Social accountability of medical education: Aspects on global accreditation.

Medical doctors constitute a profession which embraces trust from and accountability to society. This responsibility extends to all medical educational institutions. Social accountability of medical education means a willingness and ability to adjust to the needs of patients and health care systems both nationally and globally. But it also implies a responsibility to contribute to the development of medicine and society through fostering competence for research and improvement. Accreditation is a process by which a statutory body evaluates and recognises an educational institution and/or its programme with respect to meeting approved criteria. It is a means for quality assurance, but also a strong power to reinforce the need for improvement and reforms. It must be performed through internationally recognised and transparent standards and should foremost promote quality development. The social accountability of medical education must be included in all accreditation processes at all levels. The global standards programme by World Federation for Medical Education (WFME) provides tools for national or regional accreditation but also guidance for reforms and quality improvement. The standards are used worldwide and have been adopted to local needs in most parts of the world. They are framed to specify attainment at two levels: basic standards or minimum requirements and standards for quality development. The concept of social accountability is embedded in all parts of the WFME standards documents. In 2011, a revision of the standards for undergraduate education has been instituted. Strengthening of aspects on social accountability of medical education will be a particular concern

Self-energy correction to the hyperfine structure splitting of hydrogenlike atoms

A first testing ground for QED in the combined presence of a strong Coulomb field and a strong magnetic field is provided by the precise measurement of the hyperfine structure splitting of hydrogenlike 209Bi. We present a complete calculation of the one-loop self-energy correction to the first-order hyperfine interaction for various nuclear charges. In the low-Z regime we almost perfectly agree with the Z alpha expansion, but for medium and high Z there is a substantial deviation

Subclinical sympathetic neuropathy appears early in the course of Crohn's disease

<p>Abstract</p> <p>Background</p> <p>We have previously demonstrated that patients with Crohn's disease (CD) of long duration have signs of autonomic neuropathy. The aim of this study was to examine whether autonomic neuropathy is an early manifestation of CD, or a sign appearing late in the course.</p> <p>Methods</p> <p>Twenty patients, median age 40 years, with a short duration of CD were included. Examination of autonomic reflexes included heart rate reaction to tilt (acceleration index – AI, brake index – BI) and heart rate variation to deep-breathing (expiration/inspiration index-E/I). Seven years later the same examinations were repeated, and in addition we examined the vasoconstriction response to indirect cooling by laser Doppler (vasoconstriction-index – VAC-index). The results were compared with healthy individuals.</p> <p>Results</p> <p>There was no difference in the blood pressure between controls and the patients with CD at rest, but eight minutes after tilt, the systolic blood pressure was lowered in patients compared to controls, both at the first assessment (p = 0.016) and after seven years (p = 0.042). The change in systolic blood pressure between rest and eight minutes after tilt was not significant at the first assessment, while a significant change compared to controls was observed seven years later (p = 0.028). This indicates a progressive dysfunction. There were no differences in E/I, AI, BI or VAC indexes between patients and controls.</p> <p>Conclusion</p> <p>Patients with CD suffer from autonomic neuropathy early in their disease, suggesting involvement of many different organ systems in this entity.</p

Organic Pig Production in Europe - Health Management in Common Organic Pig Farming

Organic farmers in Europe have developed different housing systems for pigs based on the availability of land, soil characteristics, climate, tradition and national organic certification schemes. This guide gives an overview of the typical housing systems used for pigs in organic farming. It lists advantages and disadvantages of the different systems and provides relevant recommendations to farmers for health managment

Increased prevalence of seropositivity for non-gastric Helicobacter species in patients with autoimmune liver disease

Various Helicobacter species have been isolated from the stomach, intestinal tract and liver of a variety of mammalian and some avian species, and Helicobacter DNA has been detected in human bile and liver samples. An immunoblot assay was established to analyse serum antibody responses to non-gastric Helicobacter species in patients with autoimmune liver diseases, in comparison with healthy individuals. Sera from 36 patients with primary sclerosing cholangitis (PSC), 21 with primary biliary cirrhosis, 19 with autoimmune chronic hepatitis and 80 blood donors were analysed by immunoblot, using cell-surface proteins from Helicobacter pullorum, Helicobacter bilis and Helicobacter hepaticus as antigens. Prior to testing, sera were cross-absorbed with a whole-cell lysate of Helicobacter pylori. Antibody reactivity to various proteins of these three Helicobacter species was measured by densitometric scanning and results were processed by computer software to estimate antigenic specificity. Results were also compared with antibody response to H. pylori. For H. pullorum, reactivity to at least two of the proteins with molecular masses of 48, 45, 37, 20 and 16 kDa, for H. hepaticus, reactivity to the 76, 30 and 21 kDa proteins and for H. bilis, reactivity to the 22 and 20 kDa proteins, seemed to have high specificity. Positive immunoblot results with sera from patients with PSC to antigens of H. pullorum, H. bilis and H. hepaticus were found in 38, 22 and 25 of cases, respectively, and from patients with other autoimmune liver diseases, in 30, 22 and 22 of cases, respectively. Prevalence of serum antibodies to non-gastric Helicobacter species was significantly higher in patients with autoimmune chronic liver diseases than in healthy blood donors (P < 0.001). Increased antibody levels to enterohepatic Helicobacter species raise questions concerning an infectious role of these emerging bacterial pathogens in human autoimmune liver diseases

Measurement of line widths and permanent electric dipole moment change of the Ce 4f-5d transition in Y_2SiO_5 for a qubit readout scheme in rare-earth ion based quantum computing

In this work the inhomogeneous (zero-phonon line) and homogeneous line widths, and one projection of the permanent electric dipole moment change for the Ce 4f-5d transition in Y_2SiO_5 were measured in order to investigate the possibility for using Ce as a sensor to detect the hyperfine state of a spatially close-lying Pr or Eu ion. The experiments were carried out on Ce doped or Ce-Pr co-doped single Y_2SiO_5 crystals. The homogeneous line width was measured to be about 3 MHz, which is essentially limited by the excited state lifetime. Based on the line width measurements, the oscillator strength, absorption cross section and saturation intensity were calculated to be about 9*10^-7, 5*10^-19 m^2 and 1*10^7 W/m^2, respectively. One projection of the difference in permanent dipole moment, Delt_miu_Ce, between the ground and excited states of the Ce ion was measured as 6.3 * 10^-30 C*m, which is about 26 times as large as that of Pr ions. The measurements done on Ce ions indicate that the Ce ion is a promising candidate to be used as a probe to read out a single qubit ion state for the quantum computing using rare-earth ions.Comment: 9 figures, 8 page

Costs of on-demand and prophylactic treatment for severe haemophilia in Norway and Sweden.

The expected annual cost (in the year 2000 prices) for a 30-year-old patient with average individual and treatment characteristics for on-demand EUR 51 832 (95% CI: 44 324-59 341) and for prophylaxis EUR 146 118 (95% CI: 129 965-162 271), was obtained from panel-data analysis of an 11-year retrospective panel of 156 patients with severe haemophilia in Norway and Sweden. Costs included haemophilia-related treatment costs within the health-care sector (factor concentrate, doctors' visits, diagnostic procedures, hospitalisation, invasive procedures, etc.) and cost for haemophilia-related resource use in other sectors (lost production, use of special equipment, adaptation of workplace and domicile, etc). Although costs of lost production, reconstructive surgery and hospitalisation were higher for on-demand, they did not balance out the higher costs of factor-concentrate consumption in prophylaxis. The cut-off risk of premature death, where on-demand and prophylaxis would have been equally costly, was 3.7 percentage units higher for on-demand than for prophylaxis. Such a great risk difference has not been reported elsewhere to our knowledge. Estimated cost-elasticities indicated that annual costs of prophylaxis would increase by approximately the same proportion as a potential increase in the price of factor concentrate and decrease less than proportionately with a reduction in prescribed dose kg-1. For on-demand, the annual costs would increase by approximately the same proportion as an increase in the prescribed dose kg-1