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Medical Schools (medical + school)
Kinds of Medical Schools Terms modified by Medical Schools Selected AbstractsA CASE OF PYOGENIC GRANULOMA IN THE SIGMOID COLON TREATED WITH ARGON PLASMA COAGULATIONDIGESTIVE ENDOSCOPY, Issue 3 2005Tomoko Morita Pyogenic granuloma (PG) with hemorrhagic tendency, is often recognized in the oral mucosa and skin, but rare in the gastrointestinal tract. Only 20 cases have been reported in the gastric mucosa. There have been no reports of gastrointestinal PG treated by argon plasma coagulation (APC). We report here the first case of PG in the sigmoid colon treated by APC. The patient was a 64-year-old woman complaining of constipation who was referred to a university hospital of Kochi Medical School. She presented with easily bleeding mucosa, as revealed by a total colonoscopic study in the sigmoid colon. Magnifying colonoscopic examination showed two sessile small polyps in the sigmoid colon. Pathological examination of the biopsy specimens revealed pyogenic granuloma. We treated this lesion by endoscopic APC. No recurrence has been found as of 9 months after APC therapy. [source] Clinical Andrology Unit, University Medical School, ,ód,, PolandINTERNATIONAL JOURNAL OF ANDROLOGY, Issue 2001Article first published online: 18 JUL 200 First page of article [source] Our experience in eight cases with urinary hydatid disease: A series of 372 cases held in nine different clinicsINTERNATIONAL JOURNAL OF UROLOGY, Issue 9 2006LMAZ Objectives: Hydatid disease, a parasitic infestation caused by the larval stage of the cestode Echinococcus granulosus, is diagnosed commonly in the east and south-east regions of Turkey. The aim of this study is to emphasize the relatively frequent occurrences of echinococcosis in our region, and to discuss therapeutic options and treatment results according to current literature. Methods: A retrospective 10-year review of nine different clinics' records of the Research Hospital of the Medical School of Yüzüncü Y,l University revealed 372 hydatid disease cases that were localized in various organs and treated surgically (271 cases) or drained percutaneously (99 cases). Hydatid disease was diagnosed by ultrasonography (US) and computed tomography scans (CT) and confirmed histopathologically. Results: The involved organ was lung in 203 cases (131 adults, 72 children), liver in 150, spleen in 9, brain in 2, kidneys in 7 cases and the retrovesical area in 1 case. The urogenital system is involved at a rate of 2.15%. Two hundred and seventy-one cases were treated surgically and 99 percutaneously. Two cases with renal hydatid cyst refused the surgical procedure (one had a solitary kidney with hydatid cyst). Albendazole was administered to 192 patients; 93 patients had open surgical procedure and 99 patients underwent percutaneous procedure. Cysts were excised totally in the open surgical procedure; however, involved kidneys were removed totally (four cases) except one. Cystectomy and omentoplasty was performed in one case. Complications were as follows: in six cases, cystic material was spilled into the bronchial cavity during the dissection and a renal hydatid cyst ruptured and spilled retroperitoneally. Conclusion: Hydatid disease is a serious health problem in Turkey. The mainly affected organs are liver and lung. It can be treated surgical or by percutaneous aspiration. [source] Interview with a Quality Leader: Dr. Ashish JhaJOURNAL FOR HEALTHCARE QUALITY, Issue 5 2010Kevin C. Park Abstract: Dr. Jha is an Associate Professor of Medicine at Harvard Medical School. The major themes of his research are: 1. Quality of care provided by healthcare systems, with a focus on healthcare disparities as a marker of poor care. 2. Information technology among other tools as potential solutions for reducing medical errors and disparities while improving overall quality. 3. Organizations that provide care for minorities and underserved populations and the role clinical information systems can play in improving their care. [source] Providing Nutrition Supplements to Institutionalized Seniors with Probable Alzheimer's Disease Is Least Beneficial to Those with Low Body Weight StatusJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2004Karen W. H. Young MSc Objectives: To examine whether providing a midmorning nutrition supplement increases habitual energy intake in seniors with probable Alzheimer's disease (AD) and to investigate the effects of body weight status and cognitive and behavioral function on the response to the intervention. Design: Randomized, crossover, nonblinded clinical trial. Setting: A fully accredited geriatric teaching facility affiliated with the University of Toronto's Medical School with a home for the aged. Participants: Thirty-four institutionalized seniors with probable AD who ate independently. Intervention: Nutrition supplements were provided between breakfast and lunch for 21 consecutive days and compared with 21 consecutive days of habitual intake. Measurements: Investigator-weighed food intake, body weight, cognitive function (Severe Impairment Battery and Global Deterioration Scale), behavioral disturbances (Neuropsychiatric Inventory,Nursing Home Version), and behavioral function (London Psychogeriatric Rating Scale). Results: Relative to habitual intake, group mean analyses showed increased 24-hour energy, protein, and carbohydrate intake during the supplement phase, but five of 31 subjects who finished all study phases completely compensated for the energy provided by the supplement by reducing lunch intake, and 24-hour energy intake was enhanced in only 21 of 31 subjects. Compensation at lunch was more likely in subjects with lower body mass indices, increased aberrant motor behavior, poorer attention, and increased