The Daughters of Bridget McGhee

When Huxley proposed, Blythe imagined herself fifty years into the future at his funeral. He was such a good man, they’d say. Seventy-two is too young, they’d say. She’d nod and, she had imagined, remember this moment – them lounging in her bed during the early afternoon with the sunlight threatening to burst from behind the drawn shades, him lying on his side with his left arm anchored around her waist, and the tickle of his thumb as he traced circles on her bellybutton. She rubbed her nose against his neck and breathed. His scent was different from that of Walter. Huxley smelled of pears and basil. Walter smelled of leather and soap. She didn’t smell Walter intentionally, of course. He walked into the White Dog the prior day while she was drinking a mint-mocha cappuccino and studying for an exam on medical physiology. The wind whiffed his odor towards her. She didn’t look at him, but she couldn’t stop from inhaling. “People get married after college,” Huxley swung his right leg over and straddled her, forcing her to look at him. “It’s almost been a year since we graduated. It’s what we should do.” She had wondered if he could donate organs if he were seventy-two years old. Not his liver or heart or anything like that, of course, but maybe his eyes. It’d be a shame if they couldn’t preserve his eyes. She noticed them first: they were alert and misty blue, like Santa’s. But then she wondered if eye characteristics like color were even changed during cornea transplants. Walter had plain brown eyes. She hated brown eyes. She told people that she had brown eyes, because they were dark and no one ever looked close enough. Except Huxley. They were at dinner with mutual friends and were talking about eye color, and how they all wished that theirs were like those of the young Afghan girl on the 1985 cover of National Geographic.

Democratic Transition and Political Patronage

Mr. Korosenyi begins by analysing the particular relationship holding between politics and administration in different countries. Within Europe three major patterns have emerged in the 20th century. Firstly there is the politically neutral British Civil Service, secondly the German and French state bureaucracies, which traditionally are supposed to embody the "common good", and thirdly there is the patronage system of the so-called consociate democracies, e.g. Austria. In general Mr. Korosenyi believes that, though politics do not penetrate into the Hungarian administration to the extent they do in Belgium and Austria, nevertheless, there is a stronger fusion than there is in the traditional British pattern. He is particularly interested in this relationship with regard to its effect on democratic institution building and the stabilisation of the new regime in Hungary, now the old "nomenklatura" system has been abolished. The structure of the Hungarian government was a result of the constitutional amendments of 1989 and 1990. Analysing this period, it becomes clear that for all the political actors who initiated and supported the democratic transition to democracy, the underlying assumption was a radical depoliticisation of the administration in order to maintain its stability. The political leadership of the executive is a cabinet government. The government is structured along ministries, each headed by a politician, i.e. the minister, who is a member of the cabinet. The minister's political secretary is not a cabinet member, but he or she is a politician, usually a member of the parliament. The head of the administration of the ministry is the administrative state secretary, who is a civil servant. He or she usually has four deputies, also civil servants. Naturally it is assumed that there should be a clear separation between politicians and civil servants. However in practice, the borders can be blurred, giving rise to a hybrid known as the "political civil servant". Mr. Korosenyi analyses the different faces of these hybrids. They are civil servants for the following reasons. They need special educational qualifications, working experience, a civil service exam etc., they are not allowed to do anything which is incompatible with their impartial role, and they cannot occupy political office nor may they appear in the name of any political party. On the other hand, the accepted political dimension to their function is revealed by the following facts. The state secretary (a civil servant) may participate in cabinet meetings instead of the minister. The state secretary is employed by the minister. A state secretary or any of their deputies can be dismissed at any time by the minister or the prime minister. In practice then, ministers appoint to these senior administrative positions civil servants whose personal and political loyaties are strong. To the second level of political patronage in ministries belong the ministerial cabinet, press office and public relation office. The ministerial cabinet includes the private advisors and members of the personal staff of the minister. The press office and the PR office, if they exist, are not adjusted to the administrative hierarchy of the ministry, but under the direct control of the minister. In the beginning of the 1990s, such offices were exceptions; in the second half of the 90s they are accepted and to be found in most ministries. Mr. Korosenyi's work, a 92-page manuscript of a book in Hungarian, marks the first piece of literature within the field of political science which analyses the structure of the Hungarian government in the 1990s and the relationship between the political leadership and the public administration.

