Rational prescribing is essential for the quality of health care. However, many final-year medical students and junior doctors lack prescribing competence to perform this task. The availability of a list of medicines that a junior doctor working in Europe should be able to independently prescribe safely and effectively without supervision could support and harmonize teaching and training in clinical pharmacology and therapeutics (CPT) in Europe. Therefore, our aim was to achieve consensus on such a list of medicines that are widely accessible in Europe. For this, we used a modified Delphi study method consisting of three parts. In part one, we created an initial list based on a literature search. In part two, a group of 64 coordinators in CPT education, selected via the Network of Teachers in Pharmacotherapy of the European Association for Clinical Pharmacology and Therapeutics, evaluated the accessibility of each medicine in his or her country, and provided a diverse group of experts willing to participate in the Delphi part. In part three, 463 experts from 24 European countries were invited to participate in a 2-round Delphi study. In total, 187 experts (40%) from 24 countries completed both rounds and evaluated 416 medicines, 98 of which were included in the final list. The top three Anatomical Therapeutic Chemical code groups were (1) cardiovascular system (n = 23), (2) anti-infective (n = 21), and (3) musculoskeletal system (n = 11). This European List of Key Medicines for Medical Education could be a starting point for country-specific lists and could be used for the training and assessment of CPT.
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The sustainable supply of fish in the face of climate change and other drivers of change is a policy priority for Pacific nations. Creel and market surveys are increasingly used to document catches but this information has not been aggregated at a regional scale. In this paper we provide a comprehensive and standardized list of Pacific marine foodfishes in 22 Pacific Island Countriesand Territories to enable comparative analyses and improved national surveys. National lists of marine teleost fish caught for food were cleaned of errors and standardized to current valid names using authoritative global databases. National lists were subsequently aggregated to subregional and regional scales. Pacific people were found to consume more than 1000 species of marine fish (presently 1031 species), with the highest diversity observed in Melanesia and the lowest in Polynesia. A total of 14% of species names have changed since surveys were completed. An estimated 3847 species of marine fish are recorded from the region, most of which are small reef species. This list of Pacific foodfish is available through the Pacific Data Hub curated by the Pacific Community. Conclusions. The study quantifies, for the first time, the great diversity of fishes consumed by Pacific people and highlights the need for more baselines of catch, acquisition and consumption. These findings provide a foundation across the region for analysing species’ relative importance in local economies and diets, supporting fisheries management and food security policies critical to the wellbeing of Pacific people in a changing world.
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Moet ons leesonderwijs ons zorgen maken? Er is sprake van een dalende trend in gemiddelde leesvaardigheid van onze leerlingen. Het percentage laaggeletterden in Nederland daalt niet: ruim 14 procent van de vijftien jarigen is onvoldoende leesvaardig om het onderwijs op de middelbare school goed te kunnen volgen. Op het gebied van leesmotivatie vallen de scores van onze leerlingen in internationale context negatief op. Onze kinderen hebben dus in toenemende mate moeite met lezen en vinden lezen ook niet leuk. En dat terwijl we allemaal weten dat je alleen maar goed leert lezen door veel te lezen. En veel lezen doe je alleen maar wanneer je gemotiveerd bent om een boek te pakken. In ons onderwijs is er echter nauwelijks aandacht voor de rol van motivatie bij het leren lezen. In plaats daarvan wordt heel veel aandacht geschonken aan de technische aspecten van het leren lezen. Ook kan geconstateerd worden dat veel activiteiten uit de beschikbare methodes niet bijdragen aan het leesproces zelf. In veel methodes voor aanvankelijk lezen zijn in de werkboekjes veel taken opgenomen die niet leiden tot het leren lezen. Ze kosten wel leertijd en kinderen komen dan pas later dan strikt noodzakelijk is toe aan de motiverende ervaring van het echte lezen in boekjes. In de voortgezet leesmethodes gaat veel aandacht uit naar het lezen van losse woordrijtjes. Dit gaat ten koste van waar het bij vloeiend lezen om gaat: het lezen van tekst. Zwakke lezers komen hier nauwelijks aan toe. In het LIST-project is een andere koers ingeslagen door te werken vanuit het betrokkenheidperspectief van het lezen. Bij het voorbereidend en aanvankelijk lezen wordt gezorgd voor dagelijks terugkerende instructieblokken waarin van begin af aan aandacht is voor een scala aan activiteiten die betrekking hebben op lezen én schrijven in een functionele context. Bij aanvankelijk lezen wordt gewerkt met een programma waarin naast instructie van letters en leeshandeling, van het begin af aan functionele en motiverende lees- en schrijfactiviteiten onderdeel uitmaken. Uit de methode wordt alleen gebruikt wat ten dienste staat van het leren lezen. Vloeiend lezen wordt in het project bereikt door de leerlingen veel leeftijdsadequate boeken te laten lezen. Er wordt dus geen methode gebruikt. Deze boeken worden door de kinderen zelf gekozen. Leerkrachten ondersteunen de kinderen bij dit keuzeproces en bij het ontwikkelen van de eigen leesvoorkeur. Het resultaat is, dat aan het eind van de basisschool minder dan 1 procent van de kinderen met een onvoldoende leesniveau de school verlaat.
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ABSTRACT Introduction Junior doctors are responsible for a substantial number of prescribing errors, and final-year medical students lack sufficient prescribing knowledge and skills just before they graduate. Various national and international projects have been initiated to reform the teaching of clinical pharmacology and therapeutics (CP&T) during undergraduate medical training. However, there is as yet no list of commonly prescribed and available medicines that European doctors should be able to independently prescribe safely and effectively without direct supervision. Such a list could form the basis for a European Prescribing Exam and would harmonise European CP&T education. Therefore, the aim of this study is to reach consensus on a list of widely prescribed medicines, available in most European countries, that European junior doctors should be able to independently prescribe safely and effectively without direct supervision: the European List of Essential Medicines for Medical Education. Methods and analysis This modified Delphi study will recruit European CP&T teachers (expert group). Two Delphi rounds will be carried out to enable a list to be drawn up of medicines that are available in ≥80% of European countries, which are considered standard prescribing practice, and which junior doctors should be able to prescribe safely and effectively without supervision. Ethics and dissemination The study has been approved by the Medical Ethics Review Committee of VU University Medical Center (no. 2020.335) and by the Ethical Review Board of the Netherlands Association for Medical Education (approved project no. NVMO‐ERB 2020.4.8). The European List of Essential Medicines for Medical Education will be presented at national and international conferences and will be submitted to international peer-reviewed journals. It will also be used to develop and implement the European Prescribing Exam.
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Aims: Prescribing errors among junior doctors are common in clinical practice because many lack prescribing competence after graduation. This is in part due to inadequate education in clinical pharmacology and therapeutics (CP&T) in the undergraduate medical curriculum. To support CP&T education, it is important to determine which drugs medical undergraduates should be able to prescribe safely and effectively without direct supervision by the time they graduate. Currently, there is no such list with broad-based consensus. Therefore, the aim was to reach consensus on a list of essential drugs for undergraduate medical education in the Netherlands. Methods: A two-round modified Delphi study was conducted among pharmacists, medical specialists, junior doctors and pharmacotherapy teachers from all eight Dutch academic hospitals. Participants were asked to indicate whether it was essential that medical graduates could prescribe specific drugs included on a preliminary list. Drugs for which ≥80% of all respondents agreed or strongly agreed were included in the final list. Results: In all, 42 (65%) participants completed the two Delphi rounds. A total of 132 drugs (39%) from the preliminary list and two (3%) newly proposed drugs were included. Conclusions: This is the first Delphi consensus study to identify the drugs that Dutch junior doctors should be able to prescribe safely and effectively without direct supervision. This list can be used to harmonize and support the teaching and assessment of CP&T. Moreover, this study shows that a Delphi method is suitable to reach consensus on such a list, and could be used for a European list.
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'The best place to hide a dead body is page 2 of Google search results.' For some time now the image above has been circulating online. The joke accurately introduces the core question of this essay. What is the effect of the list as the most used structure of presenting online information on the way people organize and find this information? What does it mean when people constantly use the list when dealing with information?
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Inspired by taxonomist Jack Goody’s theorizing of ‘ancient lists’ as ‘intellectual technologies’, this book analyzes listing practices in modern and contemporary formations of power, and how they operate in the installation and securing of the milieus of circulation that characterize Michel Foucault’s conception of governmentality. Propelling the list’s role in the delimitation and policing of risky and threatening elements from out of history and into a contemporary analysis of power, this work demonstrates how assemblages of computer, statistical, and list technologies first deployed by the Nazi regime continue to resonate significantly in the segmenting and constitution of a critical classification of contemporary homo sapiens: the terrorist class, or homo sacer.
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Dit artikel geeft een voorbeeld van een coherent project ontwikkeld voor Passend Onderwijs dat is uitgevoerd op zes basisscholen in Twente: het LIST-project, een inhoudelijk leesinterventie project, waarin planmatig werken, gericht op verbetering van de leesprestaties een van de uitgangspunten vormt.
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Background: Previous studies found that 40-60% of the sarcoidosis patients suffer from small fiber neuropathy (SFN), substantially affecting quality of life. SFN is difficult to diagnose, as a gold standard is still lacking. The need for an easily administered screening instrument to identify sarcoidosis-associated SFN symptoms led to the development of the SFN Screening List (SFNSL). The usefulness of any questionnaire in clinical management and research trials depends on its interpretability. Obtaining a clinically relevant change score on a questionnaire requires that the smallest detectable change (SDC) and minimal important difference (MID) are known. Objectives: The aim of this study was to determine the SDC and MID for the SFNSL in patients with sarcoidosis. Methods: Patients with neurosarcoidosis and/or sarcoidosis-associated SFN symptoms (N=138) included in the online Dutch Neurosarcoidosis Registry participated in a prospective, longitudinal study. Anchor-based and distribution-based methods were used to estimate the MID and SDC, respectively. Results: The SFNSL was completed both at baseline and at 6-months’ follow-up by 89/138 patients. A marginal ROC curve (0.6) indicated cut-off values of 3.5 points, with 73% sensitivity and 49% specificity for change. The SDC was 11.8 points. Conclusions: The MID on the SFNSL is 3.5 points for a clinically relevant change over a 6-month period. The MID can be used in the follow-up and management of SFN-associated symptoms in patients with sarcoidosis, though with some caution as the SDC was found to be higher.
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