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 %).     

知识管理在中美教育机构中的应用研究

目前知识管理在教育机构中的应用较为滞后 ,但其思想和方法同样适用于像大学、教育管理部门这样的组织机构。教育机构也可以通过实施知识管理达到提高响应能力和工作效率的目的。在高等教育中 ,知识管理工作体现在面向学生的教学和管理活动中。通过对中美两国教育机构调研的数据分析可以看出 ,在与知识管理相关的因素分析上 ,如知识管理的实施与激励形式、作用力和学校规模等方面 ,中国学校与美国学校在认识上具有不同的相关程度。这些差异反映了两国知识管理发展水平的不同 ,同时 ,对中国的高校实施知识管理具有启发意义 ,即知识管理本身本非目的 ,而是一种手段 ,应将它同具体的工作有机结合 ,才能取得更好的效果。     

Clinico-Biochemical indexing of calcium urolithiasis on the basis of urinary citrate to calcium ratio and inhibition of mineralisation of urinary stone forming minerals by human urine

Urinary citric acid and calcium levels have been estimated in the urine of 20 normal healthy persons as well as 12 urinary stone patients. Inhibition efficiency of these urine samples towards the mineralisation of urinary stone forming minerals, viz., calcium phosphate, oxalate or carbonate, has been studied in an experimental model. Statistical correlation of the above data has been made by computing the coefficient of determination and unexplained variance. Clinico-biochemical indexing of calcium urolithiasis risk factor has been attempted in the light of the data.     

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     

Prostate specific antigen in patients of benign prostate hypertrophy and carcinoma prostate

Prostate Specific Antigen (PSA) has emerged as the most applicable and important tumor marker for carcinoma prostate. In the present study PSA was determined in serum of healthy subjects, patients of benign prostate hypertrophy (BPH) and Carcinoma Prostate (Ca−P) to evaluate its diagnostic efficiency in day to day management of prostate cancer patients and in differentiating patients of early prostate cancer from those with BPH. Receiver operating characteristic curve (ROC) revealed 2 ng/ml and 10 ng/ml cut off serum PSA level for BPH and untreated carcinoma prostate patients (Ca−P). An extremely significant increase (P<0.0001) was observed in mean PSA concentration in BPH patients and adenocarcinoma prostate patients when compared to healthy males. Clinical relevance of PSA was highlighted by a case study of cancer patient prior to any therapy till death.