A review of the first year's experience with an automatic message-routing system for low-cost telemedicine

The Swinfen Charitable Trust has used email for some years as a low-cost telemedicine medium to provide consultant support for doctors in developing countries. A scalable, automatic message-routing system was constructed which automates many of the tasks involved in message handling. During the first 12 months of its use, 1510 messages were processed automatically. There were 128 referrals from 18 hospitals in nine countries. Of these 128 queries, 89 (70%) were replied to within 72 h; the median delay was 1.1 day. The 39 unanswered queries were sent to backup specialists for reply and 36 of them (92%) were replied to within 72 h. In the remaining three cases, a second-line (backup) specialist was required. The referrals were handled by 54 volunteer specialists from a panel of over 70. Two system operators, located 10 time zones apart, managed the system. The median time from receipt of a new referral to its allocation to a specialist was 0.2 days (interquartile range, IQR, 0.1-0.8). The median interval between receipt of a new referral and first reply was 2.6 days (IQR 0.8-5.9). Automatic message handling solves many of the problems of manual email telemedicine systems and represents a potentially scalable way of doing low-cost telemedicine in the developing world.

Vitamin D supplementation during the first year of life and risk of schizophrenia: a Finnish birth cohort study

Objective: Based on clues from epidemiology and animal experiments, low vitamin D during early life has been proposed as a risk factor for schizophrenia. The aim of this study was to explore the association between the use of vitamin D supplements during the first year of life and risk of developing schizophrenia. Method: Subjects were drawn from the Northern Finland 1966 Birth Cohort (n = 9 114). During the first year of life, data were collected about the frequency and dose of vitamin D supplementation. Our primary outcome measures were schizophrenia, psychotic disorders other than schizophrenia, and nonpsychotic disorders as diagnosed by age 31 years. Males and females were examined separately. Results: In males, the use of either irregular or regular vitamin D supplements was associated with a reduced risk of schizophrenia (Risk ratio (RR) = 0.08, 95% CI 0.01-0.95; RR = 0.12, 95% CI 0.02-0.90, respectively) compared with no supplementation. In males, the use of at least 2000 IU of vitamin D was associated with a reduced risk of schizophrenia (RR = 0.23, 95% CI 0.06-0.95) compared to those on lower doses. There were no significant associations between either the frequency or dose of vitamin D supplements and (a) schizophrenia in females, nor with (b) nonpsychotic disorder or psychotic disorders other than schizophrenia in either males or females. Conclusion: Vitamin D supplementation during the first year of life is associated with a reduced risk of schizophrenia in males. Preventing hypovitaminosis D during early life may reduce the incidence of schizophrenia. (C) 2003 Elsevier B.V. All rights reserved.

A comparison of responses to group learning between first-year Asian and first-year Australian veterinary science students

Introduction - Group learning has been used to enhance deep (long-term) learning and promote life skills, such as decision making, communication, and interpersonal skills. However, with increasing multiculturalism in higher education, there is little information available as to the acceptance of this form of learning by Asian students or as to its value to them. Methodology - Group-learning projects, incorporating a seminar presentation, were used in first-year veterinary anatomical science classes over two consecutive years (2003 and 2004) at the School of Veterinary Science, University of Queensland. Responses of Australian and Asian students to survey forms evaluating the learning experience were analyzed and compared. Results - All students responded positively to the group learning, indicating that it was a useful learning experience and a great method for meeting colleagues. There were no significant differences between Asian and Australian students in overall responses to the survey evaluating the learning experience, except where Asian students responded significantly higher than Australian students in identifying specific skills that needed improving. Conclusions - Group learning can be successfully used in multicultural teaching to enhance deep learning. This form of learning helps to remove cultural barriers and establish a platform for continued successful group learning throughout the program.

Building learning communities to support beginning teachers use of technology

This paper reports on the early stages of a three year study that is investigating the impact of a technology-enriched teacher education program on beginning teachers' integration of computers, graphics calculators, and the internet into secondary school mathematics classrooms. Whereas much of the existing research on the role of technology in mathematics learning has been concerned with effects on curriculum content or student learning, less attention has been given to the relationship between technology use and issues of pedagogy, in particular the impact on teachers' professional learning in the context of specific classroom and school environments. Our research applies sociocultural theories of learning to consider how beginning teachers are initiated into a collaborative professional community featuring both web-based and face to face interaction, and how participation in such a community shapes their pedagogical beliefs and practices. The aim of this paper is to analyse processes through which the emerging community was established and sustained during the first year of the study. We examine features of this community in terms of identity formation, shifts in values and beliefs, and interaction patterns revealed in bulletin board discussion between students and lecturers.