Opportunities for the CTEI:disentangling frequency and quality in evaluating teaching behaviours

Students' perceptions of teaching quality are vital for quality assurance purposes. An increasingly used, department-independent instrument is the (Cleveland) clinical teaching effectiveness instrument (CTEI). Although the CTEI was developed carefully and its validity and reliability confirmed, we noted an opportunity for improvement given an intermingling in its rating scales: the labels of the answering scales refer to both frequency and quality of teaching behaviours. Our aim was to investigate whether frequency and quality scores on the CTEI items differed. A sample of 112 residents anonymously completed the CTEI with separate 5-point rating scales for frequency and quality. Differences between frequency and quality scores were analyzed using paired t tests. Quality was, on average, rated higher than frequency, with significant differences for ten out of 15 items. The mean scores differed significantly in favour of quality. As the effect size was large, the difference in mean scores was substantial. Since quality was generally rated higher than frequency, the authors recommend distinguishing frequency from quality. This distinction helps to obtain unambiguous outcomes, which may be conducive to providing concrete and accurate feedback, improving faculty development and making fair decisions concerning promotion, tenure or salar

Introduction: symbiosis as a living evolving critique

Different species, interacting in a symbiotic fashion, living together over a prolonged period of time, eventually co-evolving into new species: this vision of the biological phenomenon of symbiosis has created a strong impression—both of symbiosis as a metaphor and a material reality—of species in an intimate relationship together, cooperating in spite of differences, of becoming something else and transgressing boundaries. This idea has turned the concept of symbiosis, in its many guises and definitions, into a breeding ground for a posthuman, biologically and ecologically informed critique. Less focused on the biological process of symbiosis as such, our focus in Symbiosis: Ecologies, Assemblages and Evolution is more on how symbiosis can be used as a means to argue for an alternative worldview and even a better world...

Improving the cost-effectiveness of a healthcare system for depressive disorders by implementing telemedicine: a Health Economic Modeling Study.

OBJECTIVE: Depressive disorders are important causes of disease burden and are associated with substantial economic costs. Therefore, it is important to design a health care system that can effectively manage depression at sustainable costs. This paper computes the benefit-to-costs ratio of the current Dutch health care system for depression, and investigates whether offering more online preventive interventions improves the cost-effectiveness overall. METHODS: A health economic (Markov) model was used to synthesize clinical and economic evidence and to compute population-level costs and effects of interventions. The model compares a base-case scenario without preventive telemedicine and alternative scenarios with preventive telemedicine. The central outcome is the benefit-to-cost ratio, also known as return-on-investment (ROI). RESULTS: In terms of ROI, a health care system with preventive telemedicine for depressive disorders offers better value for money than a health care system without internet-based prevention. Overall, the ROI increases from €1.45 ($1.72) in the base-case scenario to €1.76 ($2.09) in the alternative scenario where preventive telemedicine is offered. In a scenario where the costs of offering preventive telemedicine are balanced by cutting back on the expenditure for curative interventions, ROI increases to €1.77 ($2.10), while keeping the health care budget constant. CONCLUSION: In order for a health care system for depressive disorders to remain economically sustainable, its cost-benefit ratio needs to be improved. Offering preventive telemedicine at a large scale is likely to introduce such an improvement

Hydrological landscape settings of base-rich fen mires and fen meadows:an overview

Question: Why do similar fen meadow communities occur in different landscapes? How does the hydrological system sustain base-rich fen mires and fen meadows? Location: Interdunal wetlands and heathland pools in The Netherlands, percolation mires in Germany, Poland, and Siberia, and calcareous spring fens in the High Tatra, Slovakia. Methods: This review presents an overview of the hydrological conditions of fen mires and fen meadows that are highly valued in nature conservation due to their high biodiversity and the occurrence of many Red List species. Fen types covered in this review include: (1) small hydrological systems in young calcareous dune areas, and (2) small hydrological systems in decalcified old cover sand areas in The Netherlands; (3) large hydrological systems in river valleys in Central-Europe and western-Siberia, and (4) large hydrological systems of small calcareous spring fens with active precipitation of travertine in mountain areas of Slovakia. Results: Different landscape types can sustain similar nutrient poor and base-rich habitats required by endangered fen meadow species. The hydrological systems of these landscapes are very different in size, but their groundwater flow pattern is remarkably similar. Paleo-ecological research showed that travertine forming fen vegetation types persisted in German lowland percolation mires from 6000 to 3000 BP. Similar vegetation types can still be found in small mountain mires in the Slovak Republic. Small pools in such mires form a cascade of surface water bodies that stimulate travertine formation in various ways. Travertine deposition prevents acidification of the mire and sustains populations of basiphilous species that elsewhere in Europe are highly endangered. Conclusion: Very different hydrological landscape settings can maintain a regular flow of groundwater through the top soil generating similar base-rich site conditions. This is why some fen species occur in very different landscape types, ranging from mineral interdunal wetlands to mountain mires

