Enhanced Web-Based Otitis Study Case vs Simple Paper-Case: Impact on Medical Student Objec-tive Structured Clinical Exam (OSCE) Performance

Background: Distance education methods have taken on greater importance as medical student education has moved off campus into the community. What the best methods are for conveying information to students at distant sites has not been determined. Objective: To determine if students at distant community sites who received an otitis media study case by e-mail that was enhanced with a referral to a web-based otitis study case, performed better on otitis OSCE stations than students who received the same case not enhanced with visuals or referrals to a web-based otitis case. Design/Methods: Students were randomized by community site to receive either the enhanced (E) or simple otitis study case (S). Students were e-mailed an otitis media study case during the 5th week of the rotation. Those randomized to the E-case received a case that started with a case scenario followed by a "Task" that instructed them to go to this web address: http://www.aap.org/otitismedia/www/vc/ear/index.cfm (American Academy of Pediatrics Otitis Web Site). They were then to select "Case 1" which was a continuation of the case scenario present on their e-mail. A list of learning objectives was also printed on the e-mail. Students receiving the S-case viewed the same case scenario and objectives, but were not instructed to go to the web page. All students rotated through two OSCE otitis stations. In the first station they interviewed a simulated patient(OSCE-SP) and counseled her on the management of her 12 month old with otitis. Within that station they viewed a video of a pneumoscopic exam of two ears, one ear with otitis and the other ear normal. At the 2nd otitis station the student presented the case to a faculty and was asked a series of questions about otitis media(OSCE-PR). Scores on the two stations were compared by group. Results: There were 198 students who took the OSCE. 178 (90%) responded to a survey that indicated they had opened and read the e-mailed case. There were 87 students in the E-group and 91 in the S-group. The mean ±s.d. OSCE-SP station score for the E-group was 72.6 ±12.0 vs 75.4 ±9.8 for the S-group, p=0.09. For the otitis presentation station the scores for the E-group and S-group were respectively, 82.9 ±9.6 and 83.7 ±9.4, p=0.55. Conclusions: These data suggest that enhanced visual distance education cases may offer no distinct advantage over simple paper-type case study guide

Impact of Generalist Physician Initiatives on Residency Selection

Objective:To compare the residency selection choices of students who experienced courses resulting from generalist physician initiatives to choices made by students prior to the implementation of those courses and to describe the characteristics of students selecting primary care residencies. Background:In the fall of 1994 a first year Community Continuity Experience course was initiated and in the summer of 1995 a third year Multidisciplinary Ambulatory Clerkship was begun at the University of Texas Medical Branch in Galveston. These courses were inserted into the curriculum to enhance and promote primary care education. Design/Methods:We examined the residency selections of cohorts of graduating medical students before (1992-1996) and after (1997-1999) the implementation of the primary care courses. Survey information on career preferences at matriculation and in the fourth year of medical school were available for students graduating after the programs began. We compared the career preferences and characteristics of those students who selected a primary care residency to those who did not. Results:Prior to the implementation of the programs, 45%(425/950) of students graduating selected primary care residencies compared to 45% (210/465) of students participating in the programs (p=0.88). At matriculation, 45% of students had listed a primary care discipline as their first career choice. Among the students who had indicated this degree of primary care interest 61% ended up matching in a primary care discipline. At year 4, 31% of students indicated a primary care discipline as their first career choice and 92% of these students matched to a primary care residency. By univariate analysis, minority students (53%) were more likely to select a primary care residency than non-minority students (40%); students in the two lowest grade point average quartiles (55% and 50%) selected primary care residencies compared to 37% and 38% of students in the top 2 quartiles; and students who stated that income potential had little or no impact on their choice were more likely to select a primary care residency (48%) than those who said income potential was important (37%). Conclusions:We observed no significant trend towards higher proportions of graduating students selecting primary care discipline residencies as a result of implementing courses that emphasized primary care. Those students expressing an interest in a primary care discipline at their entrance into medical school were more likely to select a primary care residency. A more significant impact on graduating students interested in primary care may be made through the medical student selection process than by altering the curriculum

National minority 'regions' in the enlarged European Union: mobilizing for third level politics?

