Journal of Audiovisual Media in Medicine
ISSN: 0140-511X (Print) (Online) Journal homepage: http://www.tandfonline.com/loi/ijau19
The Wellcome Trust tropical diseases videodisc project J. A. Longstaffe, J. Marshall & M. Whittlestone To cite this article: J. A. Longstaffe, J. Marshall & M. Whittlestone (1992) The Wellcome Trust tropical diseases videodisc project, Journal of Audiovisual Media in Medicine, 15:2, 57-60, DOI: 10.3109/17453059209018343 To link to this article: http://dx.doi.org/10.3109/17453059209018343
Published online: 10 Jul 2009.
Submit your article to this journal
Article views: 3
View related articles
Citing articles: 1 View citing articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=ijau19 Download by: [University of California, San Diego]
Date: 25 March 2016, At: 18:44
Journal of Audiovisual Media in Medicine 1992; 15: 57-60
The Wellcome Trust tropical diseases videodisc project
Downloaded by [University of California, San Diego] at 18:44 25 March 2016
J. A. LONGSTAFFE, J. MARSHALL and M. WHITTLESTONE This presentation sets out the aims and methodology involved in creating a sophisticated teaching archive in tropical medicine based on the Wellcome Museum of Medical Science. This visual archive will take the form of a videodisc database containing 30000 video stills combined with a limited amount of moving material. While authoring tools will ensure the continuing production of interactive learning material from the archive, users will have access to several hundred hours of ready made tutorials, and an expert system to teach clinical skills. They will also be able to browse through any part of the archive. Successful management strategies have involved a close and supportive relationship with the project sponsors, the formation of expert groups to solve specific problems, and a process of cont inuous form at ive eva Iuat ion. The Wellcome Museum of Medical Science (WMMS) has existed in London as a teaching and learning facility for students of tropical medicine for many years. It is based on the collections of Sir Henry Wellcome who also co-founded the pharmaceutical company, Burroughs Wellcome, now Wellcome plc. The Trusl is currently the largest non-government sponsor of medical research in the UK. The Museum has been used extensively by tropical doctors and scientists, science students, medical students and the general public. It contains a number of collections, including themed exhibits such as ‘Malaria’ or ‘Famine in Africa’, just under 1000 panels on specific disease problems, smaller collections of radiographs, black-andwhite photographs, original artwork, pathological specimens, histological tissue blocks and artefacts including models of insect vectors and viruses. There is also an extensive transparency collection which has formed a loan service to
J . A . Longstaffe, and N. Whittlestone are with the Educational Technology Service, the University of Bristol, Royal Fort Annexe, Tyndull Avenue, Bristol HS8 I UJ, U K , and J . Marhhall is at the Centre f o r International Child Health, Institute f o r Child Health, 30 Guilford Sweet, London W C I , U K
01992 Butterworth-Heinernann Ltd 0140-51 1X/92/020057-04
teachers visiting London and needing illustrative material for lectures and talks. The WMMS was closed as a conventional museum in January 1990 with the intention of transferring material to a portable electronic format relevant to the needs of the tropical community in the 1990s. Creating a teaching archive Remit
Following an extensive feasibility study, the aims are to:
1. Create a sophisticated teaching and learning archive which will facilitate the dissemination of the resources of the museum worldwide. 2. Update and enhance the current collection in ways which are sensitive to the educational needs of the 1990s and beyond. 3. Design software tools which will enable the tropical community to use this valuable resource in ways which are flexible, appropriate and effective. A learning resource will be produced in a format which can be used in tropical institutions or hospitals anywhere in the world. It is intended to enable the best teachers to spread their output over an
infinitely wider area than would otherwise be possible. This project will be ‘owned’ by the tropical community and led by its academic needs - it will not be technology led. It will be flexible enough to adapt to changing academic needs, taking appropriate advantage of technological developments (such as compact disc-based video images) as they arise. What is a teaching archive?
