High school versus graduate entry in a Saudi medical school – is there any difference in academic performance and professionalism lapses?

Background

King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) was the first university in the Kingdom of Saudi Arabia offering both high school entry and graduate entry (GE) students into medical school. We compared the academic performance and professionalism lapses of high school entry and GE students who undertook the same curriculum and examinations in the College of Medicine, Riyadh, KSAU-HS.

Methods

Examination scores of 196 high school graduates and 54 GE students over a 4-year period (2010–2014) were used as a measure of academic achievement. For assessment of professionalism lapses, we compared the number of warning letters in both streams of students.

Results

In some pre-clinical courses, high school entry students performed significantly better than GE students. There was no significant difference in academic performance of high school entry and GE students in clinical rotations. GE students had a significantly greater number of warning letters per student as compared to high school entry students.

Discussion

This is the first Saudi study to compare the performance of high school entry and GE students in a medical school. Overall, both streams of students performed equally well with high school entry students performing better than GE students in a few pre-clinical courses. We compared professionalism lapses and found an increase in number of warning letters for GE students. More studies are needed to evaluate if there are differences in other assessments of professionalism between these two streams of students.

     

Domestic and peer violence in secondary school among adolescents: can telemedicine help?

Domestic and peer violence in Macedonia is similar to other developed nations. It is present among adolescents and their families. A study was conducted on 664 secondary school students throughout Macedonia. The results indicated that 11.2% male and 16.54% female students often face different kinds of family violence. Peer violence of different forms is marked as "often" in 8.04% male respondents and 5.63% female respondents. One of possibilities in preventing this negative phenomenon is the application of telemedicine. There is a growing body of evidence that the use of telemedicine offers a good tool for mental healthcare in underserved communities, and that these services are as effective as face-to-face work with adolescents. By building an effective telemedicine network in Macedonia, both victims (adolescents) and their parents could be given a chance to contact proper institutions for help with more confidence and less stress.     

Students’ perspectives on research and assessment of a model template designed to guide beginners in research in a medical school in Cameroon

Background

Research activities for medical students and residents (trainees) are expected to serve as a foundation for the acquisition of basic research skills. Some medical schools therefore recommend research work as partial requirement for certification. However medical trainees have many difficulties concerning research, for which reason potential remedial strategies need to be constantly developed and tested. The views of medical trainees are assessed followed by their use and appraisal of a novel “self-help” tool designed for the purposes of this study with potential for improvement and a wider application.

Methods

This study was a cross-sectional survey of volunteering final-year medical students and residents of a medical school in Cameroon.

Results

This study surveyed the opinions of a total of 120 volunteers of which 82 (68%) were medical students. Three out of 82 (4%) medical students reported they had participated in research activities with a publication versus 10 out of 38 residents (26%). The reported difficulties in research for these trainees included referencing of material (84%), writing a research proposal (79%), searching for literature (73%) and knowledge of applicable statistical tests (72%) amongst others. All participants declared the “self-help” tool was simple to use, guided them to think and better understand their research focus.

Conclusion

Medical trainees require much assistance on research and some “self-help” tools such as the template used in this study might be a useful adjunct to didactic lectures.

     

It's ethical,but is it legal? Teaching ethics and law in the medical school curriculum

While Western medical ethics has ancient roots in the teachings of Hippocrates, its standing in the undergraduate medical curriculum is a distinctly modern development. Today, all of the 127 accredited U.S. medical schools offer formal biomedical ethics instruction, and nearly all offer instruction in the related discipline of health law. This article describes how biomedical ethics and health law are taught at the University of Iowa College of Medicine, one of 12 medical schools that offers separate required courses in both ethics and law. Often ethics and law overlap; often, to act ethically is to act legally. But medical students and practicing physicians also regularly confront dilemmas that pose the question, “It's ethical, but is it legal?” This article discusses the goals, methods, and core themes of teaching issues at the intersection of medicine, ethics, and law, and how the approach to this instruction is designed to offer students a tool kit to begin to deal effectively with these complex issues in professional life. Anat Rec (New Anat) 265:5–9, 2001. © 2001 Wiley‐Liss, Inc.     

Active versus passive transportation to school–differences in screen time,socio-economic position and perceived environmental characteristics in adolescent girls

Objective: The aims of this study were (1) to assess the relationships between transport to and from school (active vs. passive), sedentary behaviours, measures of socio-economic position and perceived environmental variables, and (2) to determine which, if any, variables were predictors of active transportation.

Methods: The sample comprised 705 girls with mean age of 14.7 (SD?=?1.6) years old. Questionnaires were used to describe travel mode to school and to estimate weekly television and computer use (screen time). Girls were assigned to active transportation (AT) or passive transportation (PT) groups depending on whether they walked or bicycled (AT) to and from school or travelled by car or bus (PT). Screen time was determined by the number of hours they reported watching television and using computers in the week preceding the examination, including weekends. Socio-economic position was established by parental occupation and educational level. A questionnaire assessed Perceived Neighbourhood Environments.

Results: No statistically significant differences were seen for screen time between travel groups. Occupational status of both mother (r?=??0.17) and father (r?=??0.15) and father's educational level (r?=??0.10) were significantly and negatively associated with AT, while street connectivity (r?=?0.10) was positively and significantly associated with AT. Logistic regression analysis showed that the likelihood of active commuting decreased by around 50% with increasing father's occupation (odds ratio (OR)?=?0.51; p?≤?0.05) and father's education (OR?=?0.52; p?≤?0.05) from low to middle socio-economic position groups. Further, the data showed that girls who agreed that ‘there are many four-way intersections in my neighbourhood’ were more likely to be active (OR?=?1.63; p?≤?0.05).

Conclusion: The data of this study showed that lower socio-economic position is associated with active commuting to school and that street connectivity is a predictor of active transportation in adolescent girls.     

It's ethical, but is it legal? Teaching ethics and law in the medical school curriculum

While Western medical ethics has ancient roots in the teachings of Hippocrates, its standing in the undergraduate medical curriculum is a distinctly modern development. Today, all of the 127 accredited U.S. medical schools offer formal biomedical ethics instruction, and nearly all offer instruction in the related discipline of health law. This article describes how biomedical ethics and health law are taught at the University of Iowa College of Medicine, one of 12 medical schools that offers separate required courses in both ethics and law. Often ethics and law overlap; often, to act ethically is to act legally. But medical students and practicing physicians also regularly confront dilemmas that pose the question, "It's ethical, but is it legal?" This article discusses the goals, methods, and core themes of teaching issues at the intersection of medicine, ethics, and law, and how the approach to this instruction is designed to offer students a tool kit to begin to deal effectively with these complex issues in professional life. Anat Rec (New Anat) 265:5-9, 2001.     

Growth status of indigenous school children 6–14 years in the Tarahumara Sierra,Northern Mexico,in 1990 and 2007

Aims: The study evaluated the growth status and secular change in body size of indigenous Tarahumara children in northern Mexico.

Methods: Heights and weights of Tarahumara children 6–14 years were measured in 1990 (n = 601) and 2007 (n = 583); the BMI was calculated. International criteria defined weight status while United States reference data defined stunting.

Results: Estimated secular gains in height from 1990 to 2007 were greatest in 6–7 year-old boys and declined with age to a small, non-significant secular decline in boys 12–14 years. Among girls secular gains in height were similar at 6–7 and 8–9 years, largest at 10–11 years and small and non-significant at 12–14 years. Secular gains in weight were similar among 6–7 and 8–9 year-old boys and girls, were greater in girls than in boys at 10–11 years and showed a small, non-significant secular decline in boys and girls 12–14 years. Secular change in the BMI paralleled those for weight. The prevalence of stunting declined from 1990 to 2007 in both sexes and all age groups except 12–14 year youth. Overweight was more prevalent in girls than boys in both years and increased from 4% to 7% in boys and 9% to 13% in girls. Obesity was not common among boys and girls in each age group and in both years. Stunting and overweight/obesity were not related in either 1990 or 2007.

Conclusion: Positive secular changes in growth status have occurred in Tarahumara children 6–11 years in contrast to negligible changes among children 12–14 years. The results suggest recent improvements in health and nutrition sufficient to support a positive secular trend in younger children.     

