Ensuring Basic Quality in Clinical Courses

This article describes some of the features of clinical course design that are essential for ensuring basic educational quality. It does not attempt to be thorough. A number of years ago, I served on a committee that began discussing whether it is possible to come up with “indicia of quality” that could be used to measure the quality of a clinical program or course. The question that framed the issue was “If someone wanted to determine whether one school’s professional skills program is likely to be better than another school’s program, what elements should be examined?” The committee not only guessed that it was possible to define those elements, we also believed that it could be accomplished without a great deal of trouble. Though I still think it is possible to define indicia of quality, we were wrong that it would be easy. Our initial effort foundered fairly quickly. From time to time others renewed the effort, only to abandon the project, with one exception. Sandy Ogilvy, a law professor at Catholic University School of Law in Washington, D.C., is making the most serious effort to date to describe “indicia of quality” for clinical programs

The Evolution of Legal Education in the United States and the United Kingdom: How one system became more faculty-oriented while the other became more consumer-oriented

This paper explores how our approaches to preparing lawyers for practice became so different. It traces the evolution of the systems for preparing lawyers for practice in the United Kingdom and the United States, and it examines the relative merits of our current situations. Part I describes the key differences in our systems. Part II recounts major events in the histories of legal education in the United States and the United Kingdom. Part III describes new initiatives in the United Kingdom and the United States that may improve legal education

Can We Assess What We Purport to Teach In Clinical Law Courses?

"Assessment - evaluation: A judgment about something based on an understanding of the situation.""Assess: to judge . . . the . . . quality . . . of something."Many claims are made about the educational value of clinical education in law schools. Unfortunately, the first generation of clinical law teachers did not clearly articulate our educational goals nor did we fully explore how to assess the effectiveness of our instruction. Subsequent generations of clinical teachers adopted the practices of their predecessors and mentors. Consequently, many issues related to assessments of clinical students remain unexplored, and current practices tend to be neither valid nor reliable. While clinical teachers in the United Kingdom have made more progress than those in the United States, all clinical teachers need to work together to improve our understanding of assessments and to develop improved methods for finding out whether our students are learning what we purport to teach.This article explains the importance and nature of assessments, illustrates some of the issues presented by current practices, and proposes some new directions to consider. It concludes that much work remains to be done to clarify the goals of clinical legal education and to develop valid and reliable assessment tools

Education for the Practice of Law: The Times They Are A-Changin’

I. Overview II. Catalysts for Reform … A. Calls for Reform before CLEPR [Council on Legal Education for Professional Responsibility] ... B. Calls for Reform from CLEPR to MacCrate ... C. Calls for Reform Today from MacCrate, the Profession, the Public, and Students III. Impediments to Reform IV. The Future of Education for the Practice of Law ... A. Problem-Solving Skill as the Core Objective of Legal Education ... B. Curricular Implications ... 1. Methodology ... 2. Sequencing and Structure ... 3. Teaching about Doctrine ... 4. Teaching about Skills and Values ... 5. The Core Skills and Values Curriculum ... 6. Beyond the Core Skills and Values Curriculum V. Conclusio

Contrasting Sorption Behaviours Affecting Groundwater Arsenic Concentration in Kandal Province, Cambodia

Natural arsenic (As) contamination of groundwater which provides drinking water and/or irrigation supplies remains a major public health issue, particularly in South and Southeast Asia. A number of studies have evaluated various aspects of the biogeochemical controls on As mobilization in aquifers typical to this region, however many are predicated on the assumption that key biogeochemical processes may be deduced by sampled water chemistry. The validity of this assumption has not been clearly established even though the role of sorption/desorption of As and other heavy metals onto Fe/Mn (hydr)oxides is an important control in As mobilization. Here, selective chemical extractions of sand-rich and clay-rich sediments from an As-affected aquifer in Kandal Province, Cambodia, were undertaken to explore the potential role of partial re-equilibrium through sorption/desorption reactions of As and related solutes (Fe, Mn and P) between groundwater and the associated solid aquifer matrix. In general, groundwater As is strongly affected by both pH and Eh throughout the study area. However, contrasting sorption behaviour is observed in two distinct sand-dominated (T-Sand) and clay dominated (T-Clay) transects, and plausibly attributed to differing dominant lithologies, biogeochemical and/or hydrogeological conditions. Sorption/desorption processes appear to be re-setting groundwater As concentrations in both transects, but to varying extents and in different ways. In T-Sand, which is typically highly reducing, correlations suggest that dissolved As may be sequestered by sorption/re-adsorption to Fe-bearing mineral phases and/or sedimentary organic matter; in T-Clay Eh is a major control on As mobilization although binding/occlusion of Fe-bearing minerals to sedimentary organic matter may also occur. Multiple linear regression analysis was conducted with groups categorised by transect and by Eh, and the output correlations support the contrasting sorption behaviours encountered in this study area. Irrespective of transect, however, the key biogeochemical processes which initially control As mobilization in such aquifers, may be “masked” by the re-setting of As concentrations through in-aquifer sorption/desorption processes

Genome-wide mapping reveals conserved and diverged R-loop activities in the unusual genetic landscape of the African trypanosome genome

R-loops are stable RNA–DNA hybrids that have been implicated in transcription initiation and termination, as well as in telomere maintenance, chromatin formation, and genome replication and instability. RNA Polymerase (Pol) II transcription in the protozoan parasite Trypanosoma brucei is highly unusual: virtually all genes are co-transcribed from multigene transcription units, with mRNAs generated by linked trans-splicing and polyadenylation, and transcription initiation sites display no conserved promoter motifs. Here, we describe the genome-wide distribution of R-loops in wild type mammal-infective T. brucei and in mutants lacking RNase H1, revealing both conserved and diverged functions. Conserved localization was found at centromeres, rRNA genes and retrotransposon-associated genes. RNA Pol II transcription initiation sites also displayed R-loops, suggesting a broadly conserved role despite the lack of promoter conservation or transcription initiation regulation. However, the most abundant sites of R-loop enrichment were within the regions between coding sequences of the multigene transcription units, where the hybrids coincide with sites of polyadenylation and nucleosome-depletion. Thus, instead of functioning in transcription termination the most widespread localization of R-loops in T. brucei suggests a novel correlation with pre-mRNA processing. Finally, we find little evidence for correlation between R-loop localization and mapped sites of DNA replication initiation

Whole-genome sequencing reveals host factors underlying critical COVID-19

Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2–4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes—including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)—in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease