Rationing medical education.

The purpose of this paper is to discuss the role of rationing in medical education. Medical education is expensive and there is a limit to that which governments, funders or individuals can spend on it. Rationing involves the allocation of resources that are limited. This paper discussed the pros and cons of the application of rationing to medical education and the different forms of rationing that could be applied. Even though some stakeholders in medical education might be taken aback at the prospect of rationing, the truth is that rationing has always occurred in one form or another in medical education and in healthcare more broadly. Different types of rationing exist in healthcare professional education. For example rationing may be implicit or explicit or may be based on macro-allocation or micro-allocation decisions. Funding can be distributed equally among learners, or according to the needs of individual learners, or to ensure that overall usefulness is maximised. One final option is to allow the market to operate freely and to decide in that way. These principles of rationing can apply to individual learners or to institutions or departments or learning modes. Rationing is occurring in medical education, even though it might be implicit. It is worth giving consideration to methods of rationing and to make thinking about rationing more explicit.

Prevalence of intestinal parasitic infections among school children in capital areas of the Democratic Republic of São Tomé and Príncipe, West Africa.

Background: Although the Democratic Republic of Sao Tome and Principe (DRSTP) has undertaken school children-based deworming programs against intestinal parasitic infections (IPIs) using a single dose of mebendazole annually since 2005, it remains unclear as to the outcome to date. The present study intends to investigate the recent IPIs status among school children living in capital areas of the DRSTP. Methods: A total of 252 school children (121 boys and 131 girls) of grades 4 and 5 from 4 primary schools located in the capital areas participated in the present study and their fresh fecal specimens were examined for the presence of any parasites using the merthiolate- iodine-formaldehyde concentration method as conducted. Results: The overall prevalence of IPIs was 64.7% (163/ 252). No significant gender difference in prevalence between boys (67.8%) and girls (61.8%) was found (p = 0.3). The majority of school children were infected with a single species of parasite (55.8%). Altogether, 12 different intestinal parasite species were identified in DRSTP school children, of which 9 species were pathogenic and the remaining 3 were non-pathogenic. Conclusion: Improving the detection method, sanitation facilities and personal hygiene as well as utilizing combined drugs are all important measures to greatly reduce IPIs in DRSTP school children.

Prevalence of asthma among school children in Gaborone, Botswana.

Background: Asthma prevalence is high (>10%) in developed countries and although data is still missing for most of Africa, rates are increasing in developing regions as they become more westernized. We investigated the prevalence of asthma in school children in Gaborone, Botswana. Methods: This was a cross sectional descriptive study. ISAAC methodology was used. A representative proportionate size random sample of two age groups of children (13-14 year olds and 6-7 year olds) was consecutively enrolled from 10 schools. The schools were selected using a table of random numbers. A minimum sample size of 924 individuals (462 from each group) was adequate to achieve a precision of 3 % around our estimated prevalence of asthma of 10% with 95% confidence assuming a non-response rate of 20%. Data was collected using the validated International study of Asthma and Allergies in children (ISAAC) questionnaire. In accordance with the ISAAC criteria, Asthma was defined as wheezing in the previous 12 months. Data was captured in microsoft excel and analysed using SPSS version 23. Results: The prevalence of asthma (wheezing in the previous 12 months) was 16.5% (194/1175). Among the 6-7 year olds, the prevalence of asthma (wheezing in the previous 12 months) was 15.9%, while among the 13-14 years olds it was 16.8 %. The prevalence school type was 22.3 % in private schools versus 14.5 % in public schools. More severe asthma was associated with older children, 13 -14 years. The older children reported more limited speech due to wheezing (OR= 2.0, 95% CI =1.034, 3.9, p-value=0.043), ever had asthma (OR= 1.5, 95% CI=1.031, 2.3, p-value=0.034) and wheezing during exercise (OR=3.4, 95% CI= 2.5, 4.9, p-value= <0.001) compared to the younger children 6-7 years. Children from private schools had more wheezing symptoms. They were more likely to have ever wheezed (OR=2.2, .95% CI=1.7,2.9, p-value < 0.0001), wheezed in the previous twelve months (have asthma) (OR=1.7,95%CI=1.2,2.4, p-value = 0.001), ever had asthma (OR=2.4, 95% CI=1.7,3.5, pvalue< 0.0001), and wheezed during exercise (OR=1.8, 95% CI=1.4,2.4, p-value < 0.0001). Conclusion: The prevalence of asthma amongst school children in Gaborone, Botswana is high with older children experiencing more severe symptoms of asthma.

