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Early encounters with patients provide a valuable opportunity to understand their presenting complaints and needs. In order to do this effectively, it is important to have a structured approach to evaluating their symptoms. Using a step-by-step approach, this chapter instructs you how to understand a patient’s initial presenting complaints and assess their needs in an initial assessment. This includes setting the scene with the patient, evaluating their insomnia using a structured sleep interview, and using observation to obtain helpful and pertinent clinical information in collaboration with your patient.
The last two decades have been marked by excitement for measuring implicit attitudes and implicit biases, as well as optimism that new technologies have made this possible. Despite considerable attention, this movement is marked by weak measures. Current implicit measures do not have the psychometric properties needed to meet the standards required for psychological assessment or necessary for reliable criterion prediction. Some of the creativity that defines this approach has also introduced measures with unusual properties that constrain their applications and limit interpretations. We illustrate these problems by summarizing our research using the Implicit Association Test (IAT) as a case study to reveal the challenges these measures face. We consider such issues as reliability, validity, model misspecification, sources of both random and systematic method variance, as well as unusual and arbitrary properties of the IAT’s metric and scoring algorithm. We then review and critique four new interpretations of the IAT that have been advanced to defend the measure and its properties. We conclude that the IAT is not a viable measure of individual differences in biases or attitudes. Efforts to prove otherwise have diverted resources and attention, limiting progress in the scientific study of racism and bias.
In today’s complex world, we know as educators that learning is most meaningful when established through experience – learning by doing rather than by simply listening or observing. Our learners need to be supported in nurturing their creativity, developing as critical thinkers and flexible problem solvers, to apply skills and understanding in new domains and different situations creating solutions to problems encountered. Education and life should not be isolated from each other. By providing opportunities for learners to engage and learn through authentic, real-life, relevant experiences, we are scaffolding their application of skills to learning including adapting and changing their ideas and forming habits of lifelong learners. This chapter provides educators with a guide for embedding cross-curricular exploratory learning experiences as an integral part of planning, teaching and assessment responsive to all learners; and inclusive of the theoretical foundations and instructional strategies that inform their approaches. Authentic studies will be utilised, and practical tools outlined, to demonstrate how to bring these concepts to life within a constructivist framework.
To evaluate the impact of receptive vocabulary versus years of education on neuropsychological performance of Black and White older adults.
Method:
A community-based prospectively enrolled cohort (n = 1,007; 130 Black, 877 White) in the Emory Healthy Brain Study were administered the NIH Toolbox Picture Vocabulary Test and neuropsychological measures. Group differences were evaluated with age, sex, and education or age, sex, and Toolbox Vocabulary scores as covariates to determine whether performance differences between Black versus White participants were attenuated or eliminated.
Results:
With vocabulary as a covariate, the main effect of race was no longer significant for the MoCA, Phonemic Fluency, Rey Auditory Verbal Learning Test, and Rey Complex Figure Test immediate and delayed recall. Although still significantly different between groups, the effect sizes for Animal Fluency, Trails B-A, Symbol Digit Modalities Test, and Rey Copy were attenuated, with the greatest reductions occurring for the Multilingual Naming Test and Judgment of Line Orientation.
Conclusions:
Findings support the value of using receptive vocabulary as a proxy for premorbid ability level when comparing the cognitive performance of Black and White older adults. The results extend investigations using measures of single word reading to encompass measures assessing word meaning.
Project-based learning (PBL) has gained widespread acceptance as a cutting-edge teaching approach in universities, particularly for imparting engineering design skills. PBL allows students to showcase their design skills and put into practice the theoretical concepts acquired through instruction. Throughout the various phases of the design process and project execution, students prepare design artifacts, which serve as tangible indicators of their design skills – an essential competency for engineers. The objective of this research is to evaluate and compare the application of engineering design skills among first-year and third-year engineering students as evidenced by their design artifacts. This comparative analysis aims to pinpoint areas of strength and opportunities for growth, thereby offering a holistic view of student development in design proficiency throughout their undergraduate education. Employing a standardized rubric to evaluate these artifacts allows for an unbiased assessment of the students’ design process acumen. The findings offer insights into the design skill proficiency of two student groups at different points in the design process. It is imperative for engineering educators to strategically highlight every aspect of the design process within PBL, ensuring the comprehensive development of design competencies.
Entrustable professional activities (EPAs) have gained traction in the medical education field as a means of assessing competencies. Essentially, an EPA is a profession-specific task that a trainee is entrusted to conduct unsupervised, once deemed competent by their supervisor through prior evaluations and discussions. The integration of EPAs into postgraduate assessment strategies enhances the delivery of capability-based curricula. It strategically bridges the theoretical–practical divide and addresses existing issues associated with workplace-based assessments (WBPAs). This article aims to (a) provide an overview of EPAs, (b) review the application of EPAs in postgraduate psychiatry so far, exploring their conceptual framework, implementation, qualities and potential benefits and concerns, and (c) propose a theoretical framework for their integration into the UK psychiatry curriculum.