Quantum Critical Behavior in Disordered Itinerant Ferromagnets: Instability of the Ferromagnetic Phase

An effective field theory is derived that describes the quantum critical behavior of itinerant ferromagnets as the transition is approached from the ferromagnetic phase. This complements a recent study of the critical behavior on the paramagnetic side of the phase transition, and investigates the role of the ferromagnetic Goldstone modes near criticality. We find that the Goldstone modes have no direct impact on the critical behavior, and that the critical exponents are the same as determined by combining results from the paramagnetic phase with scaling arguments.Comment: 11 pp., revtex4, no fig

pMel17 is recognised by monoclonal antibodies NKI-beteb, HMB-45 and HMB-50 and by anti-melanoma CTL.

Recently, we cloned the cDNA encoding the melanocyte lineage-specific antigen gp100 and demonstrated that gp100 is recognised by three different monoclonal antibodies (MAbs) used to diagnose malignant melanoma. In addition, we showed that tumour-infiltrating lymphocytes (TIL 1200) from a melanoma patient reacted specifically with cells transfected with the gp100 cDNA. Molecular characterisation of the gp100 cDNA revealed that the gp100 antigen is highly homologous, but not identical, to another melanocyte-specific protein, pMel17. Here, we report that cells transfected with pMel17 cDNA also react with all three MAbs used to diagnose malignant melanoma, NKI-beteb, HMB-45 and HMB-50. Moreover, pMel17 transfectants are specifically lysed by TIL1200. These data demonstrate that antigenic processing of both gp100 and pMel17 give rise to peptides seen by anti-melanoma cytotoxic T lymphocytes (CTL) and are therefore potential targets for immunotherapy of malignant melanoma

Micro-Dosing of Lime, Phosphorus and Nitrogen Fertilizers Effect on Maize Performance on an Acid Soil in Kenya

High cost of inorganic fertilizers and lime has precluded their use by smallholder farmers to remedy the problem of soil acidity and infertility in Kenya. To address the problem, we tested a precision technique referred to as micro-dosing, which involves application of small, affordable quantities of inorganic inputs on an acid soil in Busia County, Kenya. Experimental treatments were N-fertilizer (0 and 37.5 kg N ha-1), P-fertilizer (0 and 13 kg P ha-1) and lime (0, 0.77 and 1.55 tons lime ha-1). 37.5 kg N and 13 kg P ha-1 are 50% of the recommended fertilizer rates for maize production in Kenya while 0.77 and 1.55 tons lime ha-1 are 25 and 50% of the actual requirement. Soil chemical changes, maize grain yield and nutrient recovery were determined. Lime and P-fertilizer significantly affected only the top-soil pH, Ca, Mg and available P, while the effects of N-fertilizer were evident on both top- and sub-soil N likely due to its faster mobility than P and lime. Grain P-fertilizer recovery efficiencies were 14 and 16-27% due to 13 kg P and 13 kg P + 0.77-1.55 tons lime ha-1, respectively. N-fertilizer recovery efficiencies were 37 and 42-45% due to 37.5 kg N and 37.5 kg N + 0.77-1.55 tons lime ha-1, respectively. Fertilizers applied to supply 37.5 kg N, 13 kg P and 0.77-1.55 tons lime ha-1 increased grain yield above the control by 134, 39 and 12-22%, respectively, therefore micro-dosing of these inputs can increase maize production on Kenyan acid soils

"Better Safe than Sorry" - Individual Risk-free Pension Schemes in the European Union - Macroeconomic Benefits, the Mobile Working Citizen's Perspective and Why Nots

Variations between the diverse pension systems in the member states of the European Union hamper labour market mobility, across country borders but also within the countries of the European Union. From a macroeconomic perspective, and in the light of demographic pressure, this paper argues that allowing individual instead of collective pension building would greatly improve labour market flexibility and thus enhance the functioning of the monetary union. I argue that working citizens would benefit, for three reasons, from pension saving in a risk-free savings account. First, citizens would have a clear picture of the accumulation of their own pension savings throughout their working life. Second, they would pay hardly any extra costs and, third, once retired they would not be subject to the whims of government or other pension fund managers. This paper investigates the feasibility of individual pension building under various parameter settings by calculating the pension saved during a working life and the pension dis-saved after retirement. The findings show that there are no reasons why the European Union and individual member states should not allow individual risk-free pension savings accounts. This would have macroeconomic benefits and provide a solid pension provision that can enhance mobility, instead of engaging workers in different mandatory collective pension schemes that exist around in the European Union