[Mandibular fracture in a Lhasa Apso with secondary renal hyperparathyroidism]

A Lhassa Apso is presented in emergency after having been injured by another dog. It was suffering from a mandibular fracture. The clinical exam revealed generalized and excessive mobility of the whole dentition. Radiographs showed generalized jaw bone demineralisation. A blood sample was analysed and revealed chronic renal disease. We came to the conclusion that this dog was suffering from secondary renal hyperparathyroidism. The hypocalcified bone was so thin that a slight trauma induced the mandibular fracture.

Assessment of a high school geological field course

Fieldwork is supportive of students’ natural inquiry abilities. Educational research findings suggest that instructors can foster the growth of thinking skills and promote science literacy by incorporating active learning strategies (McConnel et al, 2003). Huntoon (2001) states that there is a need to determine optimal learning strategies and to document the procedure of assessing those optimal geoscience curricula. This study seeks to determine if Earth Space II, a high school geological field course, can increase students’ knowledge of selected educational objectives. This research also seeks to measure any impact Earth Space II has on students’ attitude towards science. Assessment of the Earth Space II course objectives provided data on the impact of field courses on high school students’ scientific literacy, scientific inquiry skills, and understanding of selected course objectives. Knowledge assessment was done using a multiple choice format test, the Geoscience Concept Inventory, and an open-ended format essay test. Attitude assessment occurred by utilizing a preexisting science attitude survey. Both knowledge assessments items showed a positive effect size from the pretest to the posttest. The essay exam effect size was 17 and the Geoscience Concept Inventory effect size was 0.18. A positive impact on students’ attitude toward science was observed by an increase in the overall mean Likert value from the pre-survey to the post-survey.

Effects of instructional changes on student learning of electrochemistry in an IB chemistry course

This study investigated the effectiveness of incorporating several new instructional strategies into an International Baccalaureate (IB) chemistry course in terms of how they supported high school seniors’ understanding of electrochemistry. The three new methods used were (a) providing opportunities for visualization of particle movement by student manipulation of physical models and interactive computer simulations, (b) explicitly addressing common misconceptions identified in the literature, and (c) teaching an algorithmic, step-wise approach for determining the products of an aqueous solution electrolysis. Changes in student understanding were assessed through test scores on both internally and externally administered exams over a two-year period. It was found that visualization practice and explicit misconception instruction improved student understanding, but the effect was more apparent in the short-term. The data suggested that instruction time spent on algorithm practice was insufficient to cause significant test score improvement. There was, however, a substantial increase in the percentage of the experimental group students who chose to answer an optional electrochemistry-related external exam question, indicating an increase in student confidence. Implications for future instruction are discussed.

Moving Beyond Hastiness and Superficiality: Being an Ethical Technical Communicator via Digital Communication Technologies in Health Care

This thesis examines digital technologies used by technical communicators in healthcare settings. I show that technical communicators, who function as users, advocators and evaluators, need a useable framework for ethical engagement with digital technologies, which integrally affect the physician-patient relationship. Therefore, I apply rhetorical methodology by producing useable knowledge and phenomenological methodology by examining lived experiences of technical communicators. Substantiation comes from theories spanning technical communication, philosophy, and composition studies. Evidence also emerges from qualitative interviews with communication professionals working in healthcare; my concerns arise from personal experiences with electronic recordkeeping in the exam room. This thesis anticipates challenging the presumed theory-practice divide while encouraging greater disciplinary reciprocity. Because technical communication infuses theory into productive capacity, this thesis presents the tripartite summons of the ethical technical communicator: to exercise critically-reflective action that safeguards the physician-patient relationship by ways of using digital technologies, advocating for audiences, and evaluating digital technologies.

What Makes Science Hard for Newcomers?

Part I What makes science hard for newcomers? 1) The background (briefly) of my research - (why the math anxiety model doesn’t fit) 2) The Tier analysis (a visual) – message: there are many types of science learners in your class than simply younger versions of yourself 3) Three approaches (bio, chem, physics) but only one Nature 4) The (different) vocabularies of the three Sciences 5) How mathematics is variously used in Science Part II Rules and rules-driven assignments- lQ vs OQ1) How to incorporate creativity into assignments and tests? 2) Tests- borrowing “thought questions" from other fields (If Columbus hadn't discovered the new World, when and under whose law would it have been discovered?) 3) Grading practices (partial credit, post-exam credit for finding and explaining nontrivial errors 4) Icing on the cake – applications, examples of science/engineering from Tuesdays NY Times Part III Making Change at the Departmental Level 1) Taking control of at least some portion of the curriculum 2) Varying style of presentation 3) Taking control of at least some portion of the exams 4) GRADING pros and cons of grading on a curve 5) Updating labs and lab reporting.

The Amplifier - v. 7, no. 10

In this issue...Mineral Club, Barite, Engineer Exam, Montana State Highway Commission, Career Day, lung cancer, Selective Service, Civil War, Brown's Gulch

Oral hygiene indirect instruction and periodic reinforcements: effects on index plaque in schoolchildren

The aim of this study was to evaluate the effectiveness of the indirect instruction and the influence of the periodic reinforcement on the plaque index in schoolchildren. Forty schoolchildren aged from 7 to 9 years old were selected from a public school. After determining the initial O'Leary Plaque Index all schoolchildren were submitted to a program for oral hygiene through indirect instruction -"The Smiling Robot". The schoolchildren were divided into 2 groups: with and without motivation reinforcement. The index plaque exam was performed in both groups after 30, 60 and 90 days of the educational program. Comparing the groups, the plaque index decreasing could be observed in the group with reinforcement with statistically significant difference. For the group with reinforcement, statistically significant difference among the evaluations was found. For the group without reinforcement, significant decrease in the plaque index was found after 30 days when compared to the first, third and fourth evaluations. The indirect instruction with "The Smiling Robot "promoted a positive initial impact on the decrease of plaque index in the schoolchildren. The periodic reinforcements showed more suitable results and significant reduction of the plaque index in the course of the evaluations.

Group B Streptococcus colonization in pregnancy: prevalence and prevention strategies of neonatal sepsis

Early onset neonatal sepsis due to Group B streptococci (GBS) is responsible for severe morbidity and mortality of newborns. While different preventive strategies to identify women at risk are being recommended, the optimal strategy depends on the incidence of GBS-sepsis and on the prevalence of anogenital GBS colonization. We therefore aimed to assess the Group B streptococci prevalence and its consequences on different prevention strategies. We analyzed 1316 pregnant women between March 2005 and September 2006 at our institution. The prevalence of GBS colonization was determined by selective cultures of anogenital smears. The presence of risk factors was analyzed. In addition, the direct costs of screening and intrapartum antibiotic prophylaxis were estimated for different preventive strategies. The prevalence of GBS colonization was 21%. Any maternal intrapartum risk factor was present in 37%. The direct costs of different prevention strategies have been estimated as follows: risk-based: 18,500 CHF/1000 live births, screening-based: 50,110 CHF/1000 live births, combined screening- and risk-based: 43,495/1000 live births. Strategies to prevent GBS-sepsis in newborn are necessary. With our colonization prevalence of 21%, and the intrapartum risk profile of women, the screening-based approach seems to be superior as compared to a risk-based approach.

[HPV type 16-associated anal intraepithelial neoplasia (AIN)]

A 25-year-old woman had suffered from a perianal ulcer for approximately 1 year. Topical and systemic treatments had been unsuccessful. Employing virologic and histologic techniques, we confirmed the diagnosis of an intraepithelial neoplasia. Anal intraepithelial neoplasia (AIN) is induced by carcinogenic human papillomaviruses. It can occur anywhere in the anogenital area. Because of its frequency, AIN is a crucial differential diagnosis for lesions of the anogenital area region failing to respond to standard therapies.

