The Role of Malaria Microscopy Training and Refresher Training Courses in Malaria Control Program in Iran during 2001 – 2011

Background

Malaria is still one of the most important infectious diseases in the world. The disease also is a public health problem in south and southeast of Iran. This study programmed to show the correlation between regular malaria microscopy training and refresher training courses and control of malaria in Iran.

Methods

Three types of training courses were conducted in this programme including; five – day, ten – day and bimonthly training courses. Each of the training courses contained theoretical and practical sections and training impact was evaluated by practical examination and multiple-choice quizzes through pre and post tests.

Results

Distribution pattern of the participants in the training and refresher training courses showed that the most participants were from Sistan & Baluchistan and Hormozgan provinces where malaria is endemic and most cases of the infection come out from these malarious areas. A total of 695 identified individuals were participated in the training courses. A significant conversely correlation was found between conducting malaria microscopy training courses and annual malaria cases in Iran.

Conclusion

Conducting a suitable programme for malaria microscopy training and refresher training plays an important role in the control of malaria in endemic areas. Obviously, the decrease of malaria cases in Iran has been achieved due to some activities that malaria diagnosis training was one of them.     

Körperliches Training in der Behandlung psychischer Erkrankungen

Numerous studies in healthy volunteers have demonstrated positive psychological effects of regular aerobic exercise, such as reduction of anxiety or depressive symptoms, in crease of self-esteem and improved stress management. There is also solid evidence that regular exercise is associated with therapeutic effects in psychiatric patients suffering from depressive and possibly other psychiatric disorders. The present article reviews the relevant literature and summarizes neurobiological effects of exercise, which might play a role in the effectiveness of therapeutic exercise. For instance, there is experimental evidence that regular exercise induces a downregulation of certain central serotonergic receptors, which play an important role in the pathogenesis of anxiety and depression. The last part of the article focuses on the practical aspects of how exercise programs can be utilized in the treatment of psychiatric disorders.     

Translational Research Education and Training Needs in Hawai‘i

The purpose of this needs assessment was to identify the translational research education and training needs of researchers and administrators working in Hawai‘i''s communities and to use the finding to develop an education and training plan. The assessment was led by a community advisory board with members from community health centers, social agencies, hospitals, and academia on O‘ahu. The survey, developed with input of the community advisory board, was sent to 94 administrators and researchers involved or affiliated with research being conducted in Hawai‘i. Forty-one respondents (43%) completed the survey. Respondents wanted education and training in research processes, specific research-related skills, and facilitating interactions between community and academic researchers. Sixty-one percent were interested in training related to community-engaged research and yearly seminars on “collaborative mentoring.” Popular topics of interest were related to data monitoring, networking with different cultural groups, statistics, and human subjects review. A majority of respondents wanted to attend workshops, seminars, and presentations rather than take a class. Approximately 50% of the respondents wanted to gain information through on-line training. Findings guided the development of a translational research education and training plan for the University of Hawai‘i National Institute of Health (NIH) Research Centers in Minority Institutions Multidisciplinary and Translational Research Infrastructure Expansion (RMATRIX) grant.Major Terms: community-engaged research, translational research education, translational research, health disparities     

Training in assessment and appraisal: who needs it?

The aim of this project was to develop a training programme to help consultants supervising postgraduate medical trainees to fulfil their role as Educational Supervisors. A training needs analysis was conducted which revealed that consultants did not appreciate the importance of some of their new duties. This was mainly because of the lack of clear perception of their new roles. Hence training needs to be provided.     

Quality in health care. Medical or managerial?

Explores the notion that the introduction of total quality management (TQM) in the public health-care sector indicates a conceptual break with a tradition in which the authority to define and interpret the meaning of medical practice has been located solely within the medical profession. It also serves to shift the focus of medical practice away from its contextual and interactional character towards numerical representations and codification in monetary terms. Further, it is argued that the realization of management ideals in everyday practice is dependent more on the availability of pre-existing technologies and standard procedures than on the ingenuity of particular organizational and institutional actors. These arguments are illustrated with the reutilization for TQM purposes of "local incident reports" in a Swedish hospital organization.     

The Role of the Medical School in Rural Graduate Medical Education: Pipeline or Control Valve?

