65 research outputs found
Mapping systemic lupus erythematosus and psoriatic arthritis in greater Toronto area using geographic information systems
No full textMapping Systemic Lupus Erythematosus and Psoriatic Arthritis in Greater Toronto Area Using Geographic Information Systems; by Mustafa H. Al-Maini, MD FRCPC. A thesis submitted in conformity with the requirements for the degree of Master's in Health Sciences Graduate Department of Institute of Medical Sciences, University of Toronto 2008. Systemic lupus erythematosus (SLE) and psoriatic arthritis (PsA) are immune diseases that are influenced genetically and environmentally. We used geographic information systems (GIS), to map SLE and PsA in Greater Toronto Area (GTA). Using the cumulative number of observed cases of SLE or PSA diagnosed between January 1st 1965 to June 30th 2007 and excluding patients younger than 10 years and older than 69 years, and dividing by the general population age-sex match group; we calculated age-sex-GTA region observed incidence rates. These rates were then used to compute expected incidence rates for each census tract of the general population in the GTA and maps were produced. This is the first study to use GIS to map SLE and PsA in a defined geographic area. We developed a methodology to compute expected age-sex incidence maps of SLE and PsA in a defined geographic area.M.H.S
The global challenges and opportunities in the practice of rheumatology: White paper by the World Forum on Rheumatic and Musculoskeletal Diseases
No full textRheumatic and musculoskeletal diseases (RMDs) represent a multitude of degenerative, inflammatory and auto-immune conditions affecting millions of people worldwide. Persons with these diseases may potentially experience severe chronic pain, joint damage, increasing disability and even death. With an increasingly ageing population, the prevalence and burden of RMDs are predicted to increase, placing greater demands on the global practice of rheumatology and related healthcare budgets. Effective treatment of RMDs currently faces a number of challenges in both the developed and developing world, and individual countries may face more specific local challenges. However, limited understanding of the burden of RMDs amongst public health professionals and policy-makers means that these diseases are often not considered a public health priority. The objective of this review is to increase awareness of the RMDs and to identify opportunities to address RMD challenges on both a local and global scale. On 26 September 2014, rheumatology experts from five different continents met at the World Forum on Rheumatic and Musculoskeletal Diseases (WFRMD) to discuss and identify some key challenges for the RMDs community today. The outcomes are presented in this review, focusing on access to rheumatology services, diagnostics and therapies, rheumatology education and training and on clinical trials, as well as investigator-initiated and epidemiological research. The long-term vision of the WFRMD is to increase perception of the RMDs as a major burden to society and to explore potential opportunities to improve global and local RMD care
A global perspective on the challenges and opportunities in learning about rheumatic and musculoskeletal diseases in undergraduate medical education: White paper by the World Forum on Rheumatic and Musculoskeletal Diseases (WFRMD)
No full text\ua9 2019, The Author(s). Rheumatic and musculoskeletal diseases (RMDs) encompass a spectrum of degenerative, inflammatory conditions predominantly affecting the joints. They are a leading cause of disability worldwide and an enormous socioeconomic burden. However, worldwide deficiencies in adult and paediatric RMD knowledge among medical school graduates and primary care physicians (PCPs) persist. In October 2017, the World Forum on Rheumatic and Musculoskeletal Diseases (WFRMD), an international think tank of RMD and related experts, met to discuss key challenges and opportunities in undergraduate RMD education. Topics included needs analysis, curriculum content, interprofessional education, teaching and learning methods, implementation, assessment and course evaluation and professional formation/career development, which formed a framework for this white paper. We highlight a need for all medical graduates to attain a basic level of RMD knowledge and competency to enable them to confidently diagnose, treat/manage or refer patients. The importance of attracting more medical students to a career in rheumatology, and the indisputable value of integrated, multidisciplinary and multiprofessional care are also discussed. We conclude that RMD teaching for the future will need to address what is being taught, but also where, why and to whom, to ensure that healthcare providers deliver the best patient care possible in their local setting
Access to pediatric rheumatology care for Juvenile Idiopathic Arthritis in the United Arab Emirates
No full textAbstract Background This study looks at access to care for Juvenile Idiopathic Arthritis through pediatric rheumatology in the UAE, as an example of multi-ethnic society. Methods Patients with a diagnosis of Juvenile idiopathic arthritis were identified through the hospital electronic medical records system from January 1st 2011 to December 31st 2014. All residents of the United Arab Emirates hold an Emirates identity card. We divided our patients into two groups: Emirati-Emirates, who are native Emirati children and hold the Emirati nationality, as stated on their Emirates identity card, and who therefore have full, comprehensive access to free medical care; and non-Emirati-Emirates, who represent other nationalities, as stated on their Emirates identity card. The primary objective of this study is to look at access to care for Juvenile idiopathic arthritis through pediatric rheumatology in the two groups. The secondary objective is to look at the effect of having multiple types of healthcare insurance coverage on access to biologics. A retrospective review was carried out. Results Sixty-six patients with JIA identified: 33 Emirates and 33 non-Emirates. For Emirates, the mean time from onset to first appointment with pediatric rheumatologist and diagnosis is 9 months (range: 1–48), and for non-Emirates is 12.4 months (range: 1–96). Among the Emirates, 10 patients are currently on biologic with methotrexate. Among the non-Emirates, 15 are on biologic with methotrexate. Among the Emirates, 12 are currently in remission while on treatment, as are 10 non-Emirates. Regarding disability, one Emirati patient has blindness secondary to noncompliance while under previous treatment. One Non-Emirati developed joint deformities due to periods of noncompliance and no follow up. Conclusions Delay in presentation to pediatric rheumatology has been identified as an important factor in our population, which is multi-cultural and multi-ethnic. Type of health care insurance cover did not affect number of patients getting biological therapy once patient seen in the pediatric rheumatology service
Access to pediatric rheumatology care for Juvenile Idiopathic Arthritis in the United Arab Emirates
No full textIssues in Integrating Information Technology in Learning and Teaching EFL: the Saudi Experience
No full textThe Saudi education system is facing a climate of change characterized by an interest in integrating new technology and educational approaches to improve teaching and learning. In this climate, the present paper explores the issues in integrating information technology in learning and teaching English as a foreign language (EFL) in government intermediate schools in Riyadh, the capital of Saudi Arabia. The background to information technology use in Saudi education is introduced, with specific reference to the Watani project for integrating computer and internet use into educational administration and teaching. Taking an interpretive approach, the author offers insights into the current status and use of Information and Communications Technologies (ICT) facilities in the two intermediate schools. A discrepancy is found between intention and practice. Issues are highlighted that contribute to the failure to exploit fully the potential of ICT: teacher resistance, lack of training and budgetary or resource constraints. The author concludes that the wider exploitation of information technology in learning English, supported by appropriate training, could benefit both students and teachers and offers recommendations for its implementation.
The Saudi education system is facing a climate of change characterized by an interest in integrating new technology and educational approaches to improve teaching and learning. In this climate, the present paper explores the issues in integrating information technology in learning and teaching English as a foreign language (EFL) in government intermediate schools in Riyadh, the capital of Saudi Arabia. The background to information technology use in Saudi education is introduced, with specific reference to the Watani project for integrating computer and internet use into educational administration and teaching. Taking an interpretive approach, the author offers insights into the current status and use of Information and Communications Technologies (ICT) facilities in the two intermediate schools. A discrepancy is found between intention and practice. Issues are highlighted that contribute to the failure to exploit fully the potential of ICT: teacher resistance, lack of training and budgetary or resource constraints. The author concludes that the wider exploitation of information technology in learning English, supported by appropriate training, could benefit both students and teachers and offers recommendations for its implementation
Polyphony and the anxiety of influence in the fiction of Henry James
No full textJames's fiction, especially in the Middle Phase, centres
on the figure of the artist and is characterized by, the two
interrelated aspects which previous criticism has largely
overlooked: the Bakhtinian 'polyphonic' -creation of
'author-thinkers'; and the conflict between ephebes and
precursors, for which Harold-Bloom's concept of 'the-anxiety of
influence' is the most illuminating model. Polyphony is the
narrative mode, and influence is the intra-artistic, theme.
These, as the Introduction to the thesis makes clear, are
rehearsed in James's inaugural novel, Roderick Hudson. Rowland
Mallet is an author-thinker, and his failure is caused by
authorial limitations. His monologism -is impaired by his
mistaking empathy for the authorial sympathy. Likewise,
Hudson's failure does not arise from a mercurial temperament,
but from a polyphonic shortcoming: not possessing the power of
fiction to contain the fiction of power in, his mentor. And the
relationships among the three artists - Gloriani, Hudson and
Singleton - perfectly exemplify the Bloomian-theme. It is these
two concepts, polyphony and influence, which are the major
preoccupation in the Middle Phase; as, the works chosen
demonstrate. These are a novella, a novel, and a number of
short stories all of which have been unjustifiably neglected.
Chapter One, on The Aspern Papers, argues that Tina Bordereau,
far from being, the artless victim seen by many critics,
actually challenges and defeats the narrator by the very form
of her narrative. Her 'realist' discourse undermines his
language of 'romance', and shows up its internal unstability.
Chapter Two is an extensive study of the critical reception of
The Tragic Muse. The most common areas of critical attention
have been its contemporary topicality, its relation to previous
novels on similar themes, and the possible genealogy of Gabriel
Nash. Those have all missed the core of the work. - Chapter Three
demonstrates how polyphony and the anxiety of influence make
the novel what it really is. Influence arises from the
juxtaposition of, and the wrestling between, artistic ephebes
and their precursors (Nick and Nash,, Miriam and Madame Carre).
The dialogic quality defined by Bakhtin is crucial to the
proper, and even-handed, characterization of all, the conflicts
in the novel. And since most of James's tales in the eighties
and nineties -are about 'masters - and acolytes, the anxiety of
influence remains central. Chapter Four is a study of 'The
Author of Beltraffiol' and 'The Lesson of the Master'. Again the
characters' manipulations are a crucial focus in a way that
G6rard Genette's terminology helps to illuminate. The fact that
the ephebe is the author-thinker emphasizes the inextricability
of the Bakhtinian and the Bloomian in James. Just as
polyphony offers a different focus for explicating the poetics
of James's fiction; so the ephebal conflict provides the basis
for a fresh perception of James's own artistic struggle
Computer-assisted Cooperative Learning in EFL in Saudi Arabia
No full textThe Saudi education system is facing a climate of change characterized by an interest in integrating new technology and educational approaches to improve teaching and learning. In this climate, the present article explores the feasibility of introducing computer-assisted co-operative learning in government secondary schools in Unaizah, Saudi Arabia. In particular, it considers teacher experience with/attitudes towards such learning in teaching English as a foreign language; administrative support for such innovation and students' responses to a co-operative learning environment, based on interviews and observations. The author concludes that the introduction of computer-assisted co-operative learning in English, supported by appropriate training, could benefit both students and teachers and offers recommendations for its implementation
Clinical and laboratory characteristics of patients with sickle-cell and autoimmune/connective tissue diseases
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