Der Beitrag beleuchtet den möglichen Einfluss nationaler Minderheiten im politischen Entscheidungsprozess nach der EU-Erweiterung. In einem ersten Schritt wird zunächst das Mehrebenenmodell der Governance in der EU beschrieben, wodurch lokale und regionale Autoritäten eine stärkere Rolle in der EU-Politik einnehmen. So gliedert sich das politische System in drei Ebenen: die Ebene der Supranationalität, die Ebene der Mitgliedsstaaten sowie die Ebene der Regionen. Ferner werden die Begriffsbestimmung der so genannten nationalen Minderheitenregion (NMR) formuliert und die NMR-relevanten Themen im EU-Handlungskontext dargestellt. Der zweite Schritt umfasst die Grundzüge der 'Dritte-Ebene-Politik' der NMRs und deren Institutionen. Dazu gehören (1) das Komitee der Regionen, (2) die Kohäsionspolitik der EU, (3) Parteikoalitionen nationaler Minderheiten, (4) die Repräsentation in Brüssel sowie (5) die praktizierte Para-Diplomatie. Der dritte Schritt stellt sodann die bekanntesten NMRs in Europa vor, und zwar die flämische bzw. wallonische Gemeinschaft in Belgien. Im Anschluss folgen neben der Bretagne (Frankreich) neu hinzugekommene NMRs im Zuge der EU-Erweiterung in Estland, Lettland, Polen, Rumänien, Slowakei, Zypern und der Türkei. NMRs repräsentieren sowohl starke soziale als auch antagonistische kulturelle Kräfte in der EU. Somit haben die nationalen Minderheiten aufgrund ihrer Fähigkeit zur politischen Mobilisierung durchaus die Möglichkeit, die politische Landschaft der EU nachhaltig zu prägen. (ICG2

ECMI workshop on definition of “Minority” : Flensburg, Germany ; 26-27 September 2013

Kan man kombinera en opera med båtterminal och vad händer då med operans roll

Carbon flux through citric acid cycle pathways in perfused heart by 13C NMR spectroscopy

AbstractMathematical models of the TCA cycle derived previously for 14C tracer studies have been extended to 13C NMR to measure the 13C fractional enrichment of [2-13C]acetyl-CoA entering the cycle and the relative activities of the oxidative versus anaplerotic pathways. The analysis is based upon the steady-state enrichment of 13C into the glutamate carbons. Hearts perfused with [2-13C]acetate show low but significant activity of the anaplerotic pathways. Activation of two different anaplerotic pathways is demonstrated by addition of unlabeled propionate or pyruvate to hearts perfused with [2-13C]acetate. In each case, the amount of [2-13C]acetate being oxidized and the relative carbon flux through anaplerotic versus oxidative pathways are evaluated

C++ Compilers & ISO Conformance

Conformance to Standards is becoming recognized as one of the most important assurances compiler vendors can provide to programmers. Conformance enables code portability and wider use of a language and its libraries. However, establishing the conformance of a compiler is difficult—especially for C++, which was slow to develop (with acceptance of a Standard occurring years after the language was introduced)

Response patterns in the developing social brain are organized by social and emotion features and disrupted in children diagnosed with autism spectrum disorder

© 2019 Elsevier Ltd Adults and children recruit a specific network of brain regions when engaged in “Theory of Mind” (ToM) reasoning. Recently, fMRI studies of adults have used multivariate analyses to provide a deeper characterization of responses in these regions. These analyses characterize representational distinctions within the social domain, rather than comparing responses across preferred (social) and non-preferred stimuli. Here, we conducted opportunistic multivariate analyses in two previously collected datasets (Experiment 1: n = 20 5–11 year old children and n = 37 adults; Experiment 2: n = 76 neurotypical and n = 29 5–12 year old children diagnosed with Autism Spectrum Disorder (ASD)) in order to characterize the structure of representations in the developing social brain, and in order to discover if this structure is disrupted in ASD. Children listened to stories that described characters' mental states (Mental), non-mentalistic social information (Social), and causal events in the environment (Physical), while undergoing fMRI. We measured the extent to which neural responses in ToM brain regions were organized according to two ToM-relevant models: 1) a condition model, which reflected the experimenter-generated condition labels, and 2) a data-driven emotion model, which organized stimuli according to their emotion content. We additionally constructed two control models based on linguistic and narrative features of the stories. In both experiments, the two ToM-relevant models outperformed the control models. The fit of the condition model increased with age in neurotypical children. Moreover, the fit of the condition model to neural response patterns was reduced in the RTPJ in children diagnosed with ASD. These results provide a first glimpse into the conceptual structure of information in ToM brain regions in childhood, and suggest that there are real, stable features that predict responses in these regions in children. Multivariate analyses are a promising approach for sensitively measuring conceptual and neural developmental change and individual differences in ToM.NSF (Award 1122374