Although rural-based graduate medical education is critically important in the training of competent rural family physicians, the number of physicians selecting these programs is highly dependent on what happens earlier in the pipeline, i.e., during medical school. Using the experience and outcomes research from Jefferson Medical College's Physician Short-age Area Program, as well as from published literature describing six other medical school programs with similar goals, this paper addresses the important role of these programs in substantially increasing the number of physicians interested in rural family practice. Although each of these programs differs in its structure, all contain three core features: a strong institutional mission; the targeted selection of students likely to practice in rural areas, predominantly those with rural backgrounds; and a focus on primary care, especially family practice. Outcomes show that all seven programs have been highly successful. Medical schools, therefore, can have a major impact on the number of rural physicians they produce by acting not only as a pipeline or conduit to residency programs, but also as a control valve, beginning as early as the admissions process. In order to maximize their impact on the supply and training of rural family physicians, rural residency programs should understand, support, collaborate with and help develop medical school programs whose mission is to provide rural physicians.     

Which disability? Medical evaluation and social assistance in Brazil

This article examines the concept of disability adopted by the most important cash transfer program targeting the disabled population in Brazil, the Continuous Cash Benefit (Benefício de Presta??o Continuada--BPC). The study compares the eligibility criteria established by law and the criteria used by medical examiners in the beneficiary selection process. The data are from a sample survey of 16% of the medical examiners working in the program. The questionnaire aims to assess the instructions, forms, and procedures for selecting disabled beneficiaries. The results show a discrepancy between the formal program criteria and actual practice by the examiners, suggesting an expanded concept of disability aimed at including beneficiaries with genetic, chronic, and severe infectious diseases.     

Whatever You Want? Beyond the Patient in Medical Law

Simon Woods proposes that we ought to re-orientate clinical decisions at the end of life back towards the patient, so as to honour his or her account of their "global" interests. Woods condemns the current medico-legal approach for remaining too closely tethered to the views of doctors. In this response, I trace the story of Mrs Kelly Taylor, who sought to be sedated and have life-sustaining treatment withdrawn, and I do so in order to show not only why Woods is right to detect an asymmetry in the law but also why there is more to the legal landscape than first appears. I argue that patient choice is indeed bounded-most obviously by the views of the doctors (and the judges), but no less significantly by so-called "public interest" concerns. Woods' proposal implicitly, and rightly, forces reconsideration of these public interest dimensions of medico-legal decision-making. This often invisible boundary is not presently granted the attention it deserves (not least by the judges themselves). However, as soon as we delve into the ethical values at stake, then it becomes apparent that there are many more questions to be asked regarding their meaning and interaction before we can determine the appropriate ethical prism through which to view the health care endeavour in English medical law.     

Medical savings accounts in Singapore: how much is adequate?

While many studies have examined the cost-containment aspect of medical savings accounts (MSA), few have investigated the adequacy of MSA to finance the health care expenditure. This paper estimates the present value of lifetime healthcare expenses (PVHE) of the Singaporean male and female elderly upon retirement at age 62. The estimation involves calibrating the stream of future healthcare expenditure; stochastic forecasting of cohort survival probabilities; discounting the projected lifetime healthcare expenditure. Estimated values of the PVHE under various scenarios are used to assess the adequacy of the government-decreed minimum saving to be maintained in the MSA.     

Medical physics in 2020: Will we still be relevant?

From the time when Rōentgen and other physicists made the discoveries which led to the development of radiology, radiotherapy and nuclear medicine, medical physicists have played a pivotal role in the development of new technologies that have revolutionized the way medicine is practiced today. Medical physicists have been transforming scientific advances in the research laboratories to improving the quality of life for patients; indeed innovations such as computed tomography, positron emission tomography and linear accelerators which collectively have improved the medical outcomes for millions of people. In order for radiation-delivery techniques to improve in targeting accuracy, optimal dose distribution and clinical outcome, convergence of imaging and therapy is the key. It is timely for these two specialties to work closer again. This can be achieved by means of cross-disciplinary research, common conferences and workshops, and collaboration in education and training for all. The current emphasis is on enhancing the specific skill development and competency of a medical physicist at the expense of their future roles and opportunities. This emphasis is largely driven by financial and political pressures for optimizing limited resources in health care. This has raised serious concern on the ability of the next generation of medical physicists to respond to new technologies. In addition in the background loom changes of tsunami proportion. The clearly defined boundaries between the different disciplines in medicine are increasingly blurred and those between diagnosis, therapy and management are also following suit. The use of radioactive particles to treat tumours using catheters, high-intensity focused ultrasound, electromagnetic wave ablation and photodynamic therapy are just some areas challenging the old paradigm. The uncertainty and turf battles will only explode further and medical physicists will not be spared. How would medical physicists fit into this changing scenario? We are in the midst of molecular revolution. Are we prepared to explore the newer technologies such as nanotechnology, drug discovery, pre-clinical imaging, optical imaging and biomedical informatics? How are our curricula adapting to the changing needs? We should remember the late Professor John Cameron who advocated imagination and creativity — these important attributes will make us still relevant in 2020 and beyond. To me the future is clear: “To achieve more, we should imagine together.”