This study examines the experiences of international students at The University of Toledo, where international students comprise approximately 10% of the student population. It highlights problems international students experience such as adapting to a new culture, English language problems, financial problems and lack of understanding from the broader University community. Recommendations for improvement include initiatives to raise the profile of international students, improved financial assistance and scholarships, and creating opportunities for international students to improve their spoken English skills.

Clinical assessments of photodamage are based upon a subjective evaluation of characteristic features such as wrinkling and pigmentary change, and are influenced by inter-observer differences in grading criteria. In an effort to standardize the grading of photodamage severity, we have developed a six-point photographic scale in which each of the six grades of overall photodamage severity is depicted by three photographs. The use of three photographs to portray each grade illustrates the diversity and range of manifestations within each grade. This photographic scale was tested by two groups of dermatologists, who used it on two occasions to grade the overall photodamage severity of a single group of female Caucasian subjects. Results indicate high inter-observer agreement, with chance-corrected agreement ranging from 0.44 to 0.63 and from 0.54 to 0.76 on the first and second occasions, respectively. Intra-observer repeatability was high, with chance-corrected agreement ranging from 0.56 to 0.78. Inter- and intra-observer differences were within one category in nearly all cases. Similar grades were assigned by dermatologists with and without experience in treating photodamaged patients. We conclude that application of this scale results in consistent and reproducible clinical evaluations of overall photodamage severity in Caucasian subjects. The scale may be useful in categorizing subjects for epidemiological studies, or in selecting patients for clinical trials.

Hour-long structured interviews were conducted with 16 volunteer students from four undergraduate physical chemistry classes. Many student alternative conceptions and nonconceptions were expressed about important material covering equilibrium and thermodynamics. Twenty-nine of these were prevalent (present in Ͼ25% of the students.) The student conceptions expressed in their interviews were compared with those expressed by experts in textbooks and rated using a 6-point rubric. These ratings were averaged into a rating in each of four subjects and an overall rating. Correlation indices were computed. The "quality of student conception" rating was best predicted by an aggregated t score for the results on instructor-designed in-class exams. This result indicates that instructor's exams and grades do in fact demonstrate the level of a student's understanding of this course material.

The 4-h post-ERCP amylase level is a useful test to base management decisions on. It needs to be interpreted in conjunction with clinical assessment as well as identifiable risk factors related to the patient or the procedure.

Background and purposeSouth Western Sydney comprises of a culturally and linguistically diverse (CALD) and lower socioeconomic status population group within the state of New South Wales. Geographic location and sociodemographic factors play important roles in access to healthcare and may be crucial in the success of time-critical acute stroke intervention. The aim of this study was to examine the trends in the delayed presentation to emergency department (ED) and identify factors associated with prehospital delay for an acute stroke/transient ischaemic attack (TIA) at a comprehensive stroke centre.MethodsPatient health-related data were extracted for stroke/TIA discharges for the period 2009–2017. Electronic medical record data were used to determine sociodemographic characteristics and prehospital factors, and their associations with delayed presentation≥4.5 hours from stroke onset were studied.ResultsDuring the 9-year period, population-adjusted stroke/TIA discharge rates increased from 540 to 676 per 100 000. A significant reduction in the proportion of patients presenting to ED<4.5 hours (56% in 2009 versus 46% in 2017, p<0.001) was observed. Younger patients aged 55–64 and 65–74 years, those belonging to Polynesia, South Asia and Mainland Southeast Asia, and those not using state ambulance as the mode of arrival to the hospital were at increased risk of prehospital delay.ConclusionsComprehensive reappraisal of educational programmes for early stroke recognition is required in our region due to delayed ED presentations of younger and specific CALD communities of stroke/TIA patients.