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[The thesis of the university nursing diploma. Experience at the University of Padova, Italy].

The new didactic organization of University degree of health areas considers a final qualifying examination composed, among other exams, by a written dissertation (thesis) dealing with technical-operative-experimental matters. At the faculty of Medicine and Surgery of Padua University, the council of the Degree in Nursing proposed a document about finalities, arguments, methods and operative rules for the production of the thesis as an instrument for students and teachers. During academic year 1996/97, 49 students had been graduated, for the first time in Italy. About 63% of theses were highly congruent with council's methodological instructions. When the matter of the theses was a technical aspect of an assistance problem, the theses were correct from a methodological point of view. Many professional figures supplied support to the students for the thesis, giving them a complete experience of professional application. The dimension of the thesis suggested by the Council's instruction was unrespected, the average length of the theses (30.3 pages) was significantly (p < 0.01) higher than that proposed (20 pages). This suggests that students could have an insufficient synthetic capability.

Academic Dissertations as Topic↗

[Comparative study of brain tumors treated at China Medical University, China and Kyushu University, Japan].

We have re-examined histopathological specimens of brain tumors extirpated at China Medical University from May, 1990 to June, 1992. During the last 2 years, about 400 cases of brain tumors were operated and 349 cases were histopathologically diagnosed and classified by one of the authors (T. I). The most common tumor was meningioma, 97 cases, followed by gliomas, 87 case and neurinoma, 71 cases. The sex and age distributions of these three tumor types were compared to those of Kyushu University Hospital, Japan. The most striking difference was age of meningioma and neurinoma patients, and Chinese patients were 10 years younger than Japanese patients. The incidence of 30th age group of meningioma was 25% in China and 10% in Japan. Thirty percent of neurinoma patients were operated at 30th and 40th age in China and Japan, respectively. The sex and ages of astrocytoma patients were almost the same frequencies in China and Japan. Among 22 cases of congenital tumors, 11 cases of epidermoid tumor in cerebello-pontine cistern was included. Cerebral tuberculoma, although rarely encountered in Japan, was 2 cases in China.

Adolescent↗

Feasibility of implementing a universal neonatal hearing screening programme using distortion product otoacoustic emission detection at a university hospital in Hong Kong.

OBJECTIVE: To assess the feasibility of implementing a universal neonatal hearing screening programme using distortion product otoacoustic emission detection at a major teaching hospital in Hong Kong. DESIGN: Descriptive study and questionnaire. SETTING. Teaching hospital, Hong Kong. METHODS: A total of 1064 infants, together with their mothers, were successfully recruited for the study. The participation rate was 99.3%. A three-stage hearing screening protocol using distortion product otoacoustic emission detection was adopted. Each of the participating infants was screened on three separate occasions (day 1-4, day 5-14, and day 21-30 after birth), irrespective of the test results. A questionnaire was administered to 364 randomly selected mothers to determine whether as consumers of the hearing screening service, mothers would find screening desirable. RESULTS: Results of the screening demonstrated an incidence of permanent bilateral hearing loss (>or=40 dB in the better ear) of 0.28%. The results also showed that 3.5% of the screened infants were referred for subsequent diagnostic audiological assessment, including those suspected with unilateral as well as bilateral hearing loss. Data obtained were comparable to other reported results obtained using multi-stage screening protocols. Taking both the false positive rate and the default rate into consideration, the most appropriate time for screening in this hospital setting appeared to be around day 5 to 14 when infants returned to the hospital's day centre as out-patients for routine medical follow-up. Since this day centre service is not generally provided by all maternity hospitals in Hong Kong, an alternative time for screening would be around day 21 to 30 when infants could return as out-patients solely for the hearing test. The results of the questionnaire suggested that most mothers thought a neonatal hearing screening would be desirable (91.35%). The majority (81.70%) indicated a preference for screening either within a few days of birth at the maternity ward prior to discharge from the hospital, or between 5 and 30 days when returning to the hospital as an out-patient. CONCLUSION: It was concluded that a universal neonatal hearing screening programme could be readily implemented in a maternity hospital setting in Hong Kong.

Clinical Protocols↗

[Status of the clinical laboratory in the mandatory postgraduate medical training system: in our Kyoto Prefectural University of Medicine (KPUM) University Hospital].

