Comparability of Outcome Frameworks in Medical Education: Implications for framework development

Background: The demand for international harmonization in medical education increases with the growing mobility of students and health professionals. Many medical societies and governmental offices have issued outcome frameworks (OF), which describe aims and contents of medical education based on competencies. These national standards affect the development of curricula as well as assessment and licensing procedures. Comparing OF and identifying factors that limit their comparability may thus foster international harmonization of medical education. Summary of Work: We conducted a systematic search for national OF in MedLine, EmBase and the internet. We included all OF in German or English that resulted from a national consensus process and were published or endorsed by a national society or governmental body. We extracted information in five predetermined categories: history of origin, audience, formal structure, medical schooling system and key terms. Summary of Results: Out of 1816 results, 13 OF were included into further analyses. OF reference each other, often without addressing existing differences (e.g. in target audiences). The two most cited OF are “CanMEDs” and “Scottish Doctor”. OF differ especially in their level of detail as well as in the underlying educational system. Discussion and Conclusions: Based on our results we propose a two-step blueprint for OF, that may help to establish comparability for internationally aligned key features – so-called “core competencies” – while at the same time allowing for necessary regional adaptations in terms of “secondary competencies”. Take-home messages: Considerable differences in at least five categories of OF currently hinder the comparability of outcome frameworks.

Development of colorectal cancer gene therapy

Colorectal cancer is the number two cancer killer in the United States. Although primary colorectal cancer can be resected by surgery, patients often die from metastatic disease. Liver is the most common site of metastasis for colorectal cancer. It is difficult to selectively kill metastatic colon cancer cells without damaging normal liver functions. Thus it becomes a high priority to develop a selective targeting system for the treatment of colorectal cancer liver metastasis. ^ In the current study, a gene therapy strategy that allows a therapeutic gene to selectively destroy metastatic colon cancer cells without affecting normal liver cells is developed. The APC gene is frequently mutated in colorectal cancers. These mutations activate β-catenin responsive promoters. An optimized β-catenin responsive promoter, containing TCF consensus binding sites, was engineered for this study. This TCF promoter was found to express preferentially in APC mutated/β-catenin activated colorectal cancers while maintaining a low expression level in cell lines of liver origin. A recombinant adenoviral vector AdTCF-TK, in which the TCF promoter controls expression of the herpes simplex virus thymidine kinase gene, selectively destroyed colorectal cancer cells in vitro. AdTCF-TK virus and ganciclovir treatment also inhibited the growth of solid tumour derived from the colon cancer cell line DLD-1 in nude mice. In a control experiment, the growth inhibition effect of the same virus was attenuated in a liver cancer cell line. ^ In the present study, a novel method was developed to target therapeutic gene expression to colon cancer cells at reduced liver toxicity to the patients. The same gene therapy design may also be applied to treat tumours carrying mutations in the β-catenin gene, which is a central component of the APC signal transduction pathway. In summary, the principle for a rational design of a cancer specific treatment approach is demonstrated in this study. In the future, mutations in cancer patients will be more easily identified. Using the same principle developed in this study, specific regimen can be designed to treat these patients based on the specific genetic changes found in the tumour. ^

The development of poultry farms risk assessment tool for avian influenza in Imo State, Nigeria

