The implementation of a tobacco dependence education curriculum in a Swiss Dental Hygiene School - an 8-year review

OBJECTIVE The aim of our investigation was to review the implementation of a comprehensive tobacco dependence education (TDE) curriculum at the Medi School of Dental Hygiene (MSDH), Bern, Switzerland, 2001-2008. METHODS In 2001, new forms to record patients' tobacco use history and willingness to quit were created for all the MSDH patients. In 2002, a new theoretically based tobacco dependence treatment protocol was implemented into the MSDH curriculum. Students received instruction on how to provide brief tobacco use dependence interventions as well as maintain detailed records of patient tobacco use and cessation interventions for every smoker at all dental hygiene visits. RESULTS In 2002, 17 lecture hours were added to the following subjects: pathology, periodontology, preventive dentistry, pharmacology and psychology. During the same time period, 2213 patients (56.9% women) have visited the MSDH. Smoking status was recorded in 85.7% of all the patients (30.2% smokers). Brief tobacco use interventions were recorded in 36.8% of all smokers while 7.6% of these have reported to quit smoking. CONCLUSIONS Overall, the new TDE curriculum was successfully implemented and accepted by the MSDH faculty. Applications in the clinical practice, however, may still be improved to better identify smokers and increase initial and follow-up interventions potentially leading to higher quit rates.

Flexible varieties and automorphism groups

Given an irreducible affine algebraic variety X of dimension n≥2 , we let SAut(X) denote the special automorphism group of X , that is, the subgroup of the full automorphism group Aut(X) generated by all one-parameter unipotent subgroups. We show that if SAut(X) is transitive on the smooth locus X reg , then it is infinitely transitive on X reg . In turn, the transitivity is equivalent to the flexibility of X . The latter means that for every smooth point x∈X reg the tangent space T x X is spanned by the velocity vectors at x of one-parameter unipotent subgroups of Aut(X) . We also provide various modifications and applications.

Learner preferences regarding integrating, sequencing and aligning virtual patients with other activities in the undergraduate medical curriculum: A focus group study

CONTEXT: E-learning resources, such as virtual patients (VPs), can be more effective when they are integrated in the curriculum. To gain insights that can inform guidelines for the curricular integration of VPs, we explored students' perceptions of scenarios with integrated and non-integrated VPs aimed at promoting clinical reasoning skills. METHODS: During their paediatric clerkship, 116 fifth-year medical students were given at least ten VPs embedded in eight integrated scenarios and as non-integrated add-ons. The scenarios differed in the sequencing and alignment of VPs and related educational activities, tutor involvement, number of VPs, relevance to assessment and involvement of real patients. We sought students' perceptions on the VP scenarios in focus group interviews with eight groups of 4-7 randomly selected students (n = 39). The interviews were recorded, transcribed and analysed qualitatively. RESULTS: The analysis resulted in six themes reflecting students' perceptions of important features for effective curricular integration of VPs: (i) continuous and stable online access, (ii) increasing complexity, adapted to students' knowledge, (iii) VP-related workload offset by elimination of other activities, (iv) optimal sequencing (e.g.: lecture--1 to 2 VP(s)--tutor-led small group discussion--real patient) and (V) optimal alignment of VPs and educational activities, (vi) inclusion of VP topics in assessment. CONCLUSIONS: The themes appear to offer starting points for the development of a framework to guide the curricular integration of VPs. Their impact needs to be confirmed by studies using quantitative controlled designs.

Curriculum Naturheilverfahren und Komplementärmedizin

Wie kann man in kurzer Zeit Studierenden das Wichtigste über Naturheilverfahren und Komplementärmedizin beibringen? Welche Therapieverfahren gehören in den Unterricht, und wie sieht heute überhaupt guter Unterricht aus? Im vorliegenden Curriculum für die medizinische Lehre stellen die Autorinnen und Autoren die wichtigsten Aspekte guter Lehre im Bereich der Naturheilverfahren und Komplementärmedizin kompakt dar. Es besteht aus drei Teilen: Hille Lieverscheidt schreibt über die Bedeutung von innovativer Lehre. Sie ergänzt theoretische Erläuterungen mit vielen Übungsmaterialien und Beispielen. Beate Stock-Schröer führt stichpunktartig die wichtigsten Fakten mit Erläuterungen und einer aktuelle Studienübersicht zu insgesamt 22 Therapien auf. Martin Frei-Erb und Klaus von Ammon stellen das in der Schweiz seit einigen Jahren erfolgreich umgesetzte Lehrbeispiel zum Thema Klassische Homöopathie mit Fallbeispielen und Lehrmaterialien dar. Die beiliegende Foliensammlung auf CD ist ein wertvoller und kompetenter Beitrag aus dem jeweiligen Lehrbereich der Autorinnen und Autoren. Damit ist das Curriculum ein Angebot an Lehrende der Naturheilverfahren und Komplementärmedizin, Ihren Unterricht fachlich zu überprüfen und mit neuen Methoden lebendig zu gestalten.

Fixed and Flexible: Coexistence of Obligate and Facultative Migratory Strategies in a Freshwater Fish

Migration is an important event in many animal life histories, but the degree to which individual animals participate in seasonal migrations often varies within populations. The powerful ecological and evolutionary consequences of such partial migration are now well documented, but the underlying mechanisms are still heavily debated. One potential mechanism of partial migration is between-individual variation in body condition, where animals in poor condition cannot pay the costs of migration and hence adopt a resident strategy. However, underlying intrinsic traits may overrule such environmental influence, dictating individual consistency in migratory patterns. Unfortunately, field tests of individual consistency compared to the importance of individual condition on migratory propensity are rare. Here we analyse 6 years of field data on roach migration, gathered by tagging almost 3000 individual fish and monitoring their seasonal migrations over extended periods of time. Our aims were to provide a field test of the role of condition in wild fish for migratory decisions, and also to assess individual consistency in migratory tendency. Our analyses reveal that (1) migratory strategy, in terms of migration/residency, is highly consistent within individuals over time and (2) there is a positive relationship between condition and the probability of migration, but only in individuals that adopt a migratory strategy at some point during their lives. However, life-long residents do not differ in condition to migrants, hence body condition is only a good predictor of migratory tendency in fish with migratory phenotypes and not a more general determinant of migratory tendency for the population. As resident individuals can achieve very high body condition and still remain resident, we suggest that our data provides some of the first field evidence to show that both facultative and obligate strategies can co-exist within populations of migratory animals.