A Review of Generalist and Specialist Community Health Workers for Delivering Adolescent Health Services in sub-Saharan Africa.

The health of adolescents is increasingly seen as an important international priority because the world's one point eight billion young people (aged 10 to 24 years) accounts for 15.5% of the global burden of disease and are disproportionately located in low- and middle-income countries (LMICs). Furthermore, an estimated 70% of premature adult deaths are attributable to unhealthy behaviors often initiated in adolescence (such as smoking, obesity, and physical inactivity). In order for health services to reach adolescents in LMICs, innovative service delivery models need to be explored and tested. This paper reviews the literature on generalist and specialist community health workers (CHWs) to assess their potential for strengthening the delivery of adolescent health services. We reviewed the literature on CHWs using Medline (PubMed), EBSCO Global Health, and Global Health Archive. Search terms (n = 19) were sourced from various review articles and combined with subject heading 'sub-Saharan Africa' to identify English language abstracts of original research articles on generalist and specialist CHWs. A total of 106 articles, from 1985 to 2012, and representing 24 African countries, matched our search criteria. A single study in sub-Saharan Africa used CHWs to deliver adolescent health services with promising results. Though few comprehensive evaluations of large-scale CHW programs exist, we found mixed evidence to support the use of either generalist or specialist CHW models for delivering adolescent health services. This review found that innovative service delivery approaches, such as those potentially offered by CHWs, for adolescents in sub-Saharan Africa are lacking, CHW programs have proliferated despite the absence of high quality evaluations, rigorous studies to establish the comparative effectiveness of generalist versus specialist CHW programs are needed, and further investigation of the role of CHWs in providing adolescent health services in sub-Saharan Africa is warranted

Design and Development of Software Tools for Bio-PEPA

This paper surveys the design of software tools for the Bio-PEPA process algebra. Bio-PEPA is a high-level language for modelling biological systems such as metabolic pathways and other biochemical reaction networks. Through providing tools for this modelling language we hope to allow easier use of a range of simulators and model-checkers thereby freeing the modeller from the responsibility of developing a custom simulator for the problem of interest. Further, by providing mappings to a range of different analysis tools the Bio-PEPA language allows modellers to compare analysis results which have been computed using independent numerical analysers, which enhances the reliability and robustness of the results computed.

Adaptive Guidance: Effects On Self-Regulated Learning In Technology-Based Training

Guidance provides trainees with the information necessary to make effective use of the learner control inherent in technology-based training, but also allows them to retain a sense of control over their learning (Bell & Kozlowski, 2002). One challenge, however, is determining how much learner control, or autonomy, to build into the guidance strategy. We examined the effects of alternative forms of guidance (autonomy supportive vs. controlling) on trainees’ learning and performance, and examined trainees’ cognitive ability and motivation to learn as potential moderators of these effects. Consistent with our hypotheses, trainees receiving adaptive guidance had higher levels of knowledge and performance than trainees in a learner control guidance. Controlling guidance had the most consistent positive impact on the learning outcomes, while autonomy supportive guidance demonstrated utility for more strategic outcomes. In addition, guidance was generally more effective for trainees with higher levels of cognitive ability and autonomy guidance served to enhance the positive effects of motivation to learn on the training outcomes

P15. Employing students' multilingualism and language diversity in teaching and learning

Before our innovative clinical skills session ‘Interpreting in Consultations’, we conducted an annual survey of languages spoken by students on admission, in 2006, 2007 and 2008. Froma response rate of 94% we noted that 28% of students are advanced/fluent speakers of language(s) other than English and a total of 48 languages are spoken.The session, ‘Interpreting in Consultations’, involves first and second year students who speak the same language other than English, role-playing an ‘interpreted’ consultation.Feedback from tutors and students following the session shows that using different languages serves multiple, valuable purposes, highlighting:• issues encountered with interpreters• challenges of ‘medical’ language• difficulties in transmitting a patient centred approach• how linguistic and cultural sensitivities are lost in translation.Student linguistic diversity is considerable and not used to its full potential: the single clinical skills session we report suggests there is much more to be gained. The education we design and delivermay fail to recognise what patient-centred-ness means in different languages and cultures.Future research should: consider how to make best use of multiculturalism and linguistic diversity; explore how students’ awareness of, and competence in, different languages and culturescan be developed and maintained

Comics, the Holocaust and Hiroshima

Comics, the Holocaust and Hiroshima breaks new ground by arguing that comics have a dual role as sources of cataclysm between 1939 and 1945. First for historians to gauge awareness of the Holocaust and second through close analysis, of Paroles d'Etoiles in Vichy France and Barefoot Gen in Hiroshima, as testimonies of childhood emotions, experiences and memories. Calling for an extension of the range of source material relating to persecution, genocide and the atomic bomb from 1939 to 1945, comics are posited as an agent to build on the scholarship of new cultural history, historiography, memory and trauma studies. These fields connect through the shared ground of cultural record, which can be either deliberate/explicit or incidental reference. The comics form is a flexible one with potential to explore the space between reality and representation, with visuals working as iconic translations while narrative structure relies on readers' mental contribution

Comics and the world wars: a cultural record

Comics and the World Wars argues for the use of comics as a primary source by offering a highly original argument that such examples produced during the World Wars act as a cultural record. Recuperating currently unknown or neglected strips, this work demonstrates how these can be used for the study of both world wars. Representing the fruits of over five years team research, this book reveals how sequential illustrated narratives used humour as a coping mechanism and a way to criticise authority, promoted certain forms of behaviour and discouraged others, represented a deliberately inclusive educational strategy for reading wartime content, and became a barometer for contemporary popular thinking