Implementing a new style of learning in a taught postgraduate medical ultrasound programme: Reflections on the first year

The successful introduction of an action based learning (ABL) module into the medical ultrasound programme several years ago, has led to further developments using this approach. Conflicting pressures from hospital departments requesting increasing numbers of subject specialty areas to be taught, and university managers requiring modules to be economically viable, resulted in a more creative approach to delivery of the programme. ABL requires students to take responsibility for their own learning, thereby promoting independent learning. This is generally recognised as a more effective method for acquiring knowledge and skills, particularly at postgraduate level. Following completion of the first year of this newly accredited module, the experiences of students and staff were evaluated. Results of the evaluation and feedback demonstrated that students initially struggle to understand the concept of ABL. However, results of student assessments showed that once individuals engage with the process, knowledge and skills can be successfully acquired, demonstrating that this style of learning is a tool which can be potentially used in many aspects of life. © 2009 British Medical Ultrasound Society

An Hedonic Analysis of the Effects of Lake Water Clarity on New Hampshire Lakefront Properties

Policy makers often face the problem of evaluating how water quality affects a region's economic well-being. Using water clarity as a measure of the degree of eutrophication levels (as a lake becomes inundated with nutrients, water clarity decreases markedly), analysis is performed on sales data collected over a six-year period. Our results indicate that water clarity has a significant effect on prices paid for residential properties. Effects of a one-meter change in clarity on property value are also estimated for an average lake in four real estate market areas in New Hampshire, with effects differing substantially by area. Our findings provide state and local policy makers a measure of the cost of water quality degradation as measured by changes in water clarity, and demonstrate that protecting water quality may have a positive effect on property tax revenues.Resource /Energy Economics and Policy,

Impact of the COVID-19 pandemic: The perceptions of health professions educators

What are health professions educators doing during the COVID-19 pandemic? A search of articles in MedEdPublish on the topics of COVID-19 revealed 39 articles published in the first 3 months of the pandemic. Topics included curriculum adaptation, guidelines for using technology, assessment adaptation, impact on students, faculty and career development, and conference adaptation. There was significant overlap among articles, particularly those discussing teaching, learning, and assessment practices. Common themes were adaptation, innovation, remote delivery, flexibility in the face of a pandemic, and how to continue to educate and graduate competent health professionals. All articles were descriptive, and none included data describing efficacy, likely due to the short timeline since the pandemic’s inception. Additional study is necessary to produce evidence for the teaching and assessment adaptations described. Some changes are likely to persist longer-term and may outlast the pandemic itself

The alpha-effect in cyclic secondary amines: new scaffolds for iminium ion accelerated transformations

Five-membered secondary amine heterocycles containing an α-heteroatom were prepared and shown to be ineffective as catalysts for the iminium ion catalysed Diels–Alder reaction between cinnamaldehyde and cyclopentadiene. Their six-membered counterparts proved to be highly active catalysts. In stark contrast, the catalytic activity observed when comparing the non α-heteroatom cyclic amines proline methyl ester and methyl pipecolinate showed the five-membered ring amine was significantly more active. Concurrent density functional theoretical calculations suggest a rationale for the observed trends in reactivity, highlighting that LUMO activation through an iminium ion intermediate plays a key role in catalytic activity

Fibroblast-like synoviocytes orchestrate daily rhythmic inflammation in arthritis

Rheumatoid arthritis is a chronic inflammatory disease that shows characteristic diurnal variation in symptom severity, where joint resident fibroblast-like synoviocytes (FLS) act as important mediators of arthritis pathology. We investigate the role of FLS circadian clock function in directing rhythmic joint inflammation in a murine model of inflammatory arthritis. We demonstrate FLS time-of-day-dependent gene expression is attenuated in arthritic joints, except for a subset of disease-modifying genes. The deletion of essential clock gene Bmal1 in FLS reduced susceptibility to collagen-induced arthritis but did not impact symptomatic severity in affected mice. Notably, FLS Bmal1 deletion resulted in loss of diurnal expression of disease-modulating genes across the joint, and elevated production of MMP3, a prognostic marker of joint damage in inflammatory arthritis. This work identifies the FLS circadian clock as an influential driver of daily oscillations in joint inflammation, and a potential regulator of destructive pathology in chronic inflammatory arthritis

Using Mixed-Methods to Examine Factors that Influence Exercise Prescription from Healthcare Providers: A Community-Engaged Research Project

Background: The American College of Sports Medicine\u27s Exercise is Medicine initiative supports promotion of physical activity by health care providers (HCPs). Exercise is Medicine recommends HCPs utilize strategies such as exercise prescriptions to increase and promote regular exercise and referrals to community-based exercise facilities (ExRx+). Research is needed to identify factors that will increase African-American patients\u27 ExRx+ engagement since little is known about factors that serve as facilitators or barriers to adherence. Aims: Using a community-engaged participatory research approach, the aims are to: 1) examine individual, interpersonal and environmental factors associated with ExRx+ adherence and 2) explore barriers and facilitators related to the referral process that are associated with ExRx+ adherence. Setting: Healthworks Community Fitness, a non-profit women\u27s fitness facility located in Dorchester, MA. Healthworks is the only gym in the Boston metro area which allows patients to exchange ExRx+ for a 3-month gym membership. Methods: Based on a socio-ecological framework, the mixed-methods protocol includes qualitative and quantitative methods implemented sequentially in two phases to explore factors associated with ExRx+ adherence. Adherence will be operationally defined as: 1) activation: patient redeems the ExRx+ for membership and 2) utilization: attendance during the 3 month membership. Quantitative data will focus on the patient\u27s individual (i.e, body mass index, self-efficacy) interpersonal (i.e, social support), and environmental (i.e, walkability, transportation) levels. Qualitative data will involve one-on-one interviews with patients, HCPs and Healthworks staff exploring facilitators and barriers to ExRx+ adherence. Results will inform the development of a culturally tailored intervention to promote ExRx+ adherence