Background: Nigeria was one of the 13 countries where avian influenza outbreak in poultry farms was reported during the 2006 avian influenza pandemic threat and was also the first country in Africa to report the presence of H5N1influenza among its poultry population. There are multiple hypotheses on how the avian influenza outbreak of 2006 was introduced to Nigeria, but the consensus is that once introduced, poultry farms and their workers were responsible for 70% of the spread of avian influenza virus to other poultry farms and the population. ^ The spread of avian influenza has been attributed to lack of compliance by poultry farms and their workers with poultry farm biosecurity measures. When poultry farms fail to adhere to biosecurity measures and there is an outbreak of infectious diseases like in 2006, epidemiological investigations usually assess poultry farm biosecurity—often with the aid of a questionnaire. Despite the importance of questionnaires in determining farm compliance with biosecurity measures, there have been few efforts to determine the validity of questionnaires designed to assess poultry farms risk factors. Hence, this study developed and validated a tool (questionnaire) that can be used for poultry farm risk stratification in Imo State, Nigeria. ^ Methods: Risk domains were generated using literature and recommendations from agricultural organizations and the Nigeria government for poultry farms. The risk domains were then used to develop a questionnaire. Both the risk domain and questionnaire were verified and modified by a group of five experts with a research interest in Nigeria's poultry industry and/or avian influenza prevention. Once a consensus was reached by the experts, the questionnaire was distributed to 30 selected poultry farms in Imo State, Nigeria that participated in this study. Survey responses were received for all the 30 poultry farms that were selected. The same poultry farms were visited one week after they completed the questionnaires for on-site observation. Agreement among survey and observation results were analyzed using a kappa test and rated as poor, fair, moderate, substantial, or nearly perfect; and internal consistency of the survey was also computed. ^ Result: Out of the 43 items on the questionnaire, 32 items were validated by this study. The agreement between the survey result and onsite observation was analyzed using kappa test and ranged from poor to nearly perfect. Most poultry farms had their best agreements in the contact section of the survey. The least agreement was noted in the farm management section of the survey. Thirty-two questions on the survey had a coefficient alpha > 0.70, which is a robust internal consistency for the survey. ^ Conclusion: This study developed 14 risk domains for poultry farms in Nigeria and validated 32 items from the original questionnaire that contained 43 items. The validated items can be used to determine the risk of introduction and spread of avian influenza virus in poultry farms in Imo State, Nigeria. After further validations in other states, regions and poultry farm sectors in Nigeria; this risk assessment tool can then be used to determine the risk profile of poultry farms across Nigeria.^

Biological effects of PEA3 expression in {\it HER-2\/}/{\it neu\/}-overexpressing human cancer cells and the molecular mechanisms of PEA3-mediated transcriptional repression on {\it HER-2\/}/{\it neu\/}

HER-2/neu is a receptor tyrosine kinase highly homologous with epidermal growth factor receptor. Overexpression and/or amplification of HER-2/neu has been implicated in the genesis of a number of human cancers, especially breast and ovarian cancers. Transcriptional upregulation has been shown to contribute significantly to the overexpression of this gene. Studies on the transcriptional regulation of HER-2/neu gene are important for understanding the mechanism of cell transformation and developing the therapeutic strategies to block HER-2/neu-mediated cancers. PEA3 is a DNA binding transcriptional factor and its consensus sequence exists on the HER-2/neu promoter. To examine the role of PEA3 in HER-2/neu expression and cell transformation, we transfected PEA3 into the human breast and ovarian cancer cells that overexpress HER-2/neu and showed that PEA3 dramatically represses HER-2/neu transcription. PEA3 suppresses the oncogenic neu-mediated transformation in mouse fibroblast NIH 3T3 cells. Expression of PEA3 selectively blocks the growth of human cancer cells that overexpress HER-2/neu and inhibits their colony formation. It does not occur in the cancer cells expressing basal level of HER-2/neu. Further studies in the orthotopic ovarian cancer model demonstrated that expression of PEA3 preferentially inhibits growth and tumor development of human cancer cells that overexpress HER-2/neu, the tumor-bearing mice survived significantly longer if treated by injection of the PEA3-liposome complex intraperitoneally. Immunoblotting and immunohistochemical analysis of the tumor tissues indicated that PEA3 mediates the tumor suppression activity through targeting HER-2/neu-p185. Thus, PEA3 is a negative regulator of HER-2/neu gene expression and functions as a tumor suppressor gene in the HER-2/neu-overexpressing human cancer cells.^ The molecular mechanisms of PEA3 mediated transcriptional repression were investigated. PEA3 binds specifically at the PEA3 site on HER-2/neu promoter and this promoter-binding is required for the PEA3 mediated transcriptional repression. Mutation of the PEA3 binding site on HER-2/neu promoter causes decreased transcriptional activity, indicating that the PEA3 binding site is an enhancer-like element in the HER-2/neu-overexpressing cells. We therefore hypothesized that in the HER-2/neu-overexpressing cells, PEA3 competes with a transactivator for binding to the PEA3 site, preventing the putative factor from activating the transcription of HER-2/neu. This hypothesis was supported by the data which demonstrate that PEA3 competes with another nuclear protein for binding to the HER-2/neu promoter in vitro, and expression of a truncated protein which encodes the DNA binding domain of PEA3 is sufficient to repress HER-2/neu transcription in the HER-2/neu-overexpressing human cancer cells. ^

Comentarios y conclusiones II Seminario Internacional : la interdisciplina en el ordenamiento territorial

Por el éxito y trascendencia de sus eventos anteriores, el Instituto CIFOT siente la obligación de hacer conocer las principales conclusiones del II Seminario de Ordenamiento Territorial, el que comienza a marcar pautas a partir de las preocupaciones comunes, enfoques teórico-metodológicos prevalecientes en el Ordenamiento Territorial, la planificación Estratégica y Ambiental, como también sobre las prácticas de gestión de la información territorial. Se sintetiza la idea central de las conferencias Magistrales: - Dr. Juan Gastó- Pontificia Universidad Católica de Chile- presenta “ La Ordenación Territorial como eje del Desarrollo Rural", cuyo punto central es la imposibilidad de separar la problemática territorial urbana de la rural. - Dr. Eduardo Salinas- Universidad de La Habana , Cuba- en “El Ordenamiento Territorial como instrumento de la Planificación y Gestión Ambiental" establece la necesidad de una planificación sustentable ambientalmente, con una concepción sistémica y holística de los problemas. -Dra. Elsa Laurelli -Universidad de La Plata , Argentina- en “Nuevas Tendencias del Ordenamiento Territorial en una Economía de Mercado. Limitaciones y posibilidades" plantea coexistencia de áreas receptoras de IDE vs espacios degradados y con problemáticas sociales y reflexiona sobre el rol del Estado para atenuar los efectos del mercado en el territorio y la sociedad. - Dr. Pablo Ciccolella -UBA-, Argentina. En “ Desafíos y opciones en la Gestión Urbana bajo el Capitalismo Global: Planificación Estratégica y Desarrollo Económico-Territorial" alerta sobre la planificación llave en mano que genera un desarrollo elitista, banal y efímero. - Dr. Mariano Zamorano -Universidad Nacional de Cuyo, Mendoza- presenta “ Una propuesta de Regionalización de la Provincia de Mendoza sobre la base de la Lógica Territorial " destinada a optimizar la gestión municipal y provincial. Al II Seminario de Ordenamiento Territorial concurren alrededor de 140 personas y se exponen 43 trabajos en las siguientes áreas temáticas : - 1 Nuevas tendencias en el Ordenamiento territorial . - 2 Ambiente y Ordenamiento Territorial. - 3 El Ordenamiento Territorial en el ámbito urbano. - 4 El Ordenamiento Territorial en el ámbito rural. - 5 La gestión de la información en el Ordenamiento Territorial. - 6 El rol de las Instituciones en el Ordenamiento Territorial. Conclusiones De l rico debate e intercambio de ideas realizado durante el II Seminario, se extraen tres grandes temas: - La necesidad de una visión general y holística del territorio, evitando la fragmentación disciplinar. - La interdisciplina, como campo de convergencia de problemáticas complejas. La planificación estratégica como instancia participativa y visión integral del territorio. - La metodología para el Ordenamiento Territorial debe ser verdaderamente aplicada. No se puede seguir planificando con una racionalidad limitada en busca de una imagen objetivo rígida mientras el territorio, conformado por sistemas complejos y abiertos, está en constante cambio por exigencias propias de lo global. - Un Estado en retirada no contiene la estructura necesaria ni el consenso para imponerse en sociedades democráticas con dominio absoluto de tipo capitalista.

