish cities?

Alcohol consumption may be influenced by the local alcohol retailing environment. This study is the first to examine neighbourhood alcohol outlet availability (on- and off-sales outlets) and alcohol-related health outcomes in Scotland. Alcohol-related hospitalisations and deaths were significantly higher in neighbourhoods with higher outlet densities, and off-sales outlets were more important than on-sales outlets. The relationships held for most age groups, including those under the legal minimum drinking age, although were not significant for the youngest legal drinkers (18–25 years). Alcohol-related deaths and hospitalisations were higher in more income-deprived neighbourhoods, and the gradient in deaths (but not hospitalisations) was marginally larger in neighbourhoods with higher off-sales outlet densities. Efforts to reduce alcohol-related harm should consider the potentially important role of the alcohol retail environment

International genome-wide meta-analysis identifies new primary biliary cirrhosis risk loci and targetable pathogenic pathways.

Primary biliary cirrhosis (PBC) is a classical autoimmune liver disease for which effective immunomodulatory therapy is lacking. Here we perform meta-analyses of discovery data sets from genome-wide association studies of European subjects (n=2,764 cases and 10,475 controls) followed by validation genotyping in an independent cohort (n=3,716 cases and 4,261 controls). We discover and validate six previously unknown risk loci for PBC (Pcombined<5 × 10(-8)) and used pathway analysis to identify JAK-STAT/IL12/IL27 signalling and cytokine-cytokine pathways, for which relevant therapies exist

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

A Genome-Wide Association Study of Diabetic Kidney Disease in Subjects With Type 2 Diabetes

dentification of sequence variants robustly associated with predisposition to diabetic kidney disease (DKD) has the potential to provide insights into the pathophysiological mechanisms responsible. We conducted a genome-wide association study (GWAS) of DKD in type 2 diabetes (T2D) using eight complementary dichotomous and quantitative DKD phenotypes: the principal dichotomous analysis involved 5,717 T2D subjects, 3,345 with DKD. Promising association signals were evaluated in up to 26,827 subjects with T2D (12,710 with DKD). A combined T1D+T2D GWAS was performed using complementary data available for subjects with T1D, which, with replication samples, involved up to 40,340 subjects with diabetes (18,582 with DKD). Analysis of specific DKD phenotypes identified a novel signal near GABRR1 (rs9942471, P = 4.5 x 10(-8)) associated with microalbuminuria in European T2D case subjects. However, no replication of this signal was observed in Asian subjects with T2D or in the equivalent T1D analysis. There was only limited support, in this substantially enlarged analysis, for association at previously reported DKD signals, except for those at UMOD and PRKAG2, both associated with estimated glomerular filtration rate. We conclude that, despite challenges in addressing phenotypic heterogeneity, access to increased sample sizes will continue to provide more robust inference regarding risk variant discovery for DKD.Peer reviewe