Could Staying Human in Medical Training Help Make Medicine Humane? Review of Allan D. Peterkin, Staying Human During Residency Training

Compte-rendu / Review

Teaching in rural and remote schools: a literature review

In this paper. the authors examine a wide range of recent research into the preparation and support for teachers working in rural and remote schools. The paper reviews many preservice and inservice initiatives which highlight issues affecting:teaching and learning in schools outside the major metropolitan centres. The work is reviewed from an Australian perspective but evaluates research from throughout the world. The paper concludes that despite a large body of research (Gibson, 1994), that has identified the need for specialised pre-service preparation which accommodates the social and professional differences associated with work in rural and remote areas, the implementation of such programs by teacher training institutions has been sparse, lacking in cohesion and in many cases non-existent. (C) 1998 Elsevier Science Ltd. All rights reserved.

The regional economic impacts of biofuels: A review of multisectoral modelling techniques and evaluation of applications

The regional economic impact of biofuel production depends upon a number of interrelated factors: the specific biofuels feedstock and production technology employed; the sector’s embeddedness to the rest of the economy, through its demand for local resources; the extent to which new activity is created. These issues can be analysed using multisectoral economic models. Some studies have used (fixed price) Input-Output (IO) and Social Accounting Matrix (SAM) modelling frameworks, whilst a nascent Computable General Equilibrium (CGE) literature has also begun to examine the regional (and national) impact of biofuel development. This paper reviews, compares and evaluates these approaches for modelling the regional economic impacts of biofuels.

The regional economic impacts of biofuels: A review of multisectoral modelling techniques and evaluation of applications

The regional economic impact of biofuel production depends upon a number of interrelated factors: the specific biofuels feedstock and production technology employed; the sector’s embeddedness to the rest of the economy, through its demand for local resources; the extent to which new activity is created. These issues can be analysed using multisectoral economic models. Some studies have used (fixed price) Input-Output (IO) and Social Accounting Matrix (SAM) modelling frameworks, whilst a nascent Computable General Equilibrium (CGE) literature has also begun to examine the regional (and national) impact of biofuel development. This paper reviews, compares and evaluates these approaches for modelling the regional economic impacts of biofuels.

The Poetics and Politics of the American Gothic : Gender and Slavery in Nineteenth-Century American Literature

Taking as its point of departure recent insights about the performative¦nature of genre, The Poetics and Politics of the American Gothic¦challenges the critical tendency to accept at face value that gothic¦literature is mainly about fear. Instead, Agnieszka Soltysik Monnet¦argues that the American Gothic, and gothic literature in general,¦is also about judgment: how to judge and what happens when¦judgment is confronted with situations that defy its limits.¦Poe, Hawthorne, Melville, Gilman, and James all shared a concern¦with the political and ideological debates of their time, but tended¦to approach these debates indirectly. Thus, Monnet suggests, while¦slavery and race are not the explicit subject matter of antebellum¦works by Poe and Hawthorne, they nevertheless permeate it through¦suggestive analogies and tacit references. Similarly, Melville, Gilman,¦and James use the gothic to explore the categories of gender and¦sexuality that were being renegotiated during the latter half of the¦century. Focusing on The Fall of the House of Usher, The Marble¦Faun, Pierre, The Turn of the Screw, and The Yellow Wallpaper,¦Monnet brings to bear minor texts by the same authors that further¦enrich her innovative readings of these canonical works. At the same¦time, her study persuasively argues that the Gothic's endurance¦and ubiquity are in large part related to its being uniquely adapted¦to rehearse questions about judgment and justice that continue to¦fascinate and disturb.

Clinical determinants of early parasitological response to ACTs in African patients with uncomplicated falciparum malaria: a literature review and meta-analysis of individual patient data.

BACKGROUND: Artemisinin-resistant Plasmodium falciparum has emerged in the Greater Mekong sub-region and poses a major global public health threat. Slow parasite clearance is a key clinical manifestation of reduced susceptibility to artemisinin. This study was designed to establish the baseline values for clearance in patients from Sub-Saharan African countries with uncomplicated malaria treated with artemisinin-based combination therapies (ACTs). METHODS: A literature review in PubMed was conducted in March 2013 to identify all prospective clinical trials (uncontrolled trials, controlled trials and randomized controlled trials), including ACTs conducted in Sub-Saharan Africa, between 1960 and 2012. Individual patient data from these studies were shared with the WorldWide Antimalarial Resistance Network (WWARN) and pooled using an a priori statistical analytical plan. Factors affecting early parasitological response were investigated using logistic regression with study sites fitted as a random effect. The risk of bias in included studies was evaluated based on study design, methodology and missing data. RESULTS: In total, 29,493 patients from 84 clinical trials were included in the analysis, treated with artemether-lumefantrine (n = 13,664), artesunate-amodiaquine (n = 11,337) and dihydroartemisinin-piperaquine (n = 4,492). The overall parasite clearance rate was rapid. The parasite positivity rate (PPR) decreased from 59.7 % (95 % CI: 54.5-64.9) on day 1 to 6.7 % (95 % CI: 4.8-8.7) on day 2 and 0.9 % (95 % CI: 0.5-1.2) on day 3. The 95th percentile of observed day 3 PPR was 5.3 %. Independent risk factors predictive of day 3 positivity were: high baseline parasitaemia (adjusted odds ratio (AOR) = 1.16 (95 % CI: 1.08-1.25); per 2-fold increase in parasite density, P <0.001); fever (>37.5 °C) (AOR = 1.50 (95 % CI: 1.06-2.13), P = 0.022); severe anaemia (AOR = 2.04 (95 % CI: 1.21-3.44), P = 0.008); areas of low/moderate transmission setting (AOR = 2.71 (95 % CI: 1.38-5.36), P = 0.004); and treatment with the loose formulation of artesunate-amodiaquine (AOR = 2.27 (95 % CI: 1.14-4.51), P = 0.020, compared to dihydroartemisinin-piperaquine). CONCLUSIONS: The three ACTs assessed in this analysis continue to achieve rapid early parasitological clearance across the sites assessed in Sub-Saharan Africa. A threshold of 5 % day 3 parasite positivity from a minimum sample size of 50 patients provides a more sensitive benchmark in Sub-Saharan Africa compared to the current recommended threshold of 10 % to trigger further investigation of artemisinin susceptibility.