Problemas y debates sobre la ocupación y el empleo en el agro pampeano de la sojización

Las transformaciones que sufrió el agro pampeano durante los últimos veinte años han tenido particular trascendencia sobre la mano de obra encargada de sembrar, laborar y levantar las 'cosechas récord'. Sin embargo, no existe consenso con respecto a las consecuencias que este proceso tuvo sobre el volumen global de la ocupación agropecuaria. La magnitud y velocidad de los cambios han motivado distintas reflexiones sobre la cuestión, las cuales han estado atravesadas por una polémica subyacente con respecto a la valoración que debería merecer este modelo de desarrollo agropecuario para el conjunto de la sociedad. Este escrito se propone aportar elementos estadísticos y conceptuales que consideramos han sido abordados aún parcialmente en los trabajos al respecto, los cuales, debidamente reprocesados y comparados entre sí, nos brindan un insumo de utilidad para evaluar este aspecto sustancial del desarrollo del capitalismo agrario pampeano.

Problemas y debates sobre la ocupación y el empleo en el agro pampeano de la sojización

Las transformaciones que sufrió el agro pampeano durante los últimos veinte años han tenido particular trascendencia sobre la mano de obra encargada de sembrar, laborar y levantar las 'cosechas récord'. Sin embargo, no existe consenso con respecto a las consecuencias que este proceso tuvo sobre el volumen global de la ocupación agropecuaria. La magnitud y velocidad de los cambios han motivado distintas reflexiones sobre la cuestión, las cuales han estado atravesadas por una polémica subyacente con respecto a la valoración que debería merecer este modelo de desarrollo agropecuario para el conjunto de la sociedad. Este escrito se propone aportar elementos estadísticos y conceptuales que consideramos han sido abordados aún parcialmente en los trabajos al respecto, los cuales, debidamente reprocesados y comparados entre sí, nos brindan un insumo de utilidad para evaluar este aspecto sustancial del desarrollo del capitalismo agrario pampeano.

Problemas y debates sobre la ocupación y el empleo en el agro pampeano de la sojización

Las transformaciones que sufrió el agro pampeano durante los últimos veinte años han tenido particular trascendencia sobre la mano de obra encargada de sembrar, laborar y levantar las 'cosechas récord'. Sin embargo, no existe consenso con respecto a las consecuencias que este proceso tuvo sobre el volumen global de la ocupación agropecuaria. La magnitud y velocidad de los cambios han motivado distintas reflexiones sobre la cuestión, las cuales han estado atravesadas por una polémica subyacente con respecto a la valoración que debería merecer este modelo de desarrollo agropecuario para el conjunto de la sociedad. Este escrito se propone aportar elementos estadísticos y conceptuales que consideramos han sido abordados aún parcialmente en los trabajos al respecto, los cuales, debidamente reprocesados y comparados entre sí, nos brindan un insumo de utilidad para evaluar este aspecto sustancial del desarrollo del capitalismo agrario pampeano.

Infrastructure Development of Railway in Cambodia: A Long Term Strategy

Infrastructure development means for the making of living environment, transport and communications, disaster prevention and national land conservation, agriculture, forestry and fisheries, and energy production and supply. Transport infrastructure development in Cambodia involved with (1) road, (2) railway, (3) port, inland-water way and (4) aviation. All model of transport infrastructure have special different kinds of importance. Railway is different from other base important of railways are transport passengers and traffic freight especially transport for heavy goods in huge capacity and in long distance by safer and faster. Transport in Cambodia for traffic freight export import base from Thailand and other via Sisophon and Shihanoukvill port. Traffic is increasing rapidly during nowadays railway condition in adequate of demand required. This is why Railway is selected as the topic of this paper to prevent monopoly of road transport. This paper, does review about infrastructure development plan for Railway in Cambodia as a long term strategy by review and analysis forecast on the previous performance of Royal Railways of Cambodia (RRC) transport traffic involved with condition of infrastructure development of railway in Cambodia. And also review the plan of development RRC but just only detail a plan of rehabilitation that is immediately needed. Suggest some recommendation at the last part. As Cambodia is a member country of ASEAN and also Mekong sub-region. For make sure that transport networks work effectively with a progress of economic integration, we make clear what is important for infrastructure development of railway in Cambodia from the standpoint of the development plan of Mekong sub-region. This paper is organized by 4 sections. Section 1 review about Infrastructure Development of Railway in Cambodia (IDRC) Historical Background, Follow by Section 2 will review the Current Situation of IDRC and some analysis of transport performance from previous years, Then Section 3 review of the focusing on traffic transport of RRC in the future, Section 4 review Infrastructure Development of Railway in Cambodia Future plans in long term; at last conclusion and recommendation. In section 1 does review history background of RRC from the rail first begun. But why is needed to review? Because of history background is involved infrastructure development of RRC in present time. History background made big gaps constraint and obstacle for socioeconomic development and poverty reduction, also left Cambodia with tragedy and left developed behind. After that remain infrastructure development needs huge fund and long time for restoration, reconstruction, rehabilitation and development into new technology as most of world practice.

