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Introduction: Agitation, mental illness, and delirium are common reasons for older adults to seek care in the emergency department (ED). There are significant knowledge gaps in understanding how to best screen older adults for these conditions and how to manage them. In addition, in areas where research has been performed, implementation has been slow. A working group convened to develop a set of high-priority research questions that would advance the understanding of optimal management of older adults with acute behavioral changes in the ED. This manuscript is the product of a breakout session on “Special Populations: Agitation in the Elderly” from the 2016 Coalition on Psychiatric Emergencies’ first Research Consensus Conference on Acute Mental Illness. Methods: Participants were identified with expertise in emergency medicine (EM), geriatric EM, and psychiatry. Background literature reviews were performed prior to the in-person meeting in four key areas: delirium; dementia; substance abuse or withdrawal; and mental illness in older adults. Input was solicited from all participants during the meeting, and questions were iteratively focused and revised, voted on, and ranked by importance. Results: Fourteen questions were identified by the group with high consensus for their importance related to the care of older adults with agitation in the ED. The questions were grouped into three topic areas: screening and identification; management strategies; and the approach to delirium.  Conclusion: It is important for emergency physicians to recognize the spectrum of underlying causes of behavioral changes, have the tools to screen older adults for those causes, and employ methods to treat the underlying causes and ameliorate their symptoms. Answers to the identified research questions have great potential to improve the care of older adults presenting with behavioral changes.

The Standards for Educational and Psychological Testing identify several strands of validity evidence that may be needed as support for particular interpretations and uses of assessments. Yet assessment validation often does not seem guided by these Standards, with validations lacking a particular strand even when it appears relevant to an assessment. Consequently, the degree to which validity evidence supports the proposed interpretation and use of the assessment may be compromised. Guided by the Standards, this article presents an independent validation of OECD's PISA assessment of mathematical self-efficacy (MSE) as an instructive example of this issue. OECD identifies MSE as one of a number of "factors" explaining student performance in mathematics, thereby serving the "policy orientation" of PISA. However, this independent validation identifies significant shortcomings in the strands of validity evidence available to support this interpretation and use of the assessment. The article therefore demonstrates how the Standards can guide the planning of a validation to ensure it generates the validity evidence relevant to an interpretive argument, particularly for an international large-scale assessment such as PISA. The implication is that assessment validation could yet benefit from the Standards as what Zumbo calls "a global force for testing".

Research has consistently shown 'ability' grouping (tracking) to be prey to poor practice, and to perpetuate inequity. A feature of these problems is inequitable and inaccurate practice in allocation to groups or 'tracks'. Yet little research has examined whether such practices might be improved. Here, we examine survey and interview findings from a large-scale intervention study of grouping practices in 126 English secondary schools. We find that when schools are encouraged to allocate students and move them between groups according to equitable principles by participation in a 'best practice' intervention, there is some increased equity of practice (i.e. a reduction in non-attainment factors used in allocation). However, the majority of schools continue to use subjective and potentially biased information to group students. Furthermore, some schools that claim to be using attainment setting appear to be using the inequitable practice of streaming. Our findings show that improvements in equity are constrained by operational and strategic factors, including timetabling, finance, and teachers' values and beliefs relating to student ability and progression. We suggest strategies for encouraging schools to change their grouping practices, drawing on approaches for working with complex organisations.

'Ability' or attainment grouping can introduce an additional label that influences teachers' expectations of students in specific attainment groups. This paper is based on a survey of 597 teachers across 82 schools and 34 teacher interviews in 10 schools undertaken as part of a large-scale mixed-methods study in England. The paper focuses on English and mathematics teachers' expectations of secondary school students in lower attainment groups, and explores how low-attaining students are constructed as learners who benefit from specific approaches to learning justified through discourses of nurturing and protection. The authors argue that the adoption of different pedagogical approaches for groups of low-attaining learners to nurture them may in some cases be fostering dependency on teachers and cap opportunities for more independent learning. Furthermore, more inclusive whole-school learning-culture approaches may better allow for students across the attainment range to become independent learners.

