Infectious Diseases Course Research Articles

Teaching Antimicrobial Decision-Making in Medical Education: A Qualitative Study

Background: Inappropriate use of antimicrobials contributes to the growing threat of antibiotic resistance. While physicians encounter infections in virtually every facet of medical practice, research has shown that physicians have difficulty determining the need for antimicrobials and choosing the right drug. Physicians’ difficulties with antimicrobial prescribing likely begin early in medical education, yet little is known about how medical students learn to make antimicrobial choices. Our study sought to better understand how medical students learn antimicrobial decision-making, including the impact of a new learning tool introduced in the Infectious Diseases (ID) and Microbiology preclinical course. Method: From 2021-2023, we conducted 18 individual interviews with a purposive sample of medical students at the University of Michigan who had taken the preclinical ID/Microbiology course during the 2019-2021 curricular years. We asked participants how they learned to make antimicrobial decisions and how the course and clinical rotations influenced their understanding of antimicrobial choice. The six participants who took the 2021 course were additionally asked how an antimicrobial decision-making tool introduced that year impacted that process (Figure 1). The tool was adapted from prior work on antimicrobial reasoning (Abdoler et al, 2020). Participants were asked whether they remembered being introduced to the tool (approximately 18 months prior) and if they utilized it during their clinical rotations. Results were analyzed using Dedoose Software to facilitate thematic analysis. Result: Several themes emerged on analysis. Nearly all participants reflected that they learned elements of antimicrobial decision-making during clinical rotations, through observation or direct interaction with physician mentors and patients. Several participants described the preclinical period as content learning, with clinical rotations providing a space to consolidate and scaffold knowledge, as well as transfer knowledge to new situations or tasks. Of the 6 students interviewed regarding the antimicrobial decision-making tool, only one remembered it and could accurately describe its components prior to being shown the tool during the interview. Conclusion: Results suggest that participants view the preclinical ID/Microbiology course primarily as an opportunity to learn content, and perceive learning antimicrobial decision-making directly from practicing physicians in the clinical portion of medical school. An antimicrobial decision-making tool introduced during the preclinical ID/Microbiology course in 2021 did not impact students’ conceptualization of how they learned this skill. Given that practicing physicians often make antimicrobial prescribing errors, regular re-introduction of the tool during clinical rotations may help bridge preclinical antimicrobial educational content to the clinical phase of learning, counteract inappropriate antimicrobial lessons encountered clinically, and ground students' burgeoning antimicrobial prescribing skills in a logical reasoning model.

2003. Igniting the Spark: An Exploratory Qualitative Study of Medical Student Preclinical Infectious Diseases Learning

Abstract Background Major educational goals of Infectious Diseases (ID) are to recruit more trainees into ID and promote good antimicrobial decision-making. National survey research (Bonura et al, 2016) revealed that ID curricula that deemphasize memorization are associated with greater odds of trainees entering the field of ID. As ID electives are not required during medical school, preclinical ID courses could represent the last dedicated opportunity for students to gain exposure to the field and acquire key clinical skills for antimicrobial selection. Yet little is known about how students experience preclinical ID courses. We aimed to explore how students experience and engage with these courses to better understand how best to augment their learning and interest in ID. Methods We conducted individual interviews with a purposeful sample of medical students who took the preclinical ID course during three curricular years (2019-2021). Our semi-structured interviews explored students' challenges in learning ID, as well as the motivations, learning principles, and strategies guiding that learning. We generated a codebook through an iterative, inductive process using Dedoose to code interviews and facilitate analysis. We confirmed and refined major themes over 19 interviews. Results Students face unique challenges learning ID but are motivated to succeed by both intrinsic and extrinsic factors (Table 1). We identified six core learning principles (Establishing Relevance, Organized Study, Relating Ideas, Multi-Modal Learning, Socially Constructed Learning, and Active Engagement with Material) that support student learning, deployed through four main strategies (Peer Advice, Writing it Out, Talking it Out, and Use of External Resources) (Table 2; Figure 1).Table 1.Challenges and Motivations in Learning Infectious Diseases (ID)Table 2.Infectious Diseases (ID) Learning Principles and StrategiesFigure 1.Infectious Diseases (ID) Learning Principles with Supportive Strategies Conclusion Our results build on prior research indicating that students learning ID benefit from incorporation of educational principles and strategies that move beyond rote memorization to encourage active engagement and self-reflection. We found that students preference deep, strategic learning methods propelled by intrinsic motivation, despite external pressures. Our findings have implications for optimizing ID education and ultimately increasing interest in the field. Disclosures All Authors: No reported disclosures

Implementation of team-based learning (TBL) in a second year medical school course: does prior experience with TBL improve the impact of this pedagogy?

BackgroundWe have shown that use of Team-based learning (TBL) in a first-year Infectious Diseases (ID) course improved final examination and course performance. Therefore, we implemented TBL in the second-year Women’s Health (WH) course to improve acquisition of course content. We hypothesized that prior experience with TBL in the first-year of medical school would lead to a strong correlation between TBL performance in the first and second years.MethodsOur study is a retrospective review of student TBL and final examination performance in the ID and WH courses. The ID course has weekly TBL exercises that cover all course material, while the WH course has one TBL that covers a small portion of the course material. Final examination and TBL individual readiness assurance test (iRAT) scores in the ID and WH courses from three classes (n = 226) were obtained with institutional review board approval. Statistical analyses were performed including comparisons of means and correlation studies.ResultsAverage WH iRAT scores were significantly higher than ID iRAT scores (9.19 vs. 7.40,p < 0.01), and iRAT scores in both courses were highly correlated (r = 0.35,p < 0.01). When stratifying students based on WH course performance, in struggling students, iRAT but not final examination scores were higher in the WH course than the ID course (8.73 vs. 7.00,p < 0.01 and 82.45 vs. 80.51,p > 0.05, respectively).ConclusionsOur results suggest that prior experience with TBL improves TBL iRAT scores, especially in struggling students. Prior TBL experience is also associated with consistent iRAT performance between first- and second-year courses in high performing students.

Pneumococcal Septicemia after COVID-19 in Teenager: Clinical Case

There is a hypothesis among the scientists that COVID-19 and SARS-CoV-2 have negative effect on the immune system. Many reports on multisystem inflammatory syndrome (MIS) development after COVID-19 are published worldwide. Whereas, the impact of this infection on prevalence and course of any other infectious diseases has not been studied. The aim of the study is to draw attention to the estimation of other infectious diseases course after COVID-19 by analyzing the clinical case of pneumococcal septicemia in 17 years old boy who has undergone COVID-19. We obtained data about COVID-19 during the analysis of the child's medical history. The course of infectious process was similar to the course of multisystem inflammatory syndrome in children (MIS-C), compared by clinical manifestations. The results of ELISA blood assay have proved it: we revealed IgG to SARS-CoV-2. However, PCR test revealed S. pneumoniae DNA in blood, so MIS-C diagnosis was excluded. The role of SARS-CoV-2 in other diseases in postcovid period can not be excluded, and it requires further studies. Development of screening and rehabilitation principles is recommended despite the severity of COVID-19 in children.

Incorporating physical manipulatives into an integrated pharmacotherapy course to reinforce antimicrobial spectrum of activity

Background and purposeTeaching and learning the spectrum of activity (SOA) of antimicrobial agents can be a challenge in pharmacy education. This study describes the implementation and assessment of a novel tool to aid in the instruction of SOA. Physical manipulatives were used as an active-learning technique to model bacterial pathogens for antimicrobial SOA in an infectious diseases (ID) integrated medication therapy management course. Educational activity and settingPharmacy students enrolled in two consecutive years of the ID course were provided the opportunity to utilize a set of manipulatives for in-class activities and out-of-class practice. The manipulatives were small, colored building blocks that could be used to model bacterial pathogens for antimicrobial SOA. A key was included with each set of blocks, color-coding each block to represent a different bacterial pathogen or pathogen group. Blocks were used during classroom instruction to model the SOA of antimicrobial agents, compare/contrast SOA between medications, and model bacterial pathogens requiring empiric coverage for various infections, allowing students to produce “bug-drug” matches. Course data from the previous year was utilized to compare pre-implementation aggregate performance with post-implementation data. Performance on SOA-related questions was assessed during the course, using an independent samples t-test. FindingsThe intervention group exhibited a statistically significant increased mean score on test questions relating to SOA as compared to the control group. SummaryThe use of manipulatives was associated with improved performance on SOA-related questions in an integrated ID course of pharmacy students.