This ‘electronic museum’ is called a teaching archive because it is not just a learning package. It is planned to provide a large number of good quality pictures with easy database search facilities combined with authoring facilities and other tools. These will make it possible to produce customized learning material based on the archive well into the future (see Figures 1 4 ) . The museum consists of three distinct sections, the archive, a body of interactive learning material and a set of software tools. The archive contains the basic units of information -pictures and text. It takes the form of a videodisc database containing up to 30000 video stills combined with a limited amount of moving material. Interactive learning material is created by teachers using the archive with an authoring system. This structured material will be accessed in a
Downloaded by [University of California, San Diego] at 18:44 25 March 2016
number of different ways, leading to Diseases, such as malaria or schistosomiasis, Topics, such as sexually transmitted disease or malnutrition, Countries, such as Ghana or Brazil, and Clinical features such as jaundice or fever. The system will also contain a Challenge option. which will provide the user with the opportunity t o diagnose and treat simulated cases of tropical disease. In addition to this, there will be easy to use look-up facilities, so that users can browse any part of the archive. Provision of access within the system to compact disc based texts such as the Oxford Textbook of Medicine is
also planned. The software tools include authoring facilities which enable further interactive learning modules to be created simply, as a continuous process. They also include an ‘educable database’, so that authors can add new descriptions relevant to images, and another database editor to make it possible to add or change the disease criteria in the Challenge option. Although there will be some 100-200 h of tutorials produced with the archive, it is not intended that this will provide a full coverage of the field. Instead, it will constitutc a series o f examples of the ways in which learning
material can be produced from tho archive. At the same time it will provide a reasonable volume of instantly usable material. Editable learning material
To aid further the easy production of learning material, facilities for the editing of existing learning material to suit local needs are being introduced. The software will be written in such a way that an edited tutorial will lose the ‘refereed’ flag and will display a ‘modifying author’ as well as the ‘creating author‘. This will ensure that the originator of the material gets adequate credit but will also ensure that the modifying author takes responsibility for any alterations. Hardware specifications
Figure 1. Here is an example of the combination of a video picture with text. The picture can be made ‘fullscreen’by the user by ‘pointing and clicking‘with a mouse. Acknowledgements, Dr John Anderson.
The hardware on which the Tropical Diseases videodisc will be delivered currently consists of a personal computer running DOS (disc operating system) using a 386sx processor. The videodisc player will be dual format, compatible with both phased alternate line (PAL) and National Television Standards Committee (NTSC) video staadards. The display monitor is currently, 16-colour VGA (video graphics adaptor) although it may shortly be necessary to go to one of the super VGA standards at 256 colours in order to introduce the facility for digital as well as analogue video Dictures. The overlay card which will be installed in the computer is currently specified as thc Vidcologic DVA 4000 board. This makes possible the mixing of the signals from the videodisc and the computer in
Figure 2. Maps and diagrams can be generated by video or computer graphics packages and integrated with text.
58
Longstaffe, Marshall and Whittlestone
Downloaded by [University of California, San Diego] at 18:44 25 March 2016
Figure 3. Questions can be asked in several ways. This illustrates the ’latent image’multiple choice question. When a user selects an option, a response appears. The illustration shows the screen after two different options have been selected. This type of question enables the responses to be ‘yes; ‘no’or ‘maybe: covering grey areas and incorporating an educational as well as an assessment function.
the editor to enter diseases is nearly complete. A n excellent relationship has been developed with the community of tropical medicine giving free access to many of the best image collections in the world. In 1992 it is intended to produce more attractive and sophisticated database search facilities, access thousands of new pictures and structure hundreds of new tutorials using recognized instructional design criteria. The software will be in a completed and stable form and will have been properly documented. Management and management strategies Structure
Figure 4. Authors are supplied with ‘templates‘within the authoring system, which guide them in both visual and instructional design.
order to maximize the educational effectiveness of the material. Although this delivery system sounds complex and expensive. it is designed to exploit the full potential of the videodisc package. It is intended to make it possible to use some of the facilities of the videodisc on simpler systems which lack an overlay card or even dispense with the computer. Progress so far
Currently there is a catalogue videodisc of 18000 still video images and some
moving footage. New images are being accessed and recorded daily. The database controlling these images has been designed and implemented although it needs some editing and adjustment. The authoring system, Video Interactive Program Author (VIPA), is in an advanced stage of development and is in daily use by a team of 15 authors and secretaries. Several hundred tutorials exist in incomplete form, and feedback from the authors is being used to make constant improvements and adjustments to the software. The Challenge option exists in a prototype form and
The Journal of Audiovisual Media in Medicine (1992) Vol. ISINo. 2
This project has been developed by a highly motivated and committed team. It is led by Dr Adrian Longstaffe, assisted by a Software Coordinator, Mr Michael Whittlestone and an Academic Coordinator, D r Jann Marshall. This management team has recently been augmented by a Visual Resources Manager. The Software Coordinator has charge over all hardware, software, programming and systems design aspects of the project. The Academic Coordinator has charge of all of the informational aspects of the project including the archive content, authors. subject experts and educational strategy. The Visual Resources Manager has specific charge of the archive itself, the databases, image location, acquisition and accession, visual quality, recording and copyright issues.
59
In addition to the central team which is divided between London and Bristol, there are subteams with specific tasks located in a number of other places. Examples of these are the core (shell) programming team in the Department of Informatics at St. Bartholomew’s Hospital, London, UK, the authoring system programmer in Leeds, UK, the expert system (Challenge) team at the University of Sheffield, UK, the pathology team in the University College and Middlesex Hospital Medical School, London, UK and other authors in Leeds and Liverpool, UK and hopefully soon in New York, USA.
Downloaded by [University of California, San Diego] at 18:44 25 March 2016
Strategies
The team Leadership reports to a small and supportive Monitoring Group led by the Director of the Wellcome Trust, Dr Bridget Ogilvie. It consists of representatives of the Trust, the project itself and consultants in Tropical Medicine and Medical Informatics. This short chain of command, together with the active involvement and support of the sponsoring body, is one of the principal factors in the success of the project. Links with the Medical Education and Informatics Group at St. Bartholomew’s Hospital and the Computers in Teaching Initiative Centre for Medicine are especially important. Also crucial is the existence of a 25% contingency factor in the budget - a vital necessity in such a complex and innovative area. The project management consults at every stage of development in a number of different areas such as software, education, visual presentation, epidemiology and medical coding. It does this by a number of mechanisms. There is an Advisory Group consisting of a number of interested and prominent teachers in tropical medicine who meet on an
60
occasional basis to evaluate and discuss content and educational approach. Reference is made to individuals from this group on a relatively frequent basis. Second, there are a number of ‘Expert Groups’. These are informal groups of three or more experts convened to solve specific problems. Some of these groups may meet only once and others such as the Software Group meet regularly throughout the duration of the project. Another factor contributing to success involves the profile of the project and the atmosphere of support in the tropical medical community which has enabled the management to draw on the expertise and enthusiasm of a pool of extremely talented people. The Visual Presentation Group boasts no less than two Heads of Medical Illustration from London hospitals. Beyond the expert groups the project is again fortunate to be able to call on the services of a number of individual consultants in the areas of medicine, education, visual presentation and software design. One of the most important tasks of the project management in this consultancy process is to maintain the balance between the needs and viewpoints of the specialists and the solutions that are practicable in terms of the development of the project as a whole.
learning targets and efficiency of the learning process. The project is currently designing a study of this type and a number of groups worldwide have offered their services. The philosophy in this respect is to do a number of smaller evaluations rather than a few large ones. The other side of the evaluation coin is formative evaluation. This is used on a continuous basis in every single aspect of the project. The work started with the idea of structuring a prototype body of teaching material on one disease and then getting this evaluated in a number of different ways. In practice, it has been found that a more workable method is to divide this complex process into a number of smaller tasks. These are then prototyped and evaluated independently, allowing changes to be made in the course of a number of small iterative cycles rather than a single large one. Examples of these divisions include: academic content; instructional design; screen presentation; and, in the case of the Challenge system, clinical acceptability. All of these are presented at intervals to experts and modified accordingly. Although this is a necessarily untidy and at times ulcer-provoking process, those working on the project feel that it is effective.
Evaluation strategies
Acknowledgements
Something probably common to all leaders of projects of this type is that, while they all agree that evaluation is a good thing, most feel that they have insufficiently grasped this particular nettle. One tends to think of evaluation in terms of formally conducted summative studies with control groups of students and in-depth analyses of attitude, motivation, time spent in reaching
This project could not exist without the extreme dedication of the entire team and the generosity of the senior management and Trustees of the Wellcome Trust. The project has enormous potential and its success so far has been entirely dependent on the high calibre of the people involved, both on the team and in the community of tropical medicine.
Longstaffe, Marshall and Whittlestone
ISSN: 0140-511X (Print) (Online) Journal homepage: http://www.tandfonline.com/loi/ijau19
The Wellcome Trust tropical diseases videodisc project J. A. Longstaffe, J. Marshall & M. Whittlestone To cite this article: J. A. Longstaffe, J. Marshall & M. Whittlestone (1992) The Wellcome Trust tropical diseases videodisc project, Journal of Audiovisual Media in Medicine, 15:2, 57-60, DOI: 10.3109/17453059209018343 To link to this article: http://dx.doi.org/10.3109/17453059209018343
Published online: 10 Jul 2009.
