Theory Competition and the Process of Change

The reasons why many educational change initiatives have little impact are often framed in terms of either a poorly designed process on the part of the change initiator, or in terms of problems with the attitudes, skills and/or knowledge of those responsible for implementation. In this paper, we seek to integrate these two perspectives more closely by focusing on their interface and the competing theories frequently held by the change initiators and implementers. This concept of theory competition is illustrated with a case of a national literacy initiative in New Zealand in which the change initiators wished to raise the achievement of low performing students through the development of “learning-centred” leadership in schools and evidence-based practice. The desired outcomes were not achieved because theories about what it means to be a successful leader in such a situation, the data needed to undertake the type of evidence-based analysis envisioned and school personnel beliefs about the target students were understood differently by those responsible for initiating the change and those responsible for implementing it.     

Curriculum Design of a Flipped Classroom to Enhance Haematology Learning

A common trend in higher education is the “flipped” classroom, which facilitates active learning during class. The flipped approach to teaching was instituted in a haematology ‘major’ class and the students’ attitudes and preferences for the teaching materials were surveyed. The curriculum design was explicit and involved four major components (1) the preparation of the students; (2) the weekly pre-class work; (3) the in-class active learning strategies and (4) closing the learning loop using formative quizzes. Each of these components is discussed in detail and was informed by sound pedagogical strategies. Several different sources of information and several freely available software tools to engage the students are discussed. Two iterations are reported here, with improved pass rate for the final examination from 47 to 48 % in the traditional class to 56–65 % in the flipped classroom approach. The majority of students (93 and 89 %) came to the class prepared, after viewing the screencasts and engaged fully with the activities within the face-to-face time. The students perceived that solving case studies (93 %) was the most beneficial activity for their learning and this was closely followed by the production of essay plans (71 %). The majority of students recommended that this approach be repeated the following year (69 and 75 %).     

Association of Elevated Serum Lipoprotein(a), Inflammation,Oxidative Stress and Chronic Kidney Disease with Hypertension in Non-diabetes Hypertensive Patients

Hypertension is the most common cardiovascular risk factor. Lipoprotein(a) [Lp(a)], inflammation, oxidative stress and chronic kidney disease (CKD) exacerbate the response to tissue injury and acts as markers of the vascular disease, especially in glomerulosclerosis. We compared the clinical characteristics of 138 non-diabetes hypertensive women (ndHT) patients with 417 non-diabetes normotensive subjects and tested the association of hypertension with Lp(a), inflammation, CKD and oxidative stress by using multiple logistic regression. BP, BMI, waist circumference, creatinine, Lp(a), inflammation and malondialdehyde levels were significantly higher and CKD state in the ndHT patients (p < 0.05). Multiple logistic regression showed hypertension associated with increased Lp(a), inflammation, ORs and 95 % CIs were 2.52 (1.33, 4.80), 2.75 (1.44, 5.27) after adjusting for their covariates. Elevated serum Lp(a) and inflammation levels concomitants with increased oxidative stress and CKD were the major risk factors associated with hypertension and implications for the increased risk of HT and vascular disease.     

The effect of extremely high glucose concentrations on 21 routine chemistry and thyroid Abbott assays: interference study

Introduction

Extremely high glucose concentrations have been shown to interfere with creatinine assays especially with Jaffe method in peritoneal dialysate. Because diabetes is the fastest growing chronic disease in the world, laboratories study with varying glucose concentrations. We investigated whether different levels of glucose spiked in serum interfere with 21 routine chemistry and thyroid assays at glucose concentrations between 17-51 mmol/L.

Materials and methods

Baseline (group I) serum pool with glucose concentration of 5.55 (5.44-5.61) mmol/L was prepared from patient sera. Spiking with 20% dextrose solution, sample groups were obtained with glucose concentrations: 17.09, 34.52, and 50.95 mmol/L (group II, III, IV, respectively). Total of 21 biochemistry analytes and thyroid tests were studied on Abbott c8000 and i2000sr with commercial reagents. Bias from baseline value was checked statistically and clinically.

