Feeding back to feed forward:formative assessment as a platform for effective learning

Students construct meaning through relevant learning activities (Biggs, 2003) which are largely determined by the type, amount, and timing of feedback (Carless, 2006). The aim of the present study was to develop a greater awareness and understanding of formative assessment and feedback practices and their relationship with learning. During 2011 five focus group discussions were undertaken with students and academic staff involved with a range of modules and degree pathways at a UK University. Three of the focus groups were with undergraduate students (one at each level of study), and one was with taught postgraduate students. Discussions focussed on integration of formative assessment and feedback into modules, as well as an exploration of the effectiveness of feedback on future learning. The findings revealed that in order to emphasise continuous learning – feeding back to feed forward (Rushton, 2005) – and to encourage self-regulated learning (Nicol & Macfarlane-Dick, 2006), students need to have opportunities to make mistakes and to learn from them prior to summative assessment (through formative assessment and feedback). There was also firm evidence of different approaches to learning, emphasising in particular the transitional importance of the first year of study as the foundation upon which future achievement is built

Two Steps Forward, One Step Back

In the matter of DE (an adult patient) …. and JE v (1) DE (by his litigation friend, the Official Solicitor) (2) Surrey County Council[2006] EWHC Fam 3459 (Munby J

Biomarker development for gastrointestinal and ovarian cancer: a proteomic approach

The development of new biomarkers for cancer patients would be advantageous in population screening for the early detection of cancers, pathological diagnosis, assessment of prognosis, tailoring treatment to individuals, and assessment of treatment response. With this in mind different proteomic approaches were used to identify biomarkers which could potentially aid prognosis and predict response in gastrointestinal and ovarian cancer. Raf Kinase Inhibitor Protein (RKIP) was originally purified from bovine brain extracts and named phosphatidylethanolamine-binding protein (PEBP). It has subsequently been shown to be a widely expressed and highly conserved protein. Several recent studies have suggested that RKIP may suppress metastasis in melanoma, prostate, and breast cancer, as reduction or loss of RKIP expression was observed in metastatic cell lines and metastatic tissue. In this part of the project RKIP expression was assessed by immunohistochemistry in tissue microarrays (TMA) from patients with colorectal and ovarian cancer. The results confirmed the findings of earlier studies and suggest that the level of RKIP expression is significantly and inversely associated with metastatic disease and can predict the risk of metastatic relapse in patients with no evidence of metastases at presentation. The level of RKIP expression as a prognostic factor was independent of sex, age, tumour site, mitotic index, lymphovascular invasion and tumour stage. Cytokeratin 18 (CK18) is an epithelial-specific cytokeratin that undergoes cleavage by caspases during apoptosis. Measurement of caspase-cleaved (CK18-NE) or total cytokeratin 18 (CK18) from epithelial-derived tumours could be a simple, non-invasive way to monitor or predict responses to treatment. Soluble plasma CK18-NE and CK18 were measured by ELISA from 73 patients with advanced gastrointestinal adenocarcinomas before treatment and during chemotherapy, as well as 100 healthy volunteers. Both CK18-NE and total CK18 plasma levels were significantly higher in patients compared to the healthy volunteers (p=0.015, p<0.001). The total CK18 baseline plasma levels prior to treatment were significantly higher (p=0.009) in patients who develop progressive disease than those who achieve partial response or stable disease and this correlation was confirmed in an independent validation set. The peak plasma levels of CK18 occurring in any cycle following treatment were also found to be associated with tumour response, but peak levels of CK18-NE did not reach significance (p=0.01, and p=0.07, respectively). A surface-enhanced laser desorption-ionisation mass spectrometry (SELDI-MS) pilot study on serum from 8 oesophageal cancer patients and 8 healthy volunteers revealed a novel biomarker, ~4kDa, downregulated in patients (p=0.012). An expanded 30 tumour/normal study was performed for validation which confirmed the down-regulation of this potential biomarker (p<0.0001). Attempts to identify tentatively suggested that the peptide may be inter-alpha-trypsin inhibitor heavy chain H4 precursor, which was interesting as a cleavage fragment of inter-alpha -trypsin inhibitor heavy chain H4 had been previously found to be up-regulated in patients with ovarian cancer, and down-regulated in patients with breast cancer. However, it was not possible to confidently confirm this identification. In a further part of this study, haptoglobin was found to be significantly more abundant in the serum from patients with oesophageal cancer compared to healthy volunteers. It was straightforward to isolate and identify and would be amenable to immunoassay as there are good antibodies available for confirmation. In conclusion, with the current lack of effective markers of metastatic relapse in colorectal cancer, a straightforward test like RKIP expression in the primary tumour may be a very cost-effective way to identify which patients may derive greater benefit from adjuvant treatment and closer post-operative surveillance, and in patients with advanced gastrointestinal malignancy levels of plasma CK18 are a potential marker of tumour response