mental disorganization/confusion. Conclusion: Nutrition supplements were least likely to enhance habitual energy intake in subjects who would normally be targeted for nutrition intervention,those with low body weight status. Those likely to benefit include those with higher body mass indices, less aberrant motor problems, less mental disorganization, and increased attention. [source] Reduction of Stroke Risk FactorsJOURNAL OF CLINICAL HYPERTENSION, Issue 1 2007John B. Kostis MD In October 2006, a panel of experts participated in a teleconference to discuss the reduction of stroke risk factors in patients at risk for stroke. The panel was chaired by John B. Kostis, MD, Professor and Chairman, Department of Medicine at the University of Medicine and Dentistry of New Jersey,Robert Wood Johnson Medical School, New Brunswick, NJ. Also participating were Philip B. Gorelick, MD, MPH, Director, Center for Stroke Research, University of Illinois College of Medicine, Chicago, IL, and Franz H. Messerli, MD, St Luke's-Roosevelt Hospital Center, New York, NY. [source] Orbital blood flow velocities in patients with rheumatoid arthritisJOURNAL OF CLINICAL ULTRASOUND, Issue 7 2007Besir Erdogmus MD Abstract Purpose. To assess orbital blood flow changes in patients with rheumatoid arthritis using Doppler sonography. Patients and Methods. The study comprised 35 patients who were diagnosed with RA and were treated at the Department of Physical Therapy and Rehabilitation at Duzce Medical School. A control group consisted of 35 healthy volunteers. Color Doppler imaging was used to measure peak systolic velocity (PSV) and end diastolic velocity (EDV), from which the resistance index (RI) was calculated in the ophthalmic artery (OA), central retinal artery (CRA), and posterior ciliary arteries (PCAs). Results. In the OA, PSV, EDV, and RI were, respectively, 36.7 ± 0.6 cm/sec, 9.7 ± 0.2 cm/sec, and 0.73 in the control group versus 34.7 ± 3.0 cm/sec, 9.1 ± 1.1 cm/sec, and 0.74 in the patient group. In the CRA, they were, respectively, 11.8 ± 1.7 cm/sec, 3.6 ± 0.7 cm/sec, and 0.66 in the control group versus 11.1 ± 1.7 cm/sec, 3.4 ± 0.7 cm/sec, and 0.68 in the patient group. In the PCAs, they were, respectively, 13.2 ± 1.2 cm/sec, 4.7 ± 0.6 cm/sec, and 0.65 in the control group versus 12.4 ± 1.2 cm/sec, 4.2 ± 0.6 cm/sec, and 0.66 in the PCAs. PSV, EDV, and RI of the PCAs and OA and RI of the CRA were significantly different between patients and controls, whereas there was no difference in the serum levels of glucose, triglyceride, low-density lipoprotein cholesterol, and total cholesterol. In the patient group, there was a significant correlation between orbital blood flow and duration of disease. Conclusion. Ocular blood flow appears to be slightly lower in RA patients than in healthy controls, suggesting that RA is a systemic inflammatory disease that may also involve ocular vessels. © 2007 Wiley Periodicals, Inc. J Clin Ultrasound, 2007 [source] Adefovir dipivoxil therapy in liver transplant recipients for recurrence of hepatitis B virus infection despite lamivudine plus hepatitis B immunoglobulin prophylaxisJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 12 2007Murat Akyildiz Abstract Background:, Treatment of post-transplantation recurrence of hepatitis B virus (HBV) infection despite prophylaxis with hepatitis B immunoglobulin (HBIG) and lamivudine combination therapy is not easy. Because HBV reinfection has a severe course and could result in graft failure in liver transplant recipients, prompt medication is essential. Herein is reported the authors' experience with adefovir dipivoxil (AD) therapy in 11 liver transplant recipients who had HBV reinfection despite the administration of lamivudine and HBIG. Method:, Two-hundred and nine patients underwent liver transplantation (100 deceased donor liver transplantations [DDLT], 109 living donor liver transplantation [LDLT]) due to chronic hepatitis B infection between April 1997 and May 2005 in Ege University Medical School, Liver Transplantation Unit. Patients had prophylaxis with lamivudine and low-dose HBIG combination after liver transplantation. Treatment of recurrence consisted of AD 10 mg once a day and lamivudine 300 mg/daily and HBIG was discontinued in those patients. Results:, In total there were 11 HBV recurrences: five occurred in DDLT recipients and six in LDLT recipients, at a median follow up of 18 months (range, 6,48 months). In one of 11 patients, pretransplant HBV-DNA and HBeAg were positive. Three patients had a severe course and one patient had fibrosing cholestatic hepatitis. After AD treatment, HBV-DNA level decreased in all patients and became negative in seven patients. Two patients died due to hepatocellular carcinoma recurrence after 12 and 14 months of follow up. Serum creatinine level increased mildly in one patient and no other side-effect was observed, and all patients continued therapy. Conclusion:, Adefovir dipivoxil is a safe, effective treatment option for post-transplant HBV recurrence even among patients with fibrosing cholestatic hepatitis caused by lamivudine-resistant HBV. [source] Inflammatory bio-markers and cardiovascular risk predictionJOURNAL OF INTERNAL MEDICINE, Issue 4 2002G. J. Blake Abstract.,Blake GJ, Ridker PM (Harvard Medical School, Boston, MA, USA). Inflammatory bio-markers and cardiovascular risk prediction (Review). J Intern Med 2002; 252: 283,294. Inflammatory processes are now recognized to play a central role in the pathogenesis of atherosclerosis and its complications. Plasma levels of several markers of inflammation have been found to be associated with future cardiovascular risk in a variety of clinical settings. These markers include cell adhesion molecules, cytokines, pro-atherogenic enzymes and C-reactive protein (CRP). Initially thought of as an inactive downstream marker of the inflammatory cascade, emerging evidence suggests that CRP may be directly involved in atherogenesis, and that arterial plaque can produce CRP, independent of traditional hepatic pathways. In addition to being a strong predictor of future cardiovascular risk amongst patients presenting with acute coronary syndromes, numerous studies have found that baseline levels of CRP are associated with risk of future myocardial infarction, stroke, peripheral vascular disease and cardiovascular death amongst apparently healthy populations. The combination of measurement of a marker of inflammation with lipid testing may improve upon risk stratification based on lipid testing alone, and intensification of programmes for exercise, weight loss, and smoking cessation is recommended for those with elevated CRP levels. Further trials are needed to confirm the potential benefits of statins amongst individuals with elevated CRP levels. [source] A family with IgA nephropathy and hereditary lymphoedema praecoxJOURNAL OF INTERNAL MEDICINE, Issue 5 2002M. USTA Abstract.,Usta M, Dilek K, Ersoy A, Alper E, Özbek S, Özdemir B, Filiz G, Yavuz M, Güllülü M, Yurtkuran M (Uluda, University Medical School, Bursa, Turkey). A family with IgA nephropathy and hereditary lymphoedema praecox (Case Report). J Intern Med 2002; 251: 447,451. Immunoglobulin A (IgA) nephropathy is the most common primary glomerulonephritis worldwide. The pathogenesis is still unknown and treatment has not yet been established. Rarely it can be associated with other disorders. Its association with hereditary lymphoedema is not reported before. We report four patients, a 60-year-old father, his two sons and his daughter, with hereditary lymphoedema. The family had nine members and in four of them lymphoedema was evident. The other members had neither lymphoedema nor IgA nephropathy. This is the first report of IgA nephropathy in association with hereditary lymphoedema. [source] Diet and breast cancerJOURNAL OF INTERNAL MEDICINE, Issue 5 2001W. C. Willett Abstract.,Willett WC (Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA). Diet and Breast Cancer. J Intern Med 2001; 249: 395,411. [source] Content specificity: is it the full story?MEDICAL EDUCATION, Issue 6 2008Statistical modelling of a clinical skills examination Objective, This study sought to determine the relative contributions made by transferable skills and content-specific skills to Year 2 medical student performance in a clinical skills examination. Methods, Correlated trait-correlated method models were constructed to describe the performance of 2 year groups of students in examinations held in the summers of 2004 and 2005 at Peninsula Medical School in the UK. The transferable skills components of the models were then removed to indicate the contribution made to the fit of the models to the data. Results, Although content-specific skills made the greater contribution to the 2 models of student performance (accounting for averages of 54% and 43% of the variance, respectively), transferable skills did make an important but smaller contribution (averages of 13% and 16%, respectively). When the transferable skills components of the models were removed, the fit was not as good. Conclusions, Both content-specific skills and transferable skills contributed to performance in the clinical skills examination. This challenges current thinking and has important implications, not just for those involved in clinical skills examinations, but for all medical educators. [source] Undergraduate medical students: who seeks formative feedback?MEDICAL EDUCATION, Issue 6 2007Hazel K Sinclair Objective, This study aimed to monitor which undergraduate students collected formative feedback on their degree essays and to quantify any correlations between gender or summative mark achieved and whether formative feedback was sought. Methods, We carried out a study at the University of Aberdeen Medical School, involving a total of 360 Year 3 students, comprising all 177 students in the 2004 cohort and 183 in 2005. Data on gender and summative mark were routinely collected during the degree assessment processes in March 2004 and 2005. Students signed on receipt of their feedback. Results, Less than half the students (46%) collected their formative feedback: 47% in 2004, and 45% in 2005. Overall, females were significantly more likely than males to seek formative feedback (P = 0.004). Higher achievers were significantly more likely than lower achievers to seek their feedback (P = 0.020). Conclusions, Our findings indicate that these medical students, particularly males and poor students, may not use assessment feedback as a learning experience. Female and better students are keener to seek out formative feedback that might be expected to help them continue to do well. We need to explore further why so many students do not access formative feedback, and develop strategies for addressing this issue effectively. [source] Medical students' perceptions of their educational environment: expected versus actual perceptionsMEDICAL EDUCATION, Issue 3 2007Susan Miles Objective, To compare Year 1 medical students' perceptions of their educational environment at the end of Year 1, with their expectations at the beginning of the year using the Dundee Ready Education Environment Measure (DREEM). Methods, Year 1 students (n = 130) at the University of East Anglia Medical School were asked to complete the DREEM during their induction week at the beginning of Year 1, thinking about the educational environment they expected to encounter (Expected DREEM), and again as part of a compulsory evaluation at the end of Year 1, thinking about the educational environment they had actually experienced (Actual DREEM). A total of 87 students (66.92% of