Five-year Program Research Articles

Teachers\' and Students\' Perceptions of the Learning Environment in Clinical Departments at the School of Medicine, MuhimbilI University College of Health Sciences

Background: The School of Medicine at Muhimbili is the main doctor-training institution in the country. It runs a five-year MD programme taking 200 students annually. As for many schools in low-income countries, the majority of teachers have no formal training in educational theory Objective: To describe the physical and psychosocial learning environment from teachers' and students' perspectives, describe the perceptions of teachers and students of each other, and propose ways of improving the learning environment. Methods: Fourth year students of the 2005 graduating) class and selected clinical teachers took part in a survey to document their perceptions of the school's learning environment, and the perceptions of teachers and students of each other. Structured questionnaires designed by the authors were used for recording the required information from teachers and from students for analysis. Findings: The availability of ward patients suitable for clinical training was considered adequate by 84% of the students. However, less than 50% of students thought the wards, clinics, library and operating rooms provided a conducive learning environment. Only a third of the students said they used the Internet to access learning material. Two thirds of students said it was difficult to access teachers for consultation outside of scheduled classes. While 63% of students said teachers regularly showed them how to elicit physical signs on patients, a modest 58% of students perceived their teachers as professional role models. Only 13% of students felt that teachers avoided intimidating them during clinical teaching. Seventy one per cent of teachers provided feedback to students after clinical assessment, but only 21% of the teachers believed feedback to students should be directed towards identifying students' strengths and reinforcing them rather than seeking their weaknesses for correction. Conclusion: The learning environment at the school has some strengths that should to be amplified, and numerous weaknesses that need to be corrected in order to make the environment more conducive to teaching and learning. Tanzania Medical Journal Vol. 22 (1) 2007: pp. 9-11

NAMIBIA: Five‐Year Land Resettlement Programme

Africa Research Bulletin: Economic, Financial and Technical SeriesVolume 44, Issue 9 p. 17550B-17550C NAMIBIA: Five-Year Land Resettlement Programme First published: 01 November 2007 https://doi.org/10.1111/j.1467-6346.2007.01198.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume44, Issue9November 2007Pages 17550B-17550C RelatedInformation

Comparing Fourth‐Year Dental Student Productivity and Experiences in a Dental School with Community‐Based Clinical Education

Reports and articles by the Institute of Medicine, the American Dental Education Association (ADEA) Commission on Change and Innovation in Dental Education (CCI), and the Macy Foundation have examined the challenges confronting dental education and reached the conclusion that U.S. dental education is on the brink of major change. A recent "case for change" article by the CCI makes the argument that dental education, as currently structured, is quickly becoming obsolete, overpriced, and lacking in its ability to provide the education that future practitioners will need. The Ohio State University College of Dentistry (OSUCOD) began a major reorganization of its clinical education program upon receipt of a Robert Wood Johnson Foundation-sponsored Pipeline, Profession, and Practice grant. In our fourth year of the five-year grant program, known as the OHIO Project (Oral Health Improvement through Outreach), our fourth-year dental students approached the sixty-day target of time spent in community-based clinical education. The purpose of this report is to describe the productivity of students and the characteristics of the patient pool they care for in community-based sites as compared to our school-based clinics during that final year. This report reflects the activity of 102 students in the graduating class of 2006. Attendance (clinic utilization) was estimated to be 94 percent at OSUCOD and 99 percent at OHIO Project sites. In the aggregate, the OHIO Project-based students treated a total of 11,808 unique patients and completed 26,882 procedures in the community during their 41.9-day community experience. This translates into 116 unduplicated patients and 264 procedures per student in the community-based sites for the period studied. In comparison, the same students treated 19,344 unique patients and completed 28,680 procedures during ninety-three clinic days at the school. Each student treated 190 patients and completed 281 procedures. Fourth-year dental students completed as many procedures and generated similar revenue-equivalents in community sites as they did in a dental school clinic in half the time.

55. Simulation based training of technical surgical skills: A review of a five-year collaborative research program supported by the RCPSC Medical Education Funds

During the past five years, with support from the RCPSC, a collaborative group of researchers conducted projects investigating issues related to simulation based training of technical surgical skills. The aim of this presentation is to review the body of work generated, its significance, and outline future research plans. 
 In all studies, participants were medical students and residents from 3 medical schools in Ontario. First, we successfully demonstrated that trainees benefit from simulation-based practice by improving their ability to multitask. This ability not only increases technical proficiency, but also results in an enhanced ability to learn other aspects of surgery. Second, we showed that the adaptation of learning theories helps in optimizing training curricula by matching the fidelity of a simulator to the trainees’ level of expertise. Third, we provided validation of both expert and computer based methods for assessment. We showed that computer based assessments are sufficient for the evaluation of trainees learning fundamental skills, while expert based measures are more effective in the evaluation of performance on complex technical skills. Finally we demonstrated that examination-induced stress has a facilitating effect on trainees’ skills performance. 
 This body of research lends support for the inclusion of a simulation based approach to training technical skills. It also highlights the importance of the choice of assessment methods. Collectively this work highlights the need for further research in the optimization of training methods by the incorporation of learning theory into the existing training curricula. Related to this, further research in our laboratory will investigate the effects of practice schedule and expert feedback, as well as the role of self-regulated practice in the acquisition of technical surgical skills.
 Xeroulis GJ, Park J, Moulton CA, Reznick RK, Leblanc V, Dubrowski A. Teaching suturing and knot-tying skills to medical students: a randomized controlled study comparing computer-based video instruction and (concurrent and summary) expert feedback. Surgery 2007; 141(4):442-9. 
 Brydges R, Sidhu R, Park J, Dubrowski A. Construct validity of computer-assisted assessment: quantification of movement processes during a vascular anastomosis on a live porcine model. Am J Surg. 2007; 193(4):523-9. 
 Brydges R, Carnahan H, Backstein D, Dubrowski A. Application of motor learning principles to complex surgical tasks: searching for the optimal practice schedule. J Mot Behav. 2007; 39(1):40-8.

Paleozoic Evolution and Metallogeny of Pericratonic Terranes at the Ancient Pacific Margin of North America.: MAURICE COLPRON and JOANNE NELSON, Editors. 523 Pp. Geological Association of Canada Special Paper 45. ISBN-10: 1 897095 22 8. ISBN-13: 978 1 897095 22 5; ISSN: 0072 1042. Table of Contents at http://www.gac.ca/publications/view_pub.php?id=135. 2006. Price C$74.00 (nonmembers), C$55.00 (members).

This is an exceptional product that provides a new paradigm of understanding to Cordilleran geology. This hardcover volume includes18 papers and an index, as well as two large-format folded plates of critical figures and a CD-ROM. The CD provides high- and low-resolution PDFs of each of the papers, as well as data repositories that accompany most of the papers and attest to the considerable amount of new data contained within. Additionally, the CD contains large PDFs of more than 30 geologic maps published by the different government agencies that employ the authors. Geographically, the papers are divisible into six contributions on Yukon and northernmost British Columbia, six on southeastern British Columbia, and other papers with regional compilations. A single paper is dedicated to Alaska. This publication is the result of a five-year cooperative geo-science program, the Ancient Pacific Margin National Mapping Program, that has brought together geologists from the Yukon Geological Survey, the British Columbia Geological Survey, the Geological Survey of Canada, and the U.S. Geological Survey with university researchers, students, and industry personnel. The focus of …

The Portfolio Approach to Competency-Based Assessment at the Cleveland Clinic Lerner College of Medicine

Despite the rapid expansion of interest in competency-based assessment, few descriptions of assessment systems specifically designed for a competency-based curriculum have been reported. The purpose of this article is to describe the design of a portfolio approach to a comprehensive, competency-based assessment system that is fully integrated with the curriculum to foster an educational environment focused on learning. The educational design goal of the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University was to create an integrated educational program-curriculum and instructional methods, student assessment processes, and learning environment-to prepare medical students for success in careers as physician investigators. The first class in the five-year program matriculated in 2004. To graduate, a student must demonstrate mastery of nine competencies: research, medical knowledge, communication, professionalism, clinical skills, clinical reasoning, health care systems, personal development, and reflective practice. The portfolio provides a tool for collecting and managing multiple types of assessment evidence from multiple contexts and sources within the curriculum to document competence and promote reflective practice skills. This article describes how the portfolio was developed to provide both formative and summative assessment of student achievement in relation to the program's nine competencies.

