The next challenge for world wide robotized tele-echography experiment (WORTEX 2012): from engineering success to healthcare delivery.

Access to good quality healthcare remains difficult for many patients whether they live in developed or developing countries. In developed countries, specialist medical expertise is concentrated in major hospitals in urban settings both to improve clinical outcomes and as a strategy to reduce the costs of specialist healthcare delivery. In developing countries, millions of people have limited, if any, routine access to a healthcare system and due to economic and cultural factors the accessibility of any services may be restricted. In both cases, geographical, socio-political, cultural and economic factors produce ‘medically isolated areas’ where patients find themselves disadvantaged in terms of timely diagnosis and expert and/or expensive treatment. The robotized teleechography approach, also referred to as robotized teleultrasound, offers a potential solution to diagnostic imaging in medically isolated areas. It is designed for patients requiring ultrasound scans for routine care (e.g., ante natal care) and for diagnostic imaging to investigate acute and medical emergencies conditions, including trauma care and responses to natural disasters such as earthquakes. The robotized teleechography system can hold any standard ultrasound probe; this lightweight system is positioned on the patient’s body by a healthcare assistant. The medical expert, a clinician with expertise in ultrasound imaging and diagnosis, is in a distant location and, using a dedicated joystick, remotely controls the scanning via any available communication link (Internet, satellite). The WORTEX2012 intercontinental trials of the system conducted last year successfully demonstrated the feasibility of remote robotized tele-echography in a range of cultural, technical and clinical contexts. In addition to the engineering success, these trials provided positive feedback from the participating clinicians and patients on using the system and on the system’s perceived potential to transform healthcare in medically isolated areas. The next challenge is to show evidence that this innovative technology can deliver on its promise if introduced into routine healthcare

On the ascendance of argument: A critique of the assumptions of academe's dominant form.

For at least the last several decades, argumentative writing has been of central importance in secondary and higher education, and this emphasis has been heightened by argumentation’s designation as a “cornerstone” of the Common Core State Standards. Moreover, this focus on argumentation has been encouraged by extensive scholarship that investigates how argumentation is learned and deployed in various settings and how the teaching of argumentation might be improved. However, far less attention has been paid to determining why so many literacy educators, researchers, and policy makers believe that privileging argumentative writing is justified. Using a methodology that combines ethnographic case study of writing pedagogy in an urban high school with theoretical analysis of scholarly writings that endorse argumentation, in this essay I demonstrate that the prominence of argumentation is underwritten by three commonly held assumptions: (1) that argumentative writing promotes clear and critical thinking, (2) that it provides training in the rational deliberation that is essential for a democratic citizenry, and (3) that it imparts to students a form of cultural capital that facilitates their upward academic and socioeconomic mobility. My findings are that these assumptions are unwarranted and that schools’ overemphasis on argumentation imposes severe limits on what counts as valid thought, legitimate political subjectivity, and a feasible strategy for addressing economic inequality. This study’s implication is that educators should reassess the value of argumentation and revise ELA curricula to include more diverse genres and discursive modes

On the Ascendance of Argument: A Critique of the Assumptions of Academe's Dominant Form

For at least the last several decades, argumentative writing has been of central importance in secondary and higher education, and this emphasis has been heightened by argumentation’s designation as a “cornerstone” of the Common Core State Standards. Moreover, this focus on argumentation has been encouraged by extensive scholarship that investigates how argumentation is learned and deployed in various settings and how the teaching of argumentation might be improved. However, far less attention has been paid to determining why so many literacy educators, researchers, and policy makers believe that privileging argumentative writing is justified. Using a methodology that combines ethnographic case study of writing pedagogy in an urban high school with theoretical analysis of scholarly writings that endorse argumentation, in this essay I demonstrate that the prominence of argumentation is underwritten by three commonly held assumptions: (1) that argumentative writing promotes clear and critical thinking, (2) that it provides training in the rational deliberation that is essential for a democratic citizenry, and (3) that it imparts to students a form of cultural capital that facilitates their upward academic and socioeconomic mobility. My findings are that these assumptions are unwarranted and that schools’ overemphasis on argumentation imposes severe limits on what counts as valid thought, legitimate political subjectivity, and a feasible strategy for addressing economic inequality. This study’s implication is that educators should reassess the value of argumentation and revise ELA curricula to include more diverse genres and discursive modes

Forecasting the effect of the change in timing of the ABR diagnostic radiology examinations: results of the ACR survey of practice leaders

The results of a survey sent to practice leaders in the ACR Practice of Radiology Environment Database show that the majority of responding groups will continue to hire recently trained residents and fellows even though they have been unable to take the final ABR diagnostic radiology certifying examination. However, a significant minority of private practice groups will not hire these individuals. The majority of private practices expect the timing change for the ABR certifying examinations to affect their groups' function. In contrast, the majority of academic medical school practices expect little or no impact. Residents and fellows should not expect work time off or protected time to study for the certifying examination or for their maintenance of certification examinations in the future

Establishment of a cardiac telehealth program to support cardiovascular diagnosis and care in a remote, resource-poor setting in Uganda.