the starting cohort) completed the DREEM on both occasions and gave permission for their data to be published. Results, The Expected DREEM score was 153 out of a maximum of 200, and the Actual DREEM score was 143. Student's expected perceptions of learning and teachers, and their expected academic self- and social self-perceptions were all more positive than their actual perceptions. There was no difference between expected and actual perceptions of atmosphere. Specific aspects of the educational environment showing dissonance were identified. In some areas students' low expectations had been matched by their actual experience. Conclusions, Medical students had started Year 1 with expectations about the educational environment that had not been met. However, areas showing dissonance received low item scores on the Actual DREEM and as such would be picked up for remediation, even without information about student expectations. [source] Relationship of resident characteristics, attitudes, prior training and clinical knowledge to communication skills performanceMEDICAL EDUCATION, Issue 1 2006Toni Suzuki Laidlaw Purpose, A substantial body of literature demonstrates that communication skills in medicine can be taught and retained through teaching and practice. Considerable evidence also reveals that characteristics such as gender, age, language and attitudes affect communication skills performance. Our study examined the characteristics, attitudes and prior communication skills training of residents to determine the relationship of each to patient,doctor communication. The relationship between communication skills proficiency and clinical knowledge application (biomedical and ethical) was also examined through the use of doctor-developed clinical content checklists, as very little research has been conducted in this area. Methods, A total of 78 first- and second-year residents across all departments at Dalhousie Medical School participated in a videotaped 4-station objective structured clinical examination presenting a range of communication and clinical knowledge challenges. A variety of instruments were used to gather information and assess performance. Two expert raters evaluated the videotapes. Results, Significant relationships were observed between resident characteristics, prior communication skills training, clinical knowledge and communication skills performance. Females, younger residents and residents with English as first language scored significantly higher, as did residents with prior communication skills training. A significant positive relationship was found between the clinical content checklist and communication performance. Gender was the only characteristic related significantly to attitudes. Conclusions, Gender, age, language and prior communication skills training are related to communication skills performance and have implications for resident education. The positive relationship between communication skills proficiency and clinical knowledge application is important and should be explored further. [source] Effect of ethnicity and gender on performance in undergraduate medical examinationsMEDICAL EDUCATION, Issue 11 2005Inam Haq Objective, To assess the effect of ethnicity and gender on medical student examination performance. Design, Cohort study of Year 3 medical students in 2002 and 2003. Setting, Royal Free and University College Medical School, Imperial College School of Medicine. Subjects, A total of 1216 Year 3 medical students, of whom 528 were male and 688 female, and 737 were white European and 479 Asian. Outcome measure, Performance in summative written and objective structured clinical examinations (OSCEs) in July 2002 and 2003. Results, White females performed best in all OSCEs and in 3 out of 4 written examinations. Mean scores for each OSCE and 2 out of 4 written examinations were higher for white students than for Asian students. The overall size of the effect is relatively small, being around 1,2%. Conclusion, Students of Asian origin, of both genders, educated in the UK, using English as their first language, continue to perform less well in OSCEs and written assessments than their white European peers. [source] Models for the development of graduate entry medical courses: two case studiesMEDICAL EDUCATION, Issue 11 2004David Prideaux Introduction, The introduction of graduate entry medical courses requires attention to models of decision-making and change. Much of the educational literature describes change as either centralised or decentralised with the latter claimed to be more effective. Recently Fullan has argued for the importance of an ongoing culture of change. This paper examines the change culture of two medical schools adopting graduate entry courses; Flinders University in South Australia and St George's Hospital Medical School, London. Method, Comparative case study was used. Key informants were interviewed and documents and records analysed. Data were cross-checked and categorised to generate models of change. Results, There were four components of the change culture at Flinders but they were not sufficient on their own to generate change. The process was triggered by a significant external event. The nature of the change was also important. The descriptive model developed suggested a complex interplay of factors rather than attributing the success of the change to the change mechanisms adopted alone. The model was tested for explanatory potential at St George's. The culture there was described as both ,macro-innovative' and ,micro-conservative'. External events were also important but they exerted a positive force. A more centralised approach was adopted. Discussion, The models developed represent change as ,dynamic, complex and open' rather than a simple centralised or decentralised