Physicians' knowledge and continuing medical education regarding fitness to drive: a questionnaire-based survey in Southeast Switzerland

Valid information for physicians in Switzerland concerning knowledge and continuing education in traffic medicine is not available. Also, their attitude to the legally prescribed periodic driving fitness examinations is unclear. In order to gain more information about these topics, 635 resident physicians in Southeast Switzerland were sent a questionnaire (response rate 52%). In a self-estimation, 79% of the queried physicians claimed to know the minimal medical requirements for drivers which are important in their specialty. Statistically significant differences existed between the specialties, whereby general practitioners most frequently claimed to know the minimal medical requirements (90%). It appears that the minimal medical requirements for drivers are well known to the queried physicians. Fifty-two percent of the physicians favored an expansion of continuing education in traffic medicine. Such an expansion was desired to a lesser extent by physicians without knowledge of the minimal requirements (p < 0.001). A clear majority of the medical professionals adjudged the legally prescribed periodic driving fitness examinations as being an expedient means to identify unfit drivers. A national standardized form for reporting potentially unfit drivers to the licensing authorities was supported by 68% of the responding physicians. Such a form could simplify and standardize the reports to the licensing authorities.

Fear of the unknown: local knowledge and perceptions of the Eurasian lynx

The remnant population of Balkan lynx Lynx lynx martinoi is small, isolated and highly threatened. Since 2006 a conservation project has surveyed its status and promoted its recovery in Albania and Macedonia. Eurasian lynx are often associated with conflicts of an economic or social nature, and their conservation requires a focus on the people sharing the landscape with the species. In this study we adopt methods and conceptual frameworks from anthropology to explore the local knowledge and perceptions of lynx among rural hunters and livestock breeders in the western mountains of the Republic of Macedonia in south-east Europe. The main finding was that local people rarely saw or interacted with lynx. As the level of interactions with this species is very low, the lynx doesn?t appear to be a species associated with conflicts in Macedonia. There was also a general lack of both scientific and local knowledge, which has led to somewhat negative attitudes, mainly based on myths and rumours. Poaching of lynx and their prey seem to be the main barriers to lynx conservation.

Influence of Engineering Instructors' Teaching and Learning Beliefs on Pedagogies in Engineering Science Courses

This study explored how academics' beliefs about teaching and learning influenced their teaching in engineering science courses typically taught in the second or third year of 4-year engineering undergraduate degrees. Data were collected via a national survey of 166 U. S. statics instructors and interviews at two different institutions with 17 instructors of engineering science courses such as thermodynamics, circuits and statics. The study identified a number of common beliefs about how to best support student learning of these topics; each is discussed in relation to the literature about student development and learning. Specific recommendations are given for educational developers to encourage use of research-based instructional strategies in these courses.

The free radical scavenger alpha-phenyl-tert-butyl nitrone aggravates hippocampal apoptosis and learning deficits in experimental pneumococcal meningitis

The effect of adjuvant therapy with the radical scavenger alpha-phenyl-tert-butyl nitrone (PBN; 100 mg/kg given intraperitoneally every 8 h for 5 days) on brain injury and learning function was evaluated in an infant rat model of pneumococcal meningitis. Meningitis led to cortical necrotic injury (median, 3.97% [range, 0%-38.9%] of the cortex), which was reduced to a median of 0% (range, 0%-30.9%) of the cortex (P<.001) by PBN. However, neuronal apoptosis in the hippocampal dentate gyrus was increased by PBN, compared with that by saline (median score, 1.15 [range, 0.04-1.73] vs. 0.31 [range, 0-0.92]; P<.001). Learning function 3 weeks after cured infection, as assessed by the Morris water maze, was decreased, compared with that in uninfected control animals (P<.001). Parallel to the increase in hippocampal apoptosis, PBN further impaired learning in infected animals, compared with that in saline-treated animals (P<.02). These results contrast with those of an earlier study, in which PBN reduced cortical and hippocampal neuronal injury in group B streptococcal meningitis. Thus, in pneumococcal meningitis, antioxidant therapy with PBN aggravates hippocampal injury and learning deficits.

Defining Goals and Learning Objectives for a Longitudinal Clerkship in the Complex Context of Health Care

In autumn 2007 the Swiss Medical School of Berne (Switzerland) implemented mandatory short-term clerkships in primary health care for all undergraduate medical students. Students studying for a Bachelor degree complete 8 half-days per year in the office of a general practitioner, while students studying for a Masters complete a three-week clerkship. Every student completes his clerkships in the same GP office during his four years of study. The purpose of this paper is to show how the goals and learning objectives were developed and evaluated. Method:A working group of general practitioners and faculty had the task of defining goals and learning objectives for a specific training program within the complex context of primary health care. The group based its work on various national and international publications. An evaluation of the program, a list of minimum requirements for the clerkships, an oral exam in the first year and an OSCE assignment in the third year assessed achievement of the learning objectives. Results: The findings present the goals and principal learning objectives for these clerkships, the results of the evaluation and the achievement of minimum requirements. Most of the defined learning objectives were taught and duly learned by students. Some learning objectives proved to be incompatible in the context of ambulatory primary care and had to be adjusted accordingly. Discussion: The learning objectives were evaluated and adapted to address students’ and teachers’ needs and the requirements of the medical school. The achievement of minimum requirements (and hence of the learning objectives) for clerkships has been mandatory since 2008. Further evaluations will show whether additional learning objectives need to be adopte

Theory and Practice: A Matter of Words. Language, Knowledge and Professional Community in Social Work

The relation between theory and practice in social work has always been controversial. Recently, many have underlined how language is crucial in order to capture how knowledge is used in practice. This article introduces a language perspective to the issue, rooted in the ‘strong programme’ in the sociology of knowledge and in Wittgenstein’s late work. According to this perspective, the meaning of categories and concepts corresponds to the use that concrete actors make of them as a result of on-going negotiation processes in specific contexts. Meanings may vary dramatically across social groups moved by different interests and holding different cultures. Accordingly, we may reformulate the issue of theory and practice in terms of the connections between different language games and power relationship between segments of the professional community. In this view, the point is anyway to look at how theoretical language relates to practitioners’ broader frames, and how it is transformed while providing words for making sense of experience.

Adjuvant breast cancer treatment and cognitive function: current knowledge and research directions

Evidence is mounting that potentially curative systemic adjuvant therapy for early-stage breast cancer may result in cognitive impairment. Five published studies have investigated cognitive function in this setting, and the consistent results of all five studies suggest an adverse effect of adjuvant chemotherapy. These studies are reviewed with particular attention to their methodologic limitations. For example, all five studies used cross-sectional designs, none controlled for possible confounding hormonal factors, and three examined patients who had not received a uniform chemotherapy regimen. The potential roles of chemotherapy-induced menopause and of adjuvant hormonal therapy in cognitive impairment are also discussed. Priorities for future research include confirmation of an effect of adjuvant chemotherapy in a study with a longitudinal design, closer examination of the potential contribution of hormonal factors, and similar studies on the effect of adjuvant therapy on cognitive function in other cancer types. If an effect of systemic adjuvant therapy on cognitive function is confirmed, such an effect will have implications for informed consent. It may also result in incorporation of objective measures of cognition in clinical trials of adjuvant therapy and in the investigation of preventive interventions that might minimize the impact of cognitive dysfunction after cancer treatment.