Since the beginning of mandatory postgraduate medical training in 2004, our clinical laboratory has introduced an obligatory training program for all medical trainees in our university hospital. This program is a two-hour course consisting of Gram's staining method, the laboratory ordering system, blood gas analysis and personal protective equipment against hospital infection. In addition, four medical trainees had applied to study our advanced elective training program for clinical laboratory medical education in 2005. This program requires two months for each trainee, consisting of a three-step curriculum from "basic" to "maniac". In the "basic" step, each trainee studies to acquire fundamental knowledge and techniques in such fields as electrocardiography, ultrasonic cardiography, respiratory function, blood transfusion and laboratory hematology. Assistant work in the laboratory information office is also included in this step. On the other hand, highly specific laboratory techniques such as flow cytometry (FCM) and cardiopulmonary exercise testing (CPX) are classified as "maniac". The remaining laboratory fields such as blood chemistry, therapeutic drug monitoring (TDM) or urinary sedimentation are classified as "special", and each trainee is expected to master them during the training period. To date, all trainees who have finished our elective training program feel moderate to great satisfaction. I believe that clinical laboratories in both university hospitals and clinical teaching hospitals play an important role in mandatory postgraduate medical training for each trainee to learn fundamental medical knowledge and techniques, and moreover, to learn how to work and co-operate with various co-medical partners.

Curriculum↗

[100 years of the University Hospital in Halle. The development of the Halle University Hospitals in the first decade of their existence].

This year the clinics of the Martin Luther University of Halle-Wittenberg can look back on an existence of 100 years. Their establishment took place in a phase in which the natural-scientific principle and on this basis the hospital medicine began to make their way. Improved techniques and methods rendered a concentrated performance of medical care indispensary henceforth. In the phase of their foundation the new clinics which were established on the basis of French payments of reparations are reckoned the best institutions among the union of the Prussian universities. They get a high appreciation above all by the appointment of good scientists to professorships particularly of the theoretical fields. But already after few decades increasing insufficiencies of the clinical department show the beginning of a stagnation which should set in after the turn of the century and caused the loss of the first place the clinics held up to that time.

Education, Medical↗

A comparison between nursing degree programmes offered at the University of Malta and the University of Fort Hare.

The purpose of thus study was to compare the undergraduate nursing programme of the Institute of Health Care of the University of Malta with that of the Department of Nursing Sciences of the University of Fort Hare. Historical facts about each institution are briefly described followed by a more detailed description of the respective undergraduate programmes. The programmes are compared according to the curriculum content and assessment strategy used for each. Although both programmes are four year degree programmes, distinct similarities, and differences in the curricular content and assessment strategies are noted and discussed.

Curriculum↗

The non-universality of the genetic code: the universal ancestor was a progenote.

The coevolution theory of genetic code origin (Wong, J.T. 1975, Proc. Natl Acad. Sci. U.S.A.72, 1909-1912) is assumed here to be substantially correct. This theory is based on the strict parallelism of the biosynthetic relationships between amino acids and the organization of the genetic code and postulates that these relationships were mediated by tRNA-like molecules on which the biosynthetic transformations between precursor and product amino acids took place. These transformations underlay the mechanism that gave rise to genetic code organization. One of the pathways which represents these transformations found in current organisms, and which are thus probably molecular fossils, is the Met-tRNA(fMet)-->fMet-tRNA(fMet)pathway. This pathway is present only in the Bacteria domain. This along with other observations and arguments leads us to believe that this pathway is a clear violation of the universality of the genetic code. Furthermore, the presence of this pathway only in the Bacteria domain seems to imply that the translation apparatus was still rapidly evolving when this pathway was fixed. This, in turn, appears to imply that the last universal common ancestor was a progenote. Finally, the implications that the finding of this pathway has for the stereochemical theory of genetic code origin are discussed.

Amino Acids↗

Comparison of University of Wisconsin and University of Pittsburgh solutions for heart transplantation.

