Handwritten undergraduate case reports

Background: This article describes a 'back to the future' approach to case 'write-ups', with medical students producing handwritten instead of word-processed case reports during their clinical placements. Word-processed reports had been found to have a number of drawbacks, including the inappropriate use of 'cutting and pasting', undue length and lack of focus. Method: We developed a template to be completed by hand, based on the hospital 'clerking-in process', and matched this to a new assessment proforma. An electronic survey was conducted of both students and assessors after the first year of operation to evaluate impact and utility. Results: The new template was well received by both students and assessors. Most students said they preferred handwriting the case reports (55.6%), although a significant proportion (44.4%) preferred the word processor. Many commented that the template enabled them to effectively learn the structure of a case history and to improve their history-taking skills. Most assessors who had previously marked case reports felt the new system represented an improvement. The average time spent marking each report fell from 23.56 to 16.38minutes using the new proforma. Discussion: Free text comments from the survey have led to the development of a more flexible case report template better suited to certain specialties (e.g. dermatology). This is an evolving process and there will be opportunities for further adaptation as electronic medical records become more common in hospital. © Blackwell Publishing Ltd 2012.

Textbook (non-) adoption motives, legitimizing strategies and academic field configuration

Textbooks are an integral part of structured syllabus coverage in higher education. The argument advanced in this article is that textbooks are not simply products of inscription and embodied scholarly labour for pedagogical purposes, but embedded institutional artefacts that configure entire academic subject fields. Empirically, this article shows the various ways that motives of the (non-) adoption of textbooks have field institutional configuration effects. The research contribution of our study is threefold. First, we re-theorise the textbook as an artefact that is part of the institutional work and epistemic culture of academia. Second, we empirically show that the vocabularies of motive of textbook (non-) adoption and rhetorical strategies form the basis for social action and configuration across micro, meso and macro field levels. Our final contribution is a conceptualization of the ways that textbook (non-) adoption motives ascribe meaning to the legitimating processes in the configuration of whole subject fields.

'Trusting the numbers': mineral prospecting, raising finance and the governance of knowledge

Mineral prospecting and raising finance for ‘junior’ mining firms has historically been regarded as a speculative activity. For the regulators of securities markets upon which ‘junior’ mining companies seek to raise capital, a perennial problem has been handling not only the indeterminacy of scientific claims, but also the social basis of epistemic practices. This paper examines the production of a system of public warrant and associated knowledge practices intended to enable investors to differentiate between ‘destructive’ and ‘productive’ varieties of financial speculation. It traces the use of the notion of ‘disclosure’ in constructing and legitimizing the ‘juniors’ market in Canada. It argues that though the work of ‘economics’ may be necessary in the construction of markets, it is by no means sufficient. Attention must also be given to the ways in which legal models of ‘the free-market’ can be translated and constantly re-worked across the sites and spaces of regulatory practice, animating the geographies of markets.

A composite pollen-based stratotype for inter-regional evaluation of climatic events in New Zealand over the past 30,000 years (NZ-INTIMATE project)

Our review of paleoclimate information for New Zealand pertaining to the past 30,000 years has identified a general sequence of climatic events, spanning the onset of cold conditions marking the final phase of the Last Glaciation, through to the emergence to full interglacial conditions in the early Holocene. In order to facilitate more detailed assessments of climate variability and any leads or lags in the timing of climate changes across the region, a composite stratotype is proposed for New Zealand. The stratotype is based on terrestrial stratigraphic records and is intended to provide a standard reference for the intercomparison and evaluation of climate proxy records. We nominate a specific stratigraphic type record for each climatic event, using either natural exposure or drill core stratigraphic sections. Type records were selected on thebasis of having very good numerical age control and a clear proxy record. In all cases the main proxy of the type record is subfossil pollen. The type record for the period from ca 30 to ca 18 calendar kiloyears BP (cal. ka BP) is designated in lake-bed sediments from a small morainic kettle lake (Galway tarn) in western South Island. The Galway tarn type record spans a period of full glacial conditions (Last Glacial Coldest Period, LGCP) within the Otira Glaciation, and includes three cold stadials separated by two cool interstadials. The type record for the emergence from glacial conditions following the termination of the Last Glaciation (post-Termination amelioration) is in a core of lake sediments from a maar (Pukaki volcanic crater) in Auckland, northern North Island, and spans from ca 18 to 15.64±0.41 cal. ka BP. The type record for the Lateglacial period is an exposure of interbedded peat and mud at montane Kaipo bog, eastern North Island. In this high-resolution type record, an initial mild period was succeeded at 13.74±0.13 cal. ka BP by a cooler period, which after 12.55±0.14 cal. ka BP gave way to a progressive ascent to full interglacial conditions that were achieved by 11.88±0.18 cal. ka BP. Although a type section is not formally designated for the Holocene Interglacial (11.88±0.18 cal. ka BP to the present day), the sedimentary record of Lake Maratoto on the Waikato lowlands, northwestern North Island, is identified as a prospective type section pending the integration and updating of existing stratigraphic and proxy datasets, and age models. The type records are interconnected by one or more dated tephra layers, the ages of which are derived from Bayesian depositional modelling and OxCal-based calibrations using the IntCal09 dataset. Along with the type sections and the Lake Maratoto record, important, well-dated terrestrial reference records are provided for each climate event. Climate proxies from these reference records include pollen flora, stable isotopes from speleothems, beetle and chironomid fauna, and glacier moraines. The regional composite stratotype provides a benchmark against which to compare other records and proxies. Based on the composite stratotype, we provide an updated climate event stratigraphic classification for the New Zealand region. © 2013 Elsevier Ltd.