Access, attitudes and training in information technologies and evidence-based medicine among medical students at University of Zimbabwe College of Health Sciences.

Background: The Medical Education Partnership Initiative, has helped to mitigate the digital divide in Africa. The aim of the study was to assess the level of access, attitude, and training concerning meaningful use of electronic resources and EBM among medical students at an African medical school. Methods: The study involved medical students at the University of Zimbabwe College of Health Sciences, Harare. The needs assessment tool consisted of a 21-question, paper-based, voluntary and anonymous survey. Results: A total of 61/67 (91%), responded to the survey. 60% of the medical students were ‘third-year medical students’. Among medical students, 85% of responders had access to digital medical resources, but 54% still preferred printed medical textbooks. Although 25% of responders had received training in EBM, but only 7% found it adequate. 98% of the participants did not receive formal training in journal club presentation or analytical reading of medical literature, but 77 % of them showed interest in learning these skills. Conclusion: Lack of training in EBM, journal club presentation and analytical reading skills have limited the impact of upgraded technology in enhancing the level of knowledge. This impact can be boosted by developing a curriculum with skills necessary in using EBM.

Relevance of anatomy to medical education and clinical practice: perspectives of medical students, clinicians, and educators

Introduction: Against a backdrop of ever-changing diagnostic and treatment modalities, stakeholder perceptions (medical students, clinicians, anatomy educators) are crucial for the design of an anatomy curriculum which fulfils the criteria required for safe medical practice. This study compared perceptions of students, practising clinicians, and anatomy educators with respect to the relevance of anatomy education to medicine. Methods: A quantitative survey was administered to undergraduate entry (n = 352) and graduate entry students (n = 219) at two Irish medical schools, recently graduated Irish clinicians (n = 146), and anatomy educators based in Irish and British medical schools (n = 30). Areas addressed included the association of anatomy with medical education and clinical practice, mode of instruction, and curriculum duration. Results: Graduate-entry students were less likely to associate anatomy with the development of professionalism, teamwork skills, or improved awareness of ethics in medicine. Clinicians highlighted the challenge of tailoring anatomy education to increase student readiness to function effectively in a clinical role. Anatomy educators indicated dissatisfaction with the time available for anatomy within medical curricula, and were equivocal about whether curriculum content should be responsive to societal feedback. Conclusions: The group differences identified in the current study highlight areas and requirements which medical education curriculum developers should be sensitive to when designing anatomy courses.

Medical-miner at TREC 2011 medical records track

This paper presents work done at Medical Minner Project on the TREC-2011 Medical Records Track. The paper proposes four models for medical information retrieval based on Lucene index approach. Our retrieval engine used an Lucen Index scheme with traditional stopping and stemming, enhanced with entity recognition software on query terms. Our aim in this first competition is to set a broader project that involves the develop of a configurable Apache Lucene-based framework that allows the rapid development of medical search facilities. Results around the track median have been achieved. In this exploratory track, we think that these results are a good beginning and encourage us for future developments.

The quality of interface design for educational courseware development in Malaysian educational context

Interactive educational courseware has been adopted in diverse education sectors such as primary, secondary, tertiary education, vocational and professional training. In Malaysian educational context, the ministry of education has implemented Smart School Project that aims to increase high level of academic achievement in primary and secondary schools by using interactive educational courseware. However, many researchers have reported that many coursewares fail to accommodate the learner and teacher needs. In particular, the interface design is not appropriately designed in terms of quality of learning. This paper reviews educational courseware development process in terms of defining quality of interface design and suggests a conceptual model of interface design through the integration of design components and interactive learning experience into the development process. As a result, it defines the concept of interactive learning experience in a more practical approach in order to implement each stage of the development process in a seamless and integrated way.

