Medical student attitudes to the autopsy and its utility in medical education: A brief qualitative study at one UK medical school

Attending postmortems enables students to learn anatomy and pathology within a clinical context, provides insights into effects of treatment and introduces the reality that patients die. Rates of clinical autopsies have declined and medical schools have cut obligatory autopsy sessions from their curricula making it difficult to assess medical student perceptions of, and attitudes towards, the educational value of autopsy. Our aim was to investigate these perceptions by designing a brief qualitative study comprising nominal technique and focus group discussions with Cambridge Graduate Course students, all of whom had attended autopsies. Three general themes emerged from the focus group discussions: the value of autopsy as a teaching tool and ways the experience could be improved, the initial impact of the mortuary and the autopsy itself, and the “emerging patient”—an emotional continuum running from cadaver to autopsy subject and living patient. Educational benefits of autopsy‐based teaching included greater understanding of anatomy and physiology, greater appreciation of the role of other health care professionals and an enhanced appreciation of psycho‐social aspects of medical practice. Students suggested improvements for ameliorating the difficult emotional consequences of attendance. We conclude that autopsy‐based teaching represents a low‐cost teaching technique which is highly valued by students and has application to many diverse medical specialties and skills. However, careful preparation and organization of sessions is required to maximize potential educational benefits and reduce any negative emotional impact. Anat Sci Educ 7: 87–96. © 2013 American Association of Anatomists.     

Increased plasma zonulin in patients with sepsis

Introduction:

Zonulin is a eukaryotic protein structurally similar to Vibrio cholerae’s zonula occludens toxin. It plays an important role in the opening of small intestine tight junctions. The loss of gut wall integrity during sepsis might be pivotal and has been described in various experimental as well as human studies. Increased levels of zonulin could be demonstrated in diseases associated with increased intestinal inflammation, such as celiac disease and type 1 diabetes. We therefore investigated the role of plasma levels of zonulin in patients with sepsis as a non-invasive marker of gut wall integrity.

Materials and methods:

Plasma level of zonulin was measured in 25 patients with sepsis, severe sepsis or septic shock according to ACCP/SCCM criteria at the first day of diagnosed sepsis. 18 non-septic post-surgical ICU-patients and 20 healthy volunteers served as control. Plasma levels were determined by using commercially available ELISA kit. Data are given as median and interquartile range (IQR).

Results:

Significantly higher plasma concentration of zonulin were found in the sepsis group: 6.61 ng/mL (IQR 3.51–9.46), as compared to the to the post-surgical control group: 3.40 ng/mL (IQR 2.14–5.70) (P = 0.025), as well as to the healthy group: 3.55 ng/mL (IQR 3.14–4.14) (P = 0.008).

Conclusion:

We were able demonstrate elevated levels of plasma zonulin, a potential marker of intestinal permeability in septic patients. Increased zonulin may serve as an additional mechanism for the observed increased intestinal permeability during sepsis and SIRS.     

Olympic Sport and Its Lessons for Peace

The purpose of this paper is to study the expressive part of game performance in soccer by introducing the concept of theatricality to describe a special form of expression. The aim is to contribute to the understanding of game performance by looking into the appearance, role and value of theatricality. The main argument of the paper is that theatricality can describe an important, but rarely noticed performance aspect, as it provides a unifying concept for expressive distancing in four dimensions of the players’ life-worlds: the subjective, intersubjective, collective and institutional. By explicating the value of this kind of expression in soccer the paper can provide a philosophical basis for including theatricality in performance and development strategies.     

Tournament structure and nations' success in women's professional tennis

Abstract

The relationship between domestic professional tournament structure in women's tennis and the subsequent professional ranking success of a nation's female players is examined. The 2003 women's professional tennis tournament calendar provided the distribution of events in 33 countries. Criteria used to classify nations' success in women's professional tennis were as follows: number of players with Women's Tennis Association (WTA) points, number of players with Top 200 rankings, and the combined WTA ranking of a nation's Top 5 female players. Pearson product – moment correlations were performed between the number of tournaments and the three criteria. Considerable variation was observed in the number of events organized between nations (USA, n = 56; Thailand, n = 3). All countries had internationally ranked female players, and 24 nations had players ranked in the Top 200. Results revealed relationships between a nation's number of women's professional events and both that nation's number of professionally ranked players (r = 0.60; P < 0.01) and Top 200 players (r = 0.60; P < 0.01), as well as the combined ranking of their Top 5 players (r = ?0.52; P < 0.01). While a similar association was found between the number of professional events and players ranked in the men's game, there was no significant correlation between events held and the combined standing of nations' best five ranked players. Governing bodies and national associations in tennis should consider the provision of professional, domestic competition as key to the development of female tennis players.     

Summer Scientific Research for Teachers: The Experience and its Effect

Journal of Science Teacher Education -     

The Average Expectable Environment Is Not Good Enough: A Response to Scarr

I take the position, contrary to Scarr's, that the details of socialization patterns are crucial to an understanding of normal and deviant development. Considerable evidence has accrued to justify the claim that what normal parents do or fail to do crucially affects their children's development. Research is cited to support the argument that better than "good enough" parenting optimizes the development of both normal and vulnerable children, and that parents' belief in their own effectiveness further enhances their caregiving, whereas causal attributions that assign responsibility for child outcomes to genetic factors that parents cannot change undermine parents' belief in their own effectiveness. The strong conclusions Scarr draws from heritability analyses to support her thesis that genotypes drive experiences overlook their inherent limitations.     

Does satiation close the open economy?

Pigeons responded on fixed-interval and fixed-ratio food schedules during sessions of extended duration. Pause lengths from the beginning of the session, when the subjects were hungry, resembled those found in open economies, whereas pause lengths from the end of the sessions, when the subjects were close to satiation, resembled those from closed economies. A model of motivation captured key features of the data, suggesting that a changing level of hunger is a causal factor in the behavioral differences observed between open and closed economies. Behavioral theories may provide a parsimonious alternative to economic theories in accounting for such effects.     

Understanding teacher design practices for digital inquiry–based science learning: the case of Go-Lab

Designing and implementing online or digital learning material is a demanding task for teachers. This is even more the case when this material is used for more engaged forms of learning, such as inquiry learning. In this article, we give an informed account of Go-Lab, an ecosystem that supports teachers in creating Inquiry Learning Spaces (ILSs). These ILSs are built around STEM–related online laboratories. Within the Go-Lab ecosystem, teachers can combine these online laboratories with multimedia material and learning apps, which are small applications that support learners in their inquiry learning process. The Go-Lab ecosystem offers teachers ready–made structures, such as a standard inquiry cycle, alternative scenarios or complete ILSs that can be used as they are, but it also allows teachers to configure these structures to create personalized ILSs. For this article, we analyzed data on the design process and structure of 2414 ILSs that were (co)created by teachers and that our usage data suggest have been used in classrooms. Our data show that teachers prefer to start their design from empty templates instead of more domain–related elements, that the makeup of the design team (a single teacher, a group of collaborating teachers, or a mix of teachers and project members) influences key design process characteristics such as time spent designing the ILS and number of actions involved, that the characteristics of the resulting ILSs also depend on the type of design team and that ILSs that are openly shared (i.e., published in a public repository) have different characteristics than those that are kept private.

     

“It was smart when:” Supporting prospective teachers’ noticing of students’ mathematical strengths

Learning to name and notice students’ mathematical strengths is a challenging process requiring time and multiple iterations of practice for prospective teachers (PTs) to adopt. Mathematics teacher educators (MTEs) can approximate and decompose the complex practice of naming and noticing students’ mathematical strengths so PTs learn to teach mathematics while emphasizing what students know and can do. This study uses two tools MTEs can use to support PTs as they learn to name and notice students’ mathematical strengths: A LessonSketch experience, a digital platform with comic-based storyboards showing children engaged in a mathematics task, and a strengths-based sentence frame. Our study presents the findings from the 111 noticing statements from 18 PTs as they engaged in the LessonSketch digital experience and practiced making noticing statements about what children know about mathematics. The study found that after a sentence-frame intervention, the PTs are more likely to use strengths-based language and more likely to identify mathematical evidence in their noticing statements. Uncommitted language (statements that do not align with a strength- or deficit-based coding scheme), suggests a fruitful, yet complex space for supporting more PTs as they learn to name and notice students’ mathematical strengths. The paper concludes with implications for future research in teacher education.