Tumours and cancers in Graeco-Roman times

In Graeco-Roman times all tumours (Greek: onkoi, abnormal swellings) were considered to be of inflammatory origin, the result of unfavourable hurnoural fluxes, and caused by an extravascular outpouring of fluid into tissue spaces. The neoplastic nature of tumours is a more recent concept, barely two centuries old. In Hippocratic literature tumours were mainly classified as karkin6mata, phumata, and oidemata. Phumata included a large variety of tumours, inflammatory and neoplastic in origin, and mostly benign (in modern terms), while oidemata were soft, painless tumours and even included generalised oedema (dropsy). Although all categories possibly included occasional cancers, the vast majority of what appears to have been malignant tumours were called karkinoi karkinomata (Latin: cancrum/carcinoma). There was, however, no recognition of benign and malignant, primary and secondary tumours, in the modem sense

The epidemic of Athens, 430 - 426 BC

The Athenian epidemic of 430 - 426 BC, at the outbreak of the Peloponnesian War, caused the death of the great statesman, Pericles, decimated the population and contributed significantly to the decline and fall of classical Greece. In his remarkable documentation of the epidemic, Thucydides (who survived the disease) not only left us a clear clinical picture of the pestilence but also identified its infectious nature and the fact that it conferred at least partial immunity on survivors. As confirmed by a large number of scholars who studied the subject, Thucydides' description does not accurately fit any existing disease, but we suggest that analysis of the signs and symptoms, considered in conjunction with significant epidemiological evidence, narrows down the many possibilities to epidemic typhus, plague, arboviral disease (e.g. Rift Valley fever) and smallpox. Typhus and smallpox fit best, but we favour the latter for reasons given. Unless further primary sources of information become available (and this seems most unlikely), productive speculation as to the cause of Thucydides' epidemic has probably reached the end of the road

An evaluation of the internal validity of specific learning outcomes in phase II of a revised undergraduate medical curriculum

Thesis (MPhil)--University of Stellenbosch, 2001.ENGLISH ABSTRACT: The Faculty of Medicine at the University of Stellenbosch has implemented an extensively revised undergraduate medical curriculum. Exit outcomes, that have been entitled the Profile of the Stellenbosch Doctor, have been formulated for the programme. The revised curriculum is presented in three phases. Phase I involves the study of non-clinical subjects under the guidance of the Faculties of Natural Sciences and Economic & Management Sciences. Phase II involves the study of subjects that lay the groundwork for the third phase. Phase III involves the study of pre-clinical and clinical subjects in an integrated fashion. The intended outcomes of phases II and III were elaborated by the formulation of specific learning outcomes. Determining whether the specific outcomes formulated for each module are achieved will be one aspect of quality assurance in the revised curriculum. This could be done by investigating the relationship between assessment and the specific outcomes. If, however, specific outcomes for the various modules are not congruent with the exit outcomes for the programme, then student assessment will be invalid as regards the programme outcomes. This study therefore entailed a formative evaluation of part of phase II of the revised curriculum. The aims of the study were, firstly, to determine the degree of congruence between the specific outcomes formulated for phase II and the exit outcomes for the programme and, secondly, to explore why the observed degree of congruence exists. The research strategy employed was a case study. The research techniques used were a document analysis and two questionnaire surveys. The study found that most specific outcomes formulated for phase II of the curriculum are congruent with one or more exit outcomes for the programme. However, few of the exit outcomes are addressed to any great extent by specific outcomes. This raises the concern that assessment of students based on the specific outcomes as presently formulated might not demonstrate development of students towards achievement of the exit outcomes. There are indications that this lack of congruence could be due to i) a large number of competing demands on lecturers' time; ii) lecturers not wanting to spend time doing work prioritised by others as important; iii) perceptions that work related to the revised curriculum is being forced on staff without necessarily consulting them; iv) a lack of reward for good teaching; v) the perception that the strategies adopted for the revised curriculum will not necessarily benefit students. Recommendations are made as to how these findings could be confirmed and strategies developed that could be utilised to ensure a greater degree of congruence between the specific and exit outcomes in future.AFRIKAANSE OPSOMMING: Die Fakulteit Geneeskunde van die Universiteit Stellenbosch het 'n omvangryke hersiening van hul voorgraadse geneeskundige kurrikulum geïmplementeer. Uitgangsuitkomste, getiteld die Profiel van die Stellenbosch Dokter, is vir die program geformuleer. Die hersiene kurrikulum word in drie fases aangebied. Fase I behels die studie van nie-kliniese vakke onder leiding van die Fakulteite van Natuurwetenskappe en Ekonomiese- & Bestuurswetenskappe. Fase II behels die studie van vakke wat die grondwerk lê vir die derde fase. Fase III behels die studie van prekliniese en kliniese vakke op 'n geïntegreerde wyse. Die beoogde uitkomste van fases II en III is uitgespel deur die formulering van spesifieke leeruitkomste. Die bepaling van of die spesifieke uitkomste wat vir elke module geformuleer is, bereik word, sal een aspek uitmaak van gehalteversekering in die hersiene kurrikulum. Dit sou gedoen kon word deur die verwantskap tussen assessering en die spesifieke uitkomste te ondersoek. Indien die spesifieke uitkomste vir die verskeie modules egter nie met die uitgangsuitkomste vir die program kongruent is nie, dan sal studentassessering ongeldig wees wat betref die uitkomste van die program. Hierdie studie het dus 'n formatiewe evaluering van deel van fase II van die hersiene kurrikulum behels. Die doelstellings van die studie was om, eerstens, die graad van kongruensie tussen die spesifieke uitkomste wat vir fase II geformuleer is en die uitgangsuitkomste vir die program te bepaal en, tweedens, om ondersoek in te stel na waarom die waargenome graad van kongruensie bestaan. Die navorsingsstrategie wat gebruik is, is 'n gevallestudie. Die navorsingstegnieke wat gebruik is, is 'n dokument analise en twee vraelys ondersoeke. Die studie het vasgestel dat die meeste spesifieke uitkomste vir fase II van die kurrikulum geformuleer wel met een of meer uitgangsuitkomste kongruent was. Min van die uitgangsuitkomste is egter in enige groot mate deur spesifieke uitkomste aangespreek. Die wek besorgdheid dat assessering van studente gebaseer op spesifieke uitkomste soos dit tans daar uitsien, nie noodwendig die ontwikkeling van studente in die rigting van bereiking van die uitgangsuitkomste sal demonstreer nie. Daar is aanduidings dat hierdie gebrek aan kongruensie die gevolg mag wees van: i) 'n groot aantal kompeterende eise op dosente se tyd; ii) dat dosente nie tyd wil wy aan werk wat deur ander as belangrik bepaal is nie; iii) persepsies dat werk wat met die hersiene kurrikulum verband hou op personeel afgedwing word sonder om hulle te raadpleeg; iv) 'n gebrek aan beloning vir goeie onderrig; v) die persepsie dat strategieë wat gebruik word vir die hersiene kurrikulum nie noodwendig tot voordeel van studente sal strek nie. Aanbevelings word aan die hand gedoen oor hoe hierdie bevindinge bevestig kan word en hoe strategieë ontwikkel kan word wat benut sal kan word om in die toekoms 'n groter mate van kongruensie tussen spesifieke en uitgangsuitkomste te verseker

Aretaeus of Cappadocia: the forgotten physician

Aretaeus of Cappadocia (probably first century AD) is one of the least known physicians of antiquity. Not quoted by contemporary medical writers, he was unknown to Arabic physicians of medieval times. His very significant contributions to medicine only became known when a manuscript was discovered and published in Latin in the sixteenth century. He was clearly a sound clinician and gifted medical author, responsible for the first recorded descriptions of steatorrhoea (coeliac disease), diabetes mellitus and diphtheria. In addition, his descriptions of leprosy, asthma, tetanus, acute pneumonia and epilepsy (diseases already recognised in his day) were significantly superior to those of his predecessors. He was the first to describe a heart murmur (bruit)