The Quality of Interface Design for Educational Courseware Development in Malaysian Educational Context

Interactive educational courseware has been adopted in diverse education sectors such as primary, secondary, tertiary education, vocational and professional training. In Malaysian educational context, the ministry of education has implemented Smart School Project that aims to increase high level of academic achievement in primary and secondary schools by using interactive educational courseware. However, many researchers have reported that many coursewares fail to accommodate the learner and teacher needs. In particular, the interface design is not appropriately designed in terms of quality of learning. This paper reviews educational courseware development process in terms of defining quality of interface design and suggests a conceptual model of interface design through the integration of design components and interactive learning experience into the development process. As a result, it defines the concept of interactive learning experience in a more practical approach in order to implement each stage of the development process in a seamless and integrated way.

Challenges of Malaysian developers in creating good interfaces for interactive courseware

There are many reasons why interface design for interactive courseware fails to support quality of learning experiences. The causes such as the level of interactivity, the availability of the interfaces to interact with the end users and a lack of deep knowledge about the role of interface design by the designers in the development process are most acknowledged. Related to this, as a creator for the interactive courseware, generally the developers expect the resources that they produced are effective, accurate and robust. However, rarely do the developers have the opportunity to create good interfaces with the emphasis on time consuming, money and skill. Thus, some challenges faces by them in the interface design development can’t be underestimated as well. Therefore, their perspective of the interactive courseware is important to ensure the material and also the features of the interactive courseware can facilitate teaching and learning activity. Within this context in mind, this paper highlights the challenges that faces by the Malaysian developer from the ten face to face interviewed data gathered. It discusses from the Malaysian developer perspectives that involved in the development of interface design for interactive courseware for the Smart School Project. Particularly, in creating such a great interfaces, the highlights challenges will present within the constraints of time, curriculum demand, and competencies of the development team.

Reading places

In this chapter I explore how a critical approach to reading pedagogy has evolved over time in South Australia. I start with a brief review of the groundbreaking work of Jennifer O’Brien in the early 1990s in which she adapted feminist post-structuralist approaches for early childhood classrooms. O’Brien showed that young children can and do take an analytical position with respect to reading when tasks are framed in ways that draw their attention to representation and relationships in texts. Then, drawing from a range of empirical research projects, I discuss how a semiotic approach to reading can be productive for thinking about critical and inclusive literacies. I touch briefly upon how and why we incorporated children’s reading of environmental print into the 100 children go to school project. I then outline the ways in which we have capitalised on the notion of reading places in several projects to work with primary school children and their teachers.

Prostate gland and extra-capsular tissue 3D reconstruction and measurement

Currently there are little objective parameters that can quantify the success of one form of prostate surgical removal over another. Accordingly, at Old Dominion University (ODU) we have been developing a process resulting in the use of software algorithms to assess the coverage and depth of extra-capsular soft tissue removed with the prostate by the various surgical approaches. Parameters such as the percent of capsule that is bare of soft tissue and where present the depth and extent of coverage have been assessed. First, visualization methods and tools are developed for images of prostate slices that are provided to ODU by the Pathology Department at Eastern Virginia Medical School (EVMS). The visualization tools interpolate and present 3D models of the prostates. Measurement algorithms are then applied to determine statistics about extra-capsular tissue coverage. This paper addresses the modeling, visualization, and analysis of prostate gland tissue to aid in quantifying prostate surgery success. Particular attention is directed towards the accuracy of these measurements and is addressed in the analysis discussions.

