Evaluation of a task-based community oriented teaching model in family medicine for undergraduate medical students in Iraq

BACKGROUND: The inclusion of family medicine in medical school curricula is essential for producing competent general practitioners. The aim of this study is to evaluate a task-based, community oriented teaching model of family medicine for undergraduate students in Iraqi medical schools. METHODS: An innovative training model in family medicine was developed based upon tasks regularly performed by family physicians providing health care services at the Primary Health Care Centre (PHCC) in Mosul, Iraq. Participants were medical students enrolled in their final clinical year. Students were assigned to one of two groups. The implementation group (28 students) was exposed to the experimental model and the control group (56 students) received the standard teaching curriculum. The study took place at the Mosul College of Medicine and at the Al-Hadba PHCC in Mosul, Iraq, during the academic year 1999–2000. Pre- and post-exposure evaluations comparing the intervention group with the control group were conducted using a variety of assessment tools. RESULTS: The primary endpoints were improvement in knowledge of family medicine and development of essential performance skills. Results showed that the implementation group experienced a significant increase in knowledge and performance skills after exposure to the model and in comparison with the control group. Assessment of the model by participating students revealed a high degree of satisfaction with the planning, organization, and implementation of the intervention activities. Students also highly rated the relevancy of the intervention for future work. CONCLUSION: A model on PHCC training in family medicine is essential for all Iraqi medical schools. The model is to be implemented by various relevant departments until Departments of Family medicine are established

Neuronal circuitry for pain processing in the dorsal horn

Neurons in the spinal dorsal horn process sensory information, which is then transmitted to several brain regions, including those responsible for pain perception. The dorsal horn provides numerous potential targets for the development of novel analgesics and is thought to undergo changes that contribute to the exaggerated pain felt after nerve injury and inflammation. Despite its obvious importance, we still know little about the neuronal circuits that process sensory information, mainly because of the heterogeneity of the various neuronal components that make up these circuits. Recent studies have begun to shed light on the neuronal organization and circuitry of this complex region

Essential Medicines at the National Level : The Global Asthma Network's Essential Asthma Medicines Survey 2014

Patients with asthma need uninterrupted supplies of affordable, quality-assured essential medicines. However, access in many low- and middle-income countries (LMICs) is limited. The World Health Organization (WHO) Non-Communicable Disease (NCD) Global Action Plan 2013-2020 sets an 80% target for essential NCD medicines' availability. Poor access is partly due to medicines not being included on the national Essential Medicines Lists (EML) and/or National Reimbursement Lists (NRL) which guide the provision of free/subsidised medicines. We aimed to determine how many countries have essential asthma medicines on their EML and NRL, which essential asthma medicines, and whether surveys might monitor progress. A cross-sectional survey in 2013-2015 of Global Asthma Network principal investigators generated 111/120 (93%) responses41 high-income countries and territories (HICs); 70 LMICs. Patients in HICs with NRL are best served (91% HICs included ICS (inhaled corticosteroids) and salbutamol). Patients in the 24 (34%) LMICs with no NRL and the 14 (30%) LMICs with an NRL, however no ICS are likely to have very poor access to affordable, quality-assured ICS. Many LMICs do not have essential asthma medicines on their EML or NRL. Technical guidance and advocacy for policy change is required. Improving access to these medicines will improve the health system's capacity to address NCDs.Peer reviewe

Ten steps to plan, design, and implement an endocrinology and endocrine surgery module for the Faculty of Medicine, Al-Baha University

Walyeldin EM Elfakey,1,2 Ahmed H Al-Ghamdi,1 1Pediatrics Department, Faculty of Medicine, Al-Baha University, Al-Baha, Saudi Arabia; 2Pediatrics Department, University of Bahri, Khartoum, Sudan Introduction: The Faculty of Medicine, Al-Baha University (FMBU), is a newly established medical school that implements a community-oriented and integrated system-based curriculum which is suitable for both medical students and serving the needs of the local community.  Objective: The aim of this study is to describe the steps that were followed to plan, design, and implement an endocrinology and endocrine surgery module (EESM) for the fourth-year medical students, as an example of how system-based modules are designed at FMBU.  Methods: Ten questions based on Harden’s methodolgy were asked in order to design, plan, and implement an endocrinology and endocrine surgery module. The module committee determined the needs of the module and accordingly stated the aims and objectives of the module. The module planners selected the relevant contents, teaching methods, and assessment strategies and organized them. Results: After addressing each of the ten questions, the results indicated the need, aim, objectives, and contents for the endocrinology and endocrine surgery module at FMBU. The implementation strategies were chosen according to the SPICES model. The teaching methods and the assessment strategies were selected and arranged. The module is well communicated at all levels, and the module committee used every effort to create a productive teaching environment. The module is well managed and follows the hierarchy of FMBU. Conclusion: Implementing Harden’s ten steps methodology resulted in an integrated module of endocrinology and endocrine surgery where related disciplines and systems were merged and medical and surgical endocrine topics were included. Keywords: endocrinology, endocrine surgery, module, curriculu

Crack growth in adhesively bonded joints subjected to variable frequency fatigue loading

The main aim of this article is to investigate the effect of frequency on fatigue crack propagation in adhesively bonded joints. Adhesively bonded double-cantilever beam (DCB) samples were tested in fatigue at various frequencies between 0.1 and 10 Hz. The adhesive used was a toughened epoxy, and the substrates used were a carbon fibre-reinforced polymer (CFRP) and mild steel. Results showed that the crack growth per cycle increases and the fatigue threshold decreases as the test frequency decreases. The locus of failure with the CFRP adherends was predominantly in the adhesive layer, whereas the locus of failure with the steel adherends was in the interfacial region between the steel and the adhesive. The crack growth was faster, for a given strain energy release rate, and the fatigue thresholds lower for the samples with steel adherends. Tests with variable frequency loading were also carried out, and a generalised method of predicting crack growth in samples subjected to a variable frequency loading was introduced. The predicted crack growth using this method agreed well with experimental results