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Simulation offers a safe environment within which learners can repeatedly practise a range of clinical skills without endangering patients. Comprehensive simulated environments allow a move away from isolated tasks to more complex clinical situations, recreating many of the challenges of real life. Such simulations, however, can operate in isolation from their clinical context, ignoring the learning needs of individuals within a real health care environment. To realise its full potential as a learning aid, simulation must be used alongside clinical practice and linked closely with it.

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Whether we view sustainable development as our greatest challenge or a subversive litany, every phase of education is now being urged to declare its support for education for sustainable development (ESD). In this paper, we explore the ideas behind ESD and, building on work by Foster and by Scott and Gough, we argue that it is necessary now to think of two complementary approaches: ESD 1 and ESD 2. We see ESD 1 as the promotion of informed, skilled behaviours and ways of thinking, useful in the short-term where the need is clearly identified and agreed, and ESD 2 as building capacity to think critically about what experts say and to test ideas, exploring the dilemmas and contradictions inherent in sustainable living. We note the prevalence of ESD 1 approaches, especially from policy makers; this is a concern because people rarely change their behaviour in response to a rational call to do so, and more importantly, too much successful ESD 1 in isolation would reduce our capacity to manage change ourselves and therefore make us less sustainable. We argue that ESD 2 is a necessary complement to ESD 1, making it meaningful in a learning sense. In this way we avoid an either-or debate in favour of a yes-and approach that constantly challenges us to understand what we are communicating, how we are going about it and, crucially, why we are doing it in the first place.

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Axenically propagated Entamoeba histolytica (HK9:NIH strain) were employed as starting material for the isoation of plasma membrane by a novel procedure. In the absence of known enzymatic markers, the externally disposed polypeptides of intact amoebae were iodinated and the incorporated label used to monitor membrane separation and recovery. 12 major plasma membrane polypeptides (12 x 10(3)-200 x 10(3) mol wt) were labeled and separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis. Each of these was a glycoprotein. Preincubation of amoebae with concanavalin A stabilized the plasma membranes as large sheets, facilitating its separation by low-speed centrifugation. Dissociation of the lectin with alpha-methyl mannoside, followed by additional homogenization led to vesiculation and further purification. The isolated plasma membrane was recovered in high yield (28%) and enriched 30-fold in terms of incorporated iodide. All iodinated surface glycoproteins of the intact organism were present in the plasma membrane fraction. A Ca++-dependent ATPase was enriched in the plasma membrane to a similar extent, but over one-half of the total activity was associated with internal, unlabeled membranes, suggesting a dual localization of this activity. The isolated plasma membrane was enriched in cholesterol and had a cholesterol:molar ratio of 0.87. It also contained larger amounts of an unusual phospholipid--ceramide aminoethyl phosphonate--a phospholipase-resistant species.