Intestinal helminthiasis in school background in six towns of southwestern Côte d'Ivoire

A coproparasitological investigation was conducted in six towns located in the humid dense forest area of South West C?te d'Ivoire in order to determine the prevalence of intestinal helminthosis. During this study faeces of 2220 school children aged from 4 to 15 years old were analysed by four coprological techniques: direct analysis, Kato, Baermann and Graham methods. The overall prevalence rate of intestinal helminthosis in school children in the area is 37.9%. Male subjects are more infested than females. The more frequent parasite species were: hookworm (17%), Ascaris lumbricoides (10.8%), Trichuris trichiura (8.9%) and Enterobius vermicularis (7.2%).     

Changes in plasma IL4, TNF�� and CRP in response to regular passive smoking at home among healthy school children in Khartoum, Sudan

Background

Regular exposure to tobacco smoke at home causes airway inflammation and altered cytokine regulation; however, there is variation between individuals of different countries.

Objective

To determine effects of passive smoking on plasma IL4, TNFá, and CRP in healthy male school-children in Khartoum.

Methods

A total of 135 male school-pupils (69 passive smokers and 66 non-smokers) were selected randomly from three primary schools for boys in Khartoum. Information about smoking history was collected from each pupil and his parents using a questionnaire. Plasma CRP, IL4 and TNFá were measured using commercially available ELISA kits.

Results

Plasma IL4 and TNFá in the passive smokers (mean ± SEM) is at 2.92 ± 0.93 and 19.78 ± 4.67 pg/ml respectively; whereas in the non-smokers . It is at 0.45 ± 0.28 and 5.05 ± 1.54 pg/ml respectively. The difference between the two groups is statistically significant (p <0.05). The mean plasma IL4 and TNFá were lowest with no exposure, higher with moderate exposure, and highest with heavy exposure (P < 0.05). Plasma CRP showed insignificant difference between the two groups.

Conclusion

Passive smoking causes significant rise in plasma TNFá and IL4 with a dose dependent effect among school-pupils in Khartoum.     

Can a school based programme in a natural environment reduce BMI in overweight adolescents?

Current levels of obesity amongst adolescents may be largely attributed to changes in environmental exposures that place vulnerable youth at risk, yet few studies have incorporated environmental approaches to normalising Body Mass Index (BMI). Our hypothesis is that a live-in school based programme in a natural environment can reduce the BMI of overweight children. The pilot study therefore explores the effects of such a programme on the BMI of adolescents in rural Victoria, Australia. Year 9 students (15 year olds, N = 1021) at a rural school with a physically demanding, 10-month, live-in outdoor programme had their BMIs measured at the beginning and end of the programme. Their observed BMI at the end of the programme was compared to expected BMI (based on adjustment of their initial BMI to account for normal growth using international standards). Participation in the programme reduced the BMI of boys who were in the normal to obese range (χ(2) = 8.57, p = 0.014), but not in girls. For the overweight and obese boys BMI decreased by up to 2.5 kg/m(2). These results suggests that school based environmental interventions may be effective in reducing obesity in adolescents, supporting our hypothesis. Our study is limited by its opportunistic observational nature, but it nevertheless suggests that such a live-in school programme in a natural environment may provide a valuable addition to the list of interventions available to combat the obesity epidemic. Although the programme reduced BMI in boys, the equivocal data for girls means that even an intensive programme such as this struggles to achieve a significant change in BMI across all obese adolescents. Our study nevertheless supports the need for further investigation of the possible contribution of school based programmes in natural environments to interventions to fight the obesity epidemic--because there is no magic bullet.     

Transformative school–community collaboration as a positive school climate to prevent school absenteeism

School absenteeism has become a prevalent problem that affects student development and future societies across the world. We examined whether and how the framework for transformative school–community collaboration (TSCC) can be utilized to effectively reduce school absenteeism. To achieve this goal, we analyzed clustered data involving 3428 students within 14 schools that collaborated with communities in providing out-of-school time programs. A generalized ordered logit analysis with clustered standard errors showed that overall TSCC significantly decreased the likelihood of students' school absenteeism. Democratic and empowering structures in the collaboration were particularly significant for reducing the higher level of school absenteeism. We conclude our article with practice implications to translate the core dimensions of TSCC into effective practice.     

