Online instantaneous and targeted feedback for remote learners

Providing rapid but detailed teaching feedback is a significant problem in distance education, especially for large population courses of short duration, when hand-marking is costly and assignments sent through the postal services cannot be turned round sufficiently quickly. Online assignments with automatic teaching feedback are a possible solution, providing the feedback can be well targeted to individual students. This chapter discusses the online assessment of a ‘maths for science’ course, in which meaningful feedback was given in response to student answers on both summative and purely formative exercises. Students were allowed three attempts at each question, with an increasing amount of teaching feedback being given after each attempt, so encouraging students to engage with the feedback, to learn from it, and to correct their answers if necessary. The mark awarded on the summative assessment reflected the amount of help that had been given. The designers’ concerns included producing a fair test of the course’s learning outcomes within the constraints imposed by the online format and with only minimal use of multiple choice, writing questions that might help to uncover common student misunderstandings coupled with feedback that would address these problems, and tying answer-matching to specific feedback comments. Evidence from statistical analysis of submitted work, and from student responses to questionnaires, has provided insights into the impact of this kind of feedback on the student learning experience. While the majority of students were happy with the online nature of the assessment, a significant proportion appeared to value it more for the immediate indication of their overall performance than for the detailed teaching feedback, and some were put off by the technology or their perception of it. Students were considerably more likely to submit the summative assessment if they had previously engaged online with the practice formative exercises

Using e-assessment to support distance learners of science

This paper describes the use of online interactive computer marked assignments (iCMAs) in a range of physics and general science modules at the UK Open University (OU), and an evaluation, jointly funded by the Physics Innovations Centre for Excellence in Teaching and Learning (piCETL) and the Centre for Open Learning of Mathematics, Science, Computing and Technology (COLMSCT) into student engagement with these iCMAs. Although the work has been done in the context of one particular large distance-learning university, the software used is open source and the evaluation has wider implications for those seeking to find the most appropriate way to use e-assessment to support their students' learning

Caregiver Integration During Discharge Planning for Older Adults to Reduce Resource Use: A Metaanalysis

Objectives To determine the effect of integrating informal caregivers into discharge planning on postdischarge cost and resource use in older adults. Design A systematic review and metaanalysis of randomized controlled trials that examine the effect of discharge planning with caregiver integration begun before discharge on healthcare cost and resource use outcomes. MEDLINE, EMBASE, and the Cochrane Library databases were searched for all English‐language articles published between 1990 and April 2016. Setting Hospital or skilled nursing facility. Participants Older adults with informal caregivers discharged to a community setting. Measurements Readmission rates, length of and time to post‐discharge rehospitalizations, costs of postdischarge care. Results Of 10,715 abstracts identified, 15 studies met the inclusion criteria. Eleven studies provided sufficient detail to calculate readmission rates for treatment and control participants. Discharge planning interventions with caregiver integration were associated with a 25% fewer readmissions at 90 days (relative risk (RR) = 0.75, 95% confidence interval (CI) = 0.62–0.91) and 24% fewer readmissions at 180 days (RR = 0.76, 95% CI = 0.64–0.90). The majority of studies reported statistically significant shorter time to readmission, shorter rehospitalization, and lower costs of postdischarge care among discharge planning interventions with caregiver integration. Conclusion For older adults discharged to a community setting, the integration of caregivers into the discharge planning process reduces the risk of hospital readmission

Entrepreneurial marketing in the digital age: A study of the SME tourism industry

This paper contributes to developing research enquiry relating to research at the Marketing and Entrepreneurship Interface (MEI) from the small and medium-sized firm (SME) marketing perspective. The paper presents findings emanating from a digital destinations project based on the south coast of England and a new, ongoing project on implementing digital marketing strategies in the context of small owner-managed firms. This area of research advances knowledge in several areas and is significant to the developing research of Entrepreneurial Marketing (EM) for a number of reasons. Firstly, there are still gaps in knowledge relating to the study of entrepreneurs (Li, 2008; Thomas et al., 2011) and the challenges associated with use of digital marketing and social media, including Twitter, Facebook etc. (Kim et al., 2011; Peltier et al., 2012). In addition there are reported difficulties with the embedding of e-marketing in SMEs for a number of reasons, notably employee resistance, a lack of technological ‘know how’ (Leeflang et al., 2014; Martin & Matlay, 2003) and, a lack of marketing competency, along with all the other associated limitations of a small business (Xiang & Gretzel, 2010) such as lack of finance, lack of business resource (Thompson et al., 2013). Third, these firms are geographically remote, in a rural region where they are situationally embedded and dependant on the overall effectiveness of destination marketing and where small tourism businesses often rely on a range of stakeholder relationships and agents to help promote their businesses via traditional (administrative) marketing approaches (Getz & Carlsen, 2005). Rurality also creates additional challenges with weak transport links and poor Internet connections while coastal tourist visits are often dependent on good weather and influenced by seasonality (Getz & Nilsson, 2004). Finally the fourth key challenge for entrepreneurs is detecting who they need to target their marketing towards, as digital marketing offers entrepreneurs an unbridled opportunity to market globally

Uneven spaces: core and periphery in the Gauteng City-Region

Peripheral areas of the Gauteng City-Region – like small towns on the edge, large peri-urban and commercial farming areas, sprawling dormitory townships, huge swathes of displaced urbanisation in ex-Bantustans, and remote industrial and mining areas – are all poorly understood. Yet there is evidence that many of these areas are undergoing rapid change, with profound implications for many current policy debates including what to do about inequitable economic growth patterns, how to manage ongoing population movements in the post-apartheid period, where best to locate large public housing schemes, and so on. Uneven spaces: Core and periphery in the Gauteng City-Region, GCRO’s sixth research report, comes from a clear recognition that despite the comparative wealth of Gauteng and its role in driving the national economy there are places of relative ‘peripherality’ in the GCR that require attention. The report is also a response to a strong focus in the existing literature on the physical and economic core of the province, the City of Johannesburg in particular. By contrast there is a relative paucity of analysis on less central parts of the city-region. The work is the result of a research partnership between the GCRO and the South African Research Chair in Spatial Analysis and City Planning (SA&CP), in the School of Architecture and Planning at Wits University. GCRO’s Dr Sally Peberdy wrote the first part of the report entitled ‘Uneven development – core and periphery in Gauteng’. Prof Philip Harrison and Yasmeen Dinath from SA&CP compiled the second part, ‘Gauteng – on the edge’. Both parts, albeit through different modes, consider transitions in the social- and space-economies of outlying places. The first part investigates the dynamics of peripheral areas in Gauteng through the lens of theories of uneven development. Showcasing a wealth of data and maps generated from the Census and GCRO’s own Quality of Life surveys, it analyses the multiple ways that spaces may be peripheral. These include unequal access to housing and services; the spread of income, household assets and employment opportunities; variations in perceived quality of life; and so on. The analysis builds from an initial binary delineation of parts of Gauteng as either ‘core’ or ‘periphery. It then progressively nuances our understanding by showing that notions of core and periphery are relational, that processes of change across what may be counted as core or periphery are often indeterminate and contradictory, and that there are often ‘peripheral’ areas in the heart of the GCR, and ‘core’ features in areas conventionally regarded as on the margin. This section concludes with thoughts on the role of government in creating, sustaining and ameliorating multiple forms of peripherality, The second part of the report asks the question ‘what is happening along the geographic edge of the GCR?’, and seeks to answer this both through the lens of scholarship on edge cities, peri-metropolitan areas, and agglomeration, as well as through a number of in-depth case studies in six types of peripheral areas: 1. Areas with extractive economies (Carletonville); 2. Industrialising ex-mining areas (Nigel-Heidelberg); 3. Areas with state-implanted industry (The Vaal, including Vereeniging, Vanderbijlpark and Sasolburg); 4. Decentralised growth points (Babelegi); 5. Agricultural service centres (Bronkhorstspruit); and 6, Recreational hubs (Hartbeespoort). Through its exhaustive narrative accounts of the development of specific places on the edge of the GCR, this section of the report compellingly highlights the importance of history and timing, and asks us to consider how urban development drives economic development and vice versa. Although ‘core’ and ‘periphery’ are artificial constructs, these terms gesture at very real spaces of uneven growth and development. The two parts of this report, different but complementary, considerably deepen our understanding of what is going on in parts of the city-region that are less well researched, and help focus the attention of policy-makers concerned with the causes and effects of – as well as possible solutions to – spatially uneven development outcomes.AP201

A comparison of human and computer marking of short free-text student responses

The computer marking of short-answer free-text responses of around a sentence in length has been found to be at least as good as that of six human markers. The marking accuracy of three separate computerised systems has been compared, one system (Intelligent Assessment Technologies FreeText Author) is based on computational linguistics whilst two (Regular Expressions and OpenMark) are based on the algorithmic manipulation of keywords. In all three cases, the development of high-quality response matching has been achieved by the use of real student responses to developmental versions of the questions and FreeText Author and OpenMark have been found to produce marking of broadly similar accuracy. Reasons for lack of accuracy in human marking and in each of the computer systems are discussed

Systematic review of topical treatments for fungal infections of the skin and nails of the feet

OBJECTIVE: To identify and synthesise the evidence for efficacy and cost effectiveness of topical treatments for superficial fungal infections of the skin and nails of the feet. DESIGN: Systematic review. INTERVENTIONS: Topical treatments for superficial fungal infections. MAIN OUTCOME MEASURES: Cure confirmed by culture and microscopy for skin and by culture for nails in patients with clinically diagnosed fungal infections. RESULTS: Of 126 trials identified in 121 papers, 72 (57.1%) met the inclusion criteria. Placebo controlled trials yielded pooled relative risks of failure to cure skin infections: allylamines (0.30, 95% confidence interval 0.24 to 0.38); azoles (0.54, 0.42 to 0.68); undecenoic acid (0.28, 0.11 to 0.74); and tolnaftate (0.46, 0.17 to 1.22). Although meta-analysis of 11 trials comparing allylamines and azoles showed a relative risk of failure to cure of 0.88 (0.78 to 0.99) in favour of allylamines, there was evidence of language bias. Seven reports in English favoured allylamines (0.79, 0.69 to 0.91), but four reports in foreign languages showed no difference between the two drugs (1.01, 0.90 to 1.13). Neither trial of nail infections showed significant differences between alternative topical treatments. CONCLUSIONS: Allylamines, azoles, and undecenoic acid were efficacious in placebo controlled trials. There are sufficient comparative trials to judge relative efficacy only between allylamines and azoles. Allylamines cure slightly more infections than azoles but are much more expensive than azoles. The most cost effective strategy is first to treat with azoles or undecenoic acid and to use allylamines only if that fails

Synthesis of qualitative research studies regarding the factors surrounding UK critical care trial infrastructure

© 2019 Author(s). Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJConducting clinical trials in critical care is integral to improving patient care. Unique practical and ethical considerations exist in this patient population that make patient recruitment challenging, including narrow recruitment timeframes and obtaining patient consent often in time-critical situations. Units currently vary significantly in their ability to recruit according to infrastructure and level of research activity. Aim : To identify variability in the research infrastructure of UK intensive care units (ICUs) and their ability to conduct research and recruit patients into clinical trials. Design: We evaluated factors related to intensive care patient enrolment into clinical trials in the UK. This consisted of a qualitative synthesis carried out with two datasets of in-depth interviews (distinct participants across the two datasets) conducted with 27 intensive care consultants (n=9), research nurses (n=17) and trial coordinators (n=1) from 27 units across the UK. Primary and secondary analysis of two datasets (one dataset had been analysed previously) was undertaken in the thematic analysis. Findings: The synthesis yielded an overarching core theme of Normalising Research, characterised by motivations for promoting research and fostering research-active cultures within resource constraints, with six themes under this to explain the factors influencing critical care research capacity: Organisational, Human, Study, Practical resources, Clinician, and Patient/family factors. There was a strong sense of integrating research in routine clinical practice, and recommendations are outlined. Conclusions: The central and transferable tenet of Normalising Research advocates the importance of developing a culture where research is inclusive alongside clinical practice in routine patient care and is requisite for all healthcare individuals from organisational to direct patient contact level.Peer reviewedFinal Published versio

Taking abdominal pain seriously: a case of aggressive dedifferentiated liposarcoma

Case Description: A 64 year-old female with history of PE on Eliquis with IVC filter placement, tobacco dependence, and class III obesity presents with abdominal discomfort and bilateral leg swelling. Physical examination showed a distended abdomen and bilateral leg edema and tenderness. Doppler ultrasound of the lower extremities showed extensive bilateral lower extremity deep vein thromboses (DVT). Patient developed oliguria and acute kidney injury, and ultrasound of the kidney was obtained. Kidney U.S. showed two large masses in the abdomen and pelvis. CT of the abdomen/pelvis demonstrated a mesenteric mass measuring up to 26 cm in the right mid-abdomen with multiple adjacent smaller masses. Patient underwent IR biopsy of the mass which showed a malignant neoplasm, with core biopsies showing spindled and epithelioid cells. Molecular studies were positive for MDM2 amplification, with focal weak staining for CD10 and inhibin. These features were indicative of a dedifferentiated liposarcoma given presence of MDM2; however, a poorly differentiated sex cord stromal tumor was also possible given weak staining by inhibin and CD10. Patient was not a surgical candidate but was a candidate for systemic chemotherapy. She received treatment with one cycle of Adriamycin, Ifosfamide, and Mesna (AIM) which was complicated by Ifosfamide-induced encephalopathy. She then received palliative radiation therapy and unfortunately passed secondary to cardiac arrest from suspected pulmonary embolism. Discussion: Liposarcomas (LPS) are rare mesenchymal neoplasms involving the deep soft tissues. Dedifferentiated liposarcomas (DDLPS) are high-grade aggressive neoplasms typically occur in the retroperitoneum, and have six-fold the rate of local and metastatic recurrence and disease-specific mortality than that of well-differentiated liposarcomas (WDLPS). In patients with abdominal discomfort and bilateral extremity deep thromboses, a malignant process must be on the differential. DDLPS is a focal outgrowth from precursor WDLPS lesions; therefore, early detection of these tumors is key to prompt diagnosis and management.https://scholarlycommons.henryford.com/merf2020caserpt/1021/thumbnail.jp

Self-care behaviour for minor symptoms : can Andersen’s Behavioral Model of Health Services Use help us to understand it?

Funding Information: Chief Scientist Office of the Scottish GovernmentPeer reviewedPostprin