Comparing learners’ constructs using “socio-nets”: an application of repertory grid analysis

Repertory grid analysis was employed as a means of constructing representations of learners conceptions of living things (described in previous work). Experts in biology and secondary school science learners were probed for their representations of living things. Clearly, a theory is at work in the mind of the experts. The question now is: how many of the students share this theory? A record of commonality is required, and for that a social network framework is necessary. Therefore, representations were compared using the SOCIO program which measures the similarity between individuals and a visual network produced for the groups studied. This work is part of an overall project examining the learners’ innate ability to classify and categorize living things. Classification and categorization are neglected in science curricula which has implications with respect to the renewed emphasis in education on learning about biodiversity. It was found that whereas there is a commonality with respect to learners’ conceptions, the commonality is measurable and that learners often operate within a ‘pre-scientific’ or folk-biological mode, experts operate within a highly formalized mode based on their training, and that notwithstanding such a difference in modes, there remains a degree of commonality between learners and experts

Examining the structures of students' concepts using repertory grid analysis

This work attempts to explore the methodological legacy of George Kelly – repertory grid analysis – as an aid to visually mapping the structures of students’ concepts. Although, Kelly formulated a complex Euclidian framework of psychological laws, axioms, and corollaries, we have concentrated on the methods that later workers took from Kelly’s original ‘RepGrid Test’. The central entity is a self-constructed concept, or set thereof, that may be represented in a matrix. As a matrix of integers can be manipulated by a large variety of statistical protocols, we explore in three studies how such matrices may be derived in relation to students` concepts of living kinds, and then how they may be analysed. Typcially, we use principal components analysis – a model-free form of factor analysis. The resultant loadings derived from these analyses are plotted on Cartesian planes from which additional information about the structure of the students’ conceptualizations may be derived

Comparing learners’ constructs using “socio-nets”: an application of Repertory Grid Analysis

Repertory grid analysis was employed as a means of constructing representations of learners conceptions of living things (described in previous work). Experts in biology and secondary school science learners were probed for their representations of living things. Clearly, a theory is at work in the mind of the experts. The question now is: how many of the students share this theory? A record of commonality is required, and for that a social network framework is necessary. Therefore, representations were compared using the SOCIO program which measures the similarity between individuals and a visual network produced for the groups studied. This work is part of an overall project examining the learners’ innate ability to classify and categorize living things. Classification and categorization are neglected in science curricula which has implications with respect to the renewed emphasis in education on learning about biodiversity. It was found that whereas there is a commonality with respect to learners’ conceptions, the commonality is measurable and that learners often operate within a ‘pre-scientific’ or folk-biological mode, experts operate within a highly formalized mode based on their training, and that notwithstanding such a difference in modes, there remains a degree of commonality between learners and experts

Whole-genome sequencing of patients with rare diseases in a national health system

Most patients with rare diseases do not receive a molecular diagnosis and the aetiological variants and causative genes for more than half such disorders remain to be discovered1. Here we used whole-genome sequencing (WGS) in a national health system to streamline diagnosis and to discover unknown aetiological variants in the coding and non-coding regions of the genome. We generated WGS data for 13,037 participants, of whom 9,802 had a rare disease, and provided a genetic diagnosis to 1,138 of the 7,065 extensively phenotyped participants. We identified 95 Mendelian associations between genes and rare diseases, of which 11 have been discovered since 2015 and at least 79 are confirmed to be aetiological. By generating WGS data of UK Biobank participants2, we found that rare alleles can explain the presence of some individuals in the tails of a quantitative trait for red blood cells. Finally, we identified four novel non-coding variants that cause disease through the disruption of transcription of ARPC1B, GATA1, LRBA and MPL. Our study demonstrates a synergy by using WGS for diagnosis and aetiological discovery in routine healthcare

Publisher Correction: Whole-genome sequencing of a sporadic primary immunodeficiency cohort (Nature, (2020), 583, 7814, (90-95), 10.1038/s41586-020-2265-1)

An amendment to this paper has been published and can be accessed via a link at the top of the paper

Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery

Background: Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non-steroidal anti-inflammatory drugs (NSAIDs) for reducing ileus after surgery. Methods: A prospective multicentre cohort study was delivered by an international, student- and trainee-led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre-specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury. Results: A total of 4164 patients were included, with a median age of 68 (i.q.r. 57\u201375) years (54\ub79 per cent men). Some 1153 (27\ub77 per cent) received NSAIDs on postoperative days 1\u20133, of whom 1061 (92\ub70 per cent) received non-selective cyclo-oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4\ub76 versus 4\ub78 days; hazard ratio 1\ub704, 95 per cent c.i. 0\ub796 to 1\ub712; P = 0\ub7360). There were no significant differences in anastomotic leak rate (5\ub74 versus 4\ub76 per cent; P = 0\ub7349) or acute kidney injury (14\ub73 versus 13\ub78 per cent; P = 0\ub7666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35\ub73 versus 56\ub77 per cent; P < 0\ub7001). Conclusion: NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement

Safety of hospital discharge before return of bowel function after elective colorectal surgery

© 2020 BJS Society Ltd Published by John Wiley & Sons LtdBackground: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien–Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4–7) and 7 (6–8) days respectively (P < 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent; P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46; P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent; major 3·3 versus 3·4 per cent; P = 0·110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients