How do learning issues relate with content in a problem-based learning pathophysiology course?

The relation between learning process and content coverage is becoming increasingly important for the understanding of the effects of problem-based learning (PBL) on students' learning. In our medical school, PBL is used as a major educational strategy in the discipline of pathophysiology. A computer program was developed allowing students to register learning issues identified as needed during tutorial sessions and learning issues stated as covered during the individual study periods. In our study, we compared "planned" (learning issues identified during PBL sessions) and "accomplished" learning issues (covered after the independent study periods) identified by pathophysiology students from three consecutive years. We found that the planned learning issues raised during tutorial sessions related to the issues effectively accomplished during the independent study and that their number grew stepwise from basic to preclinical to clinical sciences. Pathophysiology was, globally, the most mentioned discipline. Moreover, the most mentioned disciplines from the basic, preclinical, and clinical areas were physiology, histopathology, and internal medicine, respectively. The single-discipline approach did not limit the student's capacity to identify and cover learning issues beyond the objectives of pathophysiology.     

《联合国气候变化框架公约》与《生物多样性公约》的关系

气候变化和生物多样性损失是人类面临的两个严峻的全球性环境挑战, 有关应对气候变化和生物多样性保护国际公约的协作在全球范围内也越来越受重视。本文系统梳理了《联合国气候变化框架公约》下保护生物多样性和《生物多样性公约》下应对气候变化的发展脉络, 探讨了两公约下各缔约方针对相关议题的谈判立场及未来走向, 并对两公约进行了综合评价。《联合国气候变化框架公约》下涉及生物多样性保护的焦点议题主要有土地利用、土地利用变化和林业(Land Use, Land-Use Change and Forestry, LULUCF)、减少毁林和森林退化的碳排放机制(Reducing Emissions from Deforestation and Forest Degradation, REDD)及损失和损害国际机制, 《生物多样性公约》下涉及应对气候变化的焦点议题主要有协同增效、减少毁林和森林退化的碳排放机制(REDD)和地球工程及相关问题。本文最后还就我国应对气候变化和生物多样性国际谈判及国内履约提出了建议: (1)整合谈判团队力量, 促进两公约协同增效; (2)做好交叉议题的研判和谈判预案, 主动引领谈判进程; (3)为《联合国气候变化框架公约》谈判提供损失和损害风险评估数据; (4)加强《生物多样性公约》下地球工程议题的科学研究与国际交流。     

Inclusion of Ethical Issues in Dementia Guidelines: A Thematic Text Analysis

Background

Clinical practice guidelines (CPGs) aim to improve professionalism in health care. However, current CPG development manuals fail to address how to include ethical issues in a systematic and transparent manner. The objective of this study was to assess the representation of ethical issues in general CPGs on dementia care.

Methods and Findings

To identify national CPGs on dementia care, five databases of guidelines were searched and national psychiatric associations were contacted in August 2011 and in June 2013. A framework for the assessment of the identified CPGs'' ethical content was developed on the basis of a prior systematic review of ethical issues in dementia care. Thematic text analysis and a 4-point rating score were employed to assess how ethical issues were addressed in the identified CPGs. Twelve national CPGs were included. Thirty-one ethical issues in dementia care were identified by the prior systematic review. The proportion of these 31 ethical issues that were explicitly addressed by each CPG ranged from 22% to 77%, with a median of 49.5%. National guidelines differed substantially with respect to (a) which ethical issues were represented, (b) whether ethical recommendations were included, (c) whether justifications or citations were provided to support recommendations, and (d) to what extent the ethical issues were explained.

Conclusions

Ethical issues were inconsistently addressed in national dementia guidelines, with some guidelines including most and some including few ethical issues. Guidelines should address ethical issues and how to deal with them to help the medical profession understand how to approach care of patients with dementia, and for patients, their relatives, and the general public, all of whom might seek information and advice in national guidelines. There is a need for further research to specify how detailed ethical issues and their respective recommendations can and should be addressed in dementia guidelines. Please see later in the article for the Editors'' Summary     

Political polarization of conservation issues in the era of COVID-19: An examination of partisan perspectives and priorities in the United States

As a zoonotic disease with unprecedented global impacts, COVID-19 may influence how people prioritize issues related to wildlife conservation. Using a nationally representative sample of US residents, we investigated: (1) how COVID-19 affected the relative importance of conservation issues among adults with different political ideologies, and (2) how the pandemic affected political polarization of conservation issues during the 2020 general election in the United States. Conservation issues such as endangered species and controlling zoonotic disease ranked low in importance among the 14 policy issues considered, even lower than environmental issues such as climate change and environmental protection; however, the importance of all conservation issues increased as a result of COVID-19. Political polarization surrounding the perceived importance of conservation issues also increased during the COVID-19 pandemic, with Democrats reporting larger increases in importance than Republicans. Polarization was driven by the most conservative Republicans and the most liberal Democrats. But this polarization was less extreme than it was for other issues such as climate change and healthcare. Findings highlight the need for communicating links between zoonotic disease and human interactions with wildlife and the environment. Acting quickly may be critical in areas where conservation issues are primed to succumb to political polarization.     

The Disclosure of Genetic Information: A Human Research Ethics Perspective

Increasing emphasis on genetic research means that growing numbers of human research projects in Australia will involve complex issues related to genetic privacy, familial information and genetic epidemiology. The Office of Population Health Genomics (Department of Health, Western Australia) hosted an interactive workshop to explore the ethical issues involved in the disclosure of genetic information, where researchers and members of human research ethics committees (HRECs) were asked to consider several case studies from an ethical perspective. Workshop participants used a variety of approaches to examine the complex ethical issues encountered, but did not consistently refer to the values and principles outlined in the National Statement on Ethical Conduct in Human Research (NHMRC 2007) or apply rational ethical approaches. Overall, the data suggested that both researchers and HREC members may benefit from further education and support regarding the application of ethical frameworks to the issues encountered in genetic research.     

区域生态学的特点、学科定位及其与相邻学科的关系

区域生态学作为生态学的一门重要分支学科,起源于20世纪70年代的区域综合科学考察和环境污染调查,旨在研究区域生态环境问题形成背景和驱动因子,探讨区域生态环境问题解决的思路和方法。基于前人研究成果和文献综述,系统分析了区域生态学研究的特点,剖析了区域生态学的性质和学科定位。在此基础上进一步比较了区域生态学与景观生态学、生态系统生态学、区域自然地理学和宏观生态学的共性与差异。认为:(1)区域生态学研究对象是具有特定生态环境属性的区域生态综合体,既具有特定要素主导下的空间均质性,也具有多种要素耦合作用下的空间异质性特征,是一门问题导向的应用性基础学科;(2)区域生态学研究需要具有多元综合、问题导向和系统集成的思维,从多层次、多视角探讨区域生态环境问题的解决方案;(3)区域生态学属于宏观生态学研究的范畴,处于分子生态学、个体生态学、种群生态学、群落生态学、生态系统生态学、景观生态学、区域生态学和全球生态学这个生态学学科体系的较高层次。     

Differences in Moral Judgment on Animal and Human Ethics Issues between University Students in Animal-Related,Human Medical and Arts Programs

Moral judgment in relation to animal ethics issues has rarely been investigated. Among the research that has been conducted, studies of veterinary students have shown greater use of reasoning based on universal principles for animal than human ethics issues. This study aimed to identify if this was unique to students of veterinary and other animal-related professions. The moral reasoning of first year students of veterinary medicine, veterinary technology, and production animal science was compared with that of students in non-animal related disciplines of human medicine and arts. All students (n = 531) completed a moral reasoning test, the VetDIT, with animal and human scenarios. When compared with reasoning on human ethics issues, the combined group of students evaluating animal ethics issues showed higher levels of Universal Principles reasoning, lower levels of Personal Interest reasoning and similar levels of Maintaining Norms reasoning. Arts students showed more personal interest reasoning than students in most animal-related programs on both animal and human ethics issues, and less norms-based reasoning on animal ethics issues. Medical students showed more norms-based reasoning on animal ethics issues than all of the animal-related groups. There were no differences in principled reasoning on animal ethics issues between program groups. This has implications for animal-related professions and education programs showing that students’ preference for principled reasoning on animal ethics issues is not unique to animal-related disciplines, and highlighting the need to develop student (and professional) capacity to apply principled reasoning to address ethics issues in animal industries to reduce the risk of moral distress.     

A Review of the Evidence to Support Influenza Vaccine Introduction in Countries and Areas of WHO's Western Pacific Region

Background

Immunization against influenza is considered an essential public health intervention to control both seasonal epidemics and pandemic influenza. According to the World Health Organization (WHO), there are five key policy and three key programmatic issues that decision-makers should consider before introducing a vaccine. These are (a) public health priority, (b) disease burden, (c) efficacy, quality and safety of the vaccine, (d) other inventions, (e) economic and financial issues, (f) vaccine presentation, (g) supply availability and (h) programmatic strength. We analyzed the body of evidence currently available on these eight issues in the WHO Western Pacific Region.