The effectiveness of University of Wisconsin (UW) and University of Pittsburgh (UP) solutions for the preservation of rat hearts was compared. Lewis rat hearts were preserved with UW (group A, n = 45) or UP (group B, n = 45) solution for 0 or 24 h and then transplanted heterotopically into the recipients' abdomen. Ten recipients in each group were observed to obtain 1-week graft survival rates. Tissue water content and tissue content of adenine nucleotides were measured 2 h after transplantation in six grafts from each group. Six hearts preserved for 0 h and seven hearts preserved for 24 h were taken from each group 24 h after grafting for histopathology. The 1-week graft survival rates of groups A24 and B24 were 60% and 10%, respectively. In the 24-h preserved grafts, adenosine triphosphate (ATP) and energy charge [(ATP + adenosine diphosphate/2)/(ATP + adenosine diphosphate + adenosine monophosphate)] of groups A and B were 0.972 +/- 0.165 and 0.200 +/- 0.123 mg/g wet tissue (P < 0.05) and 74.4% and 61.1% (P < 0.05), respectively. The tissue water content of group A24 was 71.7%, whereas that of group B24 was 74.1% (P < 0.05). Histopathology revealed more severe muscle edema and necrosis and infiltration of polymorphonuclear cells in group B24 than in group A24. We conclude that UW solution is more appropriate for rat heart preservation than UP solution.

Abdomen↗

[Universal hearing screening in newborns. Recommendations for organizing and conducting universal hearing screening for congenital hearing loss in Germany].

The Interdisciplinary Consensus Conference for Newborn Hearing Screening (IKKNHS) has worked out joint recommendations for universal hearing screening of newborns. In the consensus paper, 11 professional associations and scientific societies in the fields of gynecology and obstetrics, ENT, pediatrics, and phoniatrics and pedaudiology came to an agreement on how to implement newborn hearing screening in Germany. The paper deals with the following topics: goals of universal newborn hearing screening, target group of hearing screening, schedule for screening, personnel involved in the screening program, technologies and framework conditions of hearing screening, documentation, continuous quality control of screening, confirmation diagnostics for conspicuous test subjects, motivation to take part in screening, information on newborn hearing screening, tracking, various infrastructural situations in urban and rural regions, follow-up care, in-patient vs. out-patient screening, cost factors of screening, reporting children with permanent hearing loss to the German Central Registry for hearing loss in children.

Genetic Testing↗

A biomechanical comparison of the antegrade inserted universal femoral nail with the retrograde inserted universal tibial nail for use in femoral shaft fractures.

Femoral shaft fractures with and without bony contact were simulated in cadaver specimens fixed with one of two different types of intramedullary locked nail systems; conventional antegrade nail fixation of the femur with the universal AO femoral nail or retrograde insertion in the femur with the universal tibial nail (a smaller diameter slotted nail) were utilized. Mechanical testing simulated one leg stance, and resultant deformation was measured in bending, torsion, and shortening. In stable fractures, fracture stability was similar to both devices, while in unstable fractures, the larger femoral nail was more stable. Furthermore, the simulation of single leg stance led to a coupled deformation of varus bending, axial shortening, and external rotation, which was dependent on bone geometry.

Adult↗

Visiting elective students at the University of Toronto from the Korea University Medical College.

OBJECTIVES: The main goal of the international elective programme was to provide the Korean students with a cross-cultural educational environment. DESIGN: This programme was carried out on a voluntary basis during the summer vacation, rotating students through various clinical divisions in the teaching hospital. SETTING: The University of Toronto. SUBJECTS: Medical students from the Korea University Medical College. RESULTS: The students found the student-teacher relationship to be much more open and liberal. Due to a different curricular structure, the Canadians have better clinical skills and problem-solving abilities in real clinical settings. The cultural differences perceived by the students during the elective programme led them to believe that educational reform in Korea imperatively requires curricular change, but more importantly, a change in our traditional psychological and behavioural traits which derive from Confucianism. CONCLUSIONS: Extreme politeness, passiveness and blind respect for teachers, which are encouraged by Confucianism, are not effective in higher education. All the elective students, as well as the Canadian preceptors, believe that this programme is an invaluable asset.

Cross-Cultural Comparison↗

[Universal hearing screening in newborns -- recommendations for organizing and conducting universal hearing screening for congenital hearing loss in Germany].

The Interdisciplinary Consensus Conference for Newborn Hearing Screening (IKKNHS) has worked out joint recommendations for universal hearing screening of newborns. In the consensus paper, 11 professional associations and scientific societies in the fields of gynecology and obstetrics, ENT, pediatrics, and phoniatrics and pedaudiology came to an agreement how to implement newborn hearing screening in Germany. The paper deals with the following topics: goals of universal newborn hearing screening, target group of hearing screening, schedule for screening, personnel involved in the screening program, technologies and framework conditions of hearing screening, documentation, continuous quality control of screening, confirmation diagnostics for conspicuous test subjects, motivation to take part in screening, information on newborn hearing screening, tracking, various infrastructural situations in urban and rural regions, follow-up care, in-patient vs. out-patient screening, cost factors of screening, reporting children with permanent hearing loss to the German Central Registry for hearing loss in children.