dichotomy. While some of the elements of a change culture were evident at both schools there were longer term questions of sustainability. This has implications for development of all programmes but particularly for graduate entry schools. [source] ,I found myself to be a down to earth Dutch girl': a qualitative study into learning outcomes from international traineeshipsMEDICAL EDUCATION, Issue 7 2004Susan Niemantsverdriet Objective, To explore learning outcomes from international traineeships for undergraduate medical students. Methods, In-depth interviews were conducted with 24 undergraduate medical students at Maastricht University Medical School, the Netherlands. The 24 subjects were selected by purposeful sampling. Results, Students reported meaningful learning outcomes in 6 domains: medical knowledge; skills; international health care organisation; international medical education; society and culture, and personal growth. Discussion, International traineeships appear to provide good opportunities for students to meet the requirements of globalisation as well as some of the generic objectives of undergraduate medical education. The tentative findings of this study need to be confirmed by further studies. [source] Medical students' attitudes towards and perception of the basic sciences: a comparison between students in the old and the new curriculum at the University Medical Center Utrecht, The NetherlandsMEDICAL EDUCATION, Issue 12 2002Eugène J F M Custers Objectives The attitudes towards the basic sciences of medical students enrolled in either of 2 different curricula at the University of Utrecht Medical School in The Netherlands were investigated. The purpose of this study was threefold: first, to compare students (beginning clerks) in a conventional and an innovative curriculum; second, to compare beginning clerks with advanced clerks; and third to compare the present results with those of 2 previous American and Canadian studies in which the same questionnaire was used. Setting Beginning clerks in the old and in the innovative curriculum, and advanced clerks in the old curriculum, rated 9 statements on a 5-point (disagree , agree) Likert scale. The statements assessed students' attitudes toward the basic sciences. Results The results showed that beginning clerks in our innovative curriculum, unlike those in a conventional curriculum, consider the basic sciences as somewhat less important for medical practice and do not think that as many biomedical facts as possible should be learned before entering clinical practice. On the other hand, students in the innovative curriculum are more excited by the faculty's teaching of the basic sciences. This latter result confirms the findings in a previous Canadian study. No significant differences were found between beginning and advanced clerks in the conventional curriculum. Conclusion Students experience teaching of the basic sciences as more exciting when they are integrated in organ system blocks with clinical bearings, though they are somewhat less positive about the actual importance of these sciences. [source] Teaching and learning about human sexuality in undergraduate medical educationMEDICAL EDUCATION, Issue 5 2002Mary Dixon-Woods Background Effective management of the doctor's role in relation to human sexuality requires sensitivity and tact, an ability to put patients at ease, use of appropriate language, and therapeutic, non-discriminatory attitudes. However, previous research suggests that medical students and doctors may hold negative attitudes towards homosexuality and some forms of sexual behaviour. Some educational programmes have started to help students develop communication skills for sexual health consultations, but little work has addressed the broader issue of attitudes and values which may underlie behaviour. It is vital that medical students begin early the process of reflection and recognition of how their attitudes and values might influence their care of patients. In this paper we report on a course designed to initiate this process at Leicester-Warwick Medical School (LWMS). Course description The course utilizes techniques of desensitization, problem-solving and reflection to enable the students to achieve the learning outcomes, which are primarily oriented towards reflection and self-development. It uses a variety of teaching and learning strategies, combining peer learning with self-directed learning, and small-group learning with whole class learning. Course evaluation We report observations and a before-and-after questionnaire study of students' views and attitudes. This evaluation suggests that the course is successful in reducing students' anxieties about human sexuality and improving their confidence in developing appropriate skills. Conclusions The LWMS course is one model which might be used to begin the process of encouraging medical students to develop ways of appropriately managing their responsibilities in relation to human sexuality. [source] Faculty opinions about a revised pre-clinical curriculumMEDICAL EDUCATION, Issue 3 2002Daryoush Tavanaiepour Introduction Medical schools having innovative curricula have been encouraged to ascertain the levels of satisfaction of faculty members with the curriculum. Faculty at schools that employ problem-based learning (PBL) have been shown to have positive perceptions, but not all schools are in a position to adopt PBL on a large scale. This study sought to determine faculty members' opinions about a new curriculum that is less ambitious than one utilizing true PBL. Context and setting Since 1997, the University of Otago Medical School (Dunedin, New Zealand) has had an integrated, modular pre-clinical curriculum that emphasizes clinical relevance. It has proved popular with students. This study focused