Knowledge Transfer and Teaching Public Administration: the Academy Model

Since the beginnings of Public Administration in the US and its accompanying education in other parts of the world, government and policy have become more complex. The education in Public Administration created a professional pathway to public service. The addition of education to Public Administration came out of the Progressive Movement in the United States to make knowledge in Public Administration more important in the face of corruption brought on by patronage appointments. When nonprofits became part the US public sector as elsewhere along with nonprofit healthcare, the complexity expanded enormously, requiring professionals to know more in what has become a multidisciplinary field of study. Given the diversity and complexity of the public sector and the need for Public Administration to embrace more knowledge from many disciplines, it stands to reason that an earlier start on the education portion of Public Administration or a pathway would be beneficial. A model of early Public Administration knowledge transfer is described and illustrated below. The Academy described is based on the US career pathways and high school academies as part of the school to work educational movement. The success of the combination of these two areas will also be pointed out in the academy described. Translation of lessons learned from the Acdemy to Europe and Asia are also considered

SMART syndrome: a late reversible complication after radiation therapy for brain tumours

With intensified treatment leading to longer survival, complications of therapy for brain tumours are more frequently observed. Regarding radiation therapy, progressive and irreversible white matter disease with cognitive decline is most feared. We report on four patients with reversible clinical and radiological features occurring years after radiation for brain tumours, suggestive for the so called SMART syndrome (stroke-like migraine attacks after radiation therapy). All four patients (males, age 36–60 years) had been treated with focal brain radiation for a primary brain tumour or with whole-brain radiation therapy for brain metastases. Ranging from 2 to 10 years following radiation therapy patients presented with headache and focal neurological deficits, suggestive for tumour recurrence. Two patients also presented with focal seizures. MRI demonstrated typical cortical swelling and contrast enhancement, primarily in the parieto-occipital region. On follow-up both clinical and MRI features improved spontaneously. Three patients eventually proved to have tumour recurrence. The clinical and radiological picture of these patients is compatible with the SMART syndrome, a rare complication of radiation therapy which is probably under recognized in brain tumour patients. The pathophysiology of the SMART syndrome is poorly understood but bears similarities with the posterior reversible encephalopathy syndrome (PRES). These four cases underline that the SMART syndrome should be considered in patients formerly treated with radiation therapy for brain tumours, who present with new neurologic deficits. Before the diagnosis of SMART syndrome can be established other causes, such as local tumour recurrence, leptomeningeal disease or ischemic disease should be ruled out