Central auditory processing and central auditory processing disorder: Fundamental questions and considerations

Despite several decades of research, neither clinicians nor academics can agree on a single definition of central auditory processing (CAP) or central auditory processing disorder (CAPD). This article considers why this is the case, and comments on the resulting implications for CAP assessment and CAPD rehabilitation in the clinic.

Responding to our customers' needs: modifications to assessment in Obstetrics and Gynaecology over 20 years

Background and Objectives: This paper reports on historical changes in assessment culminating in the experience of one discipline with negotiated student feedback that has helped design and modify assessment to cater for the requirements of both students and teachers. The standard of assessment required to pass Obstetrics and Gynaecology in the four year graduate entry program in the School of Medicine at The University of Queensland, Brisbane, Australia has become less formalised and more collaborative. Changes in assessment in this discipline over the last 20 years reflect the development of an understanding of the educational principles associated with adult teaching and learning. Assessment has evolved from being teacher focussed, with questionable reliability, validity, and emphasis on outcomes, to being focussed on learning and the student. Multiplechoice examinations, combined with a collaborative approach to the reliability and validity of questions and answers and a debrief or feedback session have been found to provide an assessment format that is art acceptable measure oflearning for both teachers and students. Changes in assessment reflect a collaborative process between teachers and students based on principles of adult learning and involving negotiated student feedback. Our experience with this form of negotiated outcome for assessment is presented together with suggestions for improvement and is contrasted with assessment methods used in this department over the last 20 years. Change and refinement will continue as medical programs strive to meet the learning needs of students and assessment outcomes that are acceptable to its teachers.

Scaffolding and bilingual shared reading experiences: Promoting primary school students' learning and development

This paper explores the connections between scaffolding, second language learning and bilingual shared reading experiences. A socio- cultural theory of cognition underpins the investigation, which involved implementing a language and culture awareness program (LCAP) in a year 4 classroom and in the school community. Selected passages from observations are used to analyse the learning of three students, particularly in relation to languages other than English (LOTE). As these three case study students interacted in the classroom, at home and in the community, they co-constructed, appropriated and applied knowledge form one language to another. Through scaffolding, social spaces were constructed, where students learning and development were extended through a variety of activities that involved active participation, such as experimenting with language, asking questions and making suggestions. Extending these opportunities for student learning and development is considered in relation to creating teaching and learning environments that celebrate socio-cultural and linguistic diversity.

The net benefit of saving the Asian elephant: a policy and contingent valuation study

Reports results from a contingent valuation (CV) survey of willingness to pay (WTP) for the conservation of the Asian elephant of a sample of urban residents living in three selected housing schemes in Colombo, the capital of Sri Lanka. Face-to-face surveys were conducted using an interview schedule (IS). A non-linear logit regression model is used to analyse the respondents' responses for the payment principle questions and to identify the factors that influence their responses. We investigate whether urban residents' WTP for the conservation of elephants is sufficient to compensate farmers for the damage caused by elephants. We find that the beneficiaries (the urban residents) could compensate losers (the fanners in the areas affected by human-elephant conflict, HEC) and be better off than in the absence of elephants in Sri Lanka. Therefore, there is a strong economic case for the conservation of the wild elephant population in Sri Lanka. However, we have insufficient data to determine the optimal level of this elephant population in the Kaldor-Hicks sense. Nevertheless, the current population of elephant in Sri Lanka is Kaldor-Hicks preferable to having none. (C) 2003 Elsevier B.V. All rights reserved.