on faculty members' impressions. Methods We surveyed faculty members' opinions with a questionnaire identical to one used in studies at PBL schools. Faculty compared the students and their own levels of satisfaction in the old and new curricula on 7 to 10 items. The overall response rate was 85·4% (152 of 178). Results Perceptions of the new curriculum were positive among teachers who taught during the pre-clinical years and those who taught the students only after they reached the clinical years. Results for individual questions were in the same direction and generally similar in magnitude to those reported on identical items for PBL. Conclusion We conclude that a hybrid curriculum that is more acceptable to many traditional teachers and students than is PBL has almost as great a positive effect on faculty members' perceptions of students' abilities and of the curriculum as does PBL. [source] The value of marginality in a medical school: general practice and curriculum changeMEDICAL EDUCATION, Issue 2 2001Harriet Mowat Objective To report the process of introduction, development and sustenance of a curriculum for a department of general practice in the context of changing curricula required by the General Medical Council. Setting and context Tayside Centre for General Practice, the Department of General Practice within Dundee University Medical School. Methods Use of action research methodology common in educational and sociological research. Action research utilizes a range of data collection techniques which allow the participants in the research full opportunities to reflect on the data as it emerges and make developments accordingly. Analysis This took place as part of the process of the 5-year project. The analysis used as its starting point the sociological theory of the social construction of power within institutions. It offers the thesis that marginality seems to be a prerequisite in confronting institutional conservatism. Conclusions Use of an action research model facilitated more effective change by providing a supportive atmosphere in which to tackle changes. The marginal status of the general practice group in relation to the medical school allowed creative negotiation of alliances within the medical school. Other groups within the medical school who are introducing new curricula can learn from this report. [source] What do medical students read and why?MEDICAL EDUCATION, Issue 8 2000A survey of medical students in Newcastle-upon-Tyne, England Objectives There is increasing interest in the role of medical humanities within the undergraduate curriculum, but we know little about medical students' views on this or about their reading habits. Our study explored the reading habits of medical students, and their attitudes towards literature and the introduction of humanities into the curriculum. Design Self-completion questionnaire survey. Setting Newcastle University and Medical School. Subjects All first-, second- and third-year undergraduate medical students (384), biology students (151) and a random sample of law students (137) were sent a self-completion questionnaire to assess reading levels, attitudes towards literature and the medical humanities (medical students) and the perceived benefits of reading. Results Medical students read widely beyond their course and articulate a range of benefits from this, including: increasing awareness of life outside their experience; introspection or inspiration; emotional responses; and stimulation of an interest in reading or literature. Of the medical students, 40% (103/258) read one or more fiction books per month, but 75% (193) read fewer non-curricular books since starting university, largely because of time pressures, work, study or academic pressures and restricted access to books. A total of 77% (194) thought that medical humanities should definitely or possibly be offered in the curriculum, but of these 73% (141) thought it should be optional and 89% (172) that it should not be examined. Conclusions Medical students read literature for a variety of very positive and valued reasons, but have found leisure reading harder to maintain since starting university. They support inclusion of the humanities in medical education, but have mixed views on how this should be done. [source] Double-blind comparison of ropivacaine 7.5 mg mL,1 for sciatic nerve block. (Ninewells Hospital and Medical School, Dundee, United Kingdom) British J Anesh.PAIN PRACTICE, Issue 4 20012001;26:20 Two groups of 12 patients had a sciatic nerve block performed with 20 mL of either ropivacaine 7.5 mg mL,1 or bupivacaine 5 mg mL,1. There was no statistically significant difference in the mean time to onset of complete anesthesia of the foot or to the first request for postoperative analgesia. The quality of the block was the same in each group. Although there is no statistically significant difference in the mean time to peak plasma concentrations the mean peak concentration of ropivacaine was significantly higher than that of bupivacaine. There were no signs of systemic local anesthetic toxicity in any patient in either group. [source] Addition of sodium bicarbonate to lidocaine decreases the duration of peripheral nerve block in rat. (Harvard Medical School, Boston, MA) Anesthesiology 2000;93:1045,1052.PAIN PRACTICE, Issue 2 2001Catherine J. Sinnott This study evaluated the effect of adding sodium bicarbonate to lidocaine with and without epinephrine versus equivalent alkalinization by sodium hydroxide (NaOH) on onset, degree, and duration of peripheral nerve block. The study was broken up into two parts. Part I examined alkalinization by sodium bicarbonate versus NaOH to pH 7.8 on 0.5% lidocaine, with and without epinephrine prepared from crystalline salt. Part II examined 0.5% and 1.0% commercial lidocaine