Dialogicality in university classroom talk

University classroom talk is a collaborative struggle to make meaning. Taking the perspectival nature of interaction as central, this paper presents an investigation of the genre of spoken academic discourse and in particular the types of activities which are orientated to the goal of collaborative ideas or tasks, such as seminars, tutorials, workshops. The purpose of the investigation was to identify examples of dialogicality through an examination of stance-taking. The data used in this study is a spoken corpus of academic English created from recordings of a range of subject discipline classrooms at a UK university. A frequency-based approach to recurrent word sequences (lexical bundles) was used to identify signals of epistemic and attitudinal stance and to initiate an exploration of the features of elaboration. Findings of quantitative and qualitative analyses reveal some similarities and differences between this study and those of US based classroom contexts in relation to the use and frequency of lexical bundles. Findings also highlight the process that elaboration plays in grounding perspectives and negotiating alignment of interactants. Elaboration seems to afford the space for the enactment of student stance in relation to the tutor embodiment of discipline knowledge.

Chromosome synapsis and recombination in simple and complex chromosomal heterozygotes of tuco-tuco (Ctenomys talarum: Rodentia: Ctenomyidae):Rodentia: Ctenomyidae)

The chromosomal speciation hypothesis suggests that irregularities in synapsis, recombination, and segregation in heterozygotes for chromosome rearrangements may restrict gene flow between karyotypically distinct populations and promote speciation. Ctenomys talarum is a South American subterranean rodent inhabiting the coastal regions of Argentina, whose populations polymorphic for Robertsonian and tandem translocations seem to have a very restricted gene flow. To test if chromosomal differences are involved in isolation among its populations, we examined chromosome pairing, recombination, and meiotic silencing of unsynapsed chromatin in male meiosis of simple and complex translocation heterozygotes using immunolocalization of the MLH1 marking mature recombination nodules and phosphorylated histone γH2A.X marking unrepaired double-strand breaks. We observed small asynaptic areas labeled by γH2A.X in pericentromeric regions of the chromosomes involved in the trivalents and quadrivalents. We also observed a decrease of recombination frequency and a distalization of the crossover distribution in the heterozygotes and metacentric homozygotes compared to acrocentric homozygotes. We suggest that the asynapsis of the pericentromeric regions are unlikely to induce germ cell death and decrease fertility of the heterozygotes; however, suppressed recombination in pericentromeric areas of the multivalents may reduce gene flow between chromosomally different populations of the Talas tuco-tuco.

AgentSpeak+: AgentSpeak with Probabilistic Planning

AgentSpeak is a logic-based programming language, based on the Belief-Desire-Intention (BDI) paradigm, suitable for building complex agent-based systems. To limit the computational complexity, agents in AgentSpeak rely on a plan library to reduce the planning problem to the much simpler problem of plan selection. However, such a plan library is often inadequate when an agent is situated in an uncertain environment. In this paper, we propose the AgentSpeak+ framework, which extends AgentSpeak with a mechanism for probabilistic planning. The beliefs of an AgentSpeak+ agent are represented using epistemic states to allow an agent to reason about its uncertain observations and the uncertain effects of its actions. Each epistemic state consists of a POMDP, used to encode the agent’s knowledge of the environment, and its associated probability distribution (or belief state). In addition, the POMDP is used to select the optimal actions for achieving a given goal, even when facing uncertainty.

The Changing Context for Planning Education in the UK and the Prospects for Research-Led, Practice-Engaged Teaching

The UK’s Royal Town Planning Institute (RTPI) celebrates its centenary in 2014, marking 100 years of close relationships between university-based Planning Schools and a professional body focussed on planning practice. During this period, the context for university education and the very idea of planning has changed dramatically contributing to a continual renegotiation of the relationships between the planning profession and the educational institutions it accredits. These changes have been particularly acute in the last ten years where a number of factors have forced a rapid change in the nature of planning education in the UK. This has included a boom and then slump in the number of planning students linked to the national economic situation, a reorganisation of many planning schools and their merger with cognate disciplines such as geography and an increased focus of research output, rather than professional engagement the key institutional indicator of success. This last factor adds a particularly new dimension to the profession-university relationship, which could potentially lead to either a straining of tensions or a synergy through research-led teaching that could significantly benefit both.

This paper will briefly review the evolution of UK planning schools and the co-evolution of the main ideas informing planning education. It will then describe the current profile of UK planning schools, based on an extensive national survey conducted on behalf of the Royal Town Planning Institute. The paper will then critically review the main challenges and opportunities facing UK Planning Schools in the context of changes in both planning practice and higher education. It will then move on to the concept of research-led teaching, drawing on current practice in the UK and review how well this concept serves students and the idea of developing reflective planning practitioners. Finally, the paper will seek to draw broad lessons from the experience of the UK and reflect on the type of planning education that can best serve planning professions in a variety of international contexts in the future.

Patient safety and communication: A new assessment for doctors trained in countries where language differs from that of the host country: Results of a pilot using a domain-based assessment

Objective

Global migration of healthcare workers places responsibility on employers to comply with legal employment rights whilst ensuring patient safety remains the central goal. We describe the pilot of a communication assessment designed for doctors who trained and communicated with patients and colleagues in a different language from that of the host country. It is unique in assessing clinical communication without assessing knowledge.

A 14-station OSCE was developed using a domain-based marking scheme, covering professional communication and English language skills (speaking, listening, reading and writing) in routine, acute and emotionally challenging contexts, with patients, carers and healthcare teams. Candidates (n = 43), non-UK trained volunteers applying to the UK Foundation Programme, were provided with relevant station information prior to the exam.

The criteria for passing the test included achieving the pass score and passing 10 or more of the 14 stations. Of the 43 candidates, nine failed on the station criteria. Two failed the pass score and also the station criteria. The Cronbach's alpha coefficient was 0.866.

This pilot tested ‘proof of concept’ of a new domain-based communication assessment for non-UK trained doctors.

The test would enable employers and regulators to verify communication competence and safety in clinical contexts, independent of clinical knowledge, for doctors who trained in a language different from that of the host country.

The latest LGM culmination of the Garda Glacier (Italian Alps) and the onset of glacial termination. Age of glacial collapse and vegetation chronosequence

In the deglacial sequence of the largest end moraine system of the Italian Alps, we focused on the latest culmination of the Last Glacial Maximum, before a sudden downwasting of the piedmontane lobe occupying the modern lake basin. We obtained a robust chronology for this culmination and for the subsequent deglacial history by cross-radiocarbon dating of a proximal fluvioglacial plain and of a deglacial continuous lake sedimentation. We used reworked dinocysts to locate sources of glacial abrasion and to mark the input of glacial meltwater until depletion. The palynological record from postglacial lake sediments provided the first vegetation chronosequence directly reacting to the early Lateglacial withdrawal so far documented in the Alps.

Glacier collapse occurred soon after 17.46 +/- 0.2 ka cal BP, which is, the Manerba advance culmination. Basin deglaciation of several overdeepened foreland piedmont lakes on southern and northern sides of the Alps appears to be synchronous at millennial scale and near-synchronous with large-scale glacial retreat at global scale. The pioneering succession shows a first afforestation step at a median modeled age of 64 years after deglaciation, while rapid tree growth lagged 7 centuries. Between 16.4 +/- 0.16 and 15.5 +/- 0.16 ka cal BP, a regressive phase interrupted forest growth marking a Lateglacial phase of continental-dry climate predating GI-1. This event, spanning the most advanced phases of North-Atlantic H1, is consistently radiocarbon-framed at three deglacial lake records so far investigated on the Italian side of the Alps. Relationships with the Gschnitz stadial from the Alpine record of Lateglacial advances are discussed

Automated tumour annotation and analysis for molecular pathology using TissueMark (R)