Tailoring the Scrum Development Process to Address Agile Product Line Engineering

Software Product Line Engineering (SPLE) is becoming widely used due to the improvement it means when developing software products of the same family. However, SPLE demands long-term investment on a product-line platform that might not be profitable due to rapid changing business settings. Since Agile Software Development (ASD) approaches are being successfully applied in volatile markets, several companies have suggested the idea of integrating SPLE and ASD when a family product has to be developed. Agile Product Line Engineering (APLE) advocates the integration of SPLE and ASD to address their lacks when they are individually applied to software development. A previous literature re-view of experiences and practices on APLE revealed important challenges about how to fully put APLE into practice. Our contribution address several of these challenges by tailoring the agile method Scrum by means of three concepts that we have defined: plastic partial components, working PL-architectures, and reactive reuse.

Development of Interactive Materials by Engineering Students Using the Descartes Applets.

In a degree course such as Forestry Engineering, the general teaching objectives consist of explaining and helping students to understand the principles of Mechanics. For some time now we have encountered significant difficulties in teaching this subject due to the students' lack of motivation and to their insufficient prior preparation for the topic. If we add to this the discipline's inherent complexity and the students' preconceptions about the subject, these teaching difficulties become considerable. For this reason a series of didactic activities have been introduced sequentially in the teaching of this subject. This work describes the methodology, procedure and results for the action of developing a work project in groups using Descartes software. The results of this experiment can be considered very positive. Some of the critical preconceptions for learning the subject can be corrected, and the tutoring process in the classroom contributes to an improvement in teacherstudent communication. Since this scheme was established, the number of students taking part each academic year has increased, and this is the group with the greatest percentage of passing scores.

Social involvement for community development in rural areas of Cuenca, Spain

Community development must be accompanied by a social involvement process which creates functional groups of citizens capable of taking responsibility for their own development. It is important that this process promotes the structuring of all population groups and provides the appropriate institutional and technical support. The present paper addresses these issues based on over 25 years of experience by the Association Instituto de Desarrollo Comunitario de Cuenca in revitalizing rural areas of the Spanish province of Cuenca. This paper analyses the social involvement process encouraged by this association, the relationships between public institutions and local associations, the role of these associations and the difficulties encountered in the rural areas. The long-term perspective of this experience provides some keys which can be used to successfully support the process of social involvement ―such as information on its characteristics and methodological tools―, establish local associations and create sustainable partnerships that foster the growth of leadership within the community development process.

Ensemble transcript interaction networks: A case study on Alzheimer's disease

Systems biology techniques are a topic of recent interest within the neurological field. Computational intelligence (CI) addresses this holistic perspective by means of consensus or ensemble techniques ultimately capable of uncovering new and relevant findings. In this paper, we propose the application of a CI approach based on ensemble Bayesian network classifiers and multivariate feature subset selection to induce probabilistic dependences that could match or unveil biological relationships. The research focuses on the analysis of high-throughput Alzheimer's disease (AD) transcript profiling. The analysis is conducted from two perspectives. First, we compare the expression profiles of hippocampus subregion entorhinal cortex (EC) samples of AD patients and controls. Second, we use the ensemble approach to study four types of samples: EC and dentate gyrus (DG) samples from both patients and controls. Results disclose transcript interaction networks with remarkable structures and genes not directly related to AD by previous studies. The ensemble is able to identify a variety of transcripts that play key roles in other neurological pathologies. Classical statistical assessment by means of non-parametric tests confirms the relevance of the majority of the transcripts. The ensemble approach pinpoints key metabolic mechanisms that could lead to new findings in the pathogenesis and development of AD

Variable Speed Limits. Review and development of an aggregate indicator based on floating car data.