Urban–rural contrasts in the growth status of school children in Oaxaca,Mexico

Objectives:?The growth status of school children resident in an urban colonia and in a rural indigenous community in Oaxaca, southern Mexico, was considered in the context of two objectives, current status and the magnitude of urban–rural differences over a span of about 30 years. Both communities were initially surveyed in 1968 and 1972.

Materials and methods:?Height, body mass, segment lengths, skeletal breadths, limb circumferences, and subcutaneous fatness were taken on 361 rural (177 boys, 184 girls) and 339 urban (173 boys, 166 girls) school children, aged 6–13 years. Additional variables were derived.

Results:?Height and body mass were significantly greater in urban compared with rural children. Sitting height, estimated leg length and skeletal breadths on the trunk were also larger in urban than in rural school children, but only the difference in skeletal breadths was significant after age and body size were statistically controlled. Urban and rural children did not consistently differ in skeletal breadths on the extremities and limb circumferences. Subcutaneous fatness was more variable. After controlling for age and body size, rural girls had thicker skinfolds. The magnitude of the urban–rural difference in boys in 2000 was greater for body mass, BMI and triceps skinfold, and reduced for height, sitting height, leg length, and arm and estimated arm muscle circumferences compared with 1970. The magnitude of the urban–rural difference in girls was greater in 2000 than 30 years earlier for body mass, height, sitting height, leg length and BMI. Urban–rural differences for arm and arm muscle circumferences and the triceps skinfold were slightly smaller over the interval.

Conclusions:?Children resident in an urban colonia were taller and heavier than children resident in a rural indigenous community. After controlling for age and body size, urban–rural differences in skeletal breadths and limb circumferences were reduced or eliminated, but skinfold thicknesses were greater in rural girls. The magnitude of urban–rural differences in body size has decreased over approximately 30 years in boys, but has increased in girls.     

Expression and regulation of αB-crystallin in the kidney in vivo and in vitro

αB-crystallin, a major component of the mammalian eye lens, is a small heat shock protein and molecular chaperone that is also abundant in the mammalian kidney. The present study aimed to characterize more closely the intrarenal expression and regulation of αB-crystallin in vivo and in vitro. In normal rat kidney, the expression of αB-crystallin mRNA and protein were both close to the detection limit in cortex, but increased steeply from the outer to the inner medulla where αB-crystallin constitutes approximately 2% of total tissue protein. Immunohistochemistry disclosed papillary collecting duct cells and thin limbs as the major sites for intrapapillary αB-crystallin immunoreactivity. In rats subjected to sucrose diuresis for 3 days, αB-crystallin mRNA expression was reduced by 27 and 46% in outer and inner medulla, respectively. In agreement with the results obtained in vivo, in Madine–Darby canine kidney cells, αB-crystallin mRNA and protein were induced significantly by elevating the medium osmolality to 500 mosm/kg H₂O by the addition of NaCl and raffinose, and also by urea. The NaCl-induced increase in αB-crystallin expression was concentration-dependently blunted by SP600125, a specific JNK inhibitor. Overexpression of αB-crystallin in 293 cells resulted in increased tolerance to acute osmotic stress. These results indicate that αB-crystallin may be regulated by papillary interstitial tonicity in a JNK-dependent process. Moreover, the high abundance of αB-crystallin in the renal medulla may be important for cell survival in an environment characterized by extreme interstitial solute concentrations as present during antidiuresis.     

Saccade–vergence dynamics and interaction in children and in adults

Peak velocity, duration and accuracy of eye movements (saccade, vergence and combined saccade–vergence eye movements) were investigated in fourteen normal children (4.5 to 12 years of age) and ten normal adults (22 to 44 years of age). Horizontal movements from both eyes were recorded simultaneously by the oculometer, a photoelectric device. Peak velocity of all eye movements, saccades, and vergence (convergence and divergence), attains adult levels by the age of 4.5 years and there is no significant change over the age range studied (4.5 to 44 years). Vergence duration is longer only in young children (below 8 years of age). The reciprocal interaction between saccade and vergence during combined movements known in adults, i.e. acceleration of the vergence by the saccade (increase of velocity and decrease of duration) and deceleration of the saccade by the vergence (decrease of velocity and increase of duration) was found to be similar in children. The accuracy of eye movements is good on average for both saccades and vergence by the age of 4.5 years, and does not change with age; an exception is the variability of saccade amplitude, which is higher in children less than 8 years old. Taken together, the results indicate early maturation of brainstem structures controlling spatio-temporal aspects of saccades, vergence and their interaction.     

