Challenges in teaching the mechanics of breathing to medical and graduate students

The mechanics of breathing has always been a difficult topic for some medical and graduate students. The subject is very quantitative and contains a number of concepts that some students have trouble with, including physical principles such as pressure, flow, volume, resistance, elasticity, and compliance. Apparently, present-day students find the subject more difficult than students of 20 years ago. A possible reason for this is that the teaching of elementary physics in high school and college is now given less emphasis, whereas other topics, such as molecular biology, receive a great deal of attention. Another factor may be that many of us grew up building radios and other such devices, whereas modern students tend to plug in an electronic unit with little idea of its function. Some examples of misconceptions of present-day students who have taken our course are given. To help the weaker students, we now include a primer at the beginning of our handout for the course that covers simple physical principles. Examples of some of the most difficult concepts for students are given.     

Beyond EBM: new directions for evidence-based public health

Public health researchers, policy makers, and practitioners agree that health is the outcome of interactions between biological, behavioral, and social determinants. Nonetheless, institutional patterns of research funding and practice remain obstacles to generating research at and between each of these levels. These practices are embedded in historic assumptions about the nature of reality and how it can best be understood. Current debates over the criteria for evaluating public health research have centered on the applicability of the clinical evidence-based medicine (EBM) model to the field of public health. The EBM hierarchy, which is based on traditional scientific assumptions about causality, is insufficient and potentially harmful as the basis for evaluating research on the determinants of health. Yet those who have put forward a critique of EBM have failed to develop a plausible alternative. Critical realism, based on the philosophy of Roy Bhaskar, may provide a way out of the current stalemate, enabling public health researchers from various disciplines and research paradigms to work together, bringing the full weight of scientific knowledge to bear on increasingly complex and global public health problems.     

The Spatialisation of Disease: Foucualt and Evidence-based Medicine (EBM)

In this paper I draw on the French philosopher Michel Foucault for a viewpoint on aspects of EBM. This means that I develop his idea of the spaces occupied by disease. I give much of the paper to only one of these spaces, the space of perception of disease, in order to major on the medical gaze, one of Foucault’s best-known contributions to the philosophy of medicine. As I explain what I mean by each of the spaces of disease, I configure EBM into this space. The conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. Evidence-based clinical practice requires integration of individual clinical expertise and patient preferences with the best available external clinical evidence from systematic research and consideration of available resources. EBM can be considered a subcategory of evidence-based healthcare, which also includes other branches of health-care practice such as evidence-based nursing or evidence-based physiotherapy. EBM subcategories include evidence-based surgery and evidence-based cardiology (Guyatt et al. 2008, 783).     

Challenges of Activity Theory

One of the major distinctive features of the method of investigating nervous activity developed by I. P. Pavlov is, as we know, the synthetic formation, in the course of an experiment, of conditioned reflexes and of more complex systems of temporary connections.     

八年制医学生妇产科临床实习教学法探讨

八年制医学生临床实习是理论应用于临床实践的过程,是八年制医学生教学的重点。传统”填鸭式”的教学方法限制了八年制医学生的进一步发展,不能满足高素质教育的要求。PBL教学法是以问题为基础的教学方法。大多研究表明,PBL影响知识的应用而不影响知识的获得,而EBM一循证医学的思维恰好是医学生获取知识的最佳指导思想。本文将PBL教学法和EBM思维结合到八年制医学生妇产科实际临床教学中发现,虽然在理论考试成绩上无明显差异,但在临床病例分析能力、临床证据采集能力、教学方式满意程度等方面均优于仅用PBL或者是仅用EBM的教学组。PBL教学法联合EBM思维更能提高八年制医学生分析问题、解决问题的能力,值得进一步推广应用。     

Challenges of Compassionate Conservation

ABSTRACT

The substantial and urgent threats to the prosperity of individual nonhuman animals and the survival of species necessitate a changed approach to conservation. The current practice of seeing conservation and animal welfare as contradictory goals is not helpful. It is proposed that the approach should bring together parties to address the common root causes and to find innovative ways to accommodate multiple interests by translating beautifully written and ethically complex theories into pragmatic tools. Compassionate conservation provides a contemporary framework for animal welfare professionals and ecologists to develop new approaches. Simple tools can help in identifying areas of agreement and areas of dispute. While engaging with both ethics and animal welfare science will move animal welfare discussions forward, working together will identify shared values and goals and perhaps reveal ways to save species, one animal at a time, before it is too late.     

Challenges and opportunities of metabolomics

The metabolome is a data-rich source of information concerning all the low-molecular-weight metabolites in a biofluid, which can indicate early biological changes to the host due to perturbations in metabolic pathways. Major changes can be seen after minor stimuli, which make it a valuable target for analysis. Due to the diverse and sensitive nature of the metabolome, studies must be designed in a manner to maintain consistency, reduce variation between subjects, and optimize information recovery. Technological advancements in experimental design, mouse models and instrumentation have aided in this effort. Metabolomics has the ultimate potential to be valuable in a clinical setting where it could be used for early diagnosis of a disease and as a predictor of treatment response and survival. During drug treatment, the metabolic status of an individual could be monitored and used to indicate possible toxic effects. Metabolomics therefore has great potential for improving diagnosis, treatment and aftercare of disease.     

Challenges of a changing Earth

The Challenges of a Changing Earth: Global Change Open Science Conference was held in Amsterdam, The Netherlands, from 10 to 13 July 2001     

Computational Challenges of Personal Genomics

It is widely predicted that cost and efficiency gains in sequencing will usher in an era of personal genomics and personalized, predictive, preventive, and participatory medicine within a decade. I review the computational challenges ahead and propose general and specific directions for research and development. There is an urgent need to develop semantic ontologies that span genomics, molecular systems biology, and medical data. Although the development of such ontologies would be costly and difficult, the benefits will far outweigh the costs. I argue that availability of such ontologies would allow a revolution in web-services for personal genomics and medicine.