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How has continuing medical education fared under instructional technology? For this reappraisal, the authors review the use of tapes, slides and film, in the medical profession in the U.S. and in the British Isles; radio and telephone, television, programed instruction, and computers (in their three-fold functions as retrievers of information, consultant in the diagnostic process, and instrument of instruction). Medical educators, the authors conclude, have embraced instructional technology with enormous enthusiasm, but have not done it systematically, seeming to have replaced their customary spirit of inquiry with a spirit of faith. They have neglected the process of diagnosing their needs, following it up with a specific prescription to correct the diagnosed defect, and a careful observation to determine whether the intervention has been effective. (Author/GO)

ABSTRACT:The Weather in Richmond is a short documentary about the Oilers, the football team at Richmond High School in downtown Richmond, California, as they struggle in 2012 with the legacy of winning no games, with the exception of a forfeit, in two years. The video documents the city of Richmond’s poverty and violence, but it also is an account of the city’s cultural diversity, of the city’s industrial history and of the hopes of some of the people who grow up there.The video documents the social struggles of the players: many of them come from single­family households, many of their parents have used drugs and spent time in jail; and many of these players struggle against being drawn into Richmond’s gang culture. The video also documents the football team’s coach, Tashaka Merriweather, a then­27­year old who returned to Richmond to take care of his sick father a few years before. Merriweather went to college in Arizona after graduating from Richmond High School himself, realizing the same dreams of many of his current players: to ultimately leave Richmond, attend a university and build a better life.When Merriweather returned to Richmond, he thought that coaching at the high school would offer him the opportunity to do some good. He would try to help the young people there achieve their dreams of attending college and maybe, even, playing in the NFL, but he found the job harder than he expected, hard but rewarding. The coach now realizes he may remain in Richmond longer than he intended, improving the football team and helping its players.Often, the players leave the team before the season ends, discouraged with their losses, and distracted by family struggles. Many come to school in the mornings without much food in their stomachs because of their poverty; many are involved in the city’s gang life, which results in school suspensions and a lack of dedication to the team. Often, players are forced to leave the team because of poor grades (though a year later, in 2013, the coach succeeded in preventing a single player from needing to drop the team because of grades). The players who stick with the team say their dedication to it, and to Coach Merriweather, has prevented them from ever joining a gang and that their focus on high school football will be a major factor in their graduating.The video documents the city of Richmond’s poverty and violence, but it also is an account of the city’s cultural diversity, of the city’s industrial history; and of the health risks young people take when they play football. It is an account of an area of the San Francisco Bay that is often forgotten by the news media as it covers the affluent tech­sector­dominated neighborhoods of San Francisco and its suburbs.SOURCE LIST:1. A Journey Into North Richmond Part 2: North Richmond’s inauspicious beginnings, by Robert Rogers, Richmond Confidential, 6/8/2011 http://richmondconfidential.org/2011/06/08/part­2­north­richmonds­inauspicious­beginnings/2. Football win slips from Oilers, by Justin Pye, Richmond Confidential, 12/22/2012 http://richmondconfidential.org/2012/09/22/football­win­slips­away­from­oilers/3. CSD Eagles soar past the Oilers, 47­0, by Brittany Patterson Richmond Confidential, 9/15/2012 http://richmondconfidential.org/2012/09/15/csd­eagles­soar­past­the­oilers­47­0/4. Oilers win, by Jennifer Baires, Richmond Confidential, Richmond Confidential, 10/20/2012 http://richmondconfidential.org/2012/10/20/oilers­win/5. Oilers take back the Richmond Cup on senior night, by Rachel de Leon, Richmond Confidential, 11/3/2012 https://richmondconfidential.org/2012/11/03/oilers­take­back­the­richmond­cup­on­senior­night/SCRIPT:KEY: The Weather in RichmondPlayers on the bus going to an away game:NARRATOR: It’s game four of the season for the Richmond High School Oilers. The football team is 0­and­3In fact, they’re 0 and 25. The team hasn’t won a game in almost two years.Shots of the game:Tonight they’re playing the California High School for the Deaf. And before long it’s clear this game won’t be any different for the Oilers. They’ll lose 47 to 0.Their best linebacker, Jorge Diaz, was benched after a concussion. And another star player, runningback Nate House, had to sit out because of an asthma attack.Nate House: Ya’ll don’t come to practice, then don’t nobody know what they’re doing. We can’t have people asking oh what do I do in the middle of the game? We look stupid doing that shit. So everybody — everybody got to come to practice on Monday.Coach Morris: When everybody comes, we can have a scout team and get a look. When don’t everybody come, we got to go half time and it’s not right.Devonte to Matt: Let’s erase this one, and let’s go get Fairfield out the house. First win. Then we take a bi. Then we can ice our little boo­boos. Huh? Stay with me, huh, baby? Stay with me, bro? Good luck bro. Goodluck. My brother’s keeper, yes I am. Head up, baby, head up.Scenery from Richmond; overhead view of the city:Richmond’s a gritty suburb on the San Francisco bay. There’s chemical plants, an oil refinery, lots of railroads...Ford used to build cars here... but that was back in the 1930s. Today, with its gang wars, Richmond’s considered one of California’s most dangerous cities.... Almost no one born here wants to stay.Devonte: I seen somebody get killed on Christmas day. Me and my little brother was in the living room playing the X­Box, and we heard some like gunshots, and then the car just came flying down the street, crashed into the van that was parked in front of our apartment. And then it was a cab driver. And so like—yeah. Everybody went outside, blood started squirting out of his neck, and, yeah, That was an eye­opener right there.Shots of Coach Merriweather coaching.27­year­old Tashaka Merriweather is the Oiler’s coach. He played football here ten years ago and dreamed of joining the NFL.He didn’t make it. But he did find a way out of Richmond... playing football at Arizona State.MW: I just graduated from college, and I’m slowly accepting the reality that I’m not going to be playing in the NFL or professional, so I need to be doing something else with my life..... And then I got the phone call about my dad having a stroke and needing to come back and help out the family.KEY: Game 5: Richmond vs. Fairfield, September 21, 2012 KEY: Richmond is 0 and 4.NATIONAL ANTHEMDevonte: “We play Fairfield Falcons, and this week’s practice been kind of like harder than the others just because we’re just being hungry and ready to get this W. W is win.At halftime, the Oilers are winning, 14 to 8. LOCKER ROOM:Coach Marlyn: Do this together, and we got it! You make sure it’s about we. The minute you start putting yourself ahead of this family, then mistakes are made. Stick with the family. Do your job. Do what you’re counted on to do, and we’ll get it done. I promise you that. Stay solemn fellows One more half. (Team claps). HALFBut in the fourth quarter, Fairfield takes the lead.MW, in the locker room, players crying: “The best part of our season is ahead of us. Simple as that. Alright?”Those guys who played they ass off and played they heart out, I’m proud of you. I’m real proud of you. Those guys who keep having mental breakdowns, alright, you got to figure it out, because you’re letting your teammates down. Simple as that.MW (INTERVIEW): I don’t know if you’ve noticed, kind of driving into Richmond from other places and how the weather seems like it changes almost and there’s kind of cloudy and gloomy at times. That’s how I feel. That there’s a cloud or there’s a weight that’s on the people of Richmond, here, that’s weighing us down, and in turn that causes us to go against each other or kill each other or hate and say, ‘You can’t do that.’ I hate to say it but almost like crabs in a bucket, and we’re all trying to climb out.Jorge Diaz is the team’s star linebacker ... The coaches want to get Jorge out of Richmond. .... They’ve found him offers, and got him scholarships. But he’s staying put.... to help his mom, who’s just been released from prison. He says he’ll go to nearby community college, improve his game there, and then transfer to a four­year university, someplace else...someplace where the NFL sends recruiters.The NFL’s been a dream of mine since I was eight, and I’ve had people tell me that I wouldn’t be able to do it, I’m nothing, // the main thing is my pastor. Sadly I had a conversation with him about me pursuing football. He told me that I have more of a chance of getting struck by lightning than making it to the NFL, and that got me pretty pissed. So I stopped going to church.// I mean, the people that don’t believe in me, I really don’t associate with them because why associate myself with people that just bring my hopes down.A few blocks from the high school, the members of a local church make the team dinner every week.PASTOR CURTIS ZACKERY: “And the thing I love about what’s happeningright now is that you guys are still here. I just want to acknowledge that. You guys are still here, and you’re standing up. So you’re basically walking forward, and you’re being men of character. In the middle of suffering, you’re saying basically, ‘Hey, I’m going to stand firm, and I’m allowing this character to produce hope that tomorrow night the win’s going to come. Does anybody still have hope that the win’s going to come? (No!) Alright, that’s what I’m talking about.”KEY: Game 9: Richmond vs. Albany, October 19, 2012 KEY: Richmond is 0 and 7.The Oilers are playing the Albany Cougars ... They’re from a wealthier town... And it’s that team’s homecoming.... At halftime, Albany’s winning, twelve to six.But in the third quarter, the weather changes. Tra’von Clay, on the Oilers, finds a hole... and he scores.ThenTra’vonscoresanothertouchdown... Thenhescorestwomoretimes,andit’stheOIler’s first real win in two years...ANNOUNCER: Touchdown...... Richmond! Team lining up for high­fives, happy, celebrating. Team cheer, gathering around Coach Byrd for hisend­of­game speech.COACH: Hey, I’m proud of you. And I’ll tell you, the feeling that you feel right now, tell me I wasn’t lying when I told you there’s nothing sweeter in life than a victory. There’s nothing sweeter in life than a vicotry!COACH 2: Who we got next we all? PLAYERS: Kennedy! COACH 2: Who we got next week all? PLAYERS: Kennedy!COACH 2: (inaudible)Coach Byrd: I’m on camera, so I ain’t gonna say what I wanna say. Fuck it, I am! Fuck em!At church, for the team dinner.MW, sitting and talking to camera: One way or another, we decided to schedule our rivals as our homecoming game.” (Kate ­ “Is that how it always is?”) “No. And if I would have bet — or to chose it — I probably wouldn’t have chosen it that way, but, you know, that’s how I feel.”Players eating dinner. In Richmond, the gangs divide themselves between North Richmond..where Richmond HighSchool is.. and South Richmond, where high school students go to Kennedy.Pastor Dave Curtis: “As a football player, you should know that it’s wartime. You should know that tomorrow is going to be a battle. You have a wartime mentality because you know that you’re about to face an enemy, you’re about to face an adversary.Cut to interview with Jorge.Jorge: “My mom told me to always hide my anger. She said never show it. So most of the time, I hide it. But when I get on that field it’s like — it’s like a no­holds­barred match — it’s just let it all out.While Jorge finishes, music starts; cut to the pre­homecoming­game dance. Shouting and dancing, the team runs off the field into the dark, feet pounding.Jorge: Ever since freshman year, I’ve had so much anger, I mean, there’s times where people step out of line, and I just want to beat them down. But I just remember what my mom always says, like, ‘Don’t show your anger.’ So when I’m on that field I tend to try to tear heads off. So I just let all my anger out there.Jorege.. with his mom at a halfway house now, Jorge lives with his cousin Matt.. and Matt’s grandparents. Both of them have had parents in jail. In Matt’s RoomMatt: It’s a big rivalry game, against Kennedy. we’re in the same city. And we gonna see what team’s better. Which is us. And we got ?, our walk, our march on 23rd, and then it’s game time. And we gonna win, we gonna win. ... Tray is here.Tray walks in, says high to grandmother.Tra’von walks with Matt and Jorge to school almost every day.Cut to Tra’von and Matt talking about the game together.Matt: Towards the end of the season, you find out who your real players are, who really wants to stick around and play. And then once all the other people that didn’t feel like football was for them — they just quit — and then the people who wanted to play get in the game more. And then that’s how we got our first win.Tray: Lying flat on bed, looking at ceiling: Richmond High winning doesn’t sound normal. People were so surprised we won last week.Jorge: We ran 200 on Hercules, 400 on Albany. Tray: We only ran 200 on Albany?Jorge: Two, 200 plus. But then, just imagine how much we about to run today.Tray: Dang, 600. Cut to Jorge: Game timeMatt’s grandmother: Tray, you want a cereal bar or a banana? Tray: I’ll take a banana.Matt’s grandmother: Go get it. Go on... He want’s a banana. Bye guys. I’ll see you tonight.Matt: The game’s at 6:15. Matt’s grandmother: I’ll be there early. Jorge: Dang, she’s gonna be there around seven.Jorge, Matta and Tra’von walking to school.Jorge: Yeah, we walk to school. Sometimes we get chased by a big dog. Uh, stop at the corner store sometimes if we ain’t broke.Matt: We get some energy in our body. Jorge: Yeah, talk to some pretty girls, get turned down, keep our head upand keep doing it anyways.Shots of police gang unit officers on the sidelines before the game starts, people going through metal detectors. Mascot rallying the crowd as the team preps in the background.The word at school is something might go down tonight. One of Richmond’s football players was in a fight with some Kennedy gang rivals a few days before, so tensions are high.Cut to Merriweather, huddled with players on field.Kennedy scores immediately... and finishes the first half ahead, 16 to zero.... After halftime, Tra’von scores a touchdown.But, suddenly, the police show up and start evacuating the stands... People hear gunshots and take shelter. Stands evacuating Police escort the team from the field:POLICE MAN TO MW: Suspend game. Everybody to their spots until we clear.MW: Right here? Hey! Everybody to the fence! To the fence! To the fence! Everybody to this fence! Hurry up! Right to the edge of this fence! Hey! Stay on the left side of the scoreboard! Left side of the scoreboard!Homecoming is canceled.The police report later that some Kennedy students.. they’d been kicked out of stadium... had fired some gun shots a few blocks away.MW: If you start walking around, you on your own.Devonte: What time do we meet here to finish tomorrow?MW: I haven’t found out. It probably won’t be tomorrow — it’s probably going to be either midweek or sometime either after Friday or whenever. But for now, get undressed and let’s see if we can follow those directions.MW: It’s going to be either midweek or sometime after Friday or whenever. For now, get undressed and stay in here..let’s see if we can follow those directions. // CUT TO WOMEN YELLINGOutside, the families are angry.MOTHER: Alright, you kick everybody out of the fucking stands. My baby on the field! We going together. Together! We is! Mark’s mama. ... You turn around and put everybody out.Lockerroom:MW: So it looks like they gonna cancel the dance. So they about to kick them out, but what you all got to do, or you’re going to be stuck in here: if you got rides, start calling them right now. They probably not going to let you walk by yourselves, so start calling your rides and chill out in here.PLAYER: I’m mad, the game is cancelled, we would have won probably, who knows. Now our dance is cancelled — all of this. Man, it’s some bullshit. It’s some BS.PLAYER: We could have came back easily. We could have came back easilyPLAYER: We already know it was going to happen, we already know it was going to happen, we already know it was going to happen ...PLAYER: I’m mad ‘cause they cancelled the game!Interviews:MW: Things have changed just so fast. You know, when I played during that time, I had guys from North Richmond, from Central, from the South — all on the same team. But they wouldn’t want to kill each other.JORGE: “Yeah, at times I feel sorry for him because he could be somewhere else dealing with a team that’s five­and­oh or six­and­oh rather than Oh­and­2 or Oh­and­6, but he said it best is — the only time he’s going to leave — the only time he will leave is if they put a statue out in Richmond High of him. So I’m pretty sure he’s going to be around for a long time (smile).DEVONTE: I look up to him like a big brother. ‘Cause like he went to college and he also came from Richmond. He came out of Richmond High. So he told us his story of how he made it out of Richmond High. And I felt like if he did it, I’m pretty sure the rest of the team can do it, too.Shots of the last game.It’s the last game of the season, and the Oilers are playing De Anza, another high school in Richmond... for “The Richmond Cup”... a trophy that passes from one team to another, one game each year. And tonight, the players’ parents are sending them off.CHEERLEADING COACH: And now, our senior football players... Number 12, Quarterback Devonte Anderson, escorted by his mother, Jacquie Frazier, and his niece, Teniah.Team huddles on field.COACH MORRIS: Don’t be the guy that don’t hit. Don’t be the weak sister tonight, gentlemen.Shot of an Oiler scoring a touchdown.In the first half, each of the teams scores a touchdown. But the Oilers have been arguing among themselves, and the coach isn’t happy.Locker room at halftime:MW: We been bickering and complaining about each other all damn year, alright? All year! Only reason we lose is because we can’t get past each other. Either we don’t like each other or we don’t like the players. Whatever it is, we can’t get past each other. And it’s a shame on senior night that we want to bring the same thing that’s been hindering us all year to the field on the last game. You want to argue, we never gonna get anywhere. We gonna have six points, alright. Yall need to figure out if we gonna play with a team, as a team, in the second half or if we gonna come in here with sad faces talking about shoulda, coulda, woulda like the whole season. Figure it out.COACH 2: Let’s go, seniors.Huddle on sideline with Coach Byrd:PLAYER 2: Coach, my momma is here! My mom is here! She never seen me run the ball!COACH BYRD: Yeah, she did!Matt couldn’t play this last game because of a leg injury.Matt: (talking on sideline, looking at game): We’re actually a good team. I just don’t know why we can’t win. I mean most of our games have been close, but — we’re a good team. People just don’t see that. I don’t know why.But tonight, with parents here and a tied score, the mood in the stands is better than usual.CheerleadersDEVONTE’S SISTER: I’m Jasmine Perkins, I’m Devonte Anderson’s sister. Devonte will be the actually first person out of the family to go to college. So this is a very big, special opportunity for him and us to see someone in the family make it, to fulfill their dreams, you know, make their wishes come true.We’re going to root for him, we’re trying to get there, we need one more! Let’s make a touchdown Vonte! Let’s go!Pan from Jasmine to Tra’von scoring a touchdown.CAMERAMAN: Tra’von, what just happened?TRA’VON: I just scored a touchdown. It felt pretty good. I mean, I’ve scored a touchdown before, but it never felt this good. It never felt this good. Especially to get it for my seniors, you know, we worked so hard for this. It never felt so good. It never felt so good. I just can’t wait to finish these last three minutes and 28 seconds— with effort. Let’s get this win.Little boy on sidelines to camera:We are getting our comeback! We are getting our comeback. Richmond High rules! Who’s better now? Who’s better now? Tell me that.Players dump water on coach.The Oilers win their final game.MW: Hey! Line it up, Line it up!Players celebrate; lift up cup and chear.TEAM: Richmond! Richmond! Richmond!KEY: A year later, in 2013, the Oilers played another two­win season.KEY: The game against Kennedy was never rescheduled.KEY: Jorge is taking classes at a community college near Richmond and working two jobs to support his mother.KEY: Devonte won a basketball scholarship to the College of the Sequoias, a two­year community college in central California about 225 miles from Richmond.KEY: Coach Merriweather will begin his fourth year as Richmond High School’s Head Football Coach next fall.KEY: Produced by William HarlessCamera and Sound: William Harless Byrhonda Lyons Rachael Waldhoz Mark Oltmanns Kate ElstonRyan Loughlin Julia Marshall Derek Lartaud Byron Wilkes Wendi Jonassen Yirmeyah Beckles Dylan Bergeson Maggie Beidelman Alexis Kenyon Amina Waheed Adam GrossbergFaculty Advisor: Robert Calo, Senior Lecturer, UC Berkeley GraduateSchool of Journalism Technical Advisor: Kean Sakata

Paper presented at Annual Meeting of the Association of American Medical Colleges (79th, Houston, Texas, October 31, 1968).

This project allows medical students to assume the role of practicing physician actively engaged in the process of clinical decisionmaking. (IR)

Manpreet Sambi,1 Sabah Haq,1 Vanessa Samuel,1 Bessi Qorri,1 Fiona Haxho,1 Kelli Hill,1,2 William Harless,2 Myron R Szewczuk1 1Department of Biomedical and Medical Sciences, Queen’s University, Kingston, ON, Canada; 2ENCYT Technologies, Inc., Membertou, NS, Canada Abstract: One of the primary challenges in developing effective therapies for malignant tumors is the specific targeting of a heterogeneous cancer cell population within the tumor. The cancerous tumor is made up of a variety of distinct cells with specialized receptors and proteins that could potentially be viable targets for drugs. In addition, the diverse signals from the local microenvironment may also contribute to the induction of tumor growth and metastasis. Collectively, these factors must be strategically studied and targeted in order to develop an effective treatment protocol. Targeted multimodal approaches need to be strategically studied in order to develop a treatment protocol that is successful in controlling tumor growth and preventing metastatic burden. Breast cancer, in particular, presents a unique problem because of the variety of subtypes of cancer that can arise and the multiple drug targets that could be exploited. For example, the tumor stage and subtypes often dictate the appropriate treatment regimen. Alternate multimodal therapies should consider the importance of time-dependent drug administration, as well as targeting the local and systemic tumor environment. Many reviews and papers have briefly touched on the clinical implications of this cellular heterogeneity; however, there has been very little discussion on the development of study models that reflect this diversity and on multimodal therapies that could target these subpopulations. Here, we summarize the current understanding of the origins of intratumoral heterogeneity in breast cancer subtypes, and its implications for tumor progression, metastatic potential, and treatment regimens. We also discuss the advantages and disadvantages of utilizing specific breast cancer models for research, including in vitro monolayer systems and three-dimensional mammospheres, as well as in vivo murine models that may have the capacity to encompass this heterogeneity. Lastly, we summarize some of the current advancements in the development of multitarget therapeutics that have shown promising results in clinical and preclinical studies when used alone or in combination with traditional regimens of surgery, chemotherapy, and/or radiation. Keywords: breast cancer, alternative therapy, drug resistance, cancer stem cells&nbsp

The TIME Project of the Lister Hill National Center for Biomedical Communications is using interactive videodisc, microprocessor and voice recognition technology to create patient simulations for use in the training of medical students. These interactive case studies embody dramatic, lifelike portrayals of the social and medical conditions of a patient and allow uncued, verbal intervention by the student for independent clinical decisions.