Objective: Molecular pathology relies on identifying anomalies using PCR or analysis of DNA/RNA. This is important in solid tumours where molecular stratification of patients define targeted treatment. These molecular biomarkers rely on examination of tumour, annotation for possible macro dissection/tumour cell enrichment and the estimation of % tumour. Manually marking up tumour is error prone. Method: We have developed a method for automated tumour mark-up and % cell calculations using image analysis called TissueMark® based on texture analysis for lung, colorectal and breast (cases=245, 100, 100 respectively). Pathologists marked slides for tumour and reviewed the automated analysis. A subset of slides was manually counted for tumour cells to provide a benchmark for automated image analysis. Results: There was a strong concordance between pathological and automated mark-up (100 % acceptance rate for macro-dissection). We also showed a strong concordance between manually/automatic drawn boundaries (median exclusion/inclusion error of 91.70 %/89 %). EGFR mutation analysis was precisely the same for manual and automated annotation-based macrodissection. The annotation accuracy rates in breast and colorectal cancer were 83 and 80 % respectively. Finally, region-based estimations of tumour percentage using image analysis showed significant correlation with actual cell counts. Conclusion: Image analysis can be used for macro-dissection to (i) annotate tissue for tumour and (ii) estimate the % tumour cells and represents an approach to standardising/improving molecular diagnostics.

(Not) Commemorating the First World War and the Somme

In November 2013 the Attorney General of Northern Ireland, John Larkin, suggested the possibility to ending troubles-related historic prosecutions in Northern Ireland. These remarks provoked a considerable reaction, mostly hostile, and while the attorney’s rationale was based largely upon the practical difficulties associated with gathering reliable evidence and securing prosecutions after a lengthy time lag, his suggestion raises the question of whether forgetting would be preferable to remembering when it comes to our contested past. This paper intends to take a different slant on commemoration by exploring in broad terms the theme of ‘not commemorating’. In this regard it will examine the arguments in favour of remembering. Specifically in regard to the case of the memory of the First World War, it will examine the mistaken impression that the commemoration of that conflict was not widespread in independent Ireland during the inter-war years. Finally, it will suggest some of the greatest challenges facing contemporary Northern Irish society in marking the decade of centenaries.

Probabilistic Inference in Credal Networks: New Complexity Results

Credal networks are graph-based statistical models whose parameters take values in a set, instead of being sharply specified as in traditional statistical models (e.g., Bayesian networks). The computational complexity of inferences on such models depends on the irrelevance/independence concept adopted. In this paper, we study inferential complexity under the concepts of epistemic irrelevance and strong independence. We show that inferences under strong independence are NP-hard even in trees with binary variables except for a single ternary one. We prove that under epistemic irrelevance the polynomial-time complexity of inferences in credal trees is not likely to extend to more general models (e.g., singly connected topologies). These results clearly distinguish networks that admit efficient inferences and those where inferences are most likely hard, and settle several open questions regarding their computational complexity. We show that these results remain valid even if we disallow the use of zero probabilities. We also show that the computation of bounds on the probability of the future state in a hidden Markov model is the same whether we assume epistemic irrelevance or strong independence, and we prove an analogous result for inference in Naive Bayes structures. These inferential equivalences are important for practitioners, as hidden Markov models and Naive Bayes networks are used in real applications of imprecise probability.

Can(Plan)+: Extending the Operational Semantics of the BDI Architecture to deal with Uncertain Information

The BDI architecture, where agents are modelled based on their beliefs, desires and intentions, provides a practical approach to develop large scale systems. However, it is not well suited to model complex Supervisory Control And Data Acquisition (SCADA) systems pervaded by uncertainty. In this paper we address this issue by extending the operational semantics of Can(Plan) into Can(Plan)+. We start by modelling the beliefs of an agent as a set of epistemic states where each state, possibly using a different representation, models part of the agent's beliefs. These epistemic states are stratified to make them commensurable and to reason about the uncertain beliefs of the agent. The syntax and semantics of a BDI agent are extended accordingly and we identify fragments with computationally efficient semantics. Finally, we examine how primitive actions are affected by uncertainty and we define an appropriate form of lookahead planning.

Revising Partial Pre-Orders with Partial Pre-Orders: A Unit-Based Revision Framework

Belief revision studies strategies about how agents revise their belief states when receiving new evidence. Both in classical belief revision and in epistemic revision, a new input is either in the form of a (weighted) propositional formula or a total
pre-order (where the total pre-order is considered as a whole).
However, in some real-world applications, a new input can be a partial pre-order where each unit that constitutes the partial pre-order is important and should be considered individually. To address this issue, in this paper, we study how a partial preorder representing the prior epistemic state can be revised by another partial pre-order (the new input) from a different perspective, where the revision is conducted recursively on the individual units of partial pre-orders. We propose different revision operators (rules), dubbed the extension, match, inner and outer revision operators, from different revision points of view. We also analyze several properties for these operators.