Capacity choice and compulsion

The cases of Harold C, David Bennett and John Wilkinson are discussed in the context of compulsion applied in the course of psychiatric care

The role of herbivores as ecosystem engineers in Great Barrier Reef seagrass meadows

Abigail Scott studied how herbivore grazing can modify seagrass meadows in the Great Barrier Reef. She found that herbivores act as ecosystem engineers in these seagrass meadows, particularly green turtles and dugong. Abigail's results will be used to inform seagrass monitoring on the Great Barrier Reef

Exploring how different modes of governance act across health system levels to influence primary healthcare facility managers' use of information in decisionmaking: experience from Cape Town, South Africa

BACKGROUND: Governance, which includes decision-making at all levels of the health system, and information have been identified as key, interacting levers of health system strengthening. However there is an extensive literature detailing the challenges of supporting health managers to use formal information from health information systems (HISs) in their decision-making. While health information needs differ across levels of the health system there has been surprisingly little empirical work considering what information is actually used by primary healthcare facility managers in managing, and making decisions about, service delivery. This paper, therefore, specifically examines experience from Cape Town, South Africa, asking the question: How is primary healthcare facility managers’ use of information for decision-making influenced by governance across levels of the health system? The research is novel in that it both explores what information these facility managers actually use in decision-making, and considers how wider governance processes influence this information use. METHODS: An academic researcher and four facility managers worked as co-researchers in a multi-case study in which three areas of management were served as the cases. There were iterative cycles of data collection and collaborative analysis with individual and peer reflective learning over a period of three years. RESULTS: Central governance shaped what information and knowledge was valued – and, therefore, generated and used at lower system levels. The central level valued formal health information generated in the district-based HIS which therefore attracted management attention across the levels of the health system in terms of design, funding and implementation. This information was useful in the top-down practices of planning and management of the public health system. However, in facilities at the frontline of service delivery, there was a strong requirement for local, disaggregated information and experiential knowledge to make locally-appropriate and responsive decisions, and to perform the people management tasks required. Despite central level influences, modes of governance operating at the subdistrict level had influence over what information was valued, generated and used locally. CONCLUSIONS: Strengthening local level managers’ ability to create enabling environments is an important leverage point in supporting informed local decision-making, and, in turn, translating national policies and priorities, including equity goals, into appropriate service delivery practices.ISIScopu

A Geographic Information System for the African Coelacanth Ecosystem Programme

The African Coelacanth Ecosystem Programme (ACEP) Geographic Information System (GIS) has been developed to integrate, analyse and map all spatial data generated within the ACEP programme. A GIS is a multidisciplinary tool, and within ACEP the GIS has been used to integrate information from marine biology studies, oceanographic surveys, geophysical exploration as well as the observations made and footage taken from a research submersible. The core data in the GIS are based on deep marine ecosystems and the programme’s flagship species, Latimeria chalumnae (the coelacanth). Over and above the utility of the GIS as a tool for science through its considerable information storage, analysis and display capabilities, the ACEP GIS has been used for interactive environmental education purposes and to generate public awareness of the programme at various meetings, training events and conferences

Dr. Scott Ambrose, Interviewed by Lucy Ambrose, Reflects on His Time Working at Delta During 9/11

9/11 affected Dr. Ambrose professionally being that he was in the airline industry. After 9/11, the industry took a huge hit because no one felt comfortable with flying. Delta along with the other airlines had to come together to ask the government for aid and help each other out. He remembers it being a time when he saw the airlines let loose on competition and come together as an industry. Personally, he remembers just being fearful of another possible attack. Everyone felt lots of uncertainty during the time, especially the Ambrose\u27s being that they lived in a big city and had a child on the way

‘Publicity v Privacy: finding the balance’ When and how to publish reports of mental health homicide independent investigations

In 1994 the Department of Health published its guidance on the discharge of mentally disordered people and their continuing care in the community (HSG (94) 27) which established, for the first time, that when a mental health service user kills someone “it will always be necessary to hold an Inquiry which is independent of the providers involved”. The independent investigation (as these inquiries are now called) would take place after the completion of any legal proceedings and its purpose was stated to be: “To learn lessons for the future”. The independent investigation would be commissioned by the responsible strategic health authority, which would also decide on whether to publish it and, if so, in what form