Animals↗

Academic models for practice relief, recruitment, and retention at the University of New Mexico Medical Center and East Carolina University School of Medicine.

Locum tenens programs were independently developed by the University of New Mexico Health Sciences Center and East Carolina University School of Medicine to address health care needs within their states. The programs represent distinct models to provide locum tenens services for practices in rural and medically underserved regions through collaboration with stage government representatives and agencies. Differences between programs include years of operation, days of coverage provided, types of learners and providers involved, sources of funding, costs of the programs, and extent of institutional support. Common beneficial outcomes of the programs include coverage for struggling practices, training in rural medicine for locum tenens providers, recruitment of physicians to rural practice sites, and improved relationships with program partners. Adequate funding and institutional support are essential for success of locum tenens programs.

Career Choice↗

An evaluation of the Rural Medical Education Program of the State University Of New York Upstate Medical University, 1990-2003.

PURPOSE: The Rural Medical Education Program (RMED) of the State University of New York (SUNY) Upstate Medical University is a 36-week clinical experience in rural communities for medical students that began in 1989. The authors sought to assess RMED's success in providing a valuable educational experience for students that assists rural communities recruit physicians. METHOD: In 2004, the authors used the Physician Masterfiles of the American Medical Association to compare practice locations of SUNY Upstate graduates who completed RMED with those who did not; surveyed former RMED students to assess their satisfaction with their practice location and the importance of RMED in helping them choose a location; interviewed hospital administrators in communities that have hosted RMED students to understand the impact of RMED on host communities; and compared United States Medical Licensing Examination Step 2 scores of RMED students with those of non-RMED students to evaluate educational attainment. RESULTS: A greater percentage of former RMED students practiced in rural locations [22/86 (26%)] than did non-RMED students [95/1,307 (7%)]. Ninety-one percent (69/76) of former RMED students were satisfied with their location, and 84% (64/76) believed that RMED was important in helping them choose a location. Hospital administrators viewed the program highly because it helped them recruit physicians and benefitted their medical staff. RMED students had higher adjusted mean Step 2 scores than did non-RMED students (212.3 versus 199.1). CONCLUSION: The RMED program has successfully met its goals of providing a valuable educational experience for medical students and assisting rural communities recruit physicians.

Attitude of Health Personnel↗

Impact of the University of California, Los Angeles/Charles R. Drew University Medical Education Program on medical students' intentions to practice in underserved areas.

PURPOSE: To estimate the impact of a U.S. inner-city medical education program on medical school graduates' intentions to practice in underserved communities. METHOD: The authors conducted an analysis of secondary data on 1,088 medical students who graduated from either the joint University of California, Los Angeles/Charles R. Drew University Medical Education Program (UCLA/Drew) or the UCLA School of Medicine between 1996 and 2002. Intention to practice in underserved communities was measured using students' responses to questionnaires administered at matriculation and graduation for program improvement by the Association of American Medical Colleges. Multivariate logistic regression analysis was used to compare the odds of intending to practice in underserved communities among UCLA/Drew students with those of their counterparts in the UCLA School of Medicine. RESULTS: Compared with students in the UCLA School of Medicine, UCLA/Drew students had greater adjusted odds of reporting intention to work in underserved communities at graduation, greater odds of maintaining or increasing such intentions between matriculation and graduation, and lower odds of decreased intention to work in underserved communities between matriculation and graduation. CONCLUSIONS: Training in the UCLA/Drew program was independently associated with intention to practice medicine in underserved communities, suggesting that a medical education program can have a positive effect on students' goals to practice in underserved areas.

Adult↗

Teleportation scheme implementing the universal optimal quantum cloning machine and the universal NOT gate.

By a significant modification of the standard protocol of quantum state teleportation, two processes "forbidden" by quantum mechanics in their exact form, the universal NOT gate and the universal optimal quantum cloning machine, have been implemented contextually and optimally by a fully linear method. In particular, the first experimental demonstration of the tele-UNOT gate, a novel quantum information protocol, has been reported. The experimental results are found in full agreement with theory.

Journal Article↗