Changes of electricla reactivity of the right and left cerebral hemispheres in school children after 5–6 hours mental work

Summary A study was made in children aged 11–15 yr of the potentials induced in the right and left hemispheres before and after 5–6 hr of mental work in the classroom. The EEG was analyzed by a modification of Lowell and Dossett's method to determine the coefficient of synchronization (K_s) and the energy of the synchronized oscillations (A_s) for each flash frequency. It appeared that, from these two indices in the majority of observations, a moderate asymmetry was present before the mental work was commenced, the indices being greater for the left hemisphere. After mental work when the brain was no longer optimally excitable, the asymmetry showed both a quantitative and qualitative increase. The values of the K_s and A_s indices were now no longer greater on the left, but greater for the right hemisphere. We think that this change of synchronization is another aspect of the dynamic changes in the cortex which we have previously described as taking place after similar mental work in a comparable age group.Presented by Active Member AMN SSSR G. N. Speranskii Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol., 55, No. 2, pp. 13–16, February, 1963     

Biomechanics and Bioengineering in Dentistry

Aug.18alll8:00一10:00,10:30一12,00At Room No.1(213)CO一CHAIRMAN Prof.Yang GuitongProf.K.TsushiyaTITLEABSTRACT PAGESDesign of femoral stem based on geometrie data Rueymo Lin,et al.····················································································……87Effieieney of weak external fields on bioel飞emieally reaeting systems A .V.Chalyi,et al.···················…     

Lasers and Electro-optics in Medicine

Aug·18 ams,00一10:00,10,30一12:00At Room No.7(208)CO一CHAIRMAN Prof.Kong Fanliang Prof.F·KajiyaTITLEABSTRACT PAGESDevelopment of new eo laser angioplasty system MakotoKikuchi,et al.······································································,·······……262Intraeellular pH measurement of rat hippoeampal brain sliees usingsingle exeitation一dual emission fluoreseent dye,SNARF一l C.W.Lin,et…     

Diverse roles of TGF-β receptor II in renal fibrosis and inflammation in vivo and in vitro

TGF-β1 binds receptor II (TβRII) to exert its biological activities but its functional importance in kidney diseases remains largely unclear. In the present study, we hypothesized that TβRII may function to initiate the downstream TGF-β signalling and determine the diverse role of TGF-β1 in kidney injury. The hypothesis was examined in a model of unilateral ureteral obstructive (UUO) nephropathy and in kidney fibroblasts and tubular epithelial cells in which the TβRII was deleted conditionally. We found that disruption of TβRII inhibited severe tubulointerstitial fibrosis in the UUO kidney, which was associated with the impairment of TGF-β/Smad3 signalling, but not with the ERK/p38 MAP kinase pathway. In contrast, deletion of TβRII enhanced NF-κB signalling and renal inflammation including up-regulation of Il-1β and Tnfα in the UUO kidney. Similarly, in vitro disruption of TβRII from kidney fibroblasts or tubular epithelial cells inhibited TGF-β1-induced Smad signalling and fibrosis but impaired the anti-inflammatory effect of TGF-β1 on IL-1β-stimulated NF-κB activation and pro-inflammatory cytokine expression. In conclusion, TβRII plays an important but diverse role in regulating renal fibrosis and inflammation. Impaired TGF-β/Smad3, but not the non-canonical TGF-β signalling pathway, may be a key mechanism by which disruption of TβRII protects against renal fibrosis. In addition, deletion of TβRII also enhances NF-κB signalling along with up-regulation of renal pro-inflammatory cytokines, which may be associated with the impairment of anti-inflammatory properties of TGF-β1.