Methodology/Principal Findings

Studies indexed in PubMed and published in English between 1 January 2000 and 31 December 2010 from the 37 countries and areas of the Western Pacific Region were screened for keywords pertaining to the five policy and three programmatic issues. Studies were grouped according to country income level and vaccine target group. There were 133 articles that met the selection criteria, with most (90%) coming from high-income countries. Disease burden (n = 34), vaccine efficacy, quality and safety (n = 27) and public health priority (n = 27) were most frequently addressed by studies conducted in the Region. Many studies assessed influenza vaccine policy and programmatic issues in the general population (42%), in the elderly (24%) and in children (17%). Few studies (2%) addressed the eight issues relating to pregnant women.

Conclusions/Significance

The evidence for vaccine introduction in countries and areas in this Region remains limited, particularly in low- and middle-income countries that do not currently have influenza vaccination programmes. Surveillance activities and specialized studies can be used to assess the eight issues including disease burden among vaccine target groups and the cost-effectiveness of influenza vaccine. Multi-country studies should be considered to maximize resource utilization for cross-cutting issues such as vaccine presentation and other inventions.     

Practical Issues in the Use of Probabilistic Risk Assessment

Probabilistic risk assessment (PRA) represents an important step in the evolution of risk assessment methodology to assist decision-making at hazardous waste sites. Despite considerable progress in the development of PRA techniques, regulatory acceptance of PRA has been limited, in part because a number of practical issues in its use must yet be resolved. A recent workshop on PRA identified several areas to be addressed, including the need for: (1) better demonstration of the value of PRA in risk management; (2) PRA training and education opportunities; (3) the development of technical criteria for acceptability of a PRA; (4) policy decisions on acceptable risk distributions; (5) ways to deal with risk communication issues; and (6) a variety of technical issues, including ways to include estimates of variability and uncertainty associated with toxicity values. Solutions to many of these issues will require better dialog between risk assessors and risk managers than has existed in the past.     

Penetrance rate estimation in autosomal dominant conditions

Accurate estimates of the penetrance rate of autosomal dominant conditions are important, among other issues, for optimizing recurrence risks in genetic counseling. The present work on penetrance rate estimation from pedigree data considers the following situations: 1) estimation of the penetrance rate K (brief review of the method); 2) construction of exact credible intervals for K estimates; 3) specificity and heterogeneity issues; 4) penetrance rate estimates obtained through molecular testing of families; 5) lack of information about the phenotype of the pedigree generator; 6) genealogies containing grouped parent-offspring information; 7) ascertainment issues responsible for the inflation of K estimates.     

Ethics, evidence, and public policy

The growth of evidence-based medicine (EBM) raises a number of ethical issues that have too often been overlooked. These include issues that arise when clinicians make judgments under uncertainty, new challenges for the clinician-patient relationship, new duties for institutional review boards, issues in physician autonomy and reimbursement, and challenges for disclosure and informed consent. Ethics and EBM must be addressed by policy makers and integrated into medical education.     

The Full Spectrum of Clinical Ethical Issues in Kidney Failure. Findings of a Systematic Qualitative Review

Background

When treating patients with kidney failure, unavoidable ethical issues often arise. Current clinical practice guidelines some of them, but lack comprehensive information about the full range of relevant ethical issues in kidney failure. A systematic literature review of such ethical issues supports medical professionalism in nephrology, and offers a solid evidential base for efforts that aim to improve ethical conduct in health care.

Aim

To identify the full spectrum of clinical ethical issues that can arise for patients with kidney failure in a systematic and transparent manner.

Method

A systematic review in Medline (publications in English or German between 2000 and 2014) and Google Books (with no restrictions) was conducted. Ethical issues were identified by qualitative text analysis and normative analysis.

Results

The literature review retrieved 106 references that together mentioned 27 ethical issues in clinical care of kidney failure. This set of ethical issues was structured into a matrix consisting of seven major categories and further first and second-order categories.

Conclusions

The systematically-derived matrix helps raise awareness and understanding of the complexity of ethical issues in kidney failure. It can be used to identify ethical issues that should be addressed in specific training programs for clinicians, clinical practice guidelines, or other types of policies dealing with kidney failure.     

Management of the ocean's living resources: An essay review

Abstract

The Third United Nations Conference on the Law of the Sea (UNCLOS III) focused primarily on the peaceful uses of ocean space. Although security issues were and are involved in many peaceful uses of ocean space, they were not explicitly addressed at UNCLOS III nor covered in the U.N. Convention on the Law of Sea. Since security issues are among the major neglected issues of ocean space, it is the purpose of this article to open the discussion of the legal and political aspects of these issues as relating to the law of the sea.     

