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May 2015 Archives

Saw the webpage headline

First thought: ewwwwww.

Second thought: ooooh, I wonder what that's all about?

Answer: a little filiarid worm.

FIliarid worms are roundworms (nematodes). I knew about the one that causes the disfiguring disease known as elephantiasis, but hadn't heard about the 'eyeworm', or Loa loa. Elephantiasis is due to lymphatic filiariasis, where the nematodes congregate in lymphatic tissue; L.loa causes subcutaneous disease. Apparently it often presents as 'calabar swellings', typically on the hands & wrists, but can also travel across the eyeball. I can only think that this must be both painful and incredibly disconcerting.`

While L.loa infection isn't itself life-threatening, that changes if someone is also infected with other parasites. As the CDC notes

[r]ecognition of Loa loa infections has become more important in Africa because the presence of infection has limited programs to control or eliminate onchocerciasis and lymphatic filariasis.

Both these other parasites can be controlled by dosing patients with a drug like Ivermectin. Unfortunately the drugs can't be used in someone with a concurrent Loa loa infection, because where an individual has a high load of multiple parasites, the treatment can cause severe encephalitis, coma, or death

So it's really exciting to hear that health workers can now use a microscope attachment (& relevant app) for a smart phone to screen people for this particular parasite :) And can get results in 2 minutes or less, out in the field, with no need for a diagnostic laboratory. The challenge now is to scale up production of the technology in order to meet burgeoning need in Africa: 

Fletcher admits that for the CellScope Loa to be applied to the many millions of people in Africa who need ivermectin treatments, his lab will first have to figure out how to scale up the technology; right now, they’re assembling each scope by hand in the lab. Getting industry help could also be a challenge, he says. “It’s hard to entice companies to make devices whose very goal is to eventually eliminate the need for the device.”

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I've heard it said more than once that complementary & alternative medicine (CAM) 'does no harm' - here's just one example. I suppose that could be true of a healthy person using something like homeopathy, where the only harm is likely to be to their wallet. But time and again, forms of CAM have been shown to do harm, and now we hear of another tragic, and fatal, case. 

In Sydney, a 7-year-old child with type I diabetes has died following the use of 'slapping therapy'

Chinese therapist Hongchi Xiao, who advocates the use of slapping therapy until ­patients are bruised to cure illnesses and rid the body of poisons, is now being investigated by police over the death.

On what planet is it OK to slap a child until they are bruised, let alone to claim health benefits for this? If an adult is foolish enough to submit themselves to this (& to sustain this sort of damage), it's one thing, but a small child? And it seems it wasn't just slapping.

Participants in the seminar were asked to fast for three days and to undertake the slapping and stretching exercises that can prompt vomiting and dizzy spells, known as a "healing crisis".

Fasting? For a type I diabetic? Fasting while on medication can cause hypoglycaemia, which can be fatal if untreated. Fasting without insulin can result in diabetic ketoacidosis, which is also dangerous.

The 'healer', Hongchi Xiao, has apparently stated that 

The greater the pain and bruises while slapping means there is more poison inside the body,”

and would seem to have developed quite a marketing empire around his bizarre claims, if a quick Google search is anything to go by. Amazingly, it seems that after questioning by the Australian police, this charlatan was allowed to leave the country, and will doubtless continue to promote his nonsense elsewhere and to others.

"Alternative medicine does no harm." Yeah, right.

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On Wednesday we ran our first whanau tutorial with the first-year students - a class for those students who identify as Māori. The driver for this was the observation that a disproportionate number of the Māori students in my first-year class didn't do well in our first test, & as a result I asked Kevin, our Faculty's senior tutor responsible for supporting Māori & Pacific Island students, to see if he could help me by setting up a whanau tutorial.

So he contacted all the Māori students in the class, sorted out a time & day that worked for them, and booked a room, & both of us organised some food and drink. Kev welcomed everyone & one of the students said a karakia (prayer) before we started. Brydget, the senior tutor who runs our first-year bio labs, came along, and so did one of the tutors from Student Learning - who took on the role of asking the 'silly questions', to show the students that asking questions really is a good thing & one that's encouraged. Which gave me the chance to steal one of Brydget's lines: that the only silly question is the one you didn't ask :)

There was a test coming up and so the students wanted to work through questions from previous tests, plus they wanted to know how to learn (& remember) things like the characteristics of some animal phyla. I did a bit of talking but for much of the time we had the students working together in groups after a bit of an explanation from me. It was great seeing the energy levels, the engagement, and the fun in the classroom. Brydget & I both try for that when we're teaching, but this was a whole new level. It was quite a salutory eye-opener for me, as I've liked to think I'm an 'inclusive' teacher, but I'd never had this level of engagement from this particular cohort before, and I've learned now that I still have a long way to go.

We ended up going way over time and the students were buzzing when they left. Kevin always does exit surveys for his group work and I was really looking forward to the results: there's a lot of evidence available on the effect of supporting Māori students' learning styles, but I wanted to see how our own students had perceived the session. Fourteen of the 16 attendees completed the survey, & it turned out that

  • all 14 agreed that they could understand the presenter.
  • they loved the learning environment, commenting that it was easier to ask questions; they liked the interactions and group work & the opportunity to work out the answers; felt that I'd explained things clearly & liked it that I made sure they understood before we went on to a new topic; the sheer informality & friendly environment went down well.
  • they'd all recommend it to their friends (yay!) & rated it as either very good or excellent
  • and felt it was a great way to revise.

As I said, a salutory learning experience for me. I've always tried to make classes inclusive, interactive & so on, but it was obvious that the set-up of this particular workshop - with its focus on a specific cohort - provided the spark that was missing.

Even better, next morning a lot of the whanau participants came along to a standard tut with a lot of other students there, as they usually do - but this time things were different. They were much more active in the class, spoke up more and asked more questions than before; their confidence was at a whole new level. They were the only ones to point out to me that I'd made a mistake with labelling a diagram :) (And I said thank you, & that I appreciated it, & it showed they really understood that particular topic.) And afterwards some came up to say how much they'd enjoyed the whanau tut, and a couple followed me back to my office to ask more questions - also a first. And after the test last night I heard that they felt they were much better prepared, this time round. (I haven't started the marking yet, but I am sooo hoping that this translates into improved grades!)

So yes, we'll continue this for the rest of the semester, and on into the next half of the year. There's nothing novel in what we did, & I certainly can't claim any credit (there's a lot in the literature on how best to help Māori students in tertiary classrooms eg hereherehere, & here). I'm just mentally kicking myself, and wishing we'd done it much sooner.

And I'm thinking: the Tertiary Education Commission has identified Maori and Pacific Island students as groups that TEC would like to see increasingly more involved with tertiary education. And to do that, and to maximise their learning success, we do need to reorganise our classrooms: eg do more flipping; get used to a higher level of chatter as students work together to solve problems; reduce the formality inherent in a 'normal' teacher-driven lecture class & sometimes become learners alongside our students. And that requires recognition that students' needs have changed since those of my generation were on the learners' side of the lectern, and that learning styles can and do differ & can be accommodated by using a range of teaching techniques. In other words, a classroom culture shift - one that sees educators recognising that they, too, can be learners when it comes to meeting the needs of a changing student demographic.

And of course, the evidence is already there that making these changes benefits all students.

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