Submit your article to this journal
Article views: 3
View related articles
Citing articles: 1 View citing articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=ijau19 Download by: [University of California, San Diego]
Date: 25 March 2016, At: 18:44
Journal of Audiovisual Media in Medicine 1992; 15: 57-60
The Wellcome Trust tropical diseases videodisc project
Downloaded by [University of California, San Diego] at 18:44 25 March 2016
J. A. LONGSTAFFE, J. MARSHALL and M. WHITTLESTONE This presentation sets out the aims and methodology involved in creating a sophisticated teaching archive in tropical medicine based on the Wellcome Museum of Medical Science. This visual archive will take the form of a videodisc database containing 30000 video stills combined with a limited amount of moving material. While authoring tools will ensure the continuing production of interactive learning material from the archive, users will have access to several hundred hours of ready made tutorials, and an expert system to teach clinical skills. They will also be able to browse through any part of the archive. Successful management strategies have involved a close and supportive relationship with the project sponsors, the formation of expert groups to solve specific problems, and a process of cont inuous form at ive eva Iuat ion. The Wellcome Museum of Medical Science (WMMS) has existed in London as a teaching and learning facility for students of tropical medicine for many years. It is based on the collections of Sir Henry Wellcome who also co-founded the pharmaceutical company, Burroughs Wellcome, now Wellcome plc. The Trusl is currently the largest non-government sponsor of medical research in the UK. The Museum has been used extensively by tropical doctors and scientists, science students, medical students and the general public. It contains a number of collections, including themed exhibits such as ‘Malaria’ or ‘Famine in Africa’, just under 1000 panels on specific disease problems, smaller collections of radiographs, black-andwhite photographs, original artwork, pathological specimens, histological tissue blocks and artefacts including models of insect vectors and viruses. There is also an extensive transparency collection which has formed a loan service to
J . A . Longstaffe, and N. Whittlestone are with the Educational Technology Service, the University of Bristol, Royal Fort Annexe, Tyndull Avenue, Bristol HS8 I UJ, U K , and J . Marhhall is at the Centre f o r International Child Health, Institute f o r Child Health, 30 Guilford Sweet, London W C I , U K
01992 Butterworth-Heinernann Ltd 0140-51 1X/92/020057-04
teachers visiting London and needing illustrative material for lectures and talks. The WMMS was closed as a conventional museum in January 1990 with the intention of transferring material to a portable electronic format relevant to the needs of the tropical community in the 1990s. Creating a teaching archive Remit
Following an extensive feasibility study, the aims are to:
1. Create a sophisticated teaching and learning archive which will facilitate the dissemination of the resources of the museum worldwide. 2. Update and enhance the current collection in ways which are sensitive to the educational needs of the 1990s and beyond. 3. Design software tools which will enable the tropical community to use this valuable resource in ways which are flexible, appropriate and effective. A learning resource will be produced in a format which can be used in tropical institutions or hospitals anywhere in the world. It is intended to enable the best teachers to spread their output over an
infinitely wider area than would otherwise be possible. This project will be ‘owned’ by the tropical community and led by its academic needs - it will not be technology led. It will be flexible enough to adapt to changing academic needs, taking appropriate advantage of technological developments (such as compact disc-based video images) as they arise. What is a teaching archive?
This ‘electronic museum’ is called a teaching archive because it is not just a learning package. It is planned to provide a large number of good quality pictures with easy database search facilities combined with authoring facilities and other tools. These will make it possible to produce customized learning material based on the archive well into the future (see Figures 1 4 ) . The museum consists of three distinct sections, the archive, a body of interactive learning material and a set of software tools. The archive contains the basic units of information -pictures and text. It takes the form of a videodisc database containing up to 30000 video stills combined with a limited amount of moving material. Interactive learning material is created by teachers using the archive with an authoring system. This structured material will be accessed in a
Downloaded by [University of California, San Diego] at 18:44 25 March 2016
number of different ways, leading to Diseases, such as malaria or schistosomiasis, Topics, such as sexually transmitted disease or malnutrition, Countries, such as Ghana or Brazil, and Clinical features such as jaundice or fever. The system will also contain a Challenge option. which will provide the user with the opportunity t o diagnose and treat simulated cases of tropical disease. In addition to this, there will be easy to use look-up facilities, so that users can browse any part of the archive. Provision of access within the system to compact disc based texts such as the Oxford Textbook of Medicine is
also planned. The software tools include authoring facilities which enable further interactive learning modules to be created simply, as a continuous process. They also include an ‘educable database’, so that authors can add new descriptions relevant to images, and another database editor to make it possible to add or change the disease criteria in the Challenge option. Although there will be some 100-200 h of tutorials produced with the archive, it is not intended that this will provide a full coverage of the field. Instead, it will constitutc a series o f examples of the ways in which learning
material can be produced from tho archive. At the same time it will provide a reasonable volume of instantly usable material. Editable learning material
To aid further the easy production of learning material, facilities for the editing of existing learning material to suit local needs are being introduced. The software will be written in such a way that an edited tutorial will lose the ‘refereed’ flag and will display a ‘modifying author’ as well as the ‘creating author‘. This will ensure that the originator of the material gets adequate credit but will also ensure that the modifying author takes responsibility for any alterations. Hardware specifications
Figure 1. Here is an example of the combination of a video picture with text. The picture can be made ‘fullscreen’by the user by ‘pointing and clicking‘with a mouse. Acknowledgements, Dr John Anderson.
The hardware on which the Tropical Diseases videodisc will be delivered currently consists of a personal computer running DOS (disc operating system) using a 386sx processor. The videodisc player will be dual format, compatible with both phased alternate line (PAL) and National Television Standards Committee (NTSC) video staadