The Arab Awakening, act II: Time to move more boldly on investment

Following the Arab Awakening in late 2010, the decline of foreign direct investment (FDI) in the Middle East and North Africa (MENA) from US$63 billion in 2010 to US$ 39 billion by the end of 2011, was significant, albeit with important differences among countries. FDI inflows continued to slow slightly in 2012 and are expected to remain flat in 2013. Although FDI inflows for the region as a whole were affected by a number of factors, including the crisis in global financial markets, the sharp decrease was also related to a loss of investor confidence and political instability that affected both oil importing and exporting countries. For example, in Egypt FDI inflows fell from US$6.4 billion in 2010 to a net disinvestment of US$ 483 million in 2011.Sectors in the region that were hardest hit included agribusiness, construction, light manufacturing, renewable energies, and tourism

阿拉伯的二次觉醒：抓住时机，促进投资

2010年末的“阿拉伯觉醒”之后，中东和北非地区（MENA）的外国直接投资（FDI）从2010年的630亿美元到2011年底的390亿美元发生了明显下降，即使各国间存在显著差异。FDI流入在2012年继续略微放缓，预计将在2013年持平。虽然该地区整体FDI流入受诸多因素包括全球金融市场危机的影响，但此次石油进出口国家FDI的急剧下降也与投资者信心不足和政治不稳定有关。例如，埃及FDI流入从2010年的64亿美元减缩到2011年的4.83亿美元。该地区受打击最大的行业涉及农业综合产业、建筑业、轻工业制造业、可再生能源和旅游业

Analysis of margin classification systems for assessing the risk of local recurrence after soft tissue sarcoma resection

Purpose: To compare the ability of margin classification systems to determine local recurrence (LR) risk after soft tissue sarcoma (STS) resection. Methods: Two thousand two hundred seventeen patients with nonmetastatic extremity and truncal STS treated with surgical resection and multidisciplinary consideration of perioperative radiotherapy were retrospectively reviewed. Margins were coded by residual tumor (R) classification (in which microscopic tumor at inked margin defines R1), the R+1mm classification (in which microscopic tumor within 1 mm of ink defines R1), and the Toronto Margin Context Classification (TMCC; in which positive margins are separated into planned close but positive at critical structures, positive after whoops re-excision, and inadvertent positive margins). Multivariate competing risk regression models were created. Results: By R classification, LR rates at 10-year follow-up were 8%, 21%, and 44% in R0, R1, and R2, respectively. R+1mm classification resulted in increased R1 margins (726 v 278, P < .001), but led to decreased LR for R1 margins without changing R0 LR; for R0, the 10-year LR rate was 8% (range, 7% to 10%); for R1, the 10-year LR rate was 12% (10% to 15%) . The TMCC also showed various LR rates among its tiers (P < .001). LR rates for positive margins on critical structures were not different from R0 at 10 years (11% v 8%, P = .18), whereas inadvertent positive margins had high LR (5-year, 28% [95% CI, 19% to 37%]; 10-year, 35% [95% CI, 25% to 46%]; P < .001). Conclusion: The R classification identified three distinct risk levels for LR in STS. An R+1mm classification reduced LR differences between R1 and R0, suggesting that a negative but < 1-mm margin may be adequate with multidisciplinary treatment. The TMCC provides additional stratification of positive margins that may aid in surgical planning and patient education

Appropriate management of traumatic dental injuries at the hospital emergency department provides a positive impact on patient outcomes

The objective of this case study is to highlight the importance of medical doctors’ management of acute dental trauma. Correct diagnosis and treatment techniques are essential for an optimal long-term prognosis of restored function and aesthetics for the patient. The aim of correct management of acute traumatic dental injuries (TDI) to permanent teeth is to protect patients from inaccurate diagnosis, poor treatment by clinicians and to stabilize the condition before referring to a dentist for permanent dental care. This case shows that appropriate management of acute dental injuries by the emergency doctor prevented the loss of teeth at an earlier age

Identifying barriers that affect medical doctors’ learning of dental trauma

BackgroundIt is important that medical doctors are familiar with the management of emergency dental trauma before referring a patient to a dentist. Correct diagnosis and treatment techniques are essential for a predictable and optimal long-term prognosis.AimsThe aim is to identify and categorize statements from the literature related to barriers (factors that hinder learning) on dental trauma for medical doctors.MethodsThe authors reviewed ten papers pertaining to medical doctors’ knowledge of dental trauma and identify some common barriers to learning.ResultsThe barriers identified were classified as internal (factors associated with the learner) or external (factors associated with the learning environment). Internal barriers negatively impact learners and may cause medical doctors to lose enthusiasm or interest in the subject. External barriers, on the other hand, often arise from within the university or teaching hospital and may affect medical students’ and doctors’ theoretical learning of dental trauma or hamper their clinical experience. ConclusionFrom a limited body of literature, this report has identified some common barriers that affect doctors’ learning of dental trauma. Consequently, to further investigate the relevance of these barriers and their impact on dental trauma learning, a systematic review in this area is indicated

