Joining the dots: Conditional pass and programmatic assessment enhances recognition of problems with professionalism and factors hampering student progress

<p>Abstract</p> <p>Background</p> <p>Programmatic assessment that looks across a whole year may contribute to better decisions compared with those made from isolated assessments alone. The aim of this study is to describe and evaluate a programmatic system to handle student assessment results that is aligned not only with learning and remediation, but also with defensibility. The key components are standards based assessments, use of "Conditional Pass", and regular progress meetings.</p> <p>Methods</p> <p>The new assessment system is described. The evaluation is based on years 4-6 of a 6-year medical course. The types of concerns staff had about students were clustered into themes alongside any interventions and outcomes for the students concerned. The likelihoods of passing the year according to type of problem were compared before and after phasing in of the new assessment system.</p> <p>Results</p> <p>The new system was phased in over four years. In the fourth year of implementation 701 students had 3539 assessment results, of which 4.1% were Conditional Pass. More in-depth analysis for 1516 results available from 447 students revealed the odds ratio (95% confidence intervals) for failure was highest for students with problems identified in more than one part of the course (18.8 (7.7-46.2) p < 0.0001) or with problems with professionalism (17.2 (9.1-33.3) p < 0.0001). The odds ratio for failure was lowest for problems with assignments (0.7 (0.1-5.2) NS). Compared with the previous system, more students failed the year under the new system on the basis of performance during the year (20 or 4.5% compared with four or 1.1% under the previous system (p < 0.01)).</p> <p>Conclusions</p> <p>The new system detects more students in difficulty and has resulted in less "failure to fail". The requirement to state conditions required to pass has contributed to a paper trail that should improve defensibility. Most importantly it has helped detect and act on some of the more difficult areas to assess such as professionalism.</p

Complex circular subsidence structures in tephra deposited on large blocks of ice: Varða tuff cone, Öræfajökull, Iceland

Several broadly circular structures up to 16 m in diameter, into which higher strata have sagged and locally collapsed, are present in a tephra outcrop on southwest Öræfajökull, southern Iceland. The tephra was sourced in a nearby basaltic tuff cone at Varða. The structures have not previously been described in tuff cones, and they probably formed by the melting out of large buried blocks of ice emplaced during a preceding jökulhlaup that may have been triggered by a subglacial eruption within the Öræfajökull ice cap. They are named ice-melt subsidence structures, and they are analogous to kettle holes that are commonly found in proglacial sandurs and some lahars sourced in ice-clad volcanoes. The internal structure is better exposed in the Varða examples because of an absence of fluvial infilling and reworking, and erosion of the outcrop to reveal the deeper geometry. The ice-melt subsidence structures at Varða are a proxy for buried ice. They are the only known evidence for a subglacial eruption and associated jökulhlaup that created the ice blocks. The recognition of such structures elsewhere will be useful in reconstructing more complete regional volcanic histories as well as for identifying ice-proximal settings during palaeoenvironmental investigations

A pragmatic harm reduction approach to manage a large outbreak of wound botulism in people who inject drugs, Scotland 2015

Abstract Background People who inject drugs (PWID) are at an increased risk of wound botulism, a potentially fatal acute paralytic illness. During the first 6 months of 2015, a large outbreak of wound botulism was confirmed among PWID in Scotland, which resulted in the largest outbreak in Europe to date. Methods A multidisciplinary Incident Management Team (IMT) was convened to conduct an outbreak investigation, which consisted of enhanced surveillance of cases in order to characterise risk factors and identify potential sources of infection. Results Between the 24th of December 2014 and the 30th of May 2015, a total of 40 cases were reported across six regions in Scotland. The majority of the cases were male, over 30 and residents in Glasgow. All epidemiological evidence suggested a contaminated batch of heroin or cutting agent as the source of the outbreak. There are significant challenges associated with managing an outbreak among PWID, given their vulnerability and complex addiction needs. Thus, a pragmatic harm reduction approach was adopted which focused on reducing the risk of infection for those who continued to inject and limited consequences for those who got infected. Conclusions The management of this outbreak highlighted the importance and need for pragmatic harm reduction interventions which support the addiction needs of PWID during an outbreak of spore-forming bacteria. Given the scale of this outbreak, the experimental learning gained during this and similar outbreaks involving spore-forming bacteria in the UK was collated into national guidance to improve the management and investigation of future outbreaks among PWID