solutions, with and without epinephrine, either unalkalinized or alkalinized with sodium bicarbonate or NaOH. The study concluded that with 1% commercial lidocaine without epinephrine, sodium bicarbonate decreases the degree and duration of the block. However, in solutions with epinephrine, sodium bicarbonate hastens onset, without effecting degree or duration. Comment by Octavio Calvillo, M.D., Ph.D. There is evidence that adding sodium bicarbonate to lidocaine without epinephrine improves the quality of epidural block, whereas adding sodium bicarbonate to lidocaine with epinephrine does not. The addition of 8.4% sodium bicarbonate to 2% lidocaine without epinephrine was shown to decrease the onset time and enhance the depth of the epidural block. When bicarbonate was added to 2% lidocaine with epinephrine neither onset time nor depth of the epidural block was affected. Most investigators have used epidural block as their paradigm. The authors in this study used the sciatic nerve block of the rat. [source] Clinical spectrum of acute abdominal pain in Turkish pediatric patients: A prospective studyPEDIATRICS INTERNATIONAL, Issue 3 2004Tülay Erkan AbstractBackground:,The aim of the present study was to determine the prevalence, associated symptoms, and clinical outcomes of children with acute abdominal pain who had been admitted to an emergency department. Methods:,Children aged between 2 and 16 years who presented to the emergency department of Cerrahpa,a Medical School, Istanbul University between July 2001 and August 2002 with acute abdominal pain were enrolled in this study. A questionnaire was completed each patient admitted to our pediatric emergency unit for acute abdominal pain. Data collected included presenting signs and symptoms, the hospital follow up for all children who returned within 10 days, test results, and telephone follow up. Results:,The number of children referred to the emergency department was 7442, with 399 (5.4%) of these having acute abdominal pain. The mean age of the study population was 6.9 ± 3.5 years, and 201 of the patients were male. The five most prevalent diagnoses were: (i) upper respiratory tract infection and/or complicated with otitis media or sinusitis (23.7%); (ii) abdominal pain with uncertain etiology (15.4%); (iii) gastroenteritis (15.4%); (iv) constipation (9.4%); and (v) urinary tract infection (8%). The most common associated symptoms were decreased appetite, fever and emesis. Because of follow-up deficiency the progress of 28 patients was not obtained. Eighty-two children were referred to the department of pediatric surgery, but only 17 of 82 (20.7%) required surgical intervention (15 of these 17 for appendicitis). Eleven patients returned within 10 days for re-evaluation, but the initial diagnosis was not changed. The complaints of 57 patients with uncertain etiology were resolved within 2 days. Conclusions:,An acute complaint of abdominal pain was usually attributed to a self-limited disease. However, the percentage of surgical etiology is not negligible. [source] Enuresis: Prevalence, risk factors and urinary pathology among school children in Istanbul, TurkeyPEDIATRICS INTERNATIONAL, Issue 1 2004Emel Gür AbstractBackground: Enuresis is a common problem among children and adolescents, and can lead to important social and psychological disturbances. The aim of the present study was to establish the prevalence of enuresis among school children and determine the risk factors associated with this disorder. Methods: A cross sectional population-based study was conducted in 1576 children. The pupils enrolled in the study were chosen randomly from 14 primary schools located in seven different regions of Istanbul. Data were collected via a questionnaire completed by parents. Enuretic children were invited to the pediatric nephrology outpatient clinic of Cerrahpasa Medical School, Istanbul, Turkey. A detailed history was taken, physical and ultrasonographic examinations, urinalysis and urine culture were performed. The relationship between the prevalence of enuresis and the patients' age, gender, region, the parental educational level and employment status, number of family members, and the family's monthly income were tested by means of ,2 and logistic regression analysis. The comparison between the two enuretic groups (monosymptomatic nocturnal enuresis group vs diurnal enuresis only and diurnal,nocturnal enuresis group) regarding the sociodemographic factors were tested with the ,2 test and P < 0.05 was accepted as statistically significant. Results: The study group was composed of 1576 school children aged between 6 and 16 years. The overall prevalence of enuresis was 12.4%. When the ,2 test was used, a significant relationship was found between the prevalence of enuresis and age, educational level of the father, the family's monthly income, and number of family members. However, when logistic regression analysis was applied, there was a statistically significant relationship only between enuresis, and age and number of family members. In the whole group, monosymptomatic enuresis nocturna was found to be more common in boys. When the two enuretic children groups (monosymptomatic nocturnal, diurnal only and nocturnal,diurnal enuretics) were compared with each other regarding gender, parental educational and employment status, and number of family members, statistically significant differences were found. Both maternal and the paternal low educational status were found to be associated with monosymptomatic enuresis nocturna. Likewise, monosymptomatic enuresis nocturna was found to be more common in the children of the unemployed mothers, while diurnal enuresis was more common in the children of unemployed fathers. Nocturnal enuresis was found to be associated with large families. No