INTRODUCTION: To address workforce shortages and expand access to care, we developed a telemedicine program incorporating existing infrastructure for delivery of cardiovascular care in Gulu, Northern Uganda. Our study had three objectives: 1) assess feasibility and clinical impact 2) evaluate patient/parent satisfaction and 3) estimate costs. METHODS: All cardiology clinic visits during a two-year study period were included. All patients received an electrocardiogram and echocardiogram performed by a local nurse in Gulu which were stored and transmitted to the Uganda Heart Institute in the capital of Kampala for remote consultation by a cardiologist. Results were relayed to patients/families following cardiologist interpretation. The following telemedicine process was utilized: 1) clinical intake by nurse in Gulu; 2) ECG and echocardiography acquisition in Gulu; 3) echocardiography transmission to the Uganda Heart Institute in Kampala, Uganda; 4) remote telemedicine consultation by cardiologists in Kampala; and 5) communication of results to patients/families in Gulu. Clinical care and technical aspects were tracked. Diagnoses and recommendations were analyzed by age groups (0–5 years, 6–21 years, 22–50 years and > 50 years). A mixed methods approach involving interviews and surveys was used to assess patient satisfaction. Healthcare sector costs of telemedicine-based cardiovascular care were estimated using time-driven activity-based costing. RESULTS: Normal studies made up 47%, 55%, 76% and 45% of 1,324 patients in the four age groups from youngest to oldest. Valvular heart disease (predominantly rheumatic heart disease) was the most common diagnosis in the older three age groups. Medications were prescribed to 31%, 31%, 24%, and 48% of patients in the four age groups. The median time for consultation was 7 days. A thematic analysis of focus group transcripts displayed an overall acceptance and appreciation for telemedicine, citing cost- and time-saving benefits. The cost of telemedicine was $29.48/visit. CONCLUSIONS: Our data show that transmission and interpretation of echocardiograms from a remote clinic in northern Uganda is feasible, serves a population with a high burden of heart disease, has a significant impact on patient care, is favorably received by patients, and can be delivered at low cost. Further study is needed to better assess the impact relative to existing standards of care and cost effectiveness

Educational Progress‐Time and the Proliferation of Dual Enrollment

In this commentary, we use the occasion of the proliferation of dual enrollment to examine the discursive construction of difference between high school and college literacies, and its effects on teachers and students. This discursive divide has real, material consequences. It informs (and constrains) literacy practices and pedagogies, becomes a barrier to access (particularly when operationalized in testing procedures), contributes to dropout and attrition, exacerbates unequal power and resources in communities, and justifies hierarchical relations between high school and college faculty and staff. By deconstructing the definitions of high school and college and the metaphors of containment they rely on, we hope to shift the conversation about dual enrollment and related “bridge” programs away from one of transference or articulation between the high school and college to a more dynamic sense of emergence and negotiation as practiced in our programs and classrooms

Diverticulitis: a Comprehensive Review With Usual and Unusual Complications

Abstract Diverticulitis is characterized by inflammation of the outpouchings of the bowel wall. Imaging findings of diverticulitis include edematous thickening of the bowel wall with inflammatory changes within the adjacent mesenteric fat. Uncomplicated diverticulitis can be treated conservatively; however, complicated diverticulitis may not be responsive to medical treatment and life-threatening conditions may occur. In this review, we aimed to illustrate the ultrasonography (US) and computed tomography (CT) features of diverticulitis and its complications including perforation, phlegmon, abscess, ascending septic thrombophlebitis (phylephlebitis), bleeding, intestinal obstruction, and fistula. Teaching Points • Complications of diverticulitis may be highly variable. , • It may be difficult to diagnose diverticulitis as underlying cause of severe complications. , • MDCT is essential for the primary diagnosis of the acute diverticulitis and its complications.PubMedScopu