The transforming influence of the Greeks on Roman medical practice

When Rome conquered Greece in the second century BC, she had no equivalent to Greek rational medicine as established by Hippocrates and the Alexandrians. Roman medicine was of a quasi-religious nature, with a strong element of folk traditions and herbal medicine; the paterfamilias would treat any sickness in the family (including slaves and even animals) with his array of folk remedies. Greek rational medicine was initially received with great skepticism by the Roman elite, in particular, but it gradually transformed the scene, replacing superstition and magic with a reliance on rational science as it was understood at the time. However, the belief in herbal remedies and the Asclepian cult of temple medicine remained strong. Rome also made its own unique contributions in the fields of hygiene (effective water supplies, sewage and drainage) and military medicine (including the introduction of the first hospitals). Roman doctors gradually replaced their Greek colleagues, and by the fifth century Latin had established itself as a significant medical language. In practice Roman folk medicine was not necessarily much inferior to Greek rational medicine, because the latter was based on ill-understood and largely erroneous concepts of medical science

Pre-Hippocratic Greek medicine and its influence on the Hippocratic Corpus

The origins of the Hippocratic Corpus, traditionally held to herald the birth of empirical medicine, are traced in the works of the “pre-Socratic” philosopher-physicians. Although it retained many of the earlier, factually incorrect hypotheses on human physiology and pathology, and consequently proposed largely ineffectual therapies, the Corpus was a decisive milestone in that it described clinical disease patterns objectively, it prescribed medication on the basis of rational argument (as understood at the time) unadulterated by considerations of religion or superstition, and it was underpinned by an ethical code which has largely withstood the test of time

A model of the pre-assessment learning effects of summative assessment in medical education

It has become axiomatic that assessment impacts powerfully on student learning. However, surprisingly little research has been published emanating from authentic higher education settings about the nature and mechanism of the pre-assessment learning effects of summative assessment. Less still emanates from health sciences education settings. This study explored the pre-assessment learning effects of summative assessment in theoretical modules by exploring the variables at play in a multifaceted assessment system and the relationships between them. Using a grounded theory strategy, in-depth interviews were conducted with individual medical students and analyzed qualitatively. Respondents’ learning was influenced by task demands and system design. Assessment impacted on respondents’ cognitive processing activities and metacognitive regulation activities. Individually, our findings confirm findings from other studies in disparate non-medical settings and identify some new factors at play in this setting. Taken together, findings from this study provide, for the first time, some insight into how a whole assessment system influences student learning over time in a medical education setting. The findings from this authentic and complex setting paint a nuanced picture of how intricate and multifaceted interactions between various factors in an assessment system interact to influence student learning. A model linking the sources, mechanism and consequences of the pre-assessment learning effects of summative assessment is proposed that could help enhance the use of summative assessment as a tool to augment learning

Using an Artificial Intelligence chatbot to critically review the scientific literature on the use of Artificial Intelligence in Environmental Impact Assessment

There is considerable uncertainty about the role that Artificial Intelligence (AI) might play in Environmental Impact Assessment (EIA), including into research. AI large language model (LLM) chatbots have the potential to increase the efficiency of EIA research, but their outputs can create concerns. This paper investigates the potential time savings achievable using LLM chatbots to undertake a critical review of literature focussing on the use of AI in EIA. Using a combination of ChatGPT and Elicit, literature was reviewed to identify twelve key issues associated with the use of AI in EIA and this paper was prepared in three and a half days from initial conception. A protocol is developed to assist researchers in fact checking evidence delivered through Elicit (or other machine learning tools) which serves as a novel outcome of this research. Using comments from three peer reviewers allowed some more objective reflection on the credibility of the LLM chatbot-derived output, on the appropriateness of the time savings, and on the future research needed on the application of LLM chatbots in this context