1121. Implementation and Evaluation of a Virtual Microbiology Laboratory for Pharmacy Students

BackgroundHealth professions students learn microbiology concepts during in-person laboratories (labs). While highly rated by students, labs are extremely resource- and time-intensive. A virtual lab may minimize resource use while maintaining educational value. We report on the implementation and evaluation of a virtual lab designed to teach clinical microbiology to pharmacy students during an infectious diseases course.MethodsWe created a video in our clinical microbiology lab to depict the steps involved in processing and analyzing a patient sample. We also designed 2 web-based, interactive modules for students to practice lab techniques, such as virtually streaking an agar plate. Students viewed the video and completed the modules prior to attending a 2-hour in-person, case-based, small group discussion on higher-order clinical microbiology concepts. All students were invited to complete a post-session evaluation that assessed achievement of session objectives.ResultsSixty-nine students (65%) completed the survey. Students highly rated the video, modules, and in-class cases (Table 1). Fewer students felt confident explaining the clinical microbiology process, compared to selecting antibiotics, interpreting cultures, explaining Gram stains, and interpreting an antibiogram (Table 2). Student comments highlighted the value of the video, modules, and instructor facilitation during the in-class session. Students also suggested improvements with the module user interface and reinforcement of certain topics (e.g. clinical breakpoints) during the in-class session.Table 1: Student Ratings of the Quality of Instructional Materials Table 2: Student Self-Reported Agreement with Achievement of Session Objectives ConclusionWe demonstrated successful implementation a virtual microbiology lab within a pharmacy course. Overall student ratings of materials were favorable. We plan to refine and re-offer the virtual micro lab next year and measure its association with student performance. To facilitate the adaptation of this virtual lab by other schools, our teaching materials are available for use via https://vimeo.com/390087512 (video) and http://tiny.ucsf.edu/atlas (modules).Disclosures All Authors: No reported disclosures

First year medical student performance on weekly team-based learning exercises in an infectious diseases course: insights from top performers and struggling students

BackgroundIn Team-Based Learning (TBL) preparation of relevant coursework during self-directed learning time is evaluated by the individual readiness assurance test (iRAT). We recently reported that student performance on iRATs is strongly correlated with final examination scores in an infectious diseases (ID) course. We now investigated how student preparation for each individual iRAT exercise relates to course performance.MethodsTwo-hundred and sixty medical students were enrolled in this three-year study. Student TBL iRAT scores were collected and correlated with final examination scores using Kruskal-Wallis One-Way ANOVA and Newman-Keul’s statistical methods.ResultsStudents performing in the upper and middle 33rd percentile on the final examination showed highly significant (p < 0.01) weekly improvements in their iRAT scores. However, students performing in the lower 33rd percentile did not show improvement in their iRAT scores until the last week of the course. Although there was a highly significant correlation between final examination and iRAT scores amongst all students participating in the study, this correlation was stronger in students performing in the lower 33rd percentile.ConclusionsOur data suggest that students who do not consistently prepare for TBL, as evidenced by low iRAT scores, exhibit poorer performance on the final examination. This lack of preparation likely interferes with the efficacy of this learning method. iRAT scores can also be used for early identification of struggling students in need of additional supports. Additionally, changes in TBL incentive structure may provide more tangible rewards for pre-class preparation in particular for struggling students.

1316. An Integrative Approach to Teaching History of Medicine in Medical School

BackgroundMedical history plays a foundational role in shaping the characters and habits of thought of developing physicians. Specifically, it cultivates an ability to assess the quality and durability of current knowledge and contributes to the growth of resilience, humility and intellectual curiosity. Especially for Infectious Diseases, knowledge of its history fosters an appreciation for our evolving understanding of the field and an opportunity to spark interest in a future career. Nevertheless, it is hard to find the space for this content amidst competing priorities in the medical school curriculum. An integrative approach has been described as a way to introduce history as a longitudinal component of the existing curriculum. Our aim, using this approach, was to pilot the incorporation of history modules into the Microbiology and Infectious Diseases (Micro/ID) course at Albert Einstein College of Medicine.MethodsStudents participating in Micro/ID were shown four history modules integrated into the existing course. The first was embedded within the introductory lecture and the remaining three were prerecorded videos available through the virtual learning environment. The modules offered context to course material and introduced principles of medical history, such as the potential pitfalls of retrospective diagnosis and changing definitions of disease over time. Comprehension and retention were assessed via two questions on each of two exams. Students had the opportunity to evaluate the course material in both their examination and end-of-course evaluations.ResultsOn the first examination, 99% and 68% of students answered correctly. On the second examination, 92% and 54% answered correctly. Student evaluation of the content was positive overall with 91% rating the content satisfactory, very good or excellent. However, some questioned the value of the material while others requested expansion of the modules to include topics such as history of research ethics (Tuskegee and syphilis) and more recent history (the HIV epidemic).ConclusionAn integrative approach to teaching medical history is largely well-received by students and offers a way to introduce historical topics to an entire class. Comments from students serve as a guide to topics of interest for future iterations of the course.Disclosures All authors: No reported disclosures.

