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Distance education. Part 3. Assessment of and feedback to students at a distance.

INTRODUCTION: Assessment of students at distance, in a course with over 20 units (subjects), provides special challenges in providing timely, accurate and detailed feedback both formatively and summatively. METHOD: A description of assessment practices including reflective journals, essays, critical appraisal of literature, case studies or teaching presentations in video and written format, clinical audits, and large research projects is provided. The impact of a multitude of criterion-referenced methods of students, teachers and administrative services as well as quality assurance issues are measured. CONCLUSION: Students preferred multiple levels of formative and summative assessment using criterion referencing to exams. These methods were thought to be contextually relevant to clinical practice and examined knowledge, cognition and performance appropriately. Length of assessment task, difficulty with English as a second language and lack of detail or clarity on written feedback posed problems for a number of students. Quality assurance procedures have been put into place to rectify some of these problems.

Clinical Competence↗

Considering imperfections using 3D imaging system in angle obtaining, angle signal distance computing and multivariate distance graphing.

Fields such as medicine, biomechanics or ergonomics need to measure the positions and the rotational movements of body segments. The aim of this article is to underscore the problem of imperfection on angle measurement using a three-dimensional television system. First, the error on a single angle value is assessed through the classical Taylor's formula and through a simulating approach. Then the error is considered for an entire signal through either an experimental design or a simulating approach. To take into account such an error when comparing two angle multidimensional signals, a specific coding technique is suggested. Finally, two graphical patterns are proposed to show globally the distance between the signals with regard to the error.

Anthropometry↗

Source-surface distance and source-axis distance beam data acquisition.

Radiation beam characteristics are usually obtained by scanning in a water phantom. Central axis depth dose data, beam profiles, and isodose curves are derived from these measurements. Certain treatment planning systems require that beam profiles be scanned isocentrically rather than at a constant source-surface distance. We have looked at profiles taken both ways, with appropriate field-size correction, and find no significant difference between them. This should simplify data acquisition in many cases.

Radiometry↗

Comparison of standard one-minute treadmill exercise and strandness test (absolute walking distance) in relation to site of lesion, walking distance, and diastolic blood flow velocity (Doppler curves).

In 215 outpatients suffering from occlusive arterial disease of the lower limbs the authors compared the decrease in the ratio of ankle systolic pressure to brachial systolic pressure according to whether the treadmill exercise was limited to one minute or extended until pain forced the patient to stop. After a one-minute walk the pressure index always decreased significantly, especially when walking was restricted. The decrease in the pressure index was generally greater when the exercise was continued until the absolute walking distance, and the recovery time was usually twice as long. The fall in the pressure index was significantly greater for patients with single and multiple iliac stenoses than for those with stenoses at lower levels. In patients having a diastolic blood flow velocity on Doppler curves at rest, not modified by walking, a maximum drop in peripheral pressure was recorded after walking for one minute. In this instance there was no intensification of the decrease in peripheral pressure, unlike in patients without a diastolic blood flow velocity at rest. This one-minute test is not a maximal hemodynamic response, but it is sufficient for the appreciation of ischemia during exercise, according to the different parameters measured.

Arterial Occlusive Diseases↗

[An Internet-based "distance" learning for health, environment and sustainable development "distance learning without a frontier"].

Quality of the environment is crucial for human health. Environmental hazards may lead to adverse health effects, while a sound environment can support of enable health. It has been clear that health and environment must be understood within the context of social and economic development, which was stressed especially in the Earth Summit held in Rio de Janeiro, Brazil, in 1992. Investing in improvement of people's health and their environment is a prerequisite for sustainable development. The telecommunication revolution enables distance learning without frontiers in a reansparent and interactive environment. Applying the Internet and other telecommunication into public health including environmental health holds the greatest promise for global health. A wide application and access would facilitate and expedite the reduction of inequity prevailing between the south and north in an unprecedented speed. This proposed course is thus designed to provide an overview on health and environment in sustainable development through the Internet.

Environmental Health↗

[Determination of the energy load of erythrocytes in long-distance and medium-distance runners].

In this study erythrocytes drawn from well-trained athletes (middle- and long-distance runners) and from sedentary subjects have been compared for their adenine nucleotide contents. ADP and AMP appeared to be significantly (p less than 0,001) increased only in red cells from athletes in the rest state. After athletes' race this difference with control subjects become insignificant. Nevertheless, the observed ADP and AMP modifications are not great enough to influence the energy charge (CE) of the compared erythrocytes.

Adenine Nucleotides↗

Distance education. Part 7. Evaluation of the Graduate Diploma of Family Medicine. Does a distance education course for GPs influence their reported clinical and professional practice?

INTRODUCTION: Course evaluation is essential for continuous enhancement of teaching. This evaluation aimed to assess the impact of the Graduate Diploma of Family Medicine on the clinical practices, community activities, learning styles and personal lives of its graduates. METHODS: Cross-sectional postal questionnaire survey of all 1993 to 1997 graduates of the Graduate Diploma in Family Medicine (n = 233). RESULTS: A response rate of 70% was achieved. Male respondents felt that they treated a greater variety of conditions (p = 0.04), had undertaken more procedural work (p = 0.03), and had increased procedural confidence (p = 0.009) compared to female respondents, while the female respondents referred more (p = 0.03). Solo practitioners tended to look for evidence in clinical decision making (p = 0.006) and applied critical appraisal techniques when reading medical information provided by pharmaceutical representatives (p = 0.04). Group practitioners tended to participate in more research projects (other than drug trials) than solo practitioners (p = 0.03). There was a difference between full and part time general practitioners, even after controlling for gender, with the former more certain that general practice is where they wanted to be (p = 0.005), they also felt more competent in interpreting data, e.g. ECGs (p = 0.013). More male students indicated they preferred a reflective learning style than females (p = 0.04). CONCLUSION: The clinical electives of the Graduate Diploma in Family Medicine had the most significant impact on the clinical practices of full time GPs who were predominantly male graduates. Gender differences were apparent in styles of practice as males tended to conduct more procedural work, while female graduates preferred the gatekeeper role and referred more. The course also impacted on the students' approach to evidence in their clinical decision making. They were more critical of medical information provided by pharmaceutical representatives who are one of the major sources of CME for many GPs. Future evaluations should be based on experimental and quasi-experimental designs in order to measure changes in student perceptions and clinical practice, as well as more objective measures of learning styles.

Adult↗

Timing of autumn bird migration under climate change: advances in long-distance migrants, delays in short-distance migrants.

As a response to increasing spring temperature in temperate regions in recent years, populations of many plant and animal species, including migratory birds, have advanced the seasonal start of their reproduction or growth. However, the effects of climate changes on subsequent events of the annual cycle remain poorly understood. We investigated long-term changes in the timing of autumn migration in birds, a key event in the annual cycle limiting the reproductive period. Using data spanning a 42-year period, we analysed long-term changes in the passage of 65 species of migratory birds through Western Europe. The autumn passage of migrants wintering south of the Sahara has advanced in recent years, presumably as a result of selection pressure to cross the Sahel before its seasonal dry period. In contrast, migrants wintering north of the Sahara have delayed autumn passage. In addition, species with a variable rather than a fixed number of broods per year have delayed passage, possibly because they are free to attempt more broods. Recent climate changes seem to have a simple unidirectional effect on the seasonal onset of reproduction, but complex and opposing effects on the timing of subsequent events in the annual cycle, depending on the ecology and life history of a species. This complicates predictions of overall effects of global warming on avian communities.

Animals↗