There is a substantial international literature around the impact of different types of grouping by attainment on the academic and personal outcomes of students. This literature, however, is sparse in student voices, especially in relation to mixed-attainment practices. Research has indicated that students of different attainment levels might have different experiences and views of grouping structures. This paper represents a significant contribution to this literature. Drawing on the data collected as part of a large study on student grouping and teaching in England, we analyse the attitudes of students of different attainment levels to mixed-attainment practice, focusing on their explanations for their preferences or aversion to mixed-attainment classes. The data-set is drawn from group discussions and individual interviews with 89 students age 11/12 (Year 7) from eight secondary schools practicing mixed-attainment grouping in mathematics and English. Our analysis identifies some broad patterns in student attitudes, including a strong preference for mixed attainment among those at lower prior attainment. The analysis of the explanations students give for their opinions on mixed-attainment practice demonstrates how the learner identities of different groups of students are constituted in various ways by the discourses around 'ability', and constrained by the dominant ideology of 'ability' hierarchy.

"Setting" is a widespread practice in the UK, despite little evidence of its efficacy and substantial evidence of its detrimental impact on those allocated to the lowest sets. Taking a Bourdieusian approach, we propose that setting can be understood as a practice through which the social and cultural reproduction of dominant power relations is enacted within schools. Drawing on survey data from 12,178 Year 7 (age 11/12) students and discussion groups and individual interviews with 33 students, conducted as part of a wider project on secondary school grouping practices, we examine the views of students who experience setting, exploring the extent to which the legitimacy of the practice is accepted or challenged, focusing on students' negative views about setting. Analyses show that privileged students (White, middle class) were most likely to be in top sets whereas working-class and Black students were more likely to be in bottom sets. Students in the lowest sets (and boys, Black students and those in receipt of free school meals) were the most likely to express negative views of setting and to question the legitimacy and "fairness" of setting as a practice, whereas top-set students defended the legitimacy of setting and set allocations as "natural" and "deserved". This paper argues that setting is incompatible with social justice approaches to education and calls for the foregrounding of the views of those who are disadvantaged by the practice as a tool for challenging the doxa of setting.

Cognitive interviewing (CI) provides a method of systematically collecting validity evidence of response processes for questionnaire items. CI involves a range of techniques for prompting individuals to verbalise their responses to items. One such technique is concurrent verbalisation, as developed in Think Aloud Protocol (TAP). This article investigates the value of the technique for validating questionnaire items administered to young people in international surveys. To date, the literature on TAP has focused on allaying concerns about "reactivity"--whether response processes are affected by thinking aloud. This article investigates another concern, namely the completeness of concurrent verbalisations--the extent to which respondents verbalise their response processes. An independent, exploratory validation of the PISA assessment of student self-efficacy in mathematics by a small international team of researchers using CI with concurrent verbalisation in four education systems (England, Estonia, Hong Kong, and the Netherlands) provided the basis for this investigation. The researchers found that students generally thought aloud in response to each of the items, thereby providing validity evidence of responses processes varying within and between the education systems, but that practical steps could be taken to increase the completeness of concurrent verbalisations in future validations.

Mixed-attainment teaching has strong support from research and yet English schools are far more likely to teach students in "ability" groups. Although research has considered some of the specific benefits of mixed-attainment grouping, there has been little attention to the reasons schools avoid it. This article explores data from the pilot and recruitment phases of a large-scale study into grouping practices and seeks to identify reasons for the low rate of mixed attainment grouping in English secondary schools. We report on our struggle to recruit schools, and explore the different explanations provided by teachers as to why mixed attainment practice is seen as problematic. The difficulties are characterised as a vicious circle where schools are deterred by a paucity of exemplars and resources and the educational climate is characterised as fearful, risk-averse and time-poor. Suggestions are made as to strategies to support schools in taking up mixed attainment practices.

