The perception of the hidden curriculum on medical education: an exploratory study

<p>Abstract</p> <p>Background</p> <p>Major curriculum reform of undergraduate medical education occurred during the past decades in the United Kingdom (UK); however, the effects of the hidden curriculum, which influence the choice of primary care as a career, have not been sufficiently recognized. While Japan, where traditionally few institutions systematically foster primary care physicians and very few have truly embraced family medicine as their guiding discipline, has also experienced meaningful curriculum reform, the effect of the hidden curriculum is not well known. The aim of this study is to identify themes pertaining to the students' perceptions of the hidden curriculum affecting undergraduate medical education in bedside learning in Japan.</p> <p>Methods</p> <p>Semi-structured interviews with thematic content analysis were implemented. Undergraduate year-5 students from a Japanese medical school at a Japanese teaching hospital were recruited. Interview were planned to last between 30 to 60 minutes each, over an 8-month period in 2007. The interviewees' perceptions concerning the quality of teaching in their bedside learning and related experiences were collected and analysed thematically.</p> <p>Results</p> <p>Twenty five medical students (18 males and 7 females, mean age 25 years old) consented to participate in the interviews, and seven main themes emerged: "the perception of education as having a low priority," "the prevalence of positive/negative role models," "the persistence of hierarchy and exclusivity," "the existence of gender issues," "an overburdened medical knowledge," "human relationships with colleagues and medical team members," and "first experience from the practical wards and their patients."</p> <p>Conclusions</p> <p>Both similarities and differences were found when comparing the results to those of previous studies in the UK. Some effects of the hidden curriculum in medical education likely exist in common between the UK and Japan, despite the differences in their demographic backgrounds, cultures and philosophies.</p

Anti-Inflammatory Effect on Colitis and Modulation of Microbiota by Fermented Plant Extract Supplementation

Although results of recent studies suggest that fermented foods strongly affect the gut microbiota composition and that they relieve inflammatory bowel disease symptoms, some reports have described that fermented foods increase some inflammation markers based on differences in fermented food materials. This study evaluated the effects of fermented plant extract (FPE) on dextran sulfate sodium (DSS)-induced colitis in mice and the effects on fecal microbiota composition in humans. Mice fed 5% FPE with 3% DSS (FPE group) showed no body weight loss, atrophy of colonic length, or bloody stool, similar to mice fed a basal diet (negative group), whereas mice fed 3% DSS (positive group) exhibited those effects. Concentrations of inflammation markers IL-6 and TNF-alpha were not significantly different between FPE and negative groups; however, those concentrations became higher in the positive group. 16S ribosomal RNA gene sequencing was used to characterize fecal microbiota in healthy women before and after 3-month FPE supplementation. The FPE supplementation induced increases in Firmicutes phyla and in Clostridiales order, which play a central role in inflammation suppression. These results suggest that FPE enhances Clostridiales growth in the gut and that it has an anti-inflammatory effect

Gnarled-Trunk Evolutionary Model of Influenza A Virus Hemagglutinin

Human influenza A viruses undergo antigenic changes with gradual accumulation of amino acid substitutions on the hemagglutinin (HA) molecule. A strong antigenic mismatch between vaccine and epidemic strains often requires the replacement of influenza vaccines worldwide. To establish a practical model enabling us to predict the future direction of the influenza virus evolution, relative distances of amino acid sequences among past epidemic strains were analyzed by multidimensional scaling (MDS). We found that human influenza viruses have evolved along a gnarled evolutionary pathway with an approximately constant curvature in the MDS-constructed 3D space. The gnarled pathway indicated that evolution on the trunk favored multiple substitutions at the same amino acid positions on HA. The constant curvature was reasonably explained by assuming that the rate of amino acid substitutions varied from one position to another according to a gamma distribution. Furthermore, we utilized the estimated parameters of the gamma distribution to predict the amino acid substitutions on HA in subsequent years. Retrospective prediction tests for 12 years from 1997 to 2009 showed that 70% of actual amino acid substitutions were correctly predicted, and that 45% of predicted amino acid substitutions have been actually observed. Although it remains unsolved how to predict the exact timing of antigenic changes, the present results suggest that our model may have the potential to recognize emerging epidemic strains

Experimental Research on Performances of Air Turbines for a Fixed Oscillating Water Column-Type Wave Energy Converter

A fixed oscillating water column (OWC)-type wave energy converter is composed of an air chamber for primary conversion and an air turbine for secondary conversion. In the optimal design method of a fixed OWC-type wave energy converter, it is necessary to develop a design method which can consider the characteristics of incident wave motion, the motion of the internal free surface affected in the structure such as a partly submerged wall, the fluctuation of air pressure in an air chamber, the rotation of the air turbine. In this paper, the 2-dimensional wave tank tests in regular waves for the performance evaluation of the air turbines in a fixed OWC-type wave energy converter were conducted to obtain the data needed to make this design method. As the results, the effects of the impulse turbine specification such as the rotor inlet/outlet angle, the guide vane's number and the vane's setting angle on the primary and secondary conversion efficiencies are clarified experimentally. Furthermore, the performances of the Wells turbines with different number of blade are presented for comparison of the operating condition

Image velocimetry for clouds with relaxation labeling based on deformation consistency

Correlation-based cloud tracking has been extensively used to measure atmospheric winds, but still difficulty remains. In this study, aiming at developing a cloud tracking system for Akatsuki, an artificial satellite orbiting Venus, a formulation is developed for improving the relaxation labeling technique to select appropriate peaks of cross-correlation surfaces which tend to have multiple peaks. The formulation makes an explicit use of consistency inherent in the type of cross-correlation method where template sub-images are slid without deformation; if the resultant motion vectors indicate a too-large deformation, it is contradictory to the assumption of the method. The deformation consistency is exploited further to develop two post processes; one clusters the motion vectors into groups within each of which the consistency is perfect, and the other extends the groups using the original candidate lists. These processes are useful to eliminate erroneous vectors, distinguish motion vectors at different altitudes, and detect phase velocities of waves in fluids such as atmospheric gravity waves. As a basis of the relaxation labeling and the post processes as well as uncertainty estimation, the necessity to find isolated (well-separated) peaks of cross-correlation surfaces is argued, and an algorithm to realize it is presented. All the methods are implemented, and their effectiveness is demonstrated with initial images obtained by the ultraviolet imager onboard Akatsuki. Since the deformation consistency regards the logical consistency inherent in template matching methods, it should have broad application beyond cloud tracking

DRUG-ADMINISTERING PERSONS' EXPOSURE TO ORAL ANTICANCER DRUGS TO BE ADMINISTERED THROUGH A TUBE

Objective: The objective of this study was to quantitatively evaluate anticancer drug exposure of non-health care professionals who administer drugs through a tube employing a method devised by us. Methods: The subjects were 30 general volunteers aged 22-84 years. They wore gloves and administered Indian ink, simulating an anticancer drug, to a multipurpose adult human-type patient care simulator through a tube using 5 types of syringe, and the area stained with Indian ink was measured. Results: When comparing the number of pixels among the syringes regardless of age, Syringe B showed the lowest number (11.8±3.1 cm2), and there was a significant difference between Syringes B and E. Furthermore, we compared the total number of pixels in each age group regardless of the type of syringe. In the 20-year-old group, it was the lowest (10.9±2.3 cm2) showing significant differences in comparison with the other groups. When Syringe B was used, the number of pixels was markedly lower than on adopting the other syringes. Conclusion: It was clarified that the level of exposure to anticancer drugs markedly varies depending on the type of syringe and age. It was also clarified that the method to evaluate exposure to anticancer drugs using Indian ink devised by us is simple and useful

DRUG-ADMINISTERING PERSONS' EXPOSURE TO ORAL ANTICANCER DRUGS TO BE ADMINISTERED THROUGH A TUBE

ABSTRACTObjective: The objective of this study was to quantitatively evaluate anticancer drug exposure of non-health care professionals who administer drugsthrough a tube employing a method devised by us.Methods: The subjects were 30 general volunteers aged 22-84 years. They wore gloves and administered Indian ink, simulating an anticancer drug, toa multipurpose adult human-type patient care simulator through a tube using 5 types of syringe, and the area stained with Indian ink was measured.Results: When comparing the number of pixels among the syringes regardless of age, Syringe B showed the lowest number (11.8±3.1 cm2), and therewas a significant difference between Syringes B and E. Furthermore, we compared the total number of pixels in each age group regardless of the typeof syringe. In the 20-year-old group, it was the lowest (10.9±2.3 cm2) showing significant differences in comparison with the other groups. WhenSyringe B was used, the number of pixels was markedly lower than on adopting the other syringes.Conclusion: It was clarified that the level of exposure to anticancer drugs markedly varies depending on the type of syringe and age. It was alsoclarified that the method to evaluate exposure to anticancer drugs using Indian ink devised by us is simple and useful.Keywords: Oral anticancer drugs, Simple suspension method, Drug-administering persons' exposure