植物保护遗传学

从遗传多样性、系统发育和地理系统发育角度对当前保护遗传学在植物保护中的作用进行了探讨。在植物保护过程中,要考虑多群遗传多样性的大小,在就地和迁地保护的过程要减少近交和远交衰退影响,并可利用遗传标记为提供关于种群大小、基因流动等方面的信息。系统发育和地理系统发育的研究在于了解物种进化的历史,以确定物种保护单元。同时结合两个具体生态学问题（生境片段化和外来种）对当前植物保护遗传学的研究进行了介绍,揭示了保护遗传学在植物保护上重要作用和不可取代性,为今后研究提供参考。     

Packaging Strategies That Save Food: A Research Agenda for 2030

Thoroughly considering and optimizing packaging systems can avoid food loss and waste. We suggest a number of issues that must be explored and review the associated challenges. Five main issues were recognized through the extensive experience of the authors and engagement of multiple stakeholders. The issues promoted are classified as follows: (1) identify and obtain specific data of packaging functions that influence food waste; (2) understand the total environmental burden of product/package by considering the trade‐off between product protection and preservation and environmental footprint; (3) develop understanding of how these functions should be treated in environmental footprint evaluations; (4) improve packaging design processes to also consider reducing food waste; and (5) analyze stakeholder incentives to reduce food loss and waste. Packaging measures that save food will be important to fulfill the United Nations Sustainable Development goal to halve per capita global food waste at the retail and consumer levels and to reduce food losses along production and supply chains.     

Playback experiments: design and analysis

The scientific value of the outcome of an experiment is closely related to its design and analysis. This article deals with the design issues of pseudoreplication (whether the experimental design has the statistical features needed to answer the question as posed) and execution errors (problems arising from how the experiment was conducted). Three issues of analysis are also dealt with: the number and type of response measures to record; how measures should, and should not, be combined into a single response measure; and how to interpret an apparent lack of response. Interactive playback is considered separately because it raises its own specific design and analysis issues. Although the examples generally refer to video playback, these issues are common to all experiments in behaviour. Received: 23 September 1999 / Received in revised form: 24 February 2000 / Accepted: 25 February 2000     

花粉管中的微丝和微管

对花粉管中的微丝和微管研究的几个问题的进展进行了综述, 包括微丝和微管在花粉管中的分布;微丝和微管在花粉管胞质流动、细胞器运动以及花粉管生长中的作用等几个方面。并对今后这些方面研究的重要问题进行了论述。     

Methodology of laboratory measurements in prospective studies on gene-environment interactions: the experience of GenAir

Several large prospective investigations are under way or are planned in different parts of the world, aiming at the investigation of gene-environment interactions for chronic diseases. Technical, practical and ethical issues are raised by such large investigations. Here we describe how such issues were approached within a case-control study nested in EPIC, a large European cohort, and the kind of validation studies that have been set up. The GenAir investigation aimed at measuring the effects of air pollution and environmental tobacco smoke on human health in EPIC with a nested design and with biological measures. Validation studies included (a) comparisons between cotinine measurements, hemoglobin adducts and questionnaire data; (b) an analysis of the determinants of DNA adduct concentration; (c) comparison among different genotyping methods; (d) an analysis of the determinants of plasma DNA amounts. We also describe how the ethical issues were dealt with in our investigation.     

Survey and interzoo studies used to address husbandry problems in some zoo vertebrates

In addition to genetic and demographic considerations, SSP coordinators have been asked to systematically address husbandry issues. Three approaches to the study of captive management issues are typically used: (1) large numbers of individuals are housed at a single institution maintained in a situation that facilitates systematic evaluation of the captive environment, (2) an investigator travels to many institutions to gather data on a single taxon, or (3) an investigator surveys existing information by assembling data from a large number of individuals at a variety of institutions. Each approach has both advantages and disadvantages in terms of feasibility and the type of results obtained. The use of surveys to obtain information about husbandry parameters from a large number of animals maintained at a variety of zoos is quite possibly the most common approach used among zoo managers. Zoo husbandry surveys are typically developed to address issues problematic to a particular species, including reproductive failure and health issues. Unfortunately, surveys appear to be an often misused research tool among zoo professionals. Surveys can be improved by working with psychologists or sociologists at local universities, by narrowing the focus of the survey's purpose, and by carefully constructing each question. © 1994 Wiley-Liss, Inc.