A comparison of the learning styles among different nursing programs in Taiwan: Implications for nursing education

The purpose of this study was to explore the learning style of students in a two-year and a five-year associate degree nursing program, and a two-year baccalaureate degree of nursing program in Taiwan. The Chinese version of the Myers-Briggs Type Indicator (MBTI) form M is an instrument that measures individual preferences in four dichotomous dimensions of Jungian theory: extraversion/introversion; sensing/intuition; thinking/feeling; and judging/perceiving. The study sample included 425 nursing students: 94 students in a two-year associate degree of nursing (ADN) program, 235 students in a five-year ADN program, and 96 students in a two-year bachelor of science in nursing (BSN) program. Analyses of the data revealed that the most common learning styles were introversion, sensing, thinking, and judging (ISTJ) and introversion, sensing, feeling, and judging (ISFJ) among Taiwanese nursing students. The findings of the study indicated that the SJs comprised 41.3% of the participating nursing students. The SJ is a popular preference in nursing. A large sample is recommended for further research. This study can guide nursing educators in the design of classroom and clinical instructional strategies to respond to individual needs in order to enhance student success.

Using Early Literacy Monitoring to Prevent Reading Failure

MOST CHILDREN who do not to during the primary grades will probably never to well. Children who reach the end of third grade with low literacy skills typically have less access to the regular curriculum, require long-term support, and fall further behind their peers in literacy achievement and curricular knowledge. The negative ramifications of low literacy skills are pervasive and well documented--poor self-esteem, low motivation, behavioral difficulties, academic underachievement, and, ultimately, reduced occupational and economic status. However, these negative trajectories can be altered. Children experiencing reading difficulties can be identified early and, with appropriate early intervention during the primary grades, can to read. (1) Reading is a complex process, and that complexity is reflected in the range of philosophies, pedagogies, curricula, and programs available to guide early elementary reading instruction. It is little wonder, given the myriad of options available and the constraints imposed by limited resources and students' diverse skills, that a crucial question for practitioners and researchers alike is how best to ensure that children do to early and well. The Committee on the Prevention of Reading Difficulties in Young Children suggests a three-tier framework to address that question: 1) provide excellent classroom literacy instruction for all children, 2) further reduce literacy failure by allocating supplementary resources and offering enhanced learning opportunities to at-risk children, and 3) ameliorate the effects of established reading difficulties by providing intensive interventions. Efforts to translate research into practice always generate additional questions, and early literacy is no exception. As with most issues in education, responses to concerns about early literacy programming must take into account the needs of multiple stakeholders--students, parents, teachers, and administrators--while at the same time respecting empirical evidence of what constitutes effective practice. Research strongly supports both the vital role of early identification in the prevention of reading difficulties and the urgent need to teach children to during the first few years of school so that they can read to learn in grade 3 and beyond. These issues were the driving force behind a yearlong process in which a group of researchers from the Canadian Research Institute for Social Policy consulted with the New Brunswick Department of Education and five district school boards. The consultation evolved into a five-year pilot program aimed at lowering the rate of reading failure at the K-2 level. The pilot program involves implementing a school-based, continuous monitoring system during those crucial years to assist teachers in the early identification of children who encounter difficulty in their literacy development. This early literacy monitoring program, currently in its third year of data collection, is being piloted in 20 public schools and six federal First Nations schools. It responds to needs expressed by teachers, department officials, and school administrators and provides a mechanism for keeping parents apprised of their children's progress. IDENTIFYING WHAT WE NEED Throughout the first year of our five-year program, two members of our project team traveled frequently to participating schools and district offices to gather input from teachers, reading specialists, program coordinators, and school administrators. After each round of meetings, the entire research team, including researchers, programmers, analysts, early reading consultants, and support staff, would review partner specifications in order to design the components of the monitoring program. At each stage, return visits to districts and schools sought further input that the research team would again take into account, a process that continued over the course of the year until we had a structure in place that met the expectations of all partners. …

Undergraduate allergy teaching in a UK medical school: Comparison of the described and delivered curriculum