Saccadic Eye Movements Minimize the Consequences of Motor Noise

The durations and trajectories of our saccadic eye movements are remarkably stereotyped. We have no voluntary control over these properties but they are determined by the movement amplitude and, to a smaller extent, also by the movement direction and initial eye orientation. Here we show that the stereotyped durations and trajectories are optimal for minimizing the variability in saccade endpoints that is caused by motor noise. The optimal duration can be understood from the nature of the motor noise, which is a combination of signal-dependent noise favoring long durations, and constant noise, which prefers short durations. The different durations of horizontal vs. vertical and of centripetal vs. centrifugal saccades, and the somewhat surprising properties of saccades in oblique directions are also accurately predicted by the principle of minimizing movement variability. The simple and sensible principle of minimizing the consequences of motor noise thus explains the full stereotypy of saccadic eye movements. This suggests that saccades are so stereotyped because that is the best strategy to minimize movement errors for an open-loop motor system

Effect of forage:concentrate ratio on ruminal metabolism and duodenal flow of fatty acids in beef steers

The objective of this study was to determine the proportion of forage in the diet which would maximize duodenal flow of unsaturated fatty acids in beef steers supplemented with linseed oil. A second objective was to determine how diets differing in forage content, but equal in nitrogen (N), energy and lipid supply, would affect the duodenal flow of C18:1 and conjugated linoleic acid (CLA) isomers. Eight Hereford×Friesian steers (533±13·6 kg), prepared with rumen and duodenal cannulae were offered one of four forage:concentrate (F:C) ratios: F80C20; F60C40; F40C60 and F20C80 on a dry-matter (DM) basis. All diets were offered at 0·013 body weight and designed to be isonitrogenous and isoenergetic with total lipid made up to 0·06 DM intake with linseed oil. The experimental design was a replicated incomplete 4×4 Latin square with three periods. Increasing the concentrate component in the diet from 0·20 to 0·60 reduced rumen pH from 6·58 to 6·37 and caused a small but significant shift in volatile fatty acid molar proportions, decreasing the non-glucogenic ratio. Rumen ammonia-nitrogen concentration was also significantly reduced with increasing concentrate, from 156·8 to 101·0 mg N per l on F80C20 and F20C80, respectively. Microbial nitrogen (MN) and the efficiency of microbial protein synthesis was significantly elevated as forage level decreased from 51·6 to 72·4 g/day and 17·2 to 27·3 g MN per kg organic matter apparently digested in the rumen, respectively for F80C20 and F20C80. Intake and duodenal flow of C18:1n-9 and C18:2n-6 were significantly higher with increasing concentrate level in the diet whereas C18:3n-3 intake and flow was not different, averaging 143·6 and 6·37 g/day, respectively. There were no differences in the flows of total C18:1 trans or CLA (47·7 and 1·79 g/day, respectively) across the diets. However, although not significantly different in duodenal flow there were trends (P<0·1) for an increasing proportion of trans-10 and a decreasing proportion of trans-11 when increasing the concentrate in the diet. Biohydrogenation of C18:2n-6 decreased from 0·91 to 0·85 when increasing concentrate in the diet from 0·20 to 0·40 but further increases had no effect. F:C ratio had little effect on the flow of unsaturated fatty acids, C18:1 trans and CLA to the duodenum of beef steers, and this may relate to the ability of the rumen to buffer the large changes in concentrate intake