Part of a wider study of family interaction, this chapter focuses on the interactional competence of a person living with dementia and some ways in which her independence is facilitated, and personhood validated, by her interlocutors. Drawing on a corpus of 15 hours of naturally occurring conversation, the study investigates the interactional practices of a woman diagnosed with dementia (Dana) in conversation with a variety of interlocutors including family caregivers, teenage grandchildren and community service providers. This chapter examines sequences of advice-giving, shared reminiscence and occasions of confusion. Dana first draws on a lifetime of expertise as a waitress to advise her granddaughter who has recently begun her first job; second, in a sequence of reminiscence, conversational partners describe a shared experience that Dana is able to assess and engage with despite potentially being unable to remember the details for herself; finally, the analysis shows how the actions of probing and testing can lead to interactional breakdown and confusion, but then note how Dana is able to recover from the situation by moving to a familiar topic and claiming epistemic authority.
The chapter explores Hamas’s strategic analysis and study of Israel and the IDF. As part of its intelligence warfare, Hamas strove to increase its knowledge of the enemy. This chapter describes Hamas’s accumulation of intelligence about Israeli weaponry, IDF units, Israeli battlefield tactics, operational training, and so on. The organization particularly sought information about the capabilities of Israeli armored vehicles in order to inform its use of anti-tank weaponry. The chapter also illustrates how Hamas disseminated this knowledge in its ranks. This chapter goes on to analyze Hamas’s operational preparations for war after Israel’s withdrawal from the Gaza Strip. Further, it examines Hamas’s ongoing assessment of the possibility and characteristics of a large-scale Israeli attack, and in particular the analysis of the Israeli political and social situation used by Hamas in order to form such an assessment. In this manner, the chapter discusses the influence of Hamas’s “enemy image” of Israel – an image based on the organization’s Palestinian Islamic ideology as well as its interpretation of events and social processes in Israel – on the organization’s assessment of its enemy. The chapter also sheds light on the organization’s difficulties in strategic analysis of Israel.
Introduction: Dementia continues to be a global health concern owed to its increasing prevalence and coupled with physical and psychological burden. It is also the most feared diagnosis amongst older adults which may contribute to underdiagnosis. Pre-assessment counselling (PAC) may reduce fear and increase diagnoses when people with suspected cognitive impairment are empowered with choice and feel in control of their diagnosis journey.
Methods: This study recruited 10 clinicians from an NHS memory clinic in England, UK, and, using semi-structured interviews, sought to understand the mechanisms and effectiveness of PAC.
Results: Using reflective thematic analysis, 3 themes were found. 1. The person with dementia (PwD) is central in their diagnosis journey. 2. Candid conversations build strong therapeutic alliances. 3. Patients are more than their diagnoses.
Discussion: Clinicians emphasized the importance of timely diagnosis for the wellbeing of PwD, while also recognizing the need for patient-centred and collaborative approaches. Additionally, the study highlighted the significance of empowering PwD in decision-making processes, fostering resilience through comprehensive support, and addressing stigma through candid conversations to improve diagnostic outcomes and enhance patient engagement in dementia care. The study indicates that PAC is effective in enabling timely diagnoses, but there is a lack of dedicated appointments in NHS Trusts where PwD are empowered to manage their dementia journey and subsequent care.
The Suicide Cognitions Scale (SCS) has demonstrated considerable promise as a risk screening tool, although it has yet to be validated for use with adolescents or in Spanish-speaking populations. The aim of this study was to develop a Spanish version of the 16-item SCS-Revised (SCS-R) and to examine its psychometric properties in a sample of adolescents. Participants were 172 adolescents aged between 12 and 18 years (M = 15.32, SD = 1.57) and currently in residential care. They completed the Spanish SCS-R and a series of other psychological measures. The psychometric properties of the SCS-R were examined through factor analyses and testing of convergent/discriminant validity and construct validity. Factor analyses supported a bifactor structure, indicating that SCS-R items were primarily measuring a common underlying latent variable. SCS-R scores were positively correlated with multiple indicators of psychopathology and other suicide risk factors (e.g., depression, hopelessness) but negatively correlated with protective factors (e.g., believing that one’s mental pain will eventually end). Importantly, SCS-R scores differentiated adolescents in residential care who had previously attempted suicide from those who had only thought about suicide. Scores also differentiated adolescents who had previously attempted suicide from those who had previously only engaged in non-suicidal self-injury. This constitutes further evidence that the SCS-R measures a construct that distinguishes suicidal thought from action and is specific to suicidal forms of self-harm. Overall, the results suggest that the Spanish SCS-R is a potentially useful tool for identifying adolescents at risk of attempting suicide in residential care.