Concerns have been raised about the adequacy of allergy teaching in UK undergraduate medical curricula. Our previous work, which involved undertaking a systematic analysis of the documented curricular learning objectives relating to allergy teaching in a UK medical school, found references to allergy teaching in each of the five years of study but also identified some apparent omissions in allergy teaching. These may represent actual gaps in relation to allergy training, or alternatively may reflect dissonance between the described and delivered curricula. To compare the described and delivered undergraduate curricula on allergy and allergy-related topics in a UK medical school. We identified and e-mailed the individuals responsible for each of the 43 modules in the five-year undergraduate medical programme at the University of Edinburgh, enquiring about the delivery of allergy-related teaching within their modules. We then compared these responses with the results of the previous study mapping allergy-related teaching across the undergraduate curriculum. Fifty-one individuals were identified as being responsible for leading the 43 modules in the curriculum. Forty-nine (96%) of these module organisers responded to our enquiry; these individuals represented 41 of the 43 modules (95%). Module organisers reported that allergy-related teaching and learning was delivered in 14 modules (33%), was absent in 13 (30%) modules, and may occur to varying degrees within a further 10 (23%) modules. Module organisers' responses about the delivered curriculum on allergy were consistent with the findings from documented learning objectives in 21 (49%) modules. They also reported allergy teaching and learning in modules which had not been identified by examination of the learning objectives; however, there were still important gaps in the allergy-related curriculum. Information gathered from teaching staff confirms that specific teaching and learning on allergic disorders is currently being delivered in all five years of the undergraduate curriculum. However, comparison between the described and delivered curricula on allergy revealed discrepancies highlighting the complex nature of the undergraduate curriculum and the difficulties involved in mapping specific teaching themes within them. This assessment has revealed gaps in allergy training which need to be addressed.

Portable XRF analysis of occupational air filter samples from different workplaces using different samplers: final results, summary and conclusions

This paper concludes a five-year program on research into the use of a portable X-ray fluorescence (XRF) analyzer for analyzing lead in air sampling filters from different industrial environments, including mining, manufacturing and recycling. The results from four of these environments have already been reported. The results from two additional metal processes are presented here. At both of these sites, lead was a minor component of the total airborne metals and interferences from other elements were minimal. Nevertheless, only results from the three sites where lead was the most abundant metal were used in the overall calculation of method accuracy. The XRF analyzer was used to interrogate the filters, which were then subjected to acid digestion and analysis by inductively-coupled plasma optical-emission spectroscopy (ICP-OES). The filter samples were collected using different filter-holders or "samplers" where the size (diameter), depth and homogeneity of aerosol deposit varied from sampler to sampler. The aerosol collection efficiencies of the samplers were expected to differ, especially for larger particles. The distribution of particles once having entered the sampler was also expected to differ between samplers. Samplers were paired to allow the between-sampler variability to be addressed, and, in some cases, internal sampler wall deposits were evaluated and compared to the filter catch. It was found, rather surprisingly, that analysis of the filter deposits (by ICP-OES) of all the samplers gave equivalent results. It was also found that deposits on some of the sampler walls, which in some protocols are considered part of the sample, could be significant in comparison to the filter deposit. If it is concluded that wall-deposits should be analyzed, then XRF analysis of the filter can only give a minimum estimate of the concentration. Techniques for the statistical analysis of field data were also developed as part of this program and have been reported elsewhere. The results, based on data from the three workplaces where lead was the major element present in the samples, are summarized here. A limit of detection and a limit of quantitation are provided. Analysis of some samples using a second analyzer with a different X-ray source technology indicated reasonable agreement for some metals (but this was not evaluated for lead). Provided it is only necessary to analyze the filters, most personal samplers will provide acceptable results when used with portable XRF analysis for lead around applicable limit values.

Comparison of Chinese Medicine Education and Training in China and Australia

The similarities and differences between Chinese medicine (CM) education in China and Australia are considered in a detailed comparison of the five-year undergraduate programmes offered by the Beijing University of CM (BUCM), China and RMIT University (RMIT), Australia. BUCM is a specialist CM institution whereas RMIT is a technological university providing training in a wide range of professional areas. Both institutions are considered to be leading tertiary institutions within their respective countries. A brief account of the historical development of CM education in China and Australia is provided. We have compared the curricula and structure of the programmes and how they each address the development of essential graduate capabilities for competent and safe clinical CM practice. We have also considered the quality assurance processes and the requirements of external regulatory authorities. The curricula and educational objectives of the 2 programmes are broadly similar. Both institutions have established rigorous processes for managing teaching quality and ensuring appropriate graduates to promote evidence-based CM practice. However, there are differences relating to the healthcare systems of China and Australia and to the availability of teaching resources and clinical training facilities such as classical CM texts and CM hospitals. These differences present major challenges for the internationalisation of CM education. The findings of this study may facilitate the process of CM curriculum development in a global context.

Program for Service Evaluation of Marine Ecosystems in China Waters

State Oceanic Administration of China(SOA) has already initiated a five-year program entitledService Evaluation of Marine Ecosystems in China Waters in 2005.The principal investigator(PI) of this program is professor Chen Shang from First Institute of Oceanography,SOA.The co-PIs are professor Gao Huiwang from Ocean University of China,professor Liu Rongzi from China Institute for Marine Affairs and professor Ouyang Zhiyun from Research Center for Eco-Environmental Sciences,Chinese Academy of Sciences.The program is divided into 7 task packages:(1)Theory and assessment methods for marine ecosystem service in China waters;(2)Index system for service evaluation of marine ecosystem in China waters;(3)Evaluation methods for loss of marine ecosystem service caused by ecological disasters(red tide,pathogens and invasive species);(4)Development of software for marine ecosystem service evalution;(5)Service assessment practice of China's marine ecosystems;(6)Loss assessment of marine ecosystem service caused by ecological disasters,(7).Management plan to improve the utilization of marine ecosystem service.It aims to develop a set of service assessment system of marine ecosystem featured with local ecological and scocioeconomic development characteristics to evaluate the service value of Bohai sea, Yellow sea,East China sea,South China sea and 11 coastal provinces and service loss of marine ecosystems caused by red tide,pathogens and invasive species,will be distributed to local governments and the public. The outcomes of the program will be applied to optimize the marine function zoning and development plan of sea area and to calculate the ecological compensation fee of pollntion accidents and ocean engineering.The program will contribute to optimize the exploitation modd of costal ecosystems and to faciliate ecosystem-based marine management and the sastainable services of Chinese marine ecosystems.

Assessing Student Learning: A Case Study

In winter of 2004, the Sociology Depart ment at California State University Bakersfield (CSUB) conducted a student assessment using an embedded assessment technique?a technique wherein a class as signment serves as an assessment tool. (Allen 2004; Senter 2001). As Allen states, What differentiates embedded assessment from other class activities is that they are designed to collect information on specific program learning objectives (p. 87). We designed our assessment to measure stu dents' knowledge of theory. More specifi cally, we measured three program objec tives associated with one program goal (see Table 1). We conducted the embedded assessment for our Five-Year Program Review. Thus, similar to many departments, our decision to measure learning outcomes was moti vated by an external force (Howery 2001; Weiss 2002; Weiss et al. 2002), namely the university administration. Scholars note that academic departments are coming under increasing pressure to assess learning outcomes (Cameron et. al. 2002; Howery 2001; Wagenaar 2002; Weiss 2002; Weiss et al. 2002). Faculty often resist this pressure because they feel overburdened by the additional work load and they fear that assessment may result in a loss of autonomy (Cappell and Kamens 2002). For these reasons, members of the sociology faculty at our university were reluctant to participate in the assessment process. In the first part of this paper we describe our assessment instrument and report as sessment outcomes. Next we report on a five-point agenda for change generated by faculty in response to the assessment outcome. Finally we present an in-depth discussion of faculty reaction to the assess ment process.

Workload, Study Methods, and Motivation of Students within a BVSc Program

The workloads, study methods, and motivation of students in a five-year BVSc program were studied using questionnaires and focus groups. Students in each year of the program were asked, on three occasions over an academic year, to record details of their out-of-class study time for each course they were taking and to record the study methods they used, how they prioritized their time between subjects, and how they allocated time to study and leisure activities. Mean response rates were 57% (range: 43-85%). Overall mean out-of-class study time ranged from 19 hours per week in Year 2 to 28 hours per week in Year 4. Study time was related to the level of interest the student had in the subject, the demands of assessments, and the number of subjects being studied. Study methods were related to students' perceptions of the requirements of the subject as well as to their interest in it. Reliance on memorization and the use of set study materials were the predominant methods for courses with low interest scores, whereas higher interest was associated with a broad range of study methods. Leisure time was ring-fenced, especially when workloads were high. Students' motivation was high when they were studying subjects that were new or were seen as relevant to clinical practice; when working with animals or with enthusiastic faculty members; and when involved in subjects more tightly focused on the ultimate goal of becoming a practitioner. It was poor when students were faced with high workloads, disciplines becoming "stale," excessive detail, and low perceptions of relevance. Constant assessment activities were also seen as a burden. In terms of good learning practices, workload and the demands of assessment were considered to be antagonistic. A tension between these perceptions of students and the values of faculty in terms of the development of critical thinking skills in the program is evident.

Gondwanide continental collision and the origin of Patagonia

A review of the post-Cambrian igneous, structural and metamorphic history of Patagonia, largely revealed by a five-year programme of U–Pb zircon dating (32 samples), geochemical and isotope analysis, results in a new Late Palaeozoic collision model as the probable cause of the Gondwanide fold belts of South America and South Africa. In the northeastern part of the North Patagonian Massif, Cambro-Ordovician metasediments with a Gondwana provenance are intruded by Mid Ordovician granites analogous to those of the Famatinian arc of NW Argentina; this area is interpreted as Gondwana continental crust at least from Devonian times, probably underlain by Neoproterozoic crystalline basement affected by both Pampean and Famatinian events, with a Cambrian rifting episode previously identified in the basement of the Sierra de la Ventana. In the Devonian (following collision of the Argentine Precordillera terrane to the north), the site of magmatism jumped to the western and southwestern margins of the North Patagonian Massif, although as yet the tectonics of this magmatic event are poorly constrained. This was followed by Early Carboniferous I-type granites representing a subduction-related magmatic are and Mid Carboniferous S-type granites representing crustal anatexis. The disposition of these rocks implies that the North Patagonian Massif was in the upper plate, with northeasterly subduction beneath Gondwana prior to the collision of a southern landmass represented by the Deseado Massif and its probable extension in southeastern Patagonia. This ‘Deseado terrane’ may have originally rifted off from a similar position during the Cambrian episode. Intense metamorphism and granite emplacement in the upper plate continued into the Early Permian. Known aspects of Late Palaeozoic sedimentation, metamorphism, and deformation in the Sierra de la Ventana and adjacent Cape Fold Belt of South Africa are encompassed within this model. It is also compatible with modern geophysical and palaeomagnetic data that do not support previous hypotheses of southward-directed subduction and collision along the northern limit of Patagonia. Subsequent Permian break-off of the subducted plate, perhaps with delamination of the lower part of the upper plate, allowed access of heat to the overlying Gondwana margin and resulted in voluminous and widespread silicic plutonism and volcanism throughout Permian and into Triassic times. Thus the new model addresses and attempts to explain three long-standing geological enigmas—the origin of the Gondwanide fold belts, the origin of Patagonia, and the cause of widespread Permian silicic magmatism (Choiyoi province) in southern South America. Differing significantly from previous models, it has new implications for the crustal structure, mineral resources, and plant and animal distribution in this part of Gondwana, since the southern landmass would have had an independent evolution throughout the Early Palaeozoic.

Application of an Interactive Computer Program to Manage a Problem‐Based Dental Curriculum

Managing the change from traditional to problem-based learning (PBL) curricula is complex because PBL employs problem cases as the vehicle for learning. Each problem case covers a wide range of different learning issues across many disciplines and is coordinated by different facilitators drawn from the school's multidisciplinary pool. The objective of this project was to adapt an interactive computer program to manage a problem-based dental curriculum. Through application of a commercial database software--CATs (Curriculum Analysis Tools)--an electronic database for all modules of a five-year problem-based program was developed. This involved inputting basic information on each problem case relating to competencies covered, key words (learning objectives), participating faculty, independent study, and homework assignments, as well as inputting information on contact hours. General reports were generated to provide an overview of the curriculum. In addition, competency, key word, manpower, and clock-hour reports at three levels (individual PBL course component, yearly, and the entire curriculum) were produced. Implications and uses of such reports are discussed. The adaptation of electronic technology for managing dental curricula for use in a PBL curriculum has implications for all those involved in managing new-style PBL dental curricula and those who have concerns about managing the PBL process.

Costs of the 'Hartslag Limburg' community heart health intervention

BackgroundLittle is known about the costs of community programmes to prevent cardiovascular diseases. The present study calculated the economic costs of all interventions within a Dutch community programme called Hartslag Limburg, in such a way as to facilitate generalisation to other countries. It also calculated the difference between the economic costs and the costs incurred by the coordinating institution.MethodsHartslag Limburg was a large-scale community programme that consisted of many interventions to prevent cardiovascular diseases. The target population consisted of all inhabitants of the region (n = 180.000). Special attention was paid to reach persons with a low socio-economic status.Costs were calculated using the guidelines for economic evaluation in health care. An overview of the material and staffing input involved was drawn up for every single intervention, and volume components were attached to each intervention component. These data were gathered during to the implementation of the intervention. Finally, the input was valued, using Dutch price levels for 2004.ResultsThe economic costs of the interventions that were implemented within the five-year community programme (n = 180,000) were calculated to be about €900,000. €555,000 was spent on interventions to change people's exercise patterns, €250,000 on improving nutrition, €50,000 on smoking cessation, and €45,000 on lifestyle in general. The coordinating agency contributed about 10% to the costs of the interventions. Other institutions that were part of the programme's network and external subsidy providers contributed the other 90% of the costs.ConclusionThe current study calculated the costs of a community programme in a detailed and systematic way, allowing the costs to be easily adapted to other countries and regions. The study further showed that the difference between economic costs and the costs incurred by the coordinating agency can be very large. Cost sharing was facilitated by the unique approach used in the Hartslag Limburg programme.

China's Economy in 2005: At a New Turning Point and Need to Fix Its Development Problems

Cina's economy in 2005 chalked up another year of 9.9 percent surging growth. In 2005 the government's attention was focused on the many negative consequences of China's past unbridled economic growth, from rural poverty to environmental degradation and wide income disparities, calling for more “sustainable growth” or “balanced development”. The new development paradigm fit nicely into President Hu Jintao's concept of “scientific development”, and was embraced by the 11th Five-Year Program (2006 - 2010). The year 2006 might go down in China's economic history as an important turning point, as the Hu-Wen leadership will start new development strategies to fix problems previously associated with strong economic growth. Strictly speaking, many of China's “growth problems”, from regional disparities to environmental degradation, are actually quite inevitable - as apart of the development process. But their gravity has often been aggravated by poor governance, blatantly pro-growth policies, and local corruption. Overall, the Chinese leadership has come to realize that its past development patterns are physically unsustainable, and politically and socially unacceptable. It has embraced the need to change. But all development changes will take a long time to yield concrete results. Edited by Xiaoming Feng

Supporting offenders with multiple needs

This article draws on an evaluation of a large-scale programme in London, ‘From Dependency to Work’ (D2W), to discuss the obstacles to effective work with offenders with multiple needs. D2W, a five-year programme funded through the Single Regeneration Budget, aimed to support offenders with a range of multiple needs including drug dependence, mental health issues, employment problems and illiteracy. It was an ambitious programme that sought to co-ordinate the work of statutory and voluntary agencies in a similar way to the ‘mixed economy’ model envisaged for the National Offender Management Service (NOMS); that met with implementation problems, which limited its overall impact. These related in part to problems in finding ways of effectively assessing those with multiple needs, and planning a rational sequence of interventions; but the way in which the programme was performance-managed also destabilized the partnership to a considerable degree. The study carries important lessons for NOMS, both in relation to approaches to offender management and to contract management.

Updates and Five-year Evaluation of the S.A.F.E. Program: A Family Psychoeducational Program for Serious Mental Illness

This brief report reviews recent updates to the S.A.F.E. Program, a family psychoeducational intervention for serious mental illness created in the Veterans Affairs (VA) system. The improvements and significant content additions to the curriculum are outlined. Further, positive five-year program evaluation data are described, including high levels of participant retention and satisfaction. Program attendance is positively correlated with understanding of mental illness, awareness of VA resources, and ability to engage in self-care activities-and inversely correlated with caregiver distress. This data lays the groundwork for a randomized clinical trial and raises questions about the necessity of diagnostic-specific family programming.