ІННОВАЦІЙНІ МЕТОДИ НАВЧАННЯ У ПІДГОТОВЦІ УЧАСНИКІВ ПРОФЕСІЙНО-ОРІЄНТОВАНИХ ОЛІМПІАД

Мета роботи – представити власний досвід застосування різних варіантів імітаційної технології при підготовці учасників студентських олімпіад з професійного циклу “інфекційні хвороби”.&#x0D; Основна частина. Розглянуто інноваційні методики викладання курсу інфекційних хвороб у вищій медичній школі, впроваджені авторами з метою підвищення ефективності навчання. Докладно висвітлені питання проведення медичних студентських олімпіад з навчальних дисциплін професійного циклу. Проаналізовано власний досвід застосування варіантів імітаційної технології: методів case-study, рольових ігор, “мозкової атаки”.&#x0D; За останні 5 років на базі студентського наукового гуртка кафедри інфекційних хвороб ДЗ “Дніпропетровська медична академя МОЗ України” пройшла підготовка 53 студентів-бакалаврів. З них 14 студентів брали безпосередню участь у змаганнях на щорічних всеукраїнських олімпіадах з інфекційних хвороб. Результатом плідної підготовки стало здобуття 6 призових місць в індивідуальних змаганнях і 8 призових місць у командних змаганнях.&#x0D; Висновки. На відміну від традиційних форм навчання, впровадження активних методів, на прикладі підготовки до олімпіади, дозволяє формувати професійні вміння і діяльну реалізацію набутих знань, моделювати цілісний зміст самостійної роботи, при цьому зміщується центр значущості з процесу передачі, переробки і засвоєння інформації на самостійну творчу діяльність. Саме такий підхід може дозволити студенту набути високих результатів як під час змагання на студентській олімпіаді, так і надалі у практичній діяльності при формуванні особистості конкурентоспроможного фахівця.

Does team-based learning improve performance in an infectious diseases course in a preclinical curriculum?

ObjectivesTo examine whether introduction of Team-based Learning (TBL) improves student learning resulting in improved performance on final examination questions and decreased failures in an infectious diseases course. MethodsTo improve mastery of course content, we designed an intervention, which provided weekly TBL exercises in study years 2 and 3 to review concepts presented during didactic lectures and laboratory exercises. The remaining course structure and content was essentially unchanged. All students taking the course (n=50 in year 1, n=64 in year 2, and n=72 in year 3) participated in this study. Student final examination performance and performance on individual final examination questions were collected and analyzed for changes in response to the study intervention. ResultsAddition of weekly TBL exercises improved student performance on the course final examination as demonstrated by a statistically significant increase in the distribution of correct answer percentages for questions in common between the final examinations in years 1 and 2 and between years 1 and 3 (t(99) = 3.1454, p<0.05 and t(99) = 4.1268, p<0.01, respectively; Student-Newman-Keuls). There was no statistical difference (t(97) = 0.9814, p> 0.05; Student-Newman-Keuls) in the distribution of correct answer percentages between years two and three. There was also a decrease in final examination failures in years two and three. ConclusionsThe results suggest that TBL could be used to improve mastery and retention of course content in a preclinical infectious diseases course. Weekly exercises allow students to identify and ameliorate weaknesses in understanding and make adjustments early in the course.

Does team-based learning improve performance in an infectious diseases course in a preclinical curriculum?

To examine whether introduction of Team-based Learning (TBL) improves student learning resulting in improved performance on final examination questions and decreased failures in an infectious diseases course.

European students are more likely to provide incorrect HIV testing indications as compared to other international students

&lt;b&gt;Introduction: &lt;/b&gt; Expanding HIV testing is recognised as a major tool in halting the HIV epidemic. However, HIV testing is still advised inadequately by medical practitioners. Therefore we investigated medical students’ knowledge on HIV and indications for HIV testing. &lt;br /&gt; &lt;b&gt;Material and methods: &lt;/b&gt;Fifth year students were pre-tested while entering the infectious diseases course. Questionnaires were anonymous and covered three areas: medical practice, transmission risk and indications for HIV testing. Logistic regression models were used to identify factors associated with incorrect responses to questions on HIV testing indications.&lt;br /&gt; &lt;b&gt;Results&lt;/b&gt;: In total 224 students were included; 64% were female. The majority of students were from Europe (64.3%), followed by Asia (24.5%), North Africa (6.3%) and North America (4.9%); 72.8% were from high-income countries. Only 91 (41%) students provided correct indications for HIV testing, i.e. including sexual contacts, STDs or pregnancy in addition to medical condition. Over half (54%) listed only medical conditions related to immunodeficiency as an indication for HIV testing. In the multivariate logistic regression model the odds of incorrect indications for HIV testing were higher for European students (odds ratio (OR) = 2.56, 95% CI: 1.19–5.50; p &lt; 0.016) and those overestimating the homosexual risk of HIV infection (OR = 1.03, 95% CI: 1.00–1.06; p = 0.026). The odds were lower for students overestimating the risk of mother-to-child transmission (OR = 0.97, 95% CI: 0.96–0.98; p &lt; 0.001). &lt;br /&gt; &lt;b&gt;Conclusions&lt;/b&gt;: Students tend to represent a condition-focused HIV testing approach, underscoring the importance of behaviour-related indications, as well as the asymptomatic character of HIV infection. This observation is especially relevant for students originating from Europe.

Effectiveness of educational outreach in infectious diseases management: a cluster randomized trial in Uganda.

BackgroundIntegrated Infectious Diseases Capacity Building Evaluation (IDCAP) teams designed and implemented two health worker in-service training approaches: 1) an off-site classroom-based integrated management of infectious diseases (IMID) course with distance learning aspects, and 2) on-site support (OSS), an educational outreach intervention. We tested the effects of OSS on workload and 12 facility performance indicators for emergency triage assessment and treatment, HIV testing, and malaria and pneumonia case management among outpatients by two subgroups: 1) mid-level practitioners (MLP) who attended IMID training (IMID-MLP) and 2) health workers who did not (No-IMID).MethodsThirty-six health facilities participated in the IDCAP trial, with 18 randomly assigned to Arm A and 18 to Arm B. Two MLP in both arms received IMID. All providers at Arm A facilities received nine monthly OSS visits from April to December 2010 while Arm B did not. From November 2009 to December 2010, 777,667 outpatient visits occurred. We analyzed 669,580 (86.1 %) outpatient visits, where provider cadre was reported. Treatment was provided by 64 IMID-MLP and 1,515 No-IMID providers. The effect of OSS was measured by the difference in pre/post changes across arms after controlling for covariates (adjusted ratio of relative risks = a RRR).ResultsThe effect of OSS on patients-per-provider-per-day (workload) among IMID-MLP (aRRR = 1.21; p = 0.48) and No-IMID (aRRR = 0.90; p = 0.44) was not statistically significant. Among IMID-MLP, OSS was effective for three indicators: malaria cases receiving an appropriate antimalarial (aRRR = 1.26, 99 % CI = 1.02-1.56), patients with negative malaria test result prescribed an antimalarial (aRRR = 0.49, 99 % CI = 0.26-0.92), and patients with acid-fast bacilli smear negative result receiving empiric treatment for acute respiratory infection (aRRR = 2.04, 99 % CI = 1.06-3.94). Among No-IMID, OSS was effective for two indicators: emergency and priority patients admitted, detained or referred (aRRR = 2.12, 99 % CI = 1.05-4.28) and emergency patients receiving at least one appropriate treatment (aRRR = 1.98, 99 % CI = 1.21-3.24).ConclusionEffects of OSS on workload were not statistically significant. Significant OSS effects on facility performance across subgroups were heterogeneous. OSS supported MLP who diagnosed and treated patients to apply IMID knowledge. For other providers, OSS supported team work to manage emergency patients. This evidence on OSS effectiveness could inform interventions to improve health workers’ capacity to deliver better quality infectious diseases care.Electronic supplementary materialThe online version of this article 10.1186/s12889-016-3375-4) contains supplementary material, which is available to authorized users.

Adapting an Infectious Diseases Course for “Engaged Citizen” Themes

This article describes philosophies and perspectives underpinning scientific citizenship–focused curricular changes implemented into a pre-existing undergraduate infectious diseases course. Impetus for the curricular changes was a novel, campus-wide, multidisciplinary “Engaged Citizen” theme for the general education curriculum. The first half of the article describes the larger contexts from which the curricular changes were borne and the resulting instructional model. The second half of the article shares both student and instructor perspectives on the curricular changes and potential application of the model to other science courses.

