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Purpose In reflective writing, students are encouraged to examine their own setbacks and progress. With a shortage of guidance in how to provide feedback to students on this type of writing, teachers are often left to figure it out on the job. The central hypothesis in this paper is that the lens of reflective practice can help focus teacher efforts and ultimately improve both feedback and instruction. The purpose of this paper is not to produce a universal prescription for assessing reflective writing but rather a protocol for teacher reflective practice that can apply to challenging grading and feedback-giving situations. Design/methodology/approach Student assessment is a chance for teachers to learn about their students’ abilities and challenges and to provide feedback for improvement. Assessment and grading sessions can also become opportunities for teachers to examine their own instructional and assessment practices. This self-examination process, a cornerstone of reflective practice (Schön, 1984), is challenging, but it may be especially valuable when guidelines for feedback and assessment are hard to come by. Such may be said to be the case in student-centered learning environments such as school Fablabs and makerspaces, where stated goals commonly include cultivating learner self-regulation and resilience. These hard-to-measure constructs are typically assessed through analysis of student reflective journals. This in-depth case study uses mixed-methods to examine how a semester-long intervention affected the grading, feedback and instructional practices of a teacher in a hands-on design classroom. The intervention involved 10 grade-aloud sessions using a computer-based rubric tool (Gradescope) and a culminating card-sorting task. The lens of reflective practice was applied to understanding the teacher’s development of their own reflective capabilities. Findings During the intervention, the participating teacher grappled with grading and feedback-giving dilemmas which led to clarifications of assessment objectives; changes to instruction; and improved feedback-giving practices, many of which persisted after the intervention. The teacher perceived the intervention as adding both rigor and productive “soul-searching” to their professional practice. Lasting changes in feedback behaviors included a comprehensive rubric and an increase in the frequency, specificity and depth of feedback given to student written work. Originality/value Significant prior efforts have been directed separately at the use of reflective practice for teachers, in general, and on the feedback and grading of student process journals. This work combines these lines of inquiry in the reflective classroom assessment protocol, a novel on-the-job professional development opportunity that fosters reflective practice in times of assessment to improve instructional and feedback practices.

We report on an exploratory effort to design an interest-based learning experience for high school (step) dancers to engage with concepts in mathematics and data science. We hypothesized that generating and analyzing data from their own dance movement, through motion and audio capture, would (a) enable learners to form analogies between off-line embodied experiences and new abstract concepts and (b) support motivation to learn due to perceived relevance and usefulness of data science to dance practice. Based on initial interviews to understand the specific needs and interests of the steppers, we developed some early prototypes for visual and acoustic analysis, concentrating on pose precision, tempo, and spectral characteristics (timbre) for. Teacher and student reactions to the tools demonstrated support for our hypotheses that off-line embodied cognition would help with new knowledge acquisition and that the perceived usefulness of data science would motivate learning. Several promising future directions remain to develop an interest-based and embodied data science curriculum.

We present an exploratory study on the use of ontologies for student assessment during a focus group with teachers in student-centered learning environments. The work is framed by a theoretical argument about coherence between instructional values and assessment systems, and how this may be achieved through a ‘community of judgment’ with teachers at the center. The purpose of the study was to understand the process and perceived usefulness of collaborative ontology development, at a narrative and conceptual level without grades or detailed probabilistic relationships. Findings of two kinds are discussed. First, we identified a set of framework-building moves used by teachers during ontology-based reasoning. Second, we present evidence that participants perceived the ontology development process to be useful and empowering in sharpening their ability to communicate nuanced assessment arguments.

The challenge of assessing student progress and using information gained through assessment to improve teaching and learning is formidable. It can be argued that in student-centered learning (SCL) environments that challenge is even greater than in traditional frontal instruction classrooms. To better understand the assessment and feedback-giving practices of teachers in SCL classrooms, we invited teachers from across the United States to share with us their classroom practices relating to assessment and feedback-giving, the types of feedback they give to students, and their beliefs about the benefits and costs associated with feedback-giving. The goal of this report is to share back our preliminary findings with the participating teachers.

The current study analyzes the information collected and the lessons learned during the first six months of the CONNECARE project in Israel, in order to assess the use of the mobile technology by patients, their motivations and obstacles; as well as their satisfaction. As of the middle of February 2019, 59 patients were recruited and 18 discharged from the project and completed the feedback questionnaires. Based on preliminary data presented in this chapter, as measured against the McGaughey et al. Research Framework, it can be concluded that the usage of the CONNECARE mobile platform can be rated as moderate. The analysis together with insights from the literature, suggest that usage of the CONNECARE app could be improved by introducing additional features that would increase patients' motivation to use the system as well as its full integration into usual healthcare processes.

Overcoming Integration Failure Through Negotiation – A Workshop for Doers and Planners . "CONNECARE; A Bridge Over Troubled Waters" How to resolve conflicts of interest that prevent integrated care – an interactive workshop to generate solutions for shared dilemmas, based on real-life experience. Background: Learnings from a real life integrated healthcare venture: a new general hospital (Samson Assuta Ashdod, Israel) with an integrated care vision, in partnership with a healthcare insurer and provider of community healthcare services (Maccabi) and social services, supported by an H2020 project – CONNECARE - aimed to create and implement a digitally supported integrated care model. Why is moving from vision to reality so difficult? What are the main obstacles and challenges? How can we overcome the diverse and conflicting interests and perspectives of the major stakeholders? Aims and Objective of the workshop: To identify the different and sometimes conflicting interests of the major stakeholders – the Payer(s) (State, Region, Municipality, social insurer), the providers ( clinicians, provider organizations), the patient and his caregivers To set up consensus groups with "representatives" of all stakeholders To challenge the participants in the consensus groups to negotiate a workable integrated care model that takes into account the interests of all stakeholders To share learnings among the groups To briefly share 4 patient- centered innovative integrated care solutions that have been implemented in Ashdod with preliminary results Format: Introduction to the workshop (10 minutes) a. Setting the Scene – Dr Rachelle Kaye (4 minutes) b. Barriers to Integration – Hospital Perspective – Dr. Ofer Chen (3 minutes) c. Barriers to integration – Payer/Community Services Perspective –Keren Schecter Azoulay ( 3 minutes) Divide participants into small groups – their task to negotiate an integrated care model that takes into account the needs and interests of each stakeholder group (20 minutes) Presentation of small group findings and discussion - Dr. Rachelle Kaye, moderator (10 minutes) Presentation of integrated care solutions in Ashdod (15 minutes) a. Home Hospitalization and Home Rehabilitation – Dr Ofer Chen (5minutes) b. Community integrated care units in the hospital – Keren SchechterAzulay (5 minutes) c. CONNECARE – patient empowerment through digitally supported coordinated care – Reut Ron (5 minutes) Summary of learnings and comments from participants (5 minutes) Target audience: Health care managers, Clinicians, Researchers Learnings/Take away: Analysis of practical challenges and barriers in Implementing Integrated Care Building New models for implementing integrated care in practice that overcome the barriers Implications of Learnings for other environments

Background: Inflammatory bowel disease (IBD) is characterized by increased lymphocytic infiltrate to the lamina propria (LP) and upregulation of inflammatory chemokines and receptors. CXCL12 is a constitutive chemokine involved in lung, brain, and joint inflammation. We hypothesized that CXCL12 and its receptor, CXCR4, would have a constitutive and inflammatory role in the gut. Methods: Intestinal epithelial cells (IECs) and T lymphocytes were isolated from intestinal mucosa of IBD and control patients undergoing bowel resection. Autologous T cells were isolated from peripheral blood (PB). CXCL12 and CXCR4 expression by IECs was assessed by polymerase chain reaction and immunohistochemistry, lymphocyte phenotype by flow cytometry, and migration by Transwells. Results: IECs expressed CXCL12 and expression was increased and more diffuse in IBD compared to normal crypts (ulcerative colitis [UC] > Crohn's disease [CD], inflamed > noninflamed). CXCR4 was expressed by IECs, LP T cells (LPTs), and PB T cells (PBTs), and CXCR4+ cells were increased in IBD LP in situ. PBTs and LPTs from all patients had a high and comparable migration toward CXCL12 (P < 0.0001 and P < 0.05 vs. medium, respectively). Migration toward IBD-IEC-derived supernatant was significantly higher compared to normal. Antibodies against CXCR4 and CXCL12 blocked migration. Conclusions: CXCL12 is expressed by normal IECs and upregulated and differentially distributed in IBD IECs. CXCR4 is expressed by IECs and LPTs, and CXCR4+ cells are significantly increased in IBD LP. CXCL12 is chemotactic for both PBTs and LPTs. Thus, CXCL12 and CXCR4 have a constitutive and inflammatory role in the intestinal mucosa and their selective therapeutic manipulation may be considered in IBD management. (Inflamm Bowel Dis 2009;)

Background In contrast to healthy adults or critically ill patients, data on serum cortisol levels in noncritically ill patients admitted to general internal medicine wards has not been well characterized. We aimed to describe the distribution and range of serum cortisol levels in patients admitted to the department of medicine, to discover whether old age, severe infections, or comorbidity induced a blunted hypothalamic-pituitary-adrenal (HPA) response and whether initial serum cortisol value had a prognostic significance. Methods Morning (8 am) serum cortisol level together with epidemiologic, clinical, and laboratory data were analyzed for 252 consecutive adult (age ≥ 18 yrs) patients admitted to the department of internal medicine during a 6-weeks period. Results The mean serum cortisol level (541 ± 268 nmol/L) was within the normal range. Only one patient had a low serum cortisol level of 72 nmol/L, whereas the majority of patients had either normal (80%) or increased (19%) serum cortisol levels. Older age, sepsis, prolonged duration of fever, higher comorbidity score, and higher serum creatinine level were each associated with significantly higher serum cortisol level. In addition, a higher serum cortisol level was significantly related to longer hospitalization and higher in-hospital mortality rate. Conclusions Serum cortisol level positively correlated with age, disease severity, and outcome. All admitted patients, except one, had normal to high serum cortisol. Whether this increased cortisol level is an adequate HPA response or less than required for the disease-induced stress should be investigated in further studies.