Changing factors (mainly traffic intensity and weather conditions) affecting road conditions require a suitable optimal speed at any time. To solve this problem, variable speed limit systems (VSL) ? as opposed to fixed limits ? have been developed in recent decades. This term has included a number of speed management systems, most notably dynamic speed limits (DSL). In order to avoid the indiscriminate use of both terms in the literature, this paper proposes a simple classification and offers a review of some experiences, how their effects are evaluated and their results This study also presents a key indicator, which measures the speed homogeneity and a methodology to obtain the data based on floating cars and GPS technology applying it to a case study on a section of the M30 urban motorway in Madrid (Spain).

Diseño para el Desarrollo

Resumen El Diseño, que apenas está considerado en las políticas de desarrollo, por su parte tampoco ha prestado la adecuada atención a los aspectos de justicia y de desarrollo global. Encontramos los antecedentes del Diseño para el Desarrollo en la “transferencia de tecnología y en la imitación”; en las “tecnologías apropiadas” de los años 70; en la moda de hacer negocios para la “base de la pirámide (BoP)”; más recientemente en el concepto de “innovación apropiada”; y últimamente en el “enfoque de las capacidades”, que engloba cuestiones sobre justicia, igualdad y desarrollo. En este artículo de revisión se realiza una aproximación a la situación actual del Diseño para el Desarrollo, incluyendo productos e iniciativas empresariales, académicas e investigadoras. Para ello, se ha realizado una revisión en buscadores generalistas y en publicaciones especializadas, accesibles desde la Universidad Politécnica de Madrid. Los resultados obtenidos abarcan desde productos comerciales, repositorios en línea de tecnologías de desarrollo, documentación abierta para el diseño/adaptación de productos para el desarrollo, conferencias, revistas, grupos de investigación, iniciativas emprendedoras, etc. Se trata de un tema que no tiene una univoca expresión y que está siendo tratado en muchas áreas, tanto de las ciencias sociales, como técnicas y sanitarias. Abstract The design, which is hardly considered in development policies, has not paid adequate attention to justice and global development issues. The antecedents of Design for Development are found in the "technology transfer and imitation"; in "appropriate technologies" of the 70s; in the fashion of doing business for the "base of the pyramid (BoP)"; more recently in the concept of "appropriate innovation"; and lately in the "capabilities approach" which includes questions about justice, equality and development. In this article review is performed an approach to the current situation of Design for Development including: products, business models and academic and research perspectives. In order to achieve it, the review has been conducted through search engines in generic and specialized publications, accessible from the Polytechnic University of Madrid. The results obtained include from commercial products, online repository development technologies, open documentation for design / adaptation of products for development, to conferences, journals, research groups, entrepreneurial initiatives, etc. This is a topic that has no unambiguous expression and that is being addressed in many areas, as in the social sciences and technical and health sciences. Resumo O projeto, que dificilmente pode ser considerada nas políticas de desenvolvimento, enquanto isso não prestou a atenção suficiente às questões da justiça e do desenvolvimento global. Encontramos a história do Projeto para o Desenvolvimento na "transferência de tecnologia e na imitação"; em "tecnologias apropriadas" dos anos 70; na forma de fazer negócios para a "base da pirâmide (BoP)"; mais recentemente, o conceito de "inovação apropriado"; e, ultimamente, a "abordagem de capacidades", que inclui perguntas sobre justiça, igualdade e desenvolvimento. Neste artigo de revisão existe uma abordagem para a situação atual do projeto de desenvolvimento, incluindo produtos e iniciativas empresariais, acadêmicos e investigadoras. Para isso, realizamos uma revisão nos motores de busca gerais e publicações especializadas, acessível a partir da Universidade Politécnica de Madrid. Os resultados variam de produtos comerciais tecnologias de desenvolvimento repositório on-line, documentação aberta para o projeto / adaptação de produtos para o desenvolvimento, conferências, revistas, grupos de pesquisa, iniciativas empresariais, etc. Este é um tema que não tem um só significado e que esta sendo tratado em muitas áreas, tanto nas ciências sociais, como técnicas e sanitarias.