ABSTRACT
BACKGROUND: Many patients have disabilities; it is therefore essential that medical education includes comprehensive teaching on disability and rehabilitation. In 2006 Hannover Medical School implemented an introductory course in the curriculum for medical students, on how to communicate with persons with disability and the need for rehabilitation. The course, entitled "Introduction to medicine", has the main goals of teaching the strategy and systematic approach of medicine to solving patients' problems. METHODS: This paper describes the content, methods and outcomes of 1 of the 4 main themes of the "Introduction to medicine" course; the theme "Pain and disability", which is covered in the second week of the course. RESULTS: Evaluation of the "Pain and disability" module found that students' ratings for the category "patient involvement" were very high (93%), whereas their ratings for the category "examination of student knowledge" were low. The overall rating of the module was "good" (10.8 out of 15 points), but not "very good". CONCLUSION: The concept of the "Pain and disability" module is feasible and successful, even though it is scheduled early in the first year of the curriculum and approximately 350 students participate. Factors related to this success are: a mixture of teaching knowledge, supporting students' understanding, and applying communication and physical examination skills.
Subject(s)
Disabled Persons/education , Curriculum , Humans , Students, MedicalABSTRACT
We studied the histo- and immunopathology of the endocrine and exocrine pancreas and a number of other organs in a new insulin-dependent diabetes mellitus (IDDM) rat model (LEW.1AR1/Ztm- iddm rat). The pancreas of the acutely diabetic animals showed an inflammatory infiltrate, involving all islets and ducts. The islet infiltrate was composed mainly of ED1-positive macrophages and T lymphocytes, comprising a large number of CD8(+) lymphocytes and a few CD4(+) lymphocytes. In addition, the islets displayed apoptotic cells, characterized by condensation and fragmentation of nuclear chromatin. These cells were identified as beta cells by insulin immunostaining. Other endocrine and exocrine glands, including adrenals and thyroid, as well as salivary and submandibular glands, were unaffected. Organs from the digestive tract or systemic circulatory system, including small intestine, liver, heart, and lung also showed no involvement. The kidney was intact in acutely diabetic rats. However, 6 months after diabetes manifestation, pathological changes compatible with a diabetic nephropathy had developed, affecting both the glomerula and the proximal tubular segments. It was concluded that the autoimmune process in this new IDDM rat model is restricted to the endocrine pancreas and leads to apoptotic beta cell destruction.
