Abstract:The modern education community agrees that deep and effective learning is best promoted by situating learning in authentic activity. Many in the education community have put in place constructivist classroom practices that put students into situations where they must make hypotheses, collect data, and determine which data to use in the process of solving a problem or participating in some kind of realistic analysis or investigation. Research in case-based reasoning (CBR), which provides a plausible model of learning from problem solving situations, makes suggestions about education that are consistent with these educational theories and methodologies and which can provide added concreteness and detail. In this paper, we show how CBR's suggestions can enhance problem-based learning (PBL), which is already a well-worked-out and successful approach to education. The computational accounts CBR provides of reasoning activities, especially of knowledge access, access to old experiences (cases), and use of old experiences in reasoning, suggest guidelines about materials that should be made available as resources, the kinds of reflection that will promote transfer, qualities of good problems, qualities of the environment in which problems are solved (e.g., affordances for feedback), and sequencing a curriculum. The two approaches complement each other well, and together, we believe they provide a powerful foundation for educational practice in the constructivist tradition, one that at once combines lessons learned from classroom practice with sound cognitive theory.

There is a widespread impression that the number of patients with the autoimmune liver disease primary biliary cirrhosis (PBC) is increasing, although its incidence and prevalence vary widely. Using thorough case-finding methods and rigorous definitions to assess changes in incidence and prevalence with time and to explore the symptomatology and mortality of the disease in a large group of unselected patients, we performed a descriptive epidemiological study of PBC in a well defined population over a fixed period of time using

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Institutionalized patients with HD are more motorically, psychiatrically, and behaviorally impaired than their counterparts living at home. However, motor variables alone predicted institutionalization. Treatment strategies that delay the progression of motor dysfunction in HD may postpone the need for institutionalization.

Primary biliary cirrhosis is much more common in Newcastle than has previously been reported anywhere in the world, and prevalence appears to be rising.