Curriculum for Sale: what is the wisdom?

Learning outcomes On completing the editorial, the reader is expected to: Define ‘curriculum’, curriculum type, name and model and the bought curriculum. Explain the pros and cons of the bought curriculum vies a vie locally produced curriculum.  Describe briefly the basic principles and process of modifying the bought curriculum. The title is not intended by any means to demote what we can call ‘the bought curriculum’ which, in recent years, has become the vogue, especially in the ‘rich’ developing countries, to an extent that it should earn  a place among the various types and models of medical (or rather health science) curricula. Another similar earner, which will not be our subject here, has the unfortunate model name of ‘the highbrid curriculum’.  It would be pertinent first to touch on some definitions of terms

Impact of organic manure and combination of N P K S, on yield, fruit quality and fruit mineral content of Khenazi date palm (Phoenix dactylifera L.) cultivar: -

This study was carried out during three successive seasons 2011, 2012 and 2013 at a private orchard located in Al- Hello in Ajman Emirate (UAE). The experiment was designed to study the effect of organic manure and NPKS as soil application on yield, fruit quality, and fruit mineral nutrient content of Khenazi date palm cultivar grown in sandy soil. Fertilization treatments consisted of N1, 600g or N2, 1000g (urea 46%N), P 800g (triple superphosphate, 48% P2O5), K 1200g (potassium sulphate, 50% K2SO4) and S 700g sulphur (90% granular S), in addition to organic manure. Al experimental trees received 100g mixture of micronutrients, with the exception of the control. The results showed that combination treatments and organic manure significantly affected fruit weight, flesh weight, fruit volume, moisture content and fruit TSS. Application of different fertilization treatments significantly affected yield components of fruit, number of fruits/strand, fruit number/bunch, fruit set percent and total fruit yield / palm. The study revealed that combination of fertilizers improved fruit nutrient content of N, P, K, Ca, Mg, Fe, Zn, Mn and Cu. Moisture and TSS% content, number of fruits/strand, number of fruits/bunch, fruit nutrients content of Fe, Mn and Zn were significantly different due to the application of N1+K+S

A Regional Insight into Sudanese Women’s Participation in the December Revolution

Introduction The popular uprising against the Islamist-Military regime of Omar al-Bashir started in December 2018, and women were at the forefront of the peaceful protests in many locations throughout the country. The uprising, which is now popularly known as the December revolution, started in Damazeen in Blue Nile state with schoolgirls and boys protesting the poor living conditions and scarcity of bread. Street protests spread throughout the country, including to the capital Khartoum. Economic grievances were put in the context of authoritarianism and the corruption of the Bashir regime, which had ruled the country with an iron first for three decades (1989-2019). The main slogan of the protestors became “fall that is all” and “freedom, peace and justice”. After eight months of protests, Bashir was ousted from office through an internal military coup in April 2019. A transitional military council consisting of Bashir’s former allies took control of the state. Hundreds of thousands of Sudanese citizens formed a sit-in in front of the military headquarters in Khartoum demanding a transition to a civilian government. On June 3 rd , the sit-in was crushed by a branch of the military, namely the rapid-support forces (RSF) which until six years ago were better known as the militia janjaweed that fought the war in Darfur on behalf of the Bashir regime. Despite the killing and arrest of protesters during what has been coined the “Sudan massacre”, the protests continued. In August 2019, negotiations between the transitional military council and the Forces for Freedom and Change [1] facilitated a new transitional government guided by the Constitutional Declaration. [2] However, in October 2021, the military hijacked Sudan’s transition to democracy and the transitional government they were part of. This kickstarted new calls for a freedom, peace, and justice under the umbrella of a civilian state. Protests

Effects of transcranial direct current stimulation combined with motor relearning program on strength and balance in stroke patients

Background A stroke is characterized by neurological deficits that result in compromised muscle strength and balance, impacting the overall wellbeing of the patient, including decreased quality of life, socialization and participation in daily activities. The aim of the study is to determine the effects of transcranial direct current stimulation combined with a motor relearning program on strength and balance in sub-acute stroke patients. Methods The randomized controlled trial involved 44 subacute stroke patients, randomly assigned to either the experimental group (n = 22) or control group (n = 22). The intervention included anodal transcranial direct current stimulation (tDCS) for the experimental group and sham stimulation with a motor relearning program for the control groups. Assessments were conducted using manual muscle testing for muscle strength and the Berg Balance Scale for balance at baseline, the fourth week, and the eighth week. Results There were no statistically significant effects in the experimental group for either strength or balance (p-value > 0.05) but there were time effects for both variables especially during the intervention period in both the experimental and control groups. Conclusion There does not appear to be any short term or long-term additional effects of anodal transcranial direct current stimulation on strength and balance in subacute stroke patients

The need for national medical licensing examination in Saudi Arabia

<p>Abstract</p> <p>Background</p> <p>Medical education in Saudi Arabia is facing multiple challenges, including the rapid increase in the number of medical schools over a short period of time, the influx of foreign medical graduates to work in Saudi Arabia, the award of scholarships to hundreds of students to study medicine in various countries, and the absence of published national guidelines for minimal acceptable competencies of a medical graduate.</p> <p>Discussion</p> <p>We are arguing for the need for a Saudi national medical licensing examination that consists of two parts: Part I (Written) which tests the basic science and clinical knowledge and Part II (Objective Structured Clinical Examination) which tests the clinical skills and attitudes. We propose this examination to be mandated as a licensure requirement for practicing medicine in Saudi Arabia.</p> <p>Conclusion</p> <p>The driving and hindering forces as well as the strengths and weaknesses of implementing the licensing examination are discussed in details in this debate.</p

The global, regional, and national burden of adult lip, oral, and pharyngeal cancer in 204 countries and territories:A systematic analysis for the Global Burden of Disease Study 2019

Importance Lip, oral, and pharyngeal cancers are important contributors to cancer burden worldwide, and a comprehensive evaluation of their burden globally, regionally, and nationally is crucial for effective policy planning.Objective To analyze the total and risk-attributable burden of lip and oral cavity cancer (LOC) and other pharyngeal cancer (OPC) for 204 countries and territories and by Socio-demographic Index (SDI) using 2019 Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study estimates.Evidence Review The incidence, mortality, and disability-adjusted life years (DALYs) due to LOC and OPC from 1990 to 2019 were estimated using GBD 2019 methods. The GBD 2019 comparative risk assessment framework was used to estimate the proportion of deaths and DALYs for LOC and OPC attributable to smoking, tobacco, and alcohol consumption in 2019.Findings In 2019, 370 000 (95% uncertainty interval [UI], 338 000-401 000) cases and 199 000 (95% UI, 181 000-217 000) deaths for LOC and 167 000 (95% UI, 153 000-180 000) cases and 114 000 (95% UI, 103 000-126 000) deaths for OPC were estimated to occur globally, contributing 5.5 million (95% UI, 5.0-6.0 million) and 3.2 million (95% UI, 2.9-3.6 million) DALYs, respectively. From 1990 to 2019, low-middle and low SDI regions consistently showed the highest age-standardized mortality rates due to LOC and OPC, while the high SDI strata exhibited age-standardized incidence rates decreasing for LOC and increasing for OPC. Globally in 2019, smoking had the greatest contribution to risk-attributable OPC deaths for both sexes (55.8% [95% UI, 49.2%-62.0%] of all OPC deaths in male individuals and 17.4% [95% UI, 13.8%-21.2%] of all OPC deaths in female individuals). Smoking and alcohol both contributed to substantial LOC deaths globally among male individuals (42.3% [95% UI, 35.2%-48.6%] and 40.2% [95% UI, 33.3%-46.8%] of all risk-attributable cancer deaths, respectively), while chewing tobacco contributed to the greatest attributable LOC deaths among female individuals (27.6% [95% UI, 21.5%-33.8%]), driven by high risk-attributable burden in South and Southeast Asia.Conclusions and Relevance In this systematic analysis, disparities in LOC and OPC burden existed across the SDI spectrum, and a considerable percentage of burden was attributable to tobacco and alcohol use. These estimates can contribute to an understanding of the distribution and disparities in LOC and OPC burden globally and support cancer control planning efforts

Global, regional, and national prevalence of adult overweight and obesity, 1990–2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021

Background: Overweight and obesity is a global epidemic. Forecasting future trajectories of the epidemic is crucial for providing an evidence base for policy change. In this study, we examine the historical trends of the global, regional, and national prevalence of adult overweight and obesity from 1990 to 2021 and forecast the future trajectories to 2050. Methods: Leveraging established methodology from the Global Burden of Diseases, Injuries, and Risk Factors Study, we estimated the prevalence of overweight and obesity among individuals aged 25 years and older by age and sex for 204 countries and territories from 1990 to 2050. Retrospective and current prevalence trends were derived based on both self-reported and measured anthropometric data extracted from 1350 unique sources, which include survey microdata and reports, as well as published literature. Specific adjustment was applied to correct for self-report bias. Spatiotemporal Gaussian process regression models were used to synthesise data, leveraging both spatial and temporal correlation in epidemiological trends, to optimise the comparability of results across time and geographies. To generate forecast estimates, we used forecasts of the Socio-demographic Index and temporal correlation patterns presented as annualised rate of change to inform future trajectories. We considered a reference scenario assuming the continuation of historical trends. Findings: Rates of overweight and obesity increased at the global and regional levels, and in all nations, between 1990 and 2021. In 2021, an estimated 1·00 billion (95% uncertainty interval [UI] 0·989–1·01) adult males and 1·11 billion (1·10–1·12) adult females had overweight and obesity. China had the largest population of adults with overweight and obesity (402 million [397–407] individuals), followed by India (180 million [167–194]) and the USA (172 million [169–174]). The highest age-standardised prevalence of overweight and obesity was observed in countries in Oceania and north Africa and the Middle East, with many of these countries reporting prevalence of more than 80% in adults. Compared with 1990, the global prevalence of obesity had increased by 155·1% (149·8–160·3) in males and 104·9% (95% UI 100·9–108·8) in females. The most rapid rise in obesity prevalence was observed in the north Africa and the Middle East super-region, where age-standardised prevalence rates in males more than tripled and in females more than doubled. Assuming the continuation of historical trends, by 2050, we forecast that the total number of adults living with overweight and obesity will reach 3·80 billion (95% UI 3·39–4·04), over half of the likely global adult population at that time. While China, India, and the USA will continue to constitute a large proportion of the global population with overweight and obesity, the number in the sub-Saharan Africa super-region is forecasted to increase by 254·8% (234·4–269·5). In Nigeria specifically, the number of adults with overweight and obesity is forecasted to rise to 141 million (121–162) by 2050, making it the country with the fourth-largest population with overweight and obesity. Interpretation: No country to date has successfully curbed the rising rates of adult overweight and obesity. Without immediate and effective intervention, overweight and obesity will continue to increase globally. Particularly in Asia and Africa, driven by growing populations, the number of individuals with overweight and obesity is forecast to rise substantially. These regions will face a considerable increase in obesity-related disease burden. Merely acknowledging obesity as a global health issue would be negligent on the part of global health and public health practitioners; more aggressive and targeted measures are required to address this crisis, as obesity is one of the foremost avertible risks to health now and in the future and poses an unparalleled threat of premature disease and death at local, national, and global levels. Funding: Bill &amp; Melinda Gates Foundation