The provision of vocational education and training within contemporary political socio-economic conditions: A review of the literature

This review is in response to numerous research, studies and other reviews that present the under-addressed, longstanding need to rethink vocational education and training delivered to secondary students (VETdSS) in Australia and in similar jurisdictions. Further, it is unclear how secondary schools in Western Australia are navigating the provision of vocational education and training within contemporary political socio-economic conditions. Therefore, this paper intends to review the most recent research about VETdSS and especially research that is pertinent to secondary schools in Western Australia. Ultimately, our aim in this paper is to develop a conceptual framework that will help us to understand what research and theory-making has already been conducted in Australia relevant to VETdSS and what gaps and needs remain wanting

A mentor-mentee support program for people with anorexia nervosa

Background: Successful mentorship enhances quality of life, hope for recovery and empowers people with anorexia nervosa (AN) to develop health-promoting strategies, with immeasurable benefits for both mentor and mentee. Aims: To develop and evaluate, in consultation with stakeholders (people with AN and recovered individuals), a mentorship support program for people with AN in NSW. Methods: This study is a mixed methods participatory action research (PAR) project. Participants are pivotal in the development and design of a tailored program. Researchers work closely with stakeholders to bring and evaluate change, through cycles of learning and reflection, actively engaging participants in the research process. Results: During workshop discussions, participants (4 mentors and 5 mentees) defined the program, examined roles and responsibilities, partnerships, interaction, use of funds, conflict resolution and risk management. The workshop, conducted informally in a setting that simulated a home environment, reduced anxiety levels. Uncertainty evolved into an appreciation for the program, development of new relationships, learning that everyone had similar reservations yet reassurance that people were there to support and encourage recovery. Participants were positive and optimistic for the program’s trial. Conclusion: PAR is an apt research method for actively engaging stakeholders in the development of a tailored program to support recovery

“I Can’t Go On, I’ll Go On”: Liminality in Undergraduate Writing

According to Jan Meyer and Ray Land (2006), along with being troublesome, integrative, transformative, and probably irreversible, threshold concepts are characterized as liminal. Their liminal nature is summarized by Linda Adler- Kassner and Elizabeth Wardle (2016): “Threshold concepts involve what the name implies— thresholds. But the movement toward and the (hopeful) crossing of those thresholds isn’t straightforward; instead, it happens in a two- steps- forward- one- step- back kind of way as learners push against troublesome knowledge” (ix). Glynis Cousin (2006) observes that the idea of liminal states aids “our understanding of the conceptual transformations students undergo” in challenging learning situations, like the grasping of threshold concepts (4). And yet, Ray Land, Julie Rattray, and Peter Vivian (2014) suggest that the liminal space “has remained relatively ill- defined, something of a ‘black box’ within the conceptual framework of Threshold Concepts” (201). This chapter focuses on this liminal space. Specifically, we wanted to better understand the nature, occurrence, and impact of liminality in undergraduate writing through the lens of threshold concepts of writing, through which those concepts could in turn provide an effective theoretical and pedagogical framework for our particular context. Our setting is a relatively new writing center (established 2011) in an Irish university that has an undergraduate population of 10,050 students and a postgraduate enrollment of 1,900. Following a presentation of our distilled findings, we explore and contextualize one key action- oriented insight about undergraduates’ experiences with threshold concepts of writing that emerged from the data, that of the coexistence of apparent liminality, a stage that can be paralyzing for students, and authentic liminality, a stage that is important for students grappling with threshold concepts and that is therefore productive and potentially transformative. In the next section, we review literature that has contributed to these ideas of liminality; following that review, we describe the research that led us to these definition

The potential to quantify polypharmacy in older adult hospital inpatients using electronic prescribing software: A feasibility study

Polypharmacy in older adults is a growing problem, as some drugs may be either unnecessary or even harmful. Admission to hospital under a Medicine for the Elderly specialist physicians represents an opportunity to review patients’ medication. The recent introduction of electronic prescribing to some hospitals in the United Kingdom allows the development of tools to measure polypharmacy in in-patients, and subsequently to assess the efficacy of interventions that aim to optimize medication prescribing. We tested the feasibility of developing an Excel-based software code that measured the number of medications a group of patients were taking at admission and how many of these were still prescribed on discharge. Electronic prescribing data was obtained from the Royal Derby Hospital, over a period of 52 weeks from April 2017 to March 2018 for all patients over the age of 65 years who were admitted onto the medicine for the elderly wards and subsequently discharged. On admission, the median number of eligible medications was 11 (interquartile range IQR 8 to 15). At the time of discharge, the median number of eligible medications retained since admission was 9 (IQR 6 to 12). This represents a median number of medications that have been removed from the current medication regimen of 2 (IQR 1 to 3, p [less than] 0.001). Electronic prescribing software in hospitals allows the development of tools to measure the burden of medications, and to examine the efficacy of future interventions that are developed to optimize drug prescribing in older adults

AMPK Causes Cell Cycle Arrest in LKB1-deficient Cells via Activation of CAMKK2

The AMP-activated protein kinase (AMPK) is activated by phosphorylation at Thr172, either by the tumor suppressor kinase LKB1 or by an alternate pathway involving the Ca(2+)/calmodulin-dependent kinase, CAMKK2. Increases in AMP:ATP and ADP:ATP ratios, signifying energy deficit, promote allosteric activation and net Thr172 phosphorylation mediated by LKB1, so that the LKB1-AMPK pathway acts as an energy sensor. Many tumor cells carry loss-of-function mutations in the STK11 gene encoding LKB1, but LKB1 re-expression in these cells causes cell cycle arrest. Therefore, it was investigated as to whether arrest by LKB1 is caused by activation of AMPK or of one of the AMPK-related kinases, which are also dependent on LKB1 but are not activated by CAMKK2. In three LKB1-null tumor cell lines, treatment with the Ca(2+) ionophore A23187 caused a G1-arrest that correlated with AMPK activation and Thr172 phosphorylation. In G361 cells, expression of a truncated, CAMKK2 mutant also caused G1-arrest similar to that caused by expression of LKB1, while expression of a dominant negative AMPK mutant, or a double knockout of both AMPK-α subunits, also prevented the cell cycle arrest caused by A23187. These mechanistic findings confirm that AMPK activation triggers cell cycle arrest, and also suggest that the rapid proliferation of LKB1-null tumor cells is due to lack of the restraining influence of AMPK. However, cell cycle arrest can be restored by re-expressing LKB1 or a constitutively active CAMKK2, or by pharmacological agents that increase intracellular Ca(2+) and thus activate endogenous CAMKK2. IMPLICATIONS: Evidence here reveals that the rapid growth and proliferation of cancer cells lacking the tumor suppressor LKB1 is due to reduced activity of AMPK, and suggests a therapeutic approach by which this block might be circumvented

Patients' attitudes towards cost feedback to doctors to prevent unnecessary testing: a qualitative focus group study

ObjectivesThere is a need to improve efficiency in healthcare delivery without compromising quality of care. One approach is the development and evaluation of behavioural strategies to reduce unnecessary use of common tests. However, there is an absence of evidence on patient attitudes to the use of such approaches in the delivery of care. Our objective was to explore patient acceptability of a nudge-type intervention that aimed to modify blood test requests by hospital doctors.Study designSingle-centre qualitative study.MethodsThe financial costs of common blood tests were presented to hospital doctors on results reports for 1 year at a hospital. Focus group discussions were conducted with recent inpatients at the hospital using a semi-structured question schedule. Discussions were transcribed and analysed using qualitative content analysis to identify and prioritise common themes explaining attitudes to the intervention approach.ResultsThree focus groups involving 17 participants were conducted. Patients were generally apprehensive about the provision of blood test cost feedback to doctors. Attitudes were organised around themes representing beliefs about blood tests, the impact on doctors and their autonomy, and beliefs about unnecessary testing. Patients thought that blood tests were important, powerful and inexpensive, and cost information could place doctors under additional pressure.ConclusionThe findings identify predominantly positive beliefs about testing and negative attitudes to the use of financial costs in the decision-making of hospital doctors. Public discussion and education about the possible overuse of common tests may allow more resources to be allocated to evidence-based healthcare, by reducing the perception that such strategies to improve healthcare efficiency negatively impact on quality of care