The coccinellid Harmonia axyridis is a recent arrival in the UK and is an intraguild predator of the entomopathogenic fungus Pandora neoaphidis. Harmonia axyridis entirely consumes P. neoaphidis-sporulating cadavers and this may have a negative effect on the epizootic potential of P. neoaphidis. Here we assessed within plant transmission, and between plant vectoring, of P. neoaphidis in the presence of either H. axyridis or Coccinella septempunctata, a native coccinellid that only partially consumes fungal cadavers. Transmission was greater in the presence of coccinellids, with 21% of aphids becoming infected with the fungus whilst only 4% were infected in the control. However, there was no significant effect of coccinellid species or sex on fungal trans- mission. Between plant vectoring occurred infrequently in the presence of both species of coccinellid. The effect of H. axyridis on P. neoaphidis transmission is, therefore, likely to be similar to that of the native coccinellid C. septempunctata.
Farmers of Tamil Nadu are taking SRI to new levels. Thumbal village in Salem district has set a landmark in agriculture by forming an SRI Farmers Association; the village has had 1,500 rice-growing farmers from various districts of TN visiting them in the last three months. This farmer-to-farmer exchange is a reflection of a whole lot of new enthusiasm generated by SRI among rice-growing farmers. Tamil Nadu’s increase in average yield as discussed by Dr. B.J. Pandian in his article is reflective of TN’s remarkable achievement and of how SRI can contribute both at farm-level improvements and increase in production at the national level. But still, the up-scaling of SRI in India is an uphill task. Following the 3rd SRI symposium in Coimbatore, a core group met in February at ICRISAT to discuss strategies and to collaborate in an effort to convince governments at both state and national levels to use more effectively the resources allocation under NFSM for scaling up SRI in India by establishing a special SRI mission. This issue includes a brief report of the meeting
This paper develops the conceptual framework of barriers faced by the decision makers and management personnel of health sector. The main theme of this paper is to give a clear understanding about the adaption barriers of health technology faced by developing societies. The information about barriers would be useful for policy makers to decide about the particular technology. So that they can fulfill the defined mission of their organizations. Developing a conceptual framework is the first step in building organizational capacity. Information technology in health sector is spreading globally. Use of health information technology is offering evidence-based practice to endorse health and human prosperity. Globalization of health information system is inevitable for establishment and promotion of healthcare sector in developing societies. Present health systems in developing societies are inadequate to meet the needs of the population. Health sector of developing societies is facing a lot of barriers in establishment and promotion of health information system. These barriers include lack of infrastructure, cost, technical sophistications, lack of skilled human resources and lack of e- readiness of medical professionals. In this paper authors conducted a survey of hospitals in Pakistan to identify and categorized adaption barriers in health information technology. Existing health system should be transformed by using HIT to improve health status of population by eliminating barriers identified in this paper.
In this demo we will prove that it is - against common belief - indeed possible to build a main-memory database system that achieves world-record transaction processing throughput and best-of-breed OLAP query response times in one system in parallel on the same database state. The two workloads of online transaction processing (OLTP) and online analytical processing (OLAP) present different challenges for database architectures. Currently, users with high rates of mission-critical transactions have split their data into two separate systems, one database for OLTP and one so-called data warehouse for OLAP. While allowing for decent transaction rates, this separation has many disadvantages including data freshness issues due to the delay caused by only periodically initiating the Extract Transform Load-data staging and excessive resource consumption due to maintaining two separate information systems. We present an efficient hybrid system, called HyPer, that can handle both OLTP and OLAP simultaneously by using hardware-assisted replication mechanisms to maintain consistent snapshots of the transactional data. HyPer is a main-memory database system that guarantees the full ACID properties for OLTP transactions and executes OLAP query sessions (multiple queries) on arbitrarily current and consistent snapshots. The utilization of the processor-inherent support for virtual memory management (address translation, caching, copy-on-write) yields both at the same time: unprecedentedly high transaction rates as high as 100,000+ transactions per second and very fast OLAP query response times on a single system executing both workloads in parallel. The performance analysis is based on a combined TPC-C and TPC-H benchmark.
(June 2010 – June 2011) The main mission of the P&PR PC is to nurture and promote EMBnet's image at large. The P&PR PC is responsible for promoting any type of EMBnet activities, for the advertisement of products and services provided by the EMBnet community, as well as for proposing and developing new strategies aiming to enhance EMBnet’s visibility, and to take care of public relationships with EMBnet communities and related networks/societies. In this document, we report proposals, activities and achievements of the committee from June 2010 to May 2011.
The Royal College of Physicians and Surgeons of Canada (RCPSC) has written a series of white papers1 on a diverse group of topics. They were released last year, but the College now would like some feedback from its members. It is with interest (not much, though) that I read the white paper on assessment of competence. This should be the core of what the College does for physicians: assessment of training and maintenance of competence to a certain standard of acceptance. However, the white paper seems to be more pertinent to what I feel is currently wrong with surgical training in the country. The RCPSC writes “In-training assessment should become the dominant method of determining competence, with formative assessment taking priority over summative assessment.” This is a laudable statement. Unfortunately, in practice, the reviewer cannot make this a reality. Surgical residents are sometimes only evaluated in their specific specialty/subspecialty after 1–2 years of core training. The residents on our service get pretty immediate feedback and are judged according to the current perception of CanMeds and the realistic performance criteria needed for surgical practice. This may go against the RCPSC’s desire to stop grading performance, but if a resident cannot pin a hip by their fifth year of training, they really need to do a couple of remedial training years. If, by our evaluation, the resident is judged to have failed their rotation, they are summoned by the training director and may be put on probation, depending on their history and any extenuating circumstances. The resident will eventually come back to our service for re-evaluation. If they fail again, the process starts over. The resident can then appeal any decision, and they often do this with a lawyer. Furthermore, at this stage, the resident is into his/her senior years. The perception in our program, and apparently in some others, is that you cannot fail a senior resident, and he/she is allowed to go forward. The resident will sometimes get a lawyer to write the university so that they can take their RCPSC exams, despite failing or receiving borderline evaluations. You might think the In-Training Evaluation Report (ITER) will stop this from happening. Even the RCPSC writes that “while theoretically sound, the operational deployment of the [ITER] is seriously flawed in that it is rarely populated with reliable or objective data, allows faculty to focus on restricted performance domains, and is often completed long after the training experience has ended.” The RCPSC misses the point of why the ITER has failed. I remember more than once when I was an examiner that an ITER stating that the resident should not be writing the exam turned up after the candidate had already passed the written and oral portions of the exam. Apparently, the ITER has no weight despite containing the most meaningful information. The RCPSC writes that “assessment is heavily weighted toward the Medical Expert role, while relatively little assessment is based on well-documented supervision or observation in a real working environment that concentrates on the more global skills that define competence.” Perhaps this statement is a little out of touch with what occurs in surgery. Staff surgeons at our centre are in clinic with the residents and stand side by side with them in the operating room. The residents are evaluated on a mainly personal contact basis, so I am unsure if we need to reinvent the wheel for surgery evaluations. More to the point, the surgeons in our centre (and not just the dinosaurs) feel that the residents are no longer trained or evaluated appropriately. Shouldn’t that be important? The RCPSC would like to move toward more assessment exams on a regular basis. Is it really exams that will make the residents better doctors and surgeons? The trend certainly is moving toward small module–based training and examination, but how far do we need to let the pendulum swing? The residents are away from the ward and the operating room more as they gravitate to the classroom in an 8-to-4 cycle. If you are not present in the day-to-day evaluation of patients and their complications, then the first 5 years of practice may become too much to handle. I think the problem with current evaluation is that the evaluation tools in the hands of the staff are too restrictive. There is no way to identify a resident that needs to switch specialties, there is too little time spent in surgery and clinic in the current training programs, and there is almost no recourse but to let inadequate residents take their exams. For me, the RCPSC has lost its way. I hope for the next generation’s sake it can find its way to train competent residents — its real mission.
Le College royal des medecins et chirurgiens du Canada (CRMCC) a produit une serie de livres blancs1 sur divers sujets. Ces documents ont ete publies l’an dernier, mais le College souhaite maintenant recevoir des commentaires de ses membres. C’est avec interet (pas tres grand, toutefois) que j’ai lu celui sur l’evaluation de la competence. Cette activite devrait constituer le cœur de ce que le College fait pour les medecins: evaluation de la formation et maintien de la competence en fonction d’une certaine norme d’acceptation. Le livre blanc semble toutefois se rapporter davantage a ce qui, selon moi, ne va pas tres bien actuellement dans la formation en chirurgie au Canada. Le CRMCC ecrit que « l’evaluation pendant la formation devrait etre consideree comme la principale methode pour definir la competence, l’evaluation formative ayant priorite sur l’evaluation sommative ». Cette declaration merite des louanges, mais en pratique, l’examinateur ne peut malheureusement en faire une realite. Les medecins residents en chirurgie sont parfois evalues en fonction de leur specialite ou surspecialite precise seulement apres 1 ou 2 annees de formation de base. Ceux de notre service recoivent des commentaires assez immediats et sont juges en fonction de la perception courante de CanMeds et de criteres realistes de rendement qui s’imposent dans la pratique de la chirurgie. Cela peut aller a l’encontre du desir exprime par le CRMCC de mettre fin a l’utilisation de scores de rendement, mais si un medecin resident ne peut brocher une hanche apres 5 ans de formation, il a vraiment besoin de formation de rattrapage. Si, selon notre evaluation, le medecin resident a echoue a la fin de son stage, le directeur de la formation le convoque et peut le declarer en periode d’essai: tout depend de ses antecedents et des circonstances attenuantes. Le medecin resident finit par revenir dans notre service pour une nouvelle evaluation. S’il echoue de nouveau, le processus recommence. Le medecin resident peut alors en appeler de toute decision et cela se fait souvent avec les conseils d’un avocat. De plus, a ce stade, le medecin resident arrive a la fin de sa residence. Dans le cadre de notre programme et dans d’autres, semble-t-il, on pense qu’on ne peut faire echouer un medecin resident finissant. On lui permet donc d’aller de l’avant. Le medecin resident demande parfois a un avocat d’ecrire a l’universite pour qu’il puisse se presenter a ses examens du CRMCC, meme s’il a recu une note d’echec ou une evaluation limite. On pourrait croire que la fiche d’evaluation en fin de formation (FEFF) mettra fin a cette pratique. Meme le CRMCC ecrit: « Le deploiement fonctionnel des [FEFF], bien qu’eprouve en theorie, presente cependant une faille dans le fait que cellesci sont rarement basees sur des donnees fiables et objectives. Ce deploiement permet aux membres du corps professoral de se centrer sur des domaines ou le rendement est restreint et il se termine souvent longtemps apres la fin de l’experience de formation. » Le CRMCC se trompe sur la raison de l’echec des FEFF. Je me rappelle que plus d’une fois, lorsque j’etais examinateur, une FEFF indiquant que le medecin resident ne devrait pas se presenter a l’examen est apparue apres que le candidat s’etait deja presente a l’ecrit et a l’oral. La FEFF ne semble avoir aucun poids meme si elle contient l’information la plus significative. Le CRMCC ecrit: « Fortement axee sur le role de l’expert medical, l’evaluation est tres peu fondee sur une supervision bien documentee ou sur l’observation dans un veritable environnement de travail et se concentre sur les aptitudes plus generales qui definissent la competence ». Cette affirmation est peutetre un peu hors contexte par rapport a ce qui se passe en chirurgie. Les chirurgiens membres du personnel de notre centre travaillent en clinique avec les medecins residents et sont a leurs cotes en salle d’operation. Les medecins residents sont evalues principalement en fonction de contacts personnels et c’est pourquoi je me demande s’il faut reinventer la roue de l’evaluation en chirurgie. Qui plus est, les chirurgiens de notre centre (et non seulement les dinosaures) sont d’avis que les medecins residents ne recoivent plus une formation adequate et ne sont plus soumis a des evaluations appropriees. Ce point de vue ne devraitil pas avoir de l’importance ? Le CRMCC souhaite imposer davantage d’examens d’evaluation periodiques. Les examens ferontils vraiment des medecins residents de meilleurs medecins et chirurgiens ? La tendance est certainement a la formation par petits modules suivie d’un examen, mais jusqu’ou fautil laisser aller le pendule ? Les medecins residents sont plus longtemps loin des services et de la salle d’operation, car ils se retrouvent de plus en plus en classe suivant un cycle de 8 a 4. Les medecins qui ne participent pas a l’evaluation au jour le jour des patients et de leurs complications auront peutetre trop de difficulte au cours des 5 premieres annees de pratique. Le probleme actuel de l’evaluation, c’est que les outils d’evaluation dont dispose le personnel sont trop limitatifs. Il n’y a aucun moyen d’identifier un medecin resident qui devrait changer de specialite, un medecin resident passe trop peu de temps en chirurgie et en clinique dans le cadre des programmes de formation en vigueur et il n’y a presque aucun recours: il faut laisser les medecins residents incompetents se preparer a leurs examens. En ce qui me concerne, le CRMCC a oublie sa mission. J’espere que pour la prochaine generation, il pourra trouver un moyen de former des medecins residents competents — ce qui constitue sa veritable mission.
Not since the Korean War have the Canadian Forces engaged in combat missions like those in Afghanistan. Combat, asymmetric warfare, violent insurgency and the constant threat of improvised explosive devices all contribute to the psychological stressors experienced by Canadian soldiers. Mental health teams deployed with the soldiers and provided assessment, treatment and education. Lessons learned included refuting the myth that all psychological disorders would be related to trauma; confirming that most patients do well after exposure to trauma; confirming that treating disorders in a war zone requires flexible and creative adaptation of civilian treatment guidelines; and confirming that in a combat mission mental health practice is not limited to the clinical setting.
Tactical Combat Casualty Care (TCCC) is intended to treat potentially preventable causes of death on the battlefield, but acknowledges that application of these treatments may place the provider and even the mission in jeopardy if performed at the wrong time. Therefore, TCCC classifies the tactical situation with respect to health care provision into 3 phases (care under fire, tactical field care and tactical evacuation) and only permits certain interventions to be performed in specific phases based on the danger to the provider and casualty. In the 6 years that the Canadian Forces (CF) have been involved in sustained combat operations in Kandahar, Afghanistan, more than 1000 CF members have been injured and more than 150 have been killed. As a result, the CF gained substantial experience delivering TCCC to wounded soldiers on the battlefield. The purpose of this paper is to review the principles of TCCC and some of the lessons learned about battlefield trauma care during this conflict.