Optimising student learning on international placements in low income settings

This paper challenges the assumption that student visits to low resource settings inevitably promote the acquisition of cultural competence. Much of the literature and marketing rhetoric advocating the expansion of such ‘exposures’ lists numerous positive outcomes with an emphasis on ‘cultural learning’. With important exceptions, the concept of cultural learning remains uncontested, nestling in the fluffy haze of an inherently benevolent multi-culturalism. The emphasis in current research is on ‘learning’ or ‘competency’ at the expense of definitional clarity around the concept of culture itself. This results in a tendency to overemphasise (and essentialise) difference rather than commonality and conflates cultural learning with narrow (stereotypical) concepts of race, ethnicity and religion. The paper discusses the experiences of students undertaking placements in Uganda through Knowledge For Change, a UK charity hosting the Ethical Educational Placements project, to identify and critique this dimension of ‘learning’. Using an action-research approach combining observational research with qualitative interviews and surveys the paper uncovers the nuance of cultural learning. In important respects the behaviour that students are witnessing and attributing to culture is connected more to the specific organisational contexts that they are placed in and the patient groups they ‘serve’ than any connection to an homogenous ‘national’ culture. Poverty and gender inequality, amongst many other forms of structural inequality, result in ‘othering’ behaviour on the part of health workers towards patients that is a fundamental characteristic of public health organisations in residualised welfare systems. In this complex environment, cultural learning is not so much about celebrating difference. It is more about understanding social context and accepting that you don’t and can’t possibly know a person’s situation; and with that in mind you should treat everyone with the same degree of humility and respect. Adopting and practising ‘epistemic humility’ (Hanson et al 2011; Ahmed, Ackers-Johnson & Ackers 2017) is crucial to meaningful learning in any context. Further, a lack of understanding of the broader structural processes perpetuates inequalities between the Global North and South (Husih, 2012; Ahmed, Ackers-Johnson & Ackers, 2017) and impedes knowledge acquisition, particularly cultural learning. Moreover, hubris – or Western students’ assumptions of superiority over host health care workers (Bauer, 2017; Elit et al, 2011, Ahmed, Ackers-Johnson & Ackers, 2017) – may act as a further obstacle to cultural learning. Cultural learning is as much about learning about ourselves and what it feels like to be ‘othered’ as it is learning about others. International placements in LMICs create critical opportunities for relevant student learning. But achieving this and guarding against the risks of ‘mis-learning’ requires the level of cultural brokerage provided by ‘More Knowledgeable Others’ that we take for granted with clinical learning

Causal Connections between Water Quality and Land Use in a Rural Tropical Island Watershed: Rural Tropical Island Watershed Analysis

We examined associations between riparian canopy cover, presence or absence of cattle, rainfall, solar radiation, month of year, dissolved oxygen, turbidity, salinity, and Enterococcus concentrations in riparian surface soils with Enterococcus geometric mean in-stream water concentrations at Waipā watershed on the north side of the Hawaiian island Kaua’i. Each 1% decrease in riparian canopy cover was associated with a 4.6 most probable number (MPN)/100 ml increase of the geometric mean of Enterococcus in stream water (P < 0.05). Each unit decrease in salinity (ppt) was associated with an increase of Enterococcus by 68.2 MPN/100 ml in-stream water geometric mean concentrations (P < 0.05). Month of year was also associated with increases in stream water Enterococcus geometric mean concentrations (P < 0.05). Reducing riparian canopy cover is associated with Enterococcus increases in stream water, suggesting that decreasing riparian vegetation density could increase fecal bacteria surface runoff

Evaluating the effects of bilingual traffic signs on driver performance and safety

Variable Message Signs (VMS) can provide immediate and relevant information to road users and bilingual VMS can provide great flexibility in countries where a significant proportion of the population speak an alternative language to the majority. The study reported here evaluates the effect of various bilingual VMS configurations on driver behaviour and safety. The aim of the study was to determine whether or not the visual distraction associated with bilingual VMS signs of different configurations (length, complexity) impacted on driving performance. A driving simulator was used to allow full control over the scenarios, road environment and sign configuration and both longitudinal and lateral driver performance was assessed. Drivers were able to read one and two-line monolingual signs and two-line bilingual signs without disruption to their driving behaviour. However, drivers significantly reduced their speed in order to read four-line monolingual and four-line bilingual signs, accompanied by an increase in headway to the vehicle in front. This implies that drivers are possibly reading the irrelevant text on the bilingual sign and various methods for reducing this effect are discussed

Tyrphostins reduce chemotherapy-induced intestinal injury in mice: assessment by a biochemical assay

Intestinal injury that results from chemotherapy belongs to the major factors of dose-limitation in tumour therapy. The tyrphostins AG1714 and AG1801 reduce cisplatin and 5-FU-induced small intestinal mucosal damage, using a quantitative biochemical assay. The assay is based on the determination of the enzymatic activity of gamma-glutamyl transpeptidase, a marker of the brush border epithelium of the small intestine

Evaluation of indigenous Trichoderma isolates from Manipur as biocontrol agent against Pythium aphanidermatum on common beans

Pythium aphanidermatum is one of the common causal pathogen of damping-off disease of beans (Phaseolus vulgaris L.) grown in Manipur. A total of 110 indigenous Trichoderma isolates obtained from North east India were screened for their biocontrol activity which can inhibit the mycelial growth of P. aphanidermatum, the causal organism of damping-off in beans. Out of the total isolates, 32% of them showed strong antagonistic activity against P. aphanidermatum under in vitro condition and subsequently 20 best isolates were selected based on their mycelial inhibition capacity against P. aphanidermatum for further analysis. Different biocontrol mechanisms such as protease, chitinase, β-1,3-glucanase activity, cellulase and production of volatile and non-volatile compounds were also assayed. Based on their relative biocontrol potency, only three indigenous Trichoderma isolates (T73, T80 and T105) were selected for pot culture experiment against damping-off diseases in common beans. In greenhouse experiment, Trichoderma isolates T-105 significantly reduced the pre- and post-emergence damping-off disease incidence under artificial infection with P. aphanidermatum and showed highest disease control percentage

Visualization of Glutamine Transporter Activities in Living Cells Using Genetically Encoded Glutamine Sensors

Glutamine plays a central role in the metabolism of critical biological molecules such as amino acids, proteins, neurotransmitters, and glutathione. Since glutamine metabolism is regulated through multiple enzymes and transporters, the cellular glutamine concentration is expected to be temporally dynamic. Moreover, differentiation in glutamine metabolism between cell types in the same tissue (e.g. neuronal and glial cells) is often crucial for the proper function of the tissue as a whole, yet assessing cell-type specific activities of transporters and enzymes in such heterogenic tissue by physical fractionation is extremely challenging. Therefore, a method of reporting glutamine dynamics at the cellular level is highly desirable. Genetically encoded sensors can be targeted to a specific cell type, hence addressing this knowledge gap. Here we report the development of Föster Resonance Energy Transfer (FRET) glutamine sensors based on improved cyan and yellow fluorescent proteins, monomeric Teal Fluorescent Protein (mTFP)1 and venus. These sensors were found to be specific to glutamine, and stable to pH-changes within a physiological range. Using cos7 cells expressing the human glutamine transporter ASCT2 as a model, we demonstrate that the properties of the glutamine transporter can easily be analyzed with these sensors. The range of glutamine concentration change in a given cell can also be estimated using sensors with different affinities. Moreover, the mTFP1-venus FRET pair can be duplexed with another FRET pair, mAmetrine and tdTomato, opening up the possibility for real-time imaging of another molecule. These novel glutamine sensors will be useful tools to analyze specificities of glutamine metabolism at the single-cell level

Smoking patterns and stimulus control in intermittent and daily smokers

Intermittent smokers (ITS) - who smoke less than daily - comprise an increasing proportion of adult smokers. Their smoking patterns challenge theoretical models of smoking motivation, which emphasize regular and frequent smoking to maintain nicotine levels and avoid withdrawal, but yet have gone largely unexamined. We characterized smoking patterns among 212 ITS (smoking 4-27 days per month) compared to 194 daily smokers (DS; smoking 5-30 cigarettes daily) who monitored situational antecedents of smoking using ecological momentary assessment. Subjects recorded each cigarette on an electronic diary, and situational variables were assessed in a random subset (n = 21,539 smoking episodes); parallel assessments were obtained by beeping subjects at random when they were not smoking (n = 26,930 non-smoking occasions). Compared to DS, ITS' smoking was more strongly associated with being away from home, being in a bar, drinking alcohol, socializing, being with friends and acquaintances, and when others were smoking. Mood had only modest effects in either group. DS' and ITS' smoking were substantially and equally suppressed by smoking restrictions, although ITS more often cited self-imposed restrictions. ITS' smoking was consistently more associated with environmental cues and contexts, especially those associated with positive or "indulgent" smoking situations. Stimulus control may be an important influence in maintaining smoking and making quitting difficult among ITS. © 2014 Shiffman et al

Application of ecological momentary assessment in stress-related diseases

Many physical diseases have been reported to be associated with psychosocial factors. In these diseases, assessment relies mainly on subjective symptoms in natural settings. Therefore, it is important to assess symptoms and/or relationships between psychosocial factors and symptoms in natural settings. Symptoms are usually assessed by self-report when patients visit their doctors. However, self-report by recall has an intrinsic problem; "recall bias". Recently, ecological momentary assessment (EMA) has been proposed as a reliable method to assess and record events and subjective symptoms as well as physiological and behavioral variables in natural settings. Although EMA is a useful method to assess stress-related diseases, it has not been fully acknowledged, especially by clinicians. Therefore, the present brief review introduces the application and future direction of EMA for the assessment and intervention for stress-related diseases

Selective Inhibitors of Protozoan Protein N-myristoyltransferases as Starting Points for Tropical Disease Medicinal Chemistry Programs

Inhibition of N-myristoyltransferase has been validated pre-clinically as a target for the treatment of fungal and trypanosome infections, using species-specific inhibitors. In order to identify inhibitors of protozoan NMTs, we chose to screen a diverse subset of the Pfizer corporate collection against Plasmodium falciparum and Leishmania donovani NMTs. Primary screening hits against either enzyme were tested for selectivity over both human NMT isoforms (Hs1 and Hs2) and for broad-spectrum anti-protozoan activity against the NMT from Trypanosoma brucei. Analysis of the screening results has shown that structure-activity relationships (SAR) for Leishmania NMT are divergent from all other NMTs tested, a finding not predicted by sequence similarity calculations, resulting in the identification of four novel series of Leishmania-selective NMT inhibitors. We found a strong overlap between the SARs for Plasmodium NMT and both human NMTs, suggesting that achieving an appropriate selectivity profile will be more challenging. However, we did discover two novel series with selectivity for Plasmodium NMT over the other NMT orthologues in this study, and an additional two structurally distinct series with selectivity over Leishmania NMT. We believe that release of results from this study into the public domain will accelerate the discovery of NMT inhibitors to treat malaria and leishmaniasis. Our screening initiative is another example of how a tripartite partnership involving pharmaceutical industries, academic institutions and governmental/non-governmental organisations such as Medical Research Council and Wellcome Trust can stimulate research for neglected diseases