pre-operative serum potassium levels and peri-operative outcomes in patients undergoing cardiac surgery

Although potassium is critical for normal electro physiology, the associations between pre-operative serum potassium level and peri-operative adverse events such as arrhythmias in cardiac surgery have not been examined in detail. The objective of this study was to determine the prevalence of abnormal pre-operative serum potassium levels and whether such levels were associated with adverse peri-operative events in 50 patients undergoing coronary artery bypass grafting. Intra-operative and post-operative arrhythmias, the need for cardio-pulmonary resuscitation, cardiac death and death due to any cause prior to discharge from the post-operative intensive care unit were studied. The incidence for adverse outcome was 0.5% for death, 0.5% for cardiac death and 2% for cardio pulmonary resuscitation in patients with hypokalemia (serum potassium level <3.5 meq. L⁻¹). Hypokalemia was found to be a predictor of serious peri-operative (OR:2.2; 95% Cl: 1.2–4.1) and post-operative arrhythmias (OR: 1.7;95%Cl: 1.0–2.7). Pre-operative potassium repletion is low cost and low risk treatment measure and the data from this study suggests that screening and repletion be considered in patients scheduled for cardiac surgery.     

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.     

Action groups as a participative strategy for leading whole-school health promotion: Results on implementation from the INCLUSIVE trial in English secondary schools

Education policy increasingly promotes action groups as a key strategy for student and/or staff participation in school improvement and whole-school health promotion. Such groups can coordinate multi-component interventions, increase participation and engagement, and enable local adaptations, but few process evaluations have assessed this. We evaluated fidelity, feasibility and acceptability of action groups as part of a trial of a whole-school intervention to reduce bullying and aggression and promote health in English secondary schools, which reported multiple health and educational impacts. Action groups involved students and staff, supported by external facilitators, and drew on data on student needs. They aimed to: coordinate implementation of restorative practices and a social and emotional competencies curriculum; review policies and rules; and enact local decisions to modify school environments. Our process evaluation used interviews, focus groups, observations and questionnaires to assess action groups’ fidelity, role in coordination, role in local adaptation, support from external facilitators and data on student needs, and acceptability in engaging members. Fidelity was high in the first two years but lower in the third year when external facilitators withdrew. Student needs data were perceived as useful, but views on external facilitators were mixed. Groups successfully reviewed policies and rules, planned activities and coordinated restorative practices, but were less successful in implementing the curriculum. Success was facilitated by the involvement of school leaders. Members reported high satisfaction and empowerment. Action groups are a promising strategy for leading whole-school health promotion. Implementation is supported by external facilitation, local data and involvement of senior managers.     

The Teacher Behavior Inventory: validation of teacher behavior in an interactive lecture environment

Students’ rating of teacher behaviors provides valuable information on teaching improvement and instructional quality. Unfortunately, there is a lack of new validated instruments for measuring teacher behaviors. The Teacher Behaviors Inventory is an old inventory that was initially developed to measure teaching behaviors as regards lecture-based instructions, which is effected through the use of low-inference items. The aim of this study was to assess its continued suitability in the present educational setting by examining its construct validity and internal consistency through the lens of one lecturer’s teaching behaviors, as rated by 527 students after six interactive lectures. The variables evaluated, as mentioned above, were achieved after an items removal process, which resulted in a 32-item version. Apart from being valid and reliable, this condensed version allows for immediate assessment of teaching behaviors after an instruction session as the rating procedure is now more straightforward and less time-consuming, and also enables a reduction in rating errors. Therefore, the 32-item format serves as a practical diagnostic feedback tool in the present educational arena, permitting a longitudinal teaching behavior assessment to enhance teachers’ professional development.     

Development and Implementation of the Inaugural Anatomy Education Research Institute (AERI 2017)

Education research is increasingly being recognized as a legitimate route for faculty development in universities. However, many anatomy faculty lack the appropriate training and access to experienced mentors who can help them develop their own education research projects. Inspired by the American Physiological Society’s Institute for Teaching and Learning, the coauthors proposed and developed the inaugural Anatomy Education Research Institute (AERI 2017). Funded by an American Association of Anatomists Innovations grant, the five-day institute was held in Bloomington, Indiana in July 2017. The coauthors spent two years preparing the conference schedule, inviting speakers who could discuss education research topics and mentor applicants, reviewing applications, developing assessment instruments for the institute, and hosting the institute. A total of 62 registered participants (applicants and invited speakers) attended AERI 2017. Through a series of presentations and workshops, participants were introduced to many aspects of education research and the Scholarship of Teaching and Learning, including developing rigorous education research questions, determining appropriate methods to assess these questions, and searching the education research literature. Each day also included regular time devoted to work on their own education research project with help from more experienced mentors. Throughout the conference, participants were encouraged to post information on Twitter, using the hashtag #AERI2017. Participants had strong positive impressions of the conference and strongly requested future AERI conferences be held. Follow-up analyses will assess the institute in alignment with Kirkpatrick’s Four Levels of Evaluation Model, though preliminary evaluation indicates AERI 2017 met the original aims of the proposal.     

Turnover Causation Amongst High School Teachers in Nigeria

Four theoretical frameworks were used to explore causations of turnover amongst high school teachers in Nigeria: (1) teachers’ personal health, (2) work–family life, (3) job satisfaction, and (4) actual turnover intention. Quantitative data were obtained from 925 public high school teachers in Ogun State, South-Western Nigeria. Cronbach's Alpha reliability procedure, regression modelling and t-test were used to analyse a total of 96 causations of turnover. Ad hoc analysis returned an Alpha value of 0.78. However, this improved to 0.93 when the causation factors were reduced to 64 – those with highest item-rest and itemtotal correlations. The findings showed that job (dis)satisfaction, personal health and work– family life conflict are prominent amongst the issues that trigger the intention of Nigerian high school teachers to quit their jobs voluntarily. Insights from the findings will help funding administrators in prioritising strategic decisions around mitigating turnover.