Objective-To investigate whether prevalence of asthma in children increased in 10 years.
BackgroundWhile Peer Assisted Learning (PAL) has long occurred informally in medical education, in the past ten years, there has been increasing international interest in formally organised PAL, with many benefits for both the students and institutions. We conducted a systematic review of the literature to establish why and how PAL has been implemented, focussing on the recruitment and training process for peer tutors, the benefits for peer tutors, and the competency of peer tutors.MethodA literature search was conducted in three electronic databases. Selection of titles and abstracts were made based on pre-determined eligibility criteria. We utilized the ‘AMEE Peer assisted learning: a planning and implementation framework: AMEE Guide no. 30’ to assist us in establishing the review aims in a systematic review of the literature between 2002 and 2012. Six key questions were developed and used in our analysis of particular aspects of PAL programs within medical degree programs.ResultsWe found nineteen articles that satisfied our inclusion criteria. The PAL activities fell into three broad categories of teacher training, peer teaching and peer assessment. Variability was found in the reporting of tutor recruitment and training processes, tutor outcomes, and tutor competencies.ConclusionResults from this review suggest that there are many perceived learning benefits for student tutors. However, there were mixed results regarding the accuracy of peer assessment and feedback, and no substantial evidence to conclude that participation as a peer tutor improves one’s own examination performance. Further research into PAL in medicine is required if we are to better understand the relative impact and benefits for student tutors.
The aim of this study was to compare aerobic and resistance training in children with cystic fibrosis (CF) admitted to hospital with an intercurrent pulmonary infection with a control group. The subjects were randomized into three groups on the first day of admission. The fat-free mass (FFM) was calculated, using the skin fold thickness from four sites (biceps, triceps, subscapular, and iliac crest). Pulmonary function tests were performed within 36 hr of admission and repeated on discharge from the hospital, and again at 1 month after discharge. All subjects performed an incremental treadmill exercise test, using a modified Bruce protocol. Lower limb strength was measured using a Cybex dynamometer. An assessment of quality of life was made using the Quality of Well Being Scale, as previously reported. Activity levels were measured using a 7-day activity diary, and subjects also wore an accelerometer on their hips. There were no significant differences between the three groups in terms of disease severity, and length of stay in hospital. Subjects in all three groups received intravenous antibiotics and nutritional supplementation as determined by the physician. Children randomized to the aerobic training group participated in aerobic activities for five sessions, each of 30-min duration, a week. The children randomized to the resistance training group exercised both upper and lower limbs against a graded resistance machine. Subjects in the control group received standard chest physiotherapy. Our study demonstrated that children who received aerobic training had significantly better peak aerobic capacity, activity levels, and quality of life than children who received the resistance training program. Children who received resistance training had better weight gain (total mass, as well as fat-free mass), lung function, and leg strength than children who received aerobic training. A combination of aerobic and resistance training may be the best training program, and future studies to assess optimal training programs for CF patients are indicated.
PurposeTeam-based learning (TBL), a structured form of small-group learning, has gained popularity in medical education in recent years. A growing number of medical schools have adopted TBL in a variety of combinations and permutations across a diversity of settings, learners, and content areas. The authors conducted this systematic review to establish the extent, design, and practice of TBL programs within medical schools to inform curriculum planners and education designers.MethodThe authors searched the MEDLINE, PubMed, Web of Knowledge, and ERIC databases for articles on TBL in undergraduate medical education published between 2002 and 2012. They selected and reviewed articles that included original research on TBL programs and assessed the articles according to the seven core TBL design elements (team formation, readiness assurance, immediate feedback, sequencing of in-class problem solving, the four S’s [significant problem, same problem, specific choice, and simultaneous reporting], incentive structure, and peer review) described in established guidelines.ResultsThe authors identified 20 articles that satisfied the inclusion criteria. They found significant variability across the articles in terms of the application of the seven core design elements and the depth with which they were described. The majority of the articles, however, reported that TBL provided a positive learning experience for students.ConclusionsIn the future, faculty should adhere to a standardized TBL framework to better understand the impact and relative merits of each feature of their program.
Learning within the workplace includes the development of knowledge and skills, and an understanding of the values important to the profession and the culture of organisations. Within health care training, organisations may encompass hospitals, universities, training organisations and regulatory bodies. The practice of mentorship may help to foster an understanding of the enduring elements of practice within these organisations. Mentoring involves both a coaching and an educational role, requiring a generosity of time, empathy, a willingness to share knowledge and skills, and an enthusiasm for teaching and the success of others. Being mentored is believed to have an important influence on personal development, career guidance and career choice. Ethical issues and potential difficulties in mentorship include conflict of interest, imbalance of power and unrealistic expectations.
ABSTRACT. The relative importance of mucoid Ps. aeruginosa, non‐mucoid Ps. aeruginosa and absence of Ps. aeruginosa as indicators of the severity of lung disease was assessed in 82 age matched children and adolescents with cystic fibrosis. Both Shwachman score and forced expiratory volume in one second (FEV1) were significantly lower in subjects whose sputa yielded mucoid strains than in those whose sputa had no Ps. aeruginosa or those with non‐mucoid forms. Furthermore 29 of 32 patients (91%) with a Shwachman score below 80 and 31 of 37 (84%) with a FEV1 of less than 75% predicted had one or more positive cultures for mucoid Ps. aeruginosa. While identification of mucoid forms of Ps. aeruginosa in the respiratory tract of children and adolescents with cystic fibrosis is an unfavourable factor, non‐mucoid forms appear to be of no major significance.
Because there is no "gold standard" for defining asthma for epidemiology, we have defined current asthma as bronchial hyperresponsiveness (BHR) plus recent wheeze (in the 12 months prior to study). To describe the characteristics of groups categorized by these measurements, we studied two samples of children aged 7 to 12 yr: 210 from a population sample and 142 self-identified asthmatics. Bronchial responsiveness to histamine was measured by the rapid method, respiratory symptom history, and asthma medication use by self-administered questionnaire to parents and atopy by skin prick tests to 14 allergens. Children recorded daily Airflometer readings and symptom scores for 2 wk. Children with current asthma had more severe bronchial responsiveness, greater Airflometer variability, more symptoms, more atopy (particularly to house dust mites), and used more asthma medication than children with BHR or recent wheeze alone. Children with BHR, but not with recent wheeze, were intermediate between the current asthma and normal groups in terms of bronchial responsiveness, Airflometer variability, and atopy. Children with recent wheeze and normal responsiveness differed from the normal group only in symptoms and medication use. Our definition of current asthma discriminates a group of children that is clearly different in terms of both clinical features and physiologic measures. As such, it is the most useful definition to date for measuring the prevalence of clinically important asthma in populations.
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