An introduction and overview of the mental health conditions relevant to people with intellectual disability. The chapter focuses on the evidence base to support or refute whether they suffer greater rates of mental health problems, Psychiatric classification and prescribing; Comparison tables of international classification of diseases (ICD) versions 10 and 11; and the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) 4 and 5 and DC-LD.
This chapter provides the tools to compute catastrophe (CAT) risk, which represents a compound measure of the likelihood and magnitude of adverse consequences affecting structures, individuals, and valuable assets. The process consists of first establishing an inventory of assets (here real or simulated) exposed to potential hazards (exposure module). Estimating the expected damage resulting from a given hazard load (according to Chapter 2) is the second crucial step in the assessment process (vulnerability module). The application of damage functions to exposure data forms the basis for calculating loss estimates (loss module). To ensure consistency across perils, the mean damage ratio is used as the main measure for damage footprints D(x,y), with the final loss footprints simply expressed as L(x,y) = D(x,y) × ν(x,y), where ν(x,y) represents the exposure footprint. Damage functions are provided for various hazard loads: blasts (explosions and asteroid impacts), earthquakes, floods, hail, landslides, volcanic eruptions, and wind.
Pronunciation teaching is often based on assumptions that learners are monolingual speakers, with the sound system of their native language determining the segmental and suprasegmental difficulties that mark learners’ foreign accents. However, many, if not a majority of speakers of other languages come to pronunciation with more than one language under their command. These bilingual/multilingual speakers are the norm in a globalized world, but how we teach pronunciation rarely accounts for the knowledge and skills these speakers bring to the learning of pronunciation. This chapter describes how the characteristics of bilingual speakers suggest how pronunciation teaching can be reimagined to take into account the range and flexibility of bilingual speakers in using multiple languages. Specifically, we argue that taking a nativeness viewpoint is inconsistent with taking a bilingual viewpoint and calls for pedagogical techniques that build on the kinds of needs bilingual speakers have in pronouncing additional languages.
This chapter explores in detail the professional challenges, criteria, and principles for selecting, creating, and preparing materials and tasks for language learning. Teachers must not only be able to utilise and evaluate the language learning materials available, including those in coursebooks but also engage in a profound professional reflection on the choice of texts and language learning exercises, activities, and tasks, and ways of working with them. Beyond such critical reflections, teachers also need to be able to develop materials and design tasks both independently and in collaboration with other teachers. Therefore, this chapter discusses typologies of tasks, a model of the complex task, and potential strategies for assessing outcomes of complex tasks.
To introduce the Emory 10-element Complex Figure (CF) scoring system and recognition task. We evaluated the relationship between Emory CF scoring and traditional Osterrieth CF scoring approach in cognitively healthy volunteers. Additionally, a cohort of patients undergoing deep brain stimulation (DBS) evaluation was assessed to compare the scoring methods in a clinical population.
Method:
The study included 315 volunteers from the Emory Healthy Brain Study (EHBS) with Montreal Cognitive Assessment (MoCA) scores of 24/30 or higher. The clinical group consisted of 84 DBS candidates. Scoring time differences were analyzed in a subset of 48 DBS candidates.
Results:
High correlations between scoring methods were present for non-recognition components in both cohorts (EHBS: Copy r = 0.76, Immediate r = 0.86, Delayed r = 0.85, Recognition r = 47; DBS: Copy r = 0.80, Immediate r = 0.84, Delayed Recall r = 0.85, Recognition r = 0.37). Emory CF scoring times were significantly shorter than Osterrieth times across non-recognition conditions (all p < 0.00001, individual Cohen’s d: 1.4–2.4), resulting in an average time savings of 57%. DBS patients scored lower than EHBS participants across CF memory measures, with larger effect sizes for Emory CF scoring (Cohen’s d range = 1.0–1.2). Emory CF scoring demonstrated better group classification in logistic regression models, improving DBS candidate classification from 16.7% to 32.1% compared to Osterrieth scoring.
Conclusions:
Emory CF scoring yields results that are highly correlated with traditional Osterrieth scoring, significantly reduces scoring time burden, and demonstrates greater sensitivity to memory decline in DBS candidates. Its efficiency and sensitivity make Emory CF scoring well-suited for broader implementation in clinical research.
To describe the type of evidence and the clinical benefit of cancer medicines assessed for funding in Australia by the Pharmaceutical Benefits Advisory Committee (PBAC) and to assess it with the European Society of Medical Oncology Magnitude of Clinical Benefit Scale version 1.1 (ESMO-MCBS).