Cells Tissues Organs : preface

This volume stems from the 1st International Conference on Epithelial-Mesenchymal Transitions (EMT), which was convened by the editors on October 5–8, 2003 in the beautiful setting of Port Douglas, Queensland, Australia. EMT, the name given to the transformation of cells arranged in a coherent layer – epithelial cells – to more individualistic and potential motile cells – mesenchymal cells – was recognized decades ago by Prof. Elisabeth (Betty) Hay (Harvard Medical School, Boston, Mass., USA) as a primary mechanism in embryogenesis for remodelling tissues. More recently EMT has been seen as crucial to the spread and invasion of carcinoma, and more recently still, EMT-like changes have been detected in various pathologies marked by fi brosis. Despite the basic and clinical importance of EMT, this extremely rapidly growing fi eld had never previously had a conference devoted to it, and indeed the disciplines of developmental biology, cancer and pathology rarely interact although they have much to share. The chapters assembled for this volume encompass these three major themes of the meeting, development, pathology and cancer, and further highlight the commonality in terms of mechanisms and outcomes among them...

Matka koulun kestävän kehittämisen maisemassa

A Journey in the Landscape of Sustainable School Development “A Journey in the Landscape of Sustainable School Development” is a story of the Sorrila School development process. This research deals with a school development project as a process, and as a part of international projects on Education for Sustainable Development, with ENSI (Environment and School Initiatives) being the most important. The main purpose of the study was to analyze the change process as a general phenomenon as well as the learning connected to it. The research describes the development period 2001–2008 at the Sorrila Primary school. The research questions are as follows: 1. What did pupils learn during the research and development period? 2. How did the coordinating teacher develop personally? 3. How were the ENSI targets and other closely linked projects reached? 4. What was the feedback from the pupils, their parents and other teachers at the school? 5. How did the developing process proceed in 2001–2008? The method used was integrating action research, which also had ethnographical elements. Narrative was the form of the data as well as the manner of reporting. The method as a whole was integrating, ethnographical action research as a story. The research data consisted mostly of Knowledge Forum notes written by the teacher-researcher. Knowledge Forum is an Internetbased collaborative knowledge-building programme. Pupils’, parents’ and other teachers’ feedback, newspaper articles and students’ writings complied the data, which consists of material from seven years. Sustainable development was the basis of the school improvement. The targets of the United Nations Decade of Education for Sustainable Development (2005–2014) were part of the development projects. According to the research results the school was seen as part of complex systems where manifold and interactive learning took place. The learning of pupils, teachers and the school as a community can be characterised socioculturally. The school was able to reach a level of collaborative transformative learning. As well as several concrete projects, such as Comenius school project, school development consisted of networking at many levels. Along with the projects and networking, the school was able to apply the pedagogy of connection, by carrying out integrative and cross-disciplinary themes and using various learning and teaching methods. International cooperation was a natural part of the work. A figure of Aunt Green, the role model of the teacher researcher, was an innovation which resembled a change agent. The other role of the teacherresearcher as a coordinator, was important for her own professional development. According to the results the change process, which relied on sustainable school development, led the school along a road of positive renewals. It was not a series of projects but an ongoing process. The objectives of the international projects were accomplished to a great extent during the research period. According to the principles of action research, the main results were put forward in order to help others to develop their schools. Frictions and problems as well as positive experiences and rejecting dualities were seen as change forces. Keywords: education for sustainable development (ESD), sustainable school development, teacher professional development, integrating, pedagogy of connection, transformative learning

Beth Israel Hospital (Boston, MA) Records, undated, 1923, 1930-1964, 1988, 1991-1992

In 1916, the Jewish community of Boston established Beth Israel Hospital on Townsend Street in Roxbury to provide health care to immigrants in the area. Although accessible to everyone, the hospital provided Yiddish-speaking services for Eastern European Jewish immigrants and served kosher food, as well as conducted Jewish religious services. In 1928 the hospital entered into a teaching agreement with Harvard Medical School, Tufts University, and Simmons College. Shortly thereafter, the hospital moved to its current location in the Longwood area of Boston and expanded to a 220-bed operation. During 1935-1936, at the height of the Depression, Beth Israel spent 1.5 million dollars in free patient care and was only one of two local hospitals to offer health care to people on welfare. In 1996, Beth Israel Hospital merged with Deaconess Medical Center and became Beth Israel Deaconess Medical Center. This collection contains reports, pamphlets and hospital publications.