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Cataract is the most common cause of
visual impairment that can be effectively treated by surgery and cataract
surgery is the most commonly performed surgical procedure in the world. With
modern cataract operation techniques, patients expect excellent results.
Teaching and training of new surgeons involve both pedagogical and ethical challenges
for teachers and trainees, and also may pose a potential risk to patients. This literature-based essay
aims to describe how behavioristic, cognitive and conceptual learning
perspectives can be recognized during the trainee surgeon’s progress. It also describes how
teacher-pupil relationships may vary during the training process. Finally it
presents the concept of situational tutorship, where the teacher adapts to the
stages that the trainee passes through with increasing experience. Teaching and
trainee surgeons who are aware of pedagogical concepts such as teacher-pupil
relationships and tutoring strategies may use this knowledge to optimize the
learning process. Further research is needed to clarify how using this
knowledge may affect the training of new cataract surgeons.
The aim of this observational study
was to biochemically characterize the anaemia in GCA (giant cell arteritis) and
PMR (polymyalgia rheumatica) patients. Values for mean corpuscular volume, mean
corpuscular hemoglobin and soluble transferrin receptor were normal, whereas serum iron and total iron
binding capacity (TIBC) were subnormal, and mean ferritin was above the upper
reference limit. Iron-restricted erythropoiesis (IRE), defined as a bone marrow
smear staining positive for iron in combination with transferrin saturation
less than 20%, was present in all patients. All patients exhibited clinical and
biochemical signs of active inflammation with elevated C-reactive protein and
an increased erythrocyte sedimentation rate.
Our premise for this literature review is the global demographic change caused by the world’s population living longer and becoming older, and extensive international migration leading to multicultural societies. Increasing age leads to health problems, often long-term or chronic, requiring investments in health care. Worse health and dissimilarities in pattern of morbidity/ mortality have been found in foreign-compared to Swedish-born persons, so it is reasonable to assume that this affects use of health care. The exploratory review focuses on elderly migrants’ (>65 years) use of healthcare. The databases Pub Med, EBSCO, CINAHL and ERIC were searched in 2000-2013. A limited number of studies were found; few had a comparative approach, most were from the USA, and focused on migrants from the former Soviet Union or countries in South-East Asia. A range of factors were identified that influence patterns of health care use: language fluency, ability to communicate, self-reported health status, prevalence of chronic disease, physical distance from care provision, availability of transport to reach care, cost of care, the health insurance system, cultural norms and values regarding different forms of care, level of education, and length of residence in the host country. Most studies treated health care from a general perspective and collected data from community and hospital settings, without analysing usage separately. Some studies indicated elderly migrants making use of health care less than other groups but the pattern is not unambiguous: other studies show that there is an overuse of health care. It is therefore difficult to show any particular pattern, or possible differences in use, regarding community versus in-patient care. Studies focusing on migrants’ actual use of health care are few and further research is needed, especially because elderly people form the largest group of users of health care and will be even larger in the future.