Book Review: Where No Doctor Has Gone Before: Cuba’s Place in the Global Health Landscape

Robert Huish, Assistant Professor at Dalhousie University, Department of International Development Studies, presents an overview of the Cuban health system, the Cuban medical education system, and the government’s effort to provide care beyond its borders. This is a practical book that gives the historical background of how Cuba has survived decades of economic sanctions to become one of the world leaders in universal health care. The author examines the different aspects of Cuban health care using credible evidence and a variety of sources including the author’s own experiences in Cuba learning how health care and medical education is delivered

What Works in Rural Interprofessional Practice and Education? A Study of Student Reflections

Background: Team-based care has been proposed as a way to utilize rural healthcare resources wisely. Thus, the need to educate healthcare profession students in the fundamentals of rural team-based practice has increased in recent years. Thisstudy sought to examine student reflections of a rural interprofessional practice and education (IPE) program in an effort to learn how students described their experience and what they valued. Methods and findings: Student reflection journals from a formal rural IPE program were examined for themes related to post-experience values, attitudes, and beliefs. In general, the time spent in rural IPE led to understanding what it means to live and provide care as a team to a rural community. One important new discovery is that social interactions outside formal IPE curriculum are central to achieving programmatic goals. Conclusion: Understanding the significance of rural IPE and how to guide students both inside and outside the clinical setting will help lead the development of future IPE. The findings of this study shed light on what students valued in a rural IPE experience and, thus, have implications for where institutional resources should be concentrated

Learning by doing: the MD-PA Interprofessional Education Rural Rotation

While much investment has gone into developing interprofessional education (IPE) curriculum for healthcare professional students, many of these efforts have focused on classroom rather than clinical environments. Implementing robust IPE experiences into clinical training is often complicated by obstacles such as differing rotating schedules and differing curricular requirements. The Combined Medical-Physician Assistant Student Rural Rotation (Med-PARR) at the Oregon Health and Science University takes a practical approach to these challenges. Med-PARR students participate in focused IPE activities that overlay, or \u27float\u27, on top of each trainee\u27s profession-specific curricular requirements. Through critical reflection, goal setting, and a community-based project, students get the opportunity to critically reflect on their interprofessional roles while participating in their rural clinical settings. The practical approach of the Med-PARR can serve as a model for other institutions seeking to solve similar logistical issues in their own rural and community clinical IPE implementation efforts

“Please say what this word is”: Linguistic experience and acoustic context interact in vowel categorization

Ladefoged and Broadbent [(1957). J. Acoust. Soc. Am. 29(1), 98–104] is a foundational study in speech perception research, demonstrating that acoustic properties of earlier sounds alter perception of subsequent sounds: a context sentence with a lowered first formant (F1) frequency promotes perception of a raised F1 in a target word, and vice versa. The present study replicated the original with U.K. and U.S. listeners. While the direction of the perceptual shift was consistent with the original study, neither sample replicated the large effect sizes. This invites consideration of how linguistic experience relates to the magnitudes of these context effects

The Role of Talker in Adjusting for Different Speaking Rates in Speech Perception

Speech perception is heavily influenced by acoustic context effects, where perception of a sound is influenced by acoustic properties of surrounding sounds. Talker variability, or the acoustic variability among different talkers, can disrupt these context effects. Studies have shown that talker variability does impact Spectral Contrast Effects (SCEs; an acoustic context effect induced by variations in frequency), but it is unknown if Temporal Contrast Effects (TCEs; an acoustic context effect induced by speech rate) are similarly affected. To test this, on each trial, listeners heard a context sentence (spoken at a fast or slow rate) followed by the target word which they identified as “deer” or “tier”. Context sentences differed across three blocks (One Talker/One Sentence, One Talker/200 Sentences, and 200 Talkers/200 Sentences). TCEs were calculated as the percent “tier” responses following fast sentences (where more “tier” responses are expected) minus the percent “tier” responses following slow sentences (where fewer “tier” responses are expected). Talker variability significantly influenced TCEs, with larger TCEs in the One Talker/One Sentence block than the 200 Talkers/200 Sentences block. Thus, TCEs pattern similarly to SCEs in that talker variability decreases the sizes of acoustic context effects in speech perception.https://ir.library.louisville.edu/uars/1063/thumbnail.jp

A Spatial Analysis of Physician Assistant Programs

Purpose: The Accreditation Review Commission on Education for the Physician Assistant projects a total of 273 accredited programs by the summer of 2020. Over the past 10 years, the number of Central Application Service for Physician Assistants (CASPA) applicants per seat has increased by 53%. However, no studies have addressed the current geographic relationship of applicants to programs and program growth. The purpose of this study was to describe the geospatial patterns and relationships of physician assistant (PA) programs and CASPA applicants. Methods: Program directory information for established (n = 159), satellite (n = 18), and new PA programs (n = 95) was mapped using ArcGIS software. Permanent US ZIP codes for PA applicants (n = 22,603) from the 2014 to 2015 CASPA admissions cycle were also mapped. Point data were used to calculate the nearest neighbor by program type. Correlation was used to measure the association between PA applicants, program class size, and state population metrics. Results: Most of the 95 new PA programs were geographically close to established programs. The median distance of new programs to the nearest neighboring established program was 25.6 miles (mean 39, standard deviation 38). Both established and new PA programs were found to be highly clustered (Moran\u27s I z score \u3c 2.58, p = .01). The geographic distribution of the CASPA applicant pool was related to distribution of the US population, certified PAs, and practicing physicians. Conclusions: PA program growth has exceeded projections. The close proximity of new programs to established programs will likely result in continued competition for quality applicants, PA faculty members, and clinical training sites

Stimulus statistics change sounds from near-indiscriminable to hyperdiscriminable

Objects and events in the sensory environment are generally predictable, making most of the energy impinging upon sensory transducers redundant. Given this fact, efficient sensory systems should detect, extract, and exploit predictability in order to optimize sensitivity to less predictable inputs that are, by definition, more informative. Not only are perceptual systems sensitive to changes in physical stimulus properties, but growing evidence reveals sensitivity both to relative predictability of stimuli and to co-occurrence of stimulus attributes within stimuli. Recent results revealed that auditory perception rapidly reorganizes to efficiently capture covariance among stimulus attributes. Acoustic properties per se were perceptually abandoned, and sounds were instead processed relative to patterns of cooccurrence. Here, we show that listeners\u27 ability to distinguish sounds from one another is driven primarily by the extent to which they are consistent or inconsistent with patterns of covariation among stimulus attributes and, to a lesser extent, whether they are heard frequently or infrequently. When sounds were heard frequently and deviated minimally from the prevailing pattern of covariance among attributes, they were poorly discriminated from one another. In stark contrast, when sounds were heard rarely and markedly violated the pattern of covariance, they became hyperdiscriminable with discrimination performance beyond apparent limits of the auditory system. Plausible cortical candidates underlying these dramatic changes in perceptual organization are discussed. These findings support efficient coding of stimulus statistical structure as a model for both perceptual and neural organization. © 2016 Stilp, Kluender. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited