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

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

Mapping undergraduate exit-level assessment in a medical programme : a blueprint for clinical competence?

CITATION: Tan, C. P. L., et al. 2016. Mapping undergraduate exit-level assessment in a medical programme: a blueprint for clinical competence? African Journal of Health Professions Education, 8(1):45-49, doi:10.7196/AJHPE.2016.v8i1.546.The original publication is available at http://www.ajhpe.org.zaENGLISH SUMMARY : Background. Assessment is an essential component of a medical curriculum. High-stakes exit-level assessment used for licensing and certification purposes needs to be sound. Even though criteria for evaluating assessment practices exist, an analysis of the nature of these practices is first required. Objective. To map current exit-level assessment practices, as described in institutional documentation. Methods. This descriptive interpretive study centred on the document analysis of final-phase study guides of the undergraduate medical programme at Stellenbosch University, Cape Town, South Africa. Results. The key findings were: (i) there is a diversity of methods and approaches to assessment in the final-phase modules; (ii) modules using similar assessment methods applied different credit weightings; (iii) similar assessment methods were described differently across the study guides; and (iv) study guides varied in the amount of information provided about the assessment methods. Conclusion. There is a diverse range of assessment practices at exit level of the MB,ChB programme at Stellenbosch University. This in-depth analysis of assessment methods has highlighted areas where current practice needs to be investigated in greater depth, and where shifts to a more coherent practice should be encouraged. Assessment mapping provides a useful reference for programme co-ordinators and is applicable to other programmes.http://www.ajhpe.org.za/index.php/ajhpe/article/view/546Publisher's versio

Modelling the pre-assessment learning effects of assessment : evidence in the validity chain

Publication of this article was funded by the Stellenbosch University Open Access Fund.The original publication is available at http://onlinelibrary.wiley.com/journal/10.1111/%28ISSN%291365-2923/OBJECTIVES We previously developed a model of the pre-assessment learning effects of consequential assessment and started to validate it. The model comprises assessment factors, mechanism factors and learning effects. The purpose of this study was to continue the validation process. For stringency, we focused on a subset of assessment factor–learning effect associations that featured least commonly in a baseline qualitative study. Our aims were to determine whether these uncommon associations were operational in a broader but similar population to that in which the model was initially derived. METHODS A cross-sectional survey of 361 senior medical students at one medical school was undertaken using a purpose-made questionnaire based on a grounded theory and comprising pairs of written situational tests. In each pair, the manifestation of an assessment factor was varied. The frequencies at which learning effects were selected were compared for each item pair, using an adjusted alpha to assign significance. The frequencies at which mechanism factors were selected were calculated. RESULTS There were significant differences in the learning effect selected between the two scenarios of an item pair for 13 of this subset of 21 uncommon associations, even when a p-value of < 0.00625 was considered to indicate significance. Three mechanism factors were operational in most scenarios: agency; response efficacy, and response value. CONCLUSIONS For a subset of uncommon associations in the model, the role of most assessment factor–learning effect associations and the mechanism factors involved were supported in a broader but similar population to that in which the model was derived. Although model validation is an ongoing process, these results move the model one step closer to the stage of usefully informing interventions. Results illustrate how factors not typically included in studies of the learning effects of assessment could confound the results of interventions aimed at using assessment to influence learning.Stellenbosch UniversityPublishers' Versio

Investigating communication of findings in Environmental Impact Assessment and developing a research agenda for improvement

Environmental Impact Assessment (EIA) aims to embed consideration of the significance of predicted environmental consequences (the findings) of proposed developments into approval decision making. Achieving this aim relies on adequate communication of the findings of the EIA to the stakeholders, especially the decision makers responsible for the approval decision. However, the naïve assumption that this communication of findings can be effectively achieved through the publication of a written report pervades legislation worldwide, despite decades of evidence to the contrary. As a first step towards improving such communication, this research identifies the contingent conditions associated with effectively transferring EIA findings from an Environmental Impact Statement (EIS) to decision makers and other stakeholders based upon literature review. The transmission of meaning is found to be the major theme underpinning good communication, subdivided into discourse, readability, and legitimacy. Based on a clearer understanding of the limitations associated with an EIS as a communication medium, and acknowledging there are likely to be better mechanisms for transferring the meaning of the findings of an EIA to decision makers and other stakeholders, a pragmatic research agenda is outlined. This includes some initial suggestions of other research fields (like semiotics and social psychology), or technologies (like AI) that may provide learning and improvement opportunities