A brief overview of learning theories in medical education: Using dental trauma as an example

The literature identifies that medical student receive little or no formal dental trauma assessment and management teaching during medical school. To bridge this important gap in medical education, medical educators should look to introduce basic dental trauma teaching into undergraduates’ final year of medical school. To set up a solid foundation for long-term learning, educators should consider which theories are most suited to transfer knowledge effectively to students in particular contexts. Similarly, medical educators should consider which theory or hybrid of learning theories best fits their teaching goals. In the absence of a dental educator at the medical school, offering an online learning approach is an ideal solution for filling medical students’ knowledge gap in assessing and managing dental trauma injuries

Development and validation of the student ratings in clinical teaching scale in Australia: a methodological study

Purpose This study aimed to devise a valid measurement for assessing clinical students’ perceptions of teaching practices. Methods A new tool was developed based on a meta-analysis encompassing effective clinical teaching-learning factors. Seventy-nine items were generated using a frequency (never to always) scale. The tool was applied to the University of New South Wales year 2, 3, and 6 medical students. Exploratory and confirmatory factor analysis (exploratory factor analysis [EFA] and confirmatory factor analysis [CFA], respectively) were conducted to establish the tool’s construct validity and goodness of fit, and Cronbach’s α was used for reliability. Results In total, 352 students (44.2%) completed the questionnaire. The EFA identified student-centered learning, problem-solving learning, self-directed learning, and visual technology (reliability, 0.77 to 0.89). CFA showed acceptable goodness of fit (chi-square P<0.01, comparative fit index=0.930 and Tucker-Lewis index=0.917, root mean square error of approximation=0.069, standardized root mean square residual=0.06). Conclusion The established tool—Student Ratings in Clinical Teaching (STRICT)—is a valid and reliable tool that demonstrates how students perceive clinical teaching efficacy. STRICT measures the frequency of teaching practices to mitigate the biases of acquiescence and social desirability. Clinical teachers may use the tool to adapt their teaching practices with more active learning activities and to utilize visual technology to facilitate clinical learning efficacy. Clinical educators may apply STRICT to assess how these teaching practices are implemented in current clinical settings

Really Trying or Merely Trying

We enjoy first-person authority with respect to a certain class of actions: for these actions, we know what we are doing just because we are doing it. This paper first formulates an epistemological principle that captures this authority in terms of trying to act in a way that one has the capacity to act. It then considers a case of effortful action – running a middle distance race – that threatens this principle. And proposes the solution of changing the metaphysics of action: one can keep hold of the idea that we have first-person authority over what we are doing by adopting a disjunctive account of action

Clinical capabilities of graduates of an outcomes-based integrated medical program

<p>Abstract</p> <p>Background</p> <p>The University of New South Wales (UNSW) Faculty of Medicine replaced its old content-based curriculum with an innovative new 6-year undergraduate entry outcomes-based integrated program in 2004. This paper is an initial evaluation of the perceived and assessed clinical capabilities of recent graduates of the new outcomes-based integrated medical program compared to benchmarks from traditional content-based or process-based programs.</p> <p>Method</p> <p>Self-perceived capability in a range of clinical tasks and assessment of medical education as preparation for hospital practice were evaluated in recent graduates after 3 months working as junior doctors. Responses of the 2009 graduates of the UNSW’s new outcomes-based integrated medical education program were compared to those of the 2007 graduates of UNSW’s previous content-based program, to published data from other Australian medical schools, and to hospital-based supervisor evaluations of their clinical competence.</p> <p>Results</p> <p>Three months into internship, graduates from UNSW’s new outcomes-based integrated program rated themselves to have good clinical and procedural skills, with ratings that indicated significantly greater capability than graduates of the previous UNSW content-based program. New program graduates rated themselves significantly more prepared for hospital practice in the confidence (reflective practice), prevention (social aspects of health), interpersonal skills (communication), and collaboration (teamwork) subscales than old program students, and significantly better or equivalent to published benchmarks of graduates from other Australian medical schools. Clinical supervisors rated new program graduates highly capable for teamwork, reflective practice and communication.</p> <p>Conclusions</p> <p>Medical students from an outcomes-based integrated program graduate with excellent self-rated and supervisor-evaluated capabilities in a range of clinically-relevant outcomes. The program-wide curriculum reform at UNSW has had a major impact in developing capabilities in new graduates that are important for 21^st century medical practice.</p