statistically significant difference was demonstrated between the two groups of enuretics regarding age and family income levels. The rate of urinary abnormalities in the whole group was 7.1%. Conclusions: Enuresis is a common problem among school children and associated urinary abnormalities are not uncommon. Identification of children at risk is an essential first step before choosing the individualized management for each enuretic child. [source] Serological levels of zinc, copper and iron elements among Giardia lamblia infected children in TurkeyPEDIATRICS INTERNATIONAL, Issue 3 2002Pelin Ertan Abstract Background: Giardiasis, an intestinal protozoan infection caused by Giardia lamblia, is common in Turkey, especially among children aged between 2- and 14-years-old. Effects of giardiasis on serological levels of zinc, copper and iron elements were assessed in this study. Methods: A total of 45 children, aged between 2- and 14-years-old, who were admitted to the Pediatrics Department of Celal Bayar University Medical School with gastrointestinal complaints and diagnosed as having giardiasis by stool examinations in the Parasitology Department, were enrolled as the study group (SG). The control group (CG) consisted of 45 age-matched healthy children. Serological levels of zinc, copper and iron were measured by atomic absorption spectrophotometer in all samples. Results: As a result of the study, serum zinc levels were 67.43 ± 17.72 µg/dL and 145.20 ± 9.13 µg/dL, copper levels were 198.45 ± 39.14 µg/dL and 150 ± 21.14 µg/dL and iron levels were 87.98 ± 18.31 µg/dL and 160.45 ± 45.40 µg/dL, in SG and CG, respectively. When compared separately as SG and CG, there was a statistically significant difference between the serological levels of all these elements. Conclusion: These results revealed that giardiasis increased the serological levels of copper, like other infectious agents. However, zinc and iron levels decreased during giardiasis due to malabsorption. [source] Teachers: Recognising Excellence in Medical Education: a student-led award schemeTHE CLINICAL TEACHER, Issue 3 2010Nicola Louise Wheeler Summary Background:, The standard of clinical teaching is acknowledged by undergraduate medical students and their clinical teachers as being variable.1 Furthermore, there is very little recognition by medical schools of the teaching expertise and efforts of clinical teachers.2 Innovation:, In response to these issues, a group of medical students at the University of Birmingham's Medical School have established an awards scheme called Recognising Excellence in Medical Education (REME). This is a student-led award scheme that is supported by the Dean and other senior medical school staff, and by the students' medical society. Method:, This research used two focus groups, one comprising REME award winners and one comprising students who voted in the scheme, to discuss opinions regarding the awards, reasons why the students voted, and how clinical teachers feel about receiving the awards. Discussion:, The focus groups revealed that both students and their clinical teachers were very positive about the award scheme and the impact it has had, both personally and within the hospitals or Trusts of the award winners. The REME awards were viewed as motivating and encouraging for clinical teachers, and were particularly prized as teachers were nominated by their students. [source] Laser-Assisted Uvulopalatoplasty and Tonsillectomy for the Management of Obstructive Sleep Apnea SyndromeTHE LARYNGOSCOPE, Issue 7 2003Robert C. Kern MD Abstract Objectives/Hypothesis Laser-assisted uvulopalatoplasty (LAUP) is a widely accepted procedure for the management of snoring, but its role in the treatment of obstructive sleep apnea syndrome is currently unclear. The objective of the study was to evaluate the role of LAUP in treating moderate and severe obstructive sleep apnea syndrome. Study Design Retrospective review of a surgical treatment protocol for obstructive sleep apnea syndrome. Methods Between October 1993 and January 1999, 80 patients with moderate or severe obstructive sleep apnea syndrome and a significant component of retropalatal obstruction were treated with surgery at the Department of Otolaryngology at Northwestern University Medical School (Chicago, IL). Surgery consisted of LAUP with tonsillectomy (if tonsils were present) with the patient under general anesthesia or LAUP alone with local anesthesia (if the tonsils were absent). No patients received traditional uvulopalatopharyngoplasty. Sixty-four of the 80 patients underwent both preoperative and postoperative polysomnograms. Surgical "response" was defined as a 50% decrease in the apnea-hypopnea index (AHI) (the total number of apneic and hypopneic events per hour of sleep); surgical "cure" was defined as a 50% decrease in AHI and a final AHI of less than 20. Results The surgical response rate was 59% (38 of 64 patients), and the surgical cure rate was 39% (25 of 64 patients). Twelve patients (18.8%) had a higher AHI after surgery. The AHI (mean ± SD) changed significantly from 51.4 ± 30.9 preoperatively to 26.3 ± 20.8 on postoperative polysomnogram (P = 7.0 × 10,9). Laser-assisted uvulopalatoplasty alone was performed in 33 patients with a response rate of 61% and a cure rate of 42%. Laser-assisted uvulopalatoplasty with tonsillectomy was performed in 31 patients with a response rate of 58% and a cure rate of 35%. The overall incidence of nasopharyngeal insufficiency was 0%. Conclusion The results of the study suggested that LAUP with adjunctive tonsillectomy is an effective treatment for patients with obstructive sleep apnea syndrome and retropalatal obstruction with a lower complication rate than standard surgical therapy (uvulopalatopharyngoplasty). [source] | |||||||||||||||||||||||||||||||