How to recognize and manage psychological distress in cancer patients

Psychological distress is common in cancer patients, however, it is often unrecognized and untreated. We aimed to identify barriers to cancer patients expressing their psychological concerns, and to recommend strategies to assist oncologists to elicit, recognize, and manage psychological distress in their patients. Medline, Psychlit, and the Cochrane databases were searched for articles relating to the detection of emotional distress in patients. Patients can provide verbal and non-verbal information about their emotional state. However, many patients may not reveal emotional issues as they believe it is not a doctor's role to help with their emotional concerns. Moreover, patients may normalize or somatize their feelings. Anxiety and depression can mimic physical symptoms of cancer or treatments, and consequently emotional distress may not be detected. Techniques such as active listening, using open questions and emotional words, responding appropriately to patients' emotional cues, and a patient-centred consulting style can assist in detection. Screening tools for psychological distress and patient question prompt sheets administered prior to the consultation can also be useful. In conclusion, the application of basic communication techniques enhances detection of patients' emotional concerns. Training oncologists in these techniques should improve the psychosocial care of cancer patients.

Ten Australian elementary teachers' discourse and reported pedagogical practices during cooperative learning

This article describes the types of discourse 10 Australian grade 4-6 teachers used after they had been trained to embed cooperative learning in their curriculum and to use communication skills to promote students' thinking and to scaffold their learning. One audiotaped classroom social science lesson involving cooperative learning was analyzed for each teacher. We provide vignettes from 2 teachers as they worked with groups and from 2 student groups. The data from the audiotapes showed that the teachers used a range of mediated-learning behaviors in their interactions with the children that included challenging their perspectives, asking more cognitive and metacognitive questions, and scaffolding their learning. In turn, in their interactions with each other, the children modelled many of the types of discourse they heard their teachers use. Follow-up interviews with the teachers revealed that they believed it was important to set expectations for children's group behaviors, teach the social skills students needed to deal with disagreement in groups, and establish group structures so children understood what was required both from each other and the task. The teachers reported that mixed ability and gender groups worked best and that groups should be no larger than 5 students. All teachers' programs were based on a child-centered philosophy that recognized the importance of constructivist approaches to learning and the key role interaction plays in promoting social reasoning and learning.

Physiologically based synthetic models of hepatic disposition

Current Physiologically based pharmacokinetic (PBPK) models are inductive. We present an additional, different approach that is based on the synthetic rather than the inductive approach to modeling and simulation. It relies on object-oriented programming A model of the referent system in its experimental context is synthesized by assembling objects that represent components such as molecules, cells, aspects of tissue architecture, catheters, etc. The single pass perfused rat liver has been well described in evaluating hepatic drug pharmacokinetics (PK) and is the system on which we focus. In silico experiments begin with administration of objects representing actual compounds. Data are collected in a manner analogous to that in the referent PK experiments. The synthetic modeling method allows for recognition and representation of discrete event and discrete time processes, as well as heterogeneity in organization, function, and spatial effects. An application is developed for sucrose and antipyrine, administered separately and together PBPK modeling has made extensive progress in characterizing abstracted PK properties but this has also been its limitation. Now, other important questions and possible extensions emerge. How are these PK properties and the observed behaviors generated? The inherent heuristic limitations of traditional models have hindered getting meaningful, detailed answers to such questions. Synthetic models of the type described here are specifically intended to help answer such questions. Analogous to wet-lab experimental models, they retain their applicability even when broken apart into sub-components. Having and applying this new class of models along with traditional PK modeling methods is expected to increase the productivity of pharmaceutical research at all levels that make use of modeling and simulation.

The ethics of paying drug users who participate in research: a review and practical recommendations

THE PAYMENT OF RESEARCH PARTICIPANTS raises ethical and empirical questions that have special importance in addictions research involving drug-dependent participants. Despite a now large literature on human subjects payment, what is still needed is practical guidance for investigators and ethics committees. This paper reviews the literature on: current payment practices and guidelines; defining features of undue and due incentives and fair reimbursement; and the significance of risks and harms that may arise from paying drug using participants. We conclude that research payments are ethically acceptable in most circumstances of addictions research, but should be closely scrutinized in situations where these may exacerbate existing harms or create additional risks for participants and investigators. General principles, key questions and procedural options are highlighted for an applied approach to ethical research payments. Future research directions are identified.