Methods
All data on applications submitted to PBAC between 2010 and 2020 were extracted from PBAC Public Summary Documents available online. ESMO-MCBS ratings were retrieved from the ESMO-MCBS website.
Results
Then, 182 cancer indications for 100 cancer medicines were examined by PBAC, including 124 (68.1 percent) for solid tumors and 58 (31.9 percent) for hematological cancers. A total of 137 (75.3 percent) indications were recommended for PBS funding and 40 (21.9 percent) were rejected. Randomized clinical trials (RCTs) were the main source of evidence in 154 indications (84.6 percent), single-arm studies in 28 (15.4 percent) indications. Statistically significant improvement in overall survival (OS) was reported in 80 (44 percent) of the indications, with a median OS gain of 3.0 months (range 0.9–17.0) for solid tumors and 8.2 months (range 1–49.1) for hematological cancers when mature OS data were available. The ESMO-MCBS score was available for 99 solid tumor indications, of which 51 (51.5 percent) showed substantial clinical benefit according to ESMO-MCBS, including 40 (54.1 percent) of PBAC-recommended indications and 9 (42.9 percent) of PBAC-rejected indications. There was no association between the ESMO scoring and PBAC decision.
Conclusions
Most cancer medicines indications considered by PBAC were supported by RCTs. A minority showed a substantial improvement in OS.
Many books have been written on the topic of second language assessment, but few are easily accessible for both students and practicing language teachers. This textbook provides an up-to-date and engaging introduction to this topic, using anecdotal and real-world examples to illustrate key concepts and principles. It seamlessly connects qualitative and quantitative approaches and the use of technologies, including generative AI, to language assessment development and analysis for students with little background in these areas. Hands-on activities, exercises, and discussion questions provide opportunities for application and reflection, and the inclusion of additional resources and detailed appendices cements understanding. Ancillary resources are available including datasets and videos for students, PowerPoint teaching slides and a teacher's guide for instructors. Packed with pedagogy, this is an invaluable resource for both first and second language speakers of English, students on applied linguistics or teacher education courses, and practicing teachers of any language.
This study examined the validity of a visual inspection time (IT) task as a measure of processing speed (PS) in a sample of children with and without cerebral palsy (CP). IT tasks measure visualization speed without focusing on the motor response time to indicate decision making about the properties of those stimuli.
Methods:
Participants were 113 children ages 8–16, including 45 with congenital CP, and 68 typically developing peers. Measures were a standard visual IT task that required dual key responding and a modified version using an assistive technology button with response option scanning. Performance on these measures was examined against traditional Wechsler PS measures (Coding, Symbol Search).
Results:
IT performance shared considerable variance with traditional paper-pencil PS measures for the group with CP, but not necessarily in the typically developing group. Concurrent validity was found for both IT task versions with traditional PS measures in the group with CP. IT classification accuracy for lowered PS showed modest sensitivity and good specificity particularly for the modified IT task.
Conclusions:
As measures of PS in children with CP who are unable to validly participate in traditional PS tasks, IT tasks demonstrate adequate concurrent validity and may serve as a beneficial alternative measure of PS in this population.
In Chapter 1, the author begins by defining “language assessment” and “test” and discusses how people use them differently. A major aim of the chapter is to engage readers who have concerns about the use and effectiveness of language assessments by recognizing their potential for unfairness and discussing how users can avoid such negative consequences. To achieve this aim, the author introduces readers to some misuses of language assessment, including the infamous Shibboleth Test, the Australian Dictation Test, and the Louisiana Literacy Test. People used these assessments to intentionally discriminate against certain groups of individuals. The author then presents Kremmel and Harding’s nine aspects of language assessment literacy and discusses what this framework suggests about being language assessment literate and how following it can limit inappropriate uses of language assessments. At the end of the chapter, the author encourages readers to evaluate their own language assessment literacy.
Part III provides brief descriptions of the most frequently used self-reported questionnaires (ORTO-15, Eating Habits Questionnaire, Düsseldorf Orthorexia Scale, Teruel Orthorexia Scale, Barcelona Orthorexia Scale, Orthorexia Nervosa Inventory, ORTO-R, Orthorexia Self-Test), to outline those that seem to be suitable as self-assessment tools to measure orthorexia nervosa and those that are promising in research and clinical settings. It also proposes Orthorexia Nervosa Screening Questions to detect the risk of orthorexia nervosa. A summation of the highlights is included at the end of this chapter. The commentary of the invited international expert (Dr Adrian Meule, the University Hospital of the LMU Munich and the Schoen Clinic Roseneck, Germany ) provides valuable insights on orthorexia nervosa.