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

Over two decades of blended and online physics courses at Michigan State University

In Fall 1992, our first physics course offered online homework. Over two decades later, we have seven physics courses online, spanning the whole range of introductory course offerings, with a total of over 1600 students in 2014. We found that several of the the purely online courses had better learning success than traditional lecture courses, as measured by exam scores. Particularly successful were online materials with embedded assessment. This result can be interpreted in different ways, but may serve as an indicator that during in-class lectures, we are oftentimes not taking advantage of the fact that we have the students on-site.

Limitations of the use of pressure waves to verify correct epidural needle position in dogs

The use of pressure waves to confirm the correct position of the epidural needle has been described in several domestic species and proposed as a valid alternative to standard methods, namely, control radiographic exam and fluoroscopy. The object of this retrospective clinical study was to evaluate the sensitivity of the epidural pressure waves as a test to verify the correct needle placement in the epidural space in dogs, in order to determine whether this technique could be useful not only in the clinical setting but also when certain knowledge of needle's tip position is required, for instance when performing clinical research focusing on epidural anaesthesia. Of the 54 client-owned dogs undergoing elective surgeries and enrolled in this retrospective study, only 45% showed epidural pressure waves before and after epidural injection. Twenty-six percent of the animals showed epidural pressure waves only after the injection, whereas 29% of the dogs showed epidural pressure waves neither before nor after injection and were defined as false negatives. Our results show that the epidural pressure wave technique to verify epidural needle position lacks sensitivity, resulting in many false negatives. As a consequence, the applicability of this technique is limited to situations in which precise, exact knowledge of the needle's tip position is not mandatory.

Quality Control for SP Performance Regarding Patient Portrayal in a High-Stakes OSCE

Introduction Since the quality of patient portrayal of standardized patients (SPs) during an Objective Structured Clinical Exam (OSCE) has a major impact on the reliability and validity of the exam, quality control should be initiated. Literature about quality control of SP’s performance focuses on feedback [1, 2] or completion of checklists [3, 4]. Since we did not find a published instrument meeting our needs for the assessment of patient portrayal, we developed such an instrument after being inspired by others [5] and used it in our high-stakes exam. Methods SP trainers from all five Swiss medical faculties collected and prioritized quality criteria for patient portrayal. Items were revised with the partners twice, based on experiences during OSCEs. The final instrument contains 14 criteria for acting (i.e. adequate verbal and non-verbal expression) and standardization (i.e. verbatim delivery of the first sentence). All partners used the instrument during a high-stakes OSCE. Both, SPs and trainers were introduced to the instrument. The tool was used in training (more than 100 observations) and during the exam (more than 250 observations). FAIR_OSCE The list of items to assess the quality of the simulation by SPs was primarily developed and used to provide formative feedback to the SPs in order to help them to improve their performance. It was therefore named “Feedbackstruckture for the Assessment of Interactive Role play in Objective Structured Clinical Exams (FAIR_OSCE). It was also used to assess the quality of patient portrayal during the exam. The results were calculated for each of the five faculties individually. Formative evaluation was given to the five faculties with individual feedback without revealing results of other faculties other than overall results. Results High quality of patient portrayal during the exam was documented. More than 90% of SP performances were rated to be completely correct or sufficient. An increase in quality of performance between training and exam was noted. In example the rate of completely correct reaction in medical tests increased from 88% to 95%. 95% completely correct reactions together with 4% sufficient reactions add up to 99% of the reactions meeting the requirements of the exam. SP educators using the instrument reported an augmentation of SPs performance induced by the use of the instrument. Disadvantages mentioned were high concentration needed to explicitly observe all criteria and cumbersome handling of the paper-based forms. Conclusion We were able to document a very high quality of SP performance in our exam. The data also indicate that our training is effective. We believe that the high concentration needed using the instrument is well invested, considering the observed augmentation of performance. The development of an iPad based application for the form is planned to address the cumbersome handling of the paper.