Reframing the Meaning of Self-Directed Learning: An Updated Modeltt

Over the past several decades, self-directed learning (SDL) has been one of the most active areas of inquiry within adult education and learning. Several studies have identified trends in this body of knowledge (e.g., Brockett, Stockdale, Fogerson, Cox, Canipe, Chuprina, Donaghy, & Chadwell, 2001; Conner, Carter, Dieffenderfer, & Brockett, 2009; Kirk, Shih, Holt, Smeltzer, & Brockett, 2012). Since 1987, an international symposium has been held annually to share the latest thinking about SDL theory, research, and practice. In 2002 the International Journal of Self-Directed Learning also began publication

Obstetrical ultrasound training of and practise by general practitioners in the private sector, Free State

Background: The aim of the study was to determine the level of obstetrical ultrasound training and practice of general practitioners in the Free State private sector. Methods: In this descriptive study, questionnaires were mailed to all general practitioners in the Free State private sector. The questionnaire included demographic information about the practitioner, the ultrasound profile of the practice, and the type of machine used. Results: Four hundred and eighty-one questionnaires were sent to general practitioners and 229 (47.6%) were returned. Of the 176 practising respondents, 47 (26.8%) used ultrasound. The majority of ultrasound examinations done per month were obstetrical. Eight practitioners had relevant qualifications for using ultrasound and more than a third (18, 38.3%) had no training in ultrasound use. Less than half (19, 40.4%) of the practitioners that use ultrasound were aware of the South African Association of Ultrasound in Obstetrics and Gynaecology (SASUOG). Conclusions: The response to the questionnaire was low and may have influenced the results. The study indicates that there are general practitioners who perform ultrasound examinations without training. As general practitioners mainly do obstetrical ultrasound, it is recommended that the SASUOG play a bigger role in their training. A diploma course in ultrasound and support from medical aid organisations to only pay full fees to doctors who can prove that they have sufficient ultrasound training and competence will be ideal. For full text, click here:SA Family Pract 2004,46(6): 25-2

Reasons for doctor migration from South Africa

Background: The migration of doctors from their home countries is not a new phenomenon. Apart from voluntary migration due to various reasons,medical professionals, often from sub-Saharan Africa, are actively recruited by developed countries. Doctors in South Africa are esteemed for the highstandard of training they receive locally, a quality which renders them prime candidates for employment. Various factors are involved in the push-pull theory of migration. It has, however, been reported extensively that push factors usually play a much greater role in doctors’ decision to leave their countries of origin, than do pull factors in the host or recipient country. Push factors motivating migration most frequently include dissatisfaction with remuneration packages and working conditions, high levels of crime and violence, political instability, lack of future prospects, HIV/AIDS and a decline in education systems. In addition to a depletion of intellectual resources through losing highly qualified and skilled  individuals, source countries also face substantial monetary implications caused by the migration of doctors. Government subsidy of medical students’ training could be regarded as a lost investment when young graduates seek permanent employment abroad. The aim of the study was to investigate the profile of South African qualified physicians who had emigrated from South Africa.Methods: The investigation was conducted in 2005 as a descriptive study of participants found primarily by the snowball sampling method. Theinitial participants were known to the researcher. Participants had to be graduates from South African medical schools/faculties, living abroad andin possession of a permanent work permit in the countries where they were employed. Short-term locum doctors were not included. Information,consent letters and questionnaires were either hand-delivered or e-mailed, and completed forms and questionnaires were returned via these routes.Participation was voluntary.Results: Twenty-nine of 43 potential participants responded, of which 79.3% were male and 20.7% female between the ages of 28 and 64 years(median 47 years). The year of graduation ranged from 1964 to 2000 (median 1985), and the year of leaving the country ranged from 1993 to 2005 (median 2002). The majority (72.4%) were in private practice before they left, 27.5% had public service appointments and 17.3% were employed by private hospitals. Seventy-nine per cent of respondents had postgraduate qualifications. Countries to which migration occurred included New Zealand, United Arab Emirates, Bahrain, United Kingdom, Canada, Yemen and Australia. Forty-one per cent of respondents indicated that they would encourage South African young people to study medicine, although 75% would recommend newly graduated doctors to leave the country. Financial factors were indicated as a reason for leaving by 86.2% of the respondents, better job opportunities by 79.3%, and the high crime rate in South Africa by 75.9%. Only 50% of the respondents said that better schooling opportunities for their children played a role in their decision to leave the country.Approximately one-fifth (17.9%) of the respondents indicated that they already had family abroad by the time they decided to emigrate.Conclusions: Financial reasons were the most important motivating factor in this particular group of doctors who relocated to overseas destinations,followed by working conditions and the rate of crime and violence in the country. In comparison to other investigations published previously, theresults presented here clearly indicate a tendency that more doctors offer financial and crime-related reasons for migration from South Africa thanbefore. In order to prevent the loss of medical expertise from a society already in need of quality healthcare, issues compelling doctors to look forgreener pastures should be addressed urgently and aggressively by stakeholders

Towards Uniform Gene Bank Documentation In Europe – The Experience From The EFABISnet Project

In the EFABISnet project, a collaborative effort of EAAP, FAO and partners from 14 European countries, in cooperation with the European Regional Focal Point for Animal Genetic Resources (ERFP), national information systems for monitoring the animal genetic resources on breed level were established in Austria, Cyprus, Estonia, Georgia, Iceland, Ireland, Italy, Netherlands, Slovakia, Slovenia, Switzerland, and United Kingdom. The network was soon extended beyond the project plans, with the establishment of EFABIS databases in Finland, Greece, and Hungary. The network was then complemented by a set of inventories of national gene bank collections to strengthen the documentation of ex situ conservation programmes. These documentation systems were established by the National Focal Points for management of farm animal genetic resources. Here we present the experience gained in establishment of these national inventories of gene banks and their relevance to the Strategic Priority Areas of the Global Plan of Action which could be useful for other areas in the world

Eindrapportage Cultuurwaardeonderzoek laanbomen 2004-2008

Dit onderzoeksproject beoogt enerzijds de tevredenheid van afnemers van laanbomen te vergroten door versterking van de kwaliteit van het laanbomen sortiment; en anderzijds veelbelovende nieuwigheden in het laanbomen sortiment bijeen te brengen en te toetsen op cultuurwaarde. Het project wil daarmee de productie van een gezond en vernieuwend sortiment stimuleren en de afzet ervan in binnen- en buitenland bevorderen. Het project had twee hoofddoelen: A. Verzamelen en voor de sector beschikbaar maken van objectieve informatie met betrekking tot gebruiksproblemen van laanbomen die door maatregelen in de cultuurfase kunnen worden voorkomen. B. Bijeenbrengen en toetsen op cultuurwaarde van veelbelovende vernieuwingen in het sortiment. Bij de beoordeling van het te onderzoeken sortiment is speciaal aandacht besteed aan de hedendaagse eisen die een belangrijke rol spelen, met name op het terrein van ziektegevoeligheid; dan wel resistentie of tolerantie voor plagen en ziekten

Crow legt onverenigbaarheid laanbomen in lijst vast

Iedereen in het vak kent inmiddels het voorbeeld van Quercus frainetto op onderstam Quercus robur. Hét bekende voorbeeld van onverenigbaarheid, waarbij vroeg of laat de entpartner van de onderstam loslaat. Onverenigbaarheid is dus niet alleen een probleem in de kwekerijfase, maar kan zich ook op latere leeftijd manifesteren. Dan wordt de eindgebruiker met het probleem geconfronteerd met alle mogelijke gevolgen van dien. Niet alleen om uitval van bomen en daarmee gepaard gaande kosten te voorkomen, maar met name ook steeds meer vanwege de zorgplicht van gemeenten voor hun bomen is het van groot belang om (uitgestelde) onverenigbaarheid te voorkomen door bomen op de juiste wijze te vermeerdere

Onverenigbaarheidslijst laanbomen al ruim een jaar leidraad voor de teler

Eind 2008 lag er dan eindelijk de langverwachte laanbomenlijst van ent-onderstamcombinaties met een kans op (uitgestelde) onverenigbaarheid. Sindsdien geldt deze unieke lijst, compleet met adviezen over welke vermeerderingsmethoden wel geschikt en toepasbaar zijn, als hét standaardwerk voor menig laanboomteler. Met name de jongere generatie heeft er baat bij, aldus vermeerder- en entspecialist Gerrit Schalk uit Lienden

The prevalence of the diagnosis of increased intra-ocular pressure in a general practice

Glaucoma is one of the main causes of blindness.1 The disease occurs in 3% to 4% of all people over the age of 70 years.1 As many as 50% of patients suffering from this disease are unaware of their condition until a comparatively late stage, due to the asymptomatic nature of the disease.2 Of the objective signs of primary open angle glaucoma, the loss of visual field and pathological cupping would generally have reached an advanced stage before they could be recognised by a general practitioner, and aqueous flow can only be measured with the use of specialised equipment. However, increased intra-ocular pressure can easily be detected by tonometry performed by a general practitioner.3For full text, click here:SA Fam Pract 2006;48(3):16-1

Using patient experience in optimizing the total knee arthroplasty patient journey

Information was used to improve the patient journey and to achieve patient-centered care. Patients (\u3e18 years, purposive sampling) were interviewed once at one point of their total knee arthrosis journey within the hospital setting. Patients were accompanied and observed during their hospital visit by one of the 19 healthcare professionals which were trained as interviewers. A qualitative research approach with in-depth and semi-structured interviews using a standardized interview guide were used to gather an in-depth understanding of the perceptions of patients. Interviews were written out with the emphasis on positive and negative feedback, quotes and observations that were made. The audio recordings were verbatim transcribed and coded using selective and open coding. Thirty-five semi-structured interviews were conducted. Five different themes were identified: overall experience, waiting, communication, information and facilities. Several easy fixes were dealt with immediately to improve service quality, productivity and the organization of the healthcare service. Other improvements were discussed with the stakeholders and were resolved directly or were planned for the long-term. Involving patients and let them collaborate with healthcare professionals is essential in optimizing patient-centered care. Most feedback was related to clarification and comprehensibility of the patient journey, to improve autonomy and to remove uncertainty of the patients. Continuity of care with medical personnel, personal attention and recognition of the problem are fundamental during the knee arthrosis patient journey. Experience Framework This article is associated with the Quality & Clinical Excellence lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this lens