Grouping students by "ability" is a topic of long-standing contention in English education policy, research and practice. While policy-makers have frequently advocated the practice as reflecting educational "standards", research has consistently failed to find significant benefits of "ability" grouping; and indeed has identified disadvantages for some (low-attaining) pupil groups. However, this research evidence has apparently failed to impact on practice in England. This article, contextualised by the authors' interests in education and social inequality, seeks to do two things. First, it provides a brief analysis of the existing research evidence on the impact of "ability" grouping, with particular reference to socio-economic inequality, identifying seven different explanations for the poorer progress of pupils in low sets that emerge from the literature. Second, it applies Foucaultian "analysis of discourse" to propose potential explanations for the apparent lack of traction of existing research with policy and practice, arguing that practices of "ability grouping" reflect cultural investments in discourses of "natural order" and hierarchy, with particular resonance for the discursive and political habitus of middle-class parents. The authors postulate that investing in a powerful counter-discourse of enlightenment science, illustrated via their current randomised control trial of different approaches to pupil grouping, may offer a means to challenge hegemonic discourses that underpin current classroom practice.

ภาวะกายใจไม่สงบ(agitation)พบบ่อยทั้งในภาวะฉุกเฉินทางอายุรกรรมและจิตเวช การรักษาพยาบาลได้อย่าง เหมาะสมในกรณีดังกล่าวถือเป็นสมรรถนะหลักอย่างหนึ่งของแพทย์เวชศาสตร์ฉุกเฉิน ในบทความนี้ผู้นิพนธ์ ได้รวบรวมการใช้ยารักษาโรคจิตในกลุ่ม first-generation second-generation และยา benzodiazepines เพื่อใช้ ในการรักษาภาวะกายใจไม่สงบ(agitation)ชนิดเฉียบพลัน รวมทั้งนำ�เสนอแนวทางจำ�เพาะในการรักษาภาวะกาย ใจไม่สงบ(agitation)ที่สัมพันธ์กับภาวะต่างๆได้แก่ การได้รับสารพิษ ภาวะจิตเภท อาการเพ้อ(delirium) รวมทั้ง เกิดขึ้นโดยไม่ทราบสาเหตุ การใช้ยาเพื่อรักษาภาวะกายใจไม่สงบควรพิจารณาตามสาเหตุก่อโรคที่เป็นไปได้มาก ที่สุด ถ้าภาวะกายใจไม่สงบเกิดจากอาการเพ้อ(delirium)หรือโรคทางกายอื่นๆ แพทย์ควรทำ�การรักษาสาเหตุก่อ โรคเป็นลำ�ดับแรกแทนที่จะให้เพียงแค่ยารักษาโรคจิตหรือยา benzodiazepines เท่านั้น [West J Emerg Med. 2012;13(1):26–34.]

Agitation is common in the medical and psychiatric emergency department, and appropriate management of agitation is a core competency for emergency clinicians. In this article, the authors review the use of a variety of first-generation antipsychotic drugs, second-generation antipsychotic agents, and benzodiazepines for treatment of acute agitation, and propose specific guidelines for treatment of agitation associated with a variety of conditions, including acute intoxication, psychiatric illness, delirium, and multifocal or idiopathic causes. Pharmacologic treatment of agitation should be based on an assessment of the most likely cause for the agitation. If agitation results from a medical condition or delirium, clinicians should first attempt to treat this underlying cause instead of simply medicating with antipsychotics or benzodiazepines. [West J Emerg Med. 2012;13(1):26–34.]

The development of key competences for lifelong learning has been an important policy imperative for EU Member States. The European Reference Framework of key competences (2006) built on previous developments by the OECD, UNESCO and Member States themselves. It defined key competences as knowledge, skills and attitudes applied appropriately to contexts. Now most Member States have incorporated key competences, or similarly broad learning outcomes, into their school curriculum frameworks. This is a necessary but insufficient step towards implementation; for the effective development of learners' key competences, assessment must also change. This article focuses on the challenge of assessing cross-curricular key competences in primary and secondary education. It is based on a major study for the European Commission (Gordon, "et al.", 2009), which drew on information gathered and validated with the help of experts in each of the 27 EU Member States. The study's typology of assessment provides a basis for reviewing some recent developments in Member States. Present challenges and innovative responses are addressed, including "unpacking" key competences, "mapping" them to contexts and "accessment" of their full scope and range. Policy developments are considered in the context of the author's work with the European Commission's Thematic Working Group on the assessment of key competences. The article concludes with considerations for policy and practice.

Using documented materials, interviews, a questionnaire, and content analysis, Investigated the criteria used by faculty at a British university when grading undergraduate dissertations. Findings indicated considerable ambiguity regarding use, meaning, and application of criteria. (EV)