Théorie du langage et esthétique totalisante dans l’œuvre poétique de Christophe Tarkos

Cette thèse prend pour objet le nouage entre l’autoréflexivité et la mise en forme esthétique dans la poésie de Christophe Tarkos, produite dans les années 1990. Elle met en lumière les rapports entre l’élaboration d’une théorie du langage au sein de cette œuvre poétique et ses visées esthétiques totalisantes. Il s’agit d’identifier les principes générateurs de la théorie et de fournir une analyse de ses fondements qui s’ancrent dans la crise de la représentation moderne commençant dans la deuxième moitié du dix-neuvième siècle. Les motifs de la crise revisités par Tarkos inscrivent sa poésie dans une historicité, et notre thèse tente d’interpréter cette actualisation dans une œuvre qui donne forme au monde et à la mémoire individuelle. L’hypothèse qui chapeaute notre étude est que la théorie du langage favorise l’intelligibilité de l’œuvre totalisante en lui offrant un support réflexif. Notre thèse, qui privilégie une méthode fondée sur l’analyse des textes, se divise en trois parties. La première propose une recension de la réception critique de l’œuvre, dont nous retraçons les grandes lignes d’interprétation, de Christian Prigent à Jean-Michel Espitallier. Tout en plaçant Tarkos dans le champ poétique français, cette étape nous permet de positionner notre recherche par rapport à certains lieux communs de la critique. La deuxième partie vise à étudier la théorie du langage de Tarkos à partir de ses manifestes principaux (Le Signe =, Manifeste chou, Ma langue est poétique et La poésie est une intelligence) qui révèlent plusieurs principes, pouvoirs et limites de la langue et de la poésie. Afin de montrer la spécificité du concept de la « pâte-mot » de Tarkos, nous l’étudions dans un dialogue avec la figure de la « pâte » langagière chez la poète française Danielle Collobert. La troisième partie propose une étude de la volonté et de l’esthétique totalisantes dans l’œuvre de Tarkos, qui cherche à donner forme au réel. En effet, la poésie répond à l’excès du réel par diverses stratégies. Tout en voulant représenter son caractère débordant par une énonciation logorrhéique ou en usant de procédés comme celui de la répétition, elle cherche à le maîtriser dans des formes textuelles stables comme des fragments de prose « carrés » (Carrés, Caisses), dans des listes énumératives (Anachronisme) ou dans des réseaux d’images. La volonté totalisante chez Tarkos semble également prendre origine dans un sentiment d’urgence qui concerne, en dernière instance, une bataille contre la finitude.

Pesticides and other micro-organic contaminants in freshwater sedimentary environments - a review

A wide range of issues relating to the presence and fate of pesticides and other micro-organic contaminants (MOCs) in surface freshwater sedimentary environments is reviewed. These issues include the sources, transport and occurrence of MOCs in freshwater environments; their ecological effects; their interaction with sedimentary material; and a range of processes related to their fate, including degradation, diffusion in bed sediments, bioturbation and slow contaminant release. An emphasis is placed on those processes-chemical, physical or biological-in which sediments play a role in determining the fate of micro-organics in freshwater environments. The issues of occurrence, source and transport, and the ecological effects of micro-organics are introduced more briefly, the focus where these aspects are concerned being largely on pesticides. In the concluding section, key points and issues relating to the study of micro-organics in freshwater environments are summarised and areas where initial or further research would be welcome are highlighted. It is hoped that this paper will both form a useful reference for workers in the field of micro-organic contaminants, and also stimulate new work in the freshwater environment and beyond. (C) 2003 Elsevier Science Ltd. All rights reserved.

Pesticides and other micro-organic contaminants in freshwater sedimentary environments - a review

A wide range of issues relating to the presence and fate of pesticides and other micro-organic contaminants (MOCs) in surface freshwater sedimentary environments is reviewed. These issues include the sources, transport and occurrence of MOCs in freshwater environments; their ecological effects; their interaction with sedimentary material; and a range of processes related to their fate, including degradation, diffusion in bed sediments, bioturbation and slow contaminant release. An emphasis is placed on those processes-chemical, physical or biological-in which sediments play a role in determining the fate of micro-organics in freshwater environments. The issues of occurrence, source and transport, and the ecological effects of micro-organics are introduced more briefly, the focus where these aspects are concerned being largely on pesticides. In the concluding section, key points and issues relating to the study of micro-organics in freshwater environments are summarised and areas where initial or further research would be welcome are highlighted. It is hoped that this paper will both form a useful reference for workers in the field of micro-organic contaminants, and also stimulate new work in the freshwater environment and beyond. (C) 2003 Elsevier Science Ltd. All rights reserved.