Lectures based on cardinal symptoms in undergraduate medicine - effects of evaluation-based interventions on teaching large groups

Despite critical voices lectures are still an important teaching format in current medical curricula. With the curricular reform at Hamburg Medical Faculty in the year 2004, all subject specific lectures were replaced by cardinal symptom oriented lectures (LSV) in the new clinical curriculum. LSVs are taught throughout all six thematic blocks in years three to five. Since regular student evaluations after each thematic block seemed to demand improvement of the LSVs, this study was carried out using evaluations of individual LSVs by the participating students and by trained auditors (final year students and academic staff). Based on these evaluations feedback containing the individual evaluation data was given in written form to the lecturers combined with information material on planning an LSV using modern didactic techniques. In a second evaluation period, the effects of this intervention were studied. Only small improvements in the LSVs’ quality were noted regarding the level of marks achieved. When individual items were evaluated, especially the didactic quality, significant improvements were noticeable. Overall, on the basis of individual items students ranked the quality of the LSVs significantly higher than trained auditors during the first evaluation period. This effect was no longer seen after the second evaluation period. The inter rater reliability among the auditors was very good. This study shows that regular quality assurance is needed on the structural levels and for staff to accompany the process of embedding teaching formats into curricular concepts. Further investigation is needed to determine the adequate frequency of evaluation and the format of feedback to guarantee sustainable effects of the didactic quality of lectures

Pregnancy switches adrenergic signal transduction in rat and human uterine myocytes as probed by BKCa channel activity

We used large conductance Ca2+-activated K+ (BKCa) channel activity as a probe to characterize the inhibitory/stimulatory G protein (Gi/Gs) signalling pathways in intact cells from pregnant (PM) and non-pregnant (NPM) myometrium.Isoprenaline (10 μM) enhanced the outward current (Iout) in PM cells and inhibited Iout in NPM cells. Additional application of the α2-adrenoceptor (α2-AR) agonist clonidine (10 μM) further enhanced the isoprenaline-modulated Iout in PM cells but partially antagonized Iout in NPM cells. Clonidine alone did not affect Iout. The specific cAMP kinase (PKA) inhibitor H-89 (1 μM) abolished the effects of isoprenaline and clonidine. The specific BKCa channel blocker iberiotoxin (0·1 μM) inhibited Iout by ≈80 %; the residual current was insensitive to isoprenaline.Inhibition of Gi activity by either pertussis toxin or the GTPase activating protein RGS16 abolished inhibitory as well as stimulatory effects of clonidine on Iout.Transducin-α, a scavenger of Gi βγ dimers, converted the stimulatory action of clonidine on Iout into an inhibitory effect. Free transducin-βγ enhanced both the stimulatory and the inhibitory effects of isoprenaline on Iout.The results demonstrate that BKCa channel activity is a sensitive probe to follow adenylyl cyclase–cAMP–PKA signalling in myometrial smooth muscle cells. Both Giα-mediated inhibition and Giβγ-mediated stimulation can occur in the same cell, irrespective of pregnancy. It is speculated that the coupling between α2-AR and Gi proteins is more efficient during pregnancy and that Giβγ at high levels simply override the inhibitory action of Gi α

ML-CIRRUS: The Airborne Experiment on Natural Cirrus and Contrail Cirrus with the High-Altitude Long-Range Research Aircraft HALO

The Midlatitude Cirrus experiment (ML-CIRRUS) deployed the High Altitude and Long Range Research Aircraft (HALO) to obtain new insights into nucleation, life cycle, and climate impact of natural cirrus and aircraft-induced contrail cirrus. Direct observations of cirrus properties and their variability are still incomplete, currently limiting our understanding of the clouds’ impact on climate. Also, dynamical effects on clouds and feedbacks are not adequately represented in today’s weather prediction models.Here, we present the rationale, objectives, and selected scientific highlights of ML-CIRRUS using the G-550 aircraft of the German atmospheric science community. The first combined in situ–remote sensing cloud mission with HALO united state-of-the-art cloud probes, a lidar and novel ice residual, aerosol, trace gas, and radiation instrumentation. The aircraft observations were accompanied by remote sensing from satellite and ground and by numerical simulations.In spring 2014, HALO performed 16 flights above Europe with a focus on anthropogenic contrail cirrus and midlatitude cirrus induced by frontal systems including warm conveyor belts and other dynamical regimes (jet streams, mountain waves, and convection). Highlights from ML-CIRRUS include 1) new observations of microphysical and radiative cirrus properties and their variability in meteorological regimes typical for midlatitudes, 2) insights into occurrence of in situ–formed and lifted liquid-origin cirrus, 3) validation of cloud forecasts and satellite products, 4) assessment of contrail predictability, and 5) direct observations of contrail cirrus and their distinction from natural cirrus. Hence, ML-CIRRUS provides a comprehensive dataset on cirrus in the densely populated European midlatitudes with the scope to enhance our understanding of cirrus clouds and their role for climate and weather