Results

Creatinine increased significantly by 8.74%, 31.66%, 55.31% at groups II, III, IV, respectively with P values of < 0.001. At the median glucose concentration of 50.95 mmol/L, calcium, albumin, chloride and FT4 biased significantly clinically (-0.85%, 1.63%, 0.65%, 7.4% with P values 0.138, 0.214, 0.004, < 0.001, respectively). Remaining assays were free of interference.

Conclusion

Among the numerous biochemical parameters studied, only a few parameters are affected by dramatically increased glucose concentration. The creatinine measurements obtained in human sera with the Jaffe alkaline method at high glucose concentrations should be interpreted with caution. Other tests that were affected with extremely high glucose concentrations were calcium, albumin, chloride and FT4, hence results should be taken into consideration in patients with poor diabetic control.Key words: assay interference, glucose interference, preanalytical phase, creatinine, Jaffe kinetic assay, thyroid function tests     

Hyperactive Grey Objects

Previous papers on grey literature by the authors have described (1) the need for formal metadata to allow machine understanding and therefore scalable operations; (2) the enhancement of repositories of grey (and other) e-publications by linking with CRIS (Current Research Information Systems); (3) the use of the research process to collect metadata incrementally reducing the threshold barrier for end-users and improving quality in an ambient GRIDs environment. This paper takes the development one step further and proposes “intelligent” grey objects. The hypothesis is in 2 parts: (1) that the use of passive catalogs of metadata does not scale (a) in a highly distributed environment with millions of nodes and (b) with vastly increased volumes of R&D output grey publications with associated metadata; (2) that a new paradigm is required that (a) integrates grey with white literature and other R&D outputs such as software, data, products and patents (b) in a self-managing, self-optimizing way and that this paradigm manages automatically curation, provenance digital rights, trust, security and privacy. Concerning (1) existing repositories provide catalogs; harvesting takes increasing time ensuring non-currency. The end-user expends much manual effort/intelligence to utilize the results. The elapsed time of (1) the network (2) the centralized (or centrally controlled distributed) catalog server searches (3) end-user intervention becomes unacceptable. Concerning (2) there is no paradigm currently known to the authors that satisfies the requirement. Our proposal is outlined below. Hyperactive combines both hyperlinking and active properties of a (grey) object. Hyperlinking implies multimedia components linked to form the object and also external links to other resources. The term active implies that objects do not lie passively in a repository to be retrieved by end-users. They “get a life” and the object moves through the network knowing where it is going. A hyperactive grey object is wrapped by its (incrementally recorded) formal metadata and an associated (software) agent. It moves through process steps such as initial concept, authoring, reviewing and depositing in a repository. The workflow is based on the rules and information in the corporate data repository with which the agent interacts. Once the object is deposited, the agent associated with it actively pushes the object to the end-users (or systems) whose metadata indicate interest or an obligation in a workflowed process. The agents check the object and user (or system) metadata for rights, privacy, security parameters, and for any charges and assure compatibility. Alternatively the object can be found passively by end-user or system agents. The object can also associate itself with other objects forming relationships utilising metadata or content. Declared relationships include references and citations; workflowed relationships include versions and also links to corporate information and research datasets and software; inferenced relationships are discovered relationships such as between documents by different authors developed from an earlier idea of a third author. Components of this paradigm have been implemented to some extent. The challenge is implementing—respecting part two of the hypothesis—the integration architecture. This surely is harnessing the power of grey.

Evaluating electronic resources: Personal Development Planning resources at the Open University,a case study

This paper discusses the evaluation of Web‐based tools to support Personal Development Planning (PDP) in order to illustrate issues associated with the introduction and assessment of the effectiveness of online resources. The aims of the evaluation were based on concerns about the very complex situation that offering online resources including PDP poses for part‐time off‐campus students. In this paper the authors utilize a modified RUFDATA framework (Saunders, 2000 Saunders, M. 2000. Beginning an evaluation with RUFDATA: theorising a practical approach to evaluation planning. Evaluation, 1: 7–21.  [Google Scholar]) and consider the benefits a range of methods, including surveys and observational studies, can offer evaluations of electronic resources. They found that students used and valued some aspects of the provision but that even with best efforts of instructional designers, and user testing at the draft stage, students do not always behave as intended. This evaluation highlighted the need for a range of strategies for evaluating online resources and that regardless of student attitude there are real worries about eLearning imposing extra workload burdens on ‘time poor’ adults.