A First Step to Blended Delivery: Introducing an Online Component to an Infectious Diseases Course Using a Photography-Based Social Media Platform

There has been a shift towards blended learning in medical education—combining face-to-face lectures with online learning. In this pilot, we complemented infectious diseases lectures with online “ID memory hangers” (visual infectious diseases mnemonics with short explanations of infectious diseases concepts) on the photography-based social media platform Instagram©. Students felt the online offering was useful for studying, and they appreciated the flexibility, accessing the site at various places and times. We learned that successful implementation of an online component involves working with motivated students; choosing a familiar, easy to use technology; starting with review content online; and stressing professionalism.

NeuroAccess: breaking the cycle in resource-poor settings

NeuroAccess: breaking the cycle in resource-poor settings

Quality of Morning Report Courses in the Department of Infectious Diseases: A Prospective Study of Academic Members

Introduction: Morning report is one of the most important corner stones of medical train-ing and education in internal medicine training program. However, the pattern and exact template is not definitely described. Studying the quality of morning report courses helps to find out the weak and power points of the courses. The aim of this research is to study the quality of morning report courses prospectively with the assistance of the academic members, residents, and the students in the Department of Infectious Diseases at Tabriz University of Medical Sciences in 2010, Tabriz, Iran. Methods: In this cross-sectional study, the comments of the academic members, residents, and the students in the Infec-tious diseases course who attended to the morning report course meetings were collected utilizing two separate questionnaires about the goals of the classes. Results: The mean spending time for morning report classes was 60±20 minutes. 68.2% of participants were satisfied because of the acceptable discipline of the meetings. 57.85% of sessions were run by off call attendants. 95.2% of the reports were according to charts in the absence of the patients. In 47.1% of courses, the class management was teacher-centered. The ethical and social issues in 95.1% of cases have been observed. The evaluation of classes was gener-ally good. Conclusion: Although in this study the evaluation of meetings were generally good, it seems that the goals and the planning of the meetings should be revised.

The Importance of Educating Nonmajors in Microbiology

Educating non-science majors in the basics of microbiology is a MUST. I began teaching microbiology strictly to non-science students through an infectious-diseases course. The course introduced the history, societal aspects, and science of microbiology. My aim was to provide the non-science major with enough information to reliably and intelligently understand their world, at least in relation to microorganisms. Personally, the need for this type of knowledge in non- science majors has become more evident to me in the recent past.Six years ago I became a mother to a beautiful and healthy boy. But between 15 and 18 months of age, we began to see behavioral changes that happened to coincide with his immunization schedule. He stopped jabbering, stopped reacting to stimuli, and began a social regression. This must sound familiar in light of the controversy surrounding a link between autism and immunizations. Indeed, my son was diagnosed with sensory integration disorder and possible Asperger's syndrome, which is defined as at the mild end of the autism spectrum.My husband and I were shocked with the diagnosis. As we are both scientists, we did what we knew how to do: we scanned the literature about this diagnosis and found several discussions that linked childhood immunizations and autism. Because of our professions, we could understand the scientific language and facts. But we had questions. We lived in a state that provided immunizations only through a government health agency, so we did not have personal contact with a physician for the immunizations. We felt abandoned and confused.We discussed delaying our son's immunizations, but we knew and understood their importance. In the end, we continued his immunization schedule, but were we afraid? Yes. In fact, we opted to split the shots into two sequences, in part because of his sensory-integration issues.Now, imagine the above story, also with loving, caring parents, but parents without the background knowledge to comprehend the mountain of available literature on autism and immunizations. These parents are looking for help, understanding, and above all a way to care for their child. How do they weigh the

Liverpool neurological infectious diseases course

The Liverpool neurological infectious diseases course is for anyone who has ever struggled with a patient who has meningitis, encephalitis, or another neurological infection and not known how best to manage him or her. The course is the only one of its kind in the United Kingdom, and there were 110 delegates from across the UK when I attended, plus people from Europe, Africa, and Asia. I took the course when I was a year 4 specialist registrar, but I wish I had known about it earlier. Patients with neurological infections are common, but their management is often very difficult. The presenting syndromes are elusive, which makes the diagnosis difficult, and determining the best treatment can be hard. Liverpool is the home of the School of Tropical Medicine, and it is also the base for several important institutions such as the Walton Centre for Neurology and Neurosurgery; Alder Hey …