Why decision support systems are important for medical education

During the last decades the inclusion of digital tools in health education has rapidly lead to a continuously enlarging digital era. All the online interactions between learners and tutors, the description, creation, reuse and sharing of educational digital resources and the interlinkage between them in conjunction with cheap storage technology has led to an enormous amount of educational data. Medical education is a unique type of education due to accuracy of information needed, continuous changing competences required and alternative methods of education used. Nowadays medical education standards provide the ground for organizing the educational data and the paradata. Analysis of such education data through education data mining techniques is in its infancy, but decision support systems for medical education need further research. To the best of our knowledge, there is a gap and a clear need for identifying the challenges for decision support systems in medical education in the era of medical education standards. Thus, in this paper the role and the attributes of such a decision support system for medical education are delineated and the challenges and vision for future actions are identified

Lipid-soluble Vitamins A, D, and E in HIV-Infected Pregnant women in Tanzania.

There is limited published research examining lipid-soluble vitamins in human immunodeficiency virus (HIV)-infected pregnant women, particularly in resource-limited settings. This is an observational analysis of 1078 HIV-infected pregnant women enrolled in a trial of vitamin supplementation in Tanzania. Baseline data on sociodemographic and anthropometric characteristics, clinical signs and symptoms, and laboratory parameters were used to identify correlates of low plasma vitamin A (<0.7 micromol/l), vitamin D (<80 nmol/l) and vitamin E (<9.7 micromol/l) status. Binomial regression was used to estimate risk ratios and 95% confidence intervals. Approximately 35, 39 and 51% of the women had low levels of vitamins A, D and E, respectively. Severe anemia (hemoglobin <85 g/l; P<0.01), plasma vitamin E (P=0.02), selenium (P=0.01) and vitamin D (P=0.02) concentrations were significant correlates of low vitamin A status in multivariate models. Erythrocyte Sedimentation Rate (ESR) was independently related to low vitamin A status in a nonlinear manner (P=0.01). The correlates of low vitamin D status were CD8 cell count (P=0.01), high ESR (ESR >81 mm/h; P<0.01), gestational age at enrollment (nonlinear; P=0.03) and plasma vitamins A (P=0.02) and E (P=0.01). For low vitamin E status, the correlates were money spent on food per household per day (P<0.01), plasma vitamin A concentration (nonlinear; P<0.01) and a gestational age <16 weeks at enrollment (P<0.01). Low concentrations of lipid-soluble vitamins are widely prevalent among HIV-infected women in Tanzania and are correlated with other nutritional insufficiencies. Identifying HIV-infected persons at greater risk of poor nutritional status and infections may help inform design and implementation of appropriate interventions

A Framework to Support Interdisciplinary Engagement with Learning Analytics

Learning analytics can provide an excellent opportunity for instructors to get an in-depth understanding of students’ learning experiences in a course. However, certain technological challenges, namely limited availability of learning analytics data because of learning management system restrictions, can make accessing this data seem impossible at some institutions. Furthermore, even in cases where instructors have access to a range of student data, there may not be organized efforts to support students across various courses and university experiences. In the current chapter, the authors discuss the issue of learning analytics access and ways to leverage learning analytics data between instructors, and in some cases administrators, to create interdisciplinary opportunities for comprehensive student support. The authors consider the implications of these interactions for students, instructors, and administrators. Additionally, the authors focus on some of the technological infrastructure issues involved with accessing learning analytics and discuss the opportunities available for faculty and staff to take a multi-pronged approach to addressing overall student success.https://scholarworks.wm.edu/educationbookchapters/1045/thumbnail.jp

Social Justice and Technocracy: Tracing the Narratives of Inclusive Education in the United States

Over the past two decades, the percentage of American students with disabilities educated in general classrooms with their nondisabled peers has risen by approximately fifty percent. This gradual but steady policy shift has been driven by two distinct narratives of organisational change. The social justice narrative espouses principles of equality and caring across human differences. The narrative of technocracy creates top-down, administrative pressure through hierarchical systems based on quantitative performance data. This article examines these two primary policy narratives of inclusive education in the United States, exploring the conceptual features of each and initiating an analysis of their application in the public schools

Cancer Incidence among Former Love Canal Residents

Ba c k g r o u n d: The Love Canal was a rectangular 16-acre, 10-ft-deep chemical waste landfill situated in a residential neighborhood in Niagara Falls, New York. This seriously contaminated site came to public attention in 1978. Only one prior study examined cancer incidence in former residents of the Love Canal neighborhood (LC). Objective: In this study we aimed to describe cancer incidence in former LC residents from 1979 to 1996 and to investigate whether it differs from that of New York State (NYS) and Niagara County (NC). Me t h o d s: From 1978 to 1982, we interviewed 6,181 former residents, and 5,052 were eligible to be included in this study. In 1996, we identified 304 cancer diagnoses in this cohort using the NYS Cancer Registry. We compared LC cancer incidence with that of NYS and NC using standardized incidence ratios (SIRs), and we compared risks within the LC group by potential exposure to the landfill using survival analysis. Res u l t s: SIRs were elevated for cancers of the bladder [SIR NYS = 1.44; 95 % confidence interval (CI), 0.91–2.16] and kidney (SIR NYS = 1.48; 95 % CI, 0.76–2.58). Although CIs included 1.00, other studies have linked these cancers to chemicals similar to those found at Love Canal. We also found higher rates of bladder cancer among residents exposed as children, based on two cases. Co n c l u s i o n s: In explaining these excess risks, the role of exposure to the landfill is unclear given such limitations as a relatively small and incomplete study cohort, imprecise exposure measurements, and the exclusion of cancers diagnosed before 1979. Given the relatively young age of the cohort, further surveillance is warranted. Key w o r d s: cancer, community health, exposure assessment, hazardous waste sites, Love Canal. Environ Health Perspect 117:1265–1271 (2009). doi:10.1289/ehp.0800153 available vi

Telephone Consultation for Improving Health of People Living with or at Risk of HIV: A Systematic Review

BACKGROUND: Low cost, effective interventions are needed to deal with the major global burden of HIV/AIDS. Telephone consultation offers the potential to improve health of people living with HIV/AIDS cost-effectively and to reduce the burden on affected people and health systems. The aim of this systematic review was to assess the effectiveness of telephone consultation for HIV/AIDS care. METHODS: We undertook a comprehensive search of peer-reviewed and grey literature. Two authors independently screened citations, extracted data and assessed the quality of randomized controlled trials which compared telephone interventions with control groups for HIV/AIDS care. Telephone interventions were voice calls with landlines or mobile phones. We present a narrative overview of the results as the obtained trials were highly heterogeneous in design and therefore the data could not be pooled for statistical analysis. RESULTS: The search yielded 3321 citations. Of these, nine studies involving 1162 participants met the inclusion criteria. The telephone was used for giving HIV test results (one trial) and for delivering behavioural interventions aimed at improving mental health (four trials), reducing sexual transmission risk (one trial), improving medication adherence (two trials) and smoking cessation (one trial). Limited effectiveness of the intervention was found in the trial giving HIV test results, in one trial supporting medication adherence and in one trial for smoking cessation by telephone. CONCLUSIONS: We found some evidence of the benefits of interventions delivered by telephone for the health of people living with HIV or at risk of HIV. However, only limited conclusions can be drawn as we only found nine studies for five different interventions and they mainly took place in the United States. Nevertheless, given the high penetration of low-cost mobile phones in countries with high HIV endemicity, more evidence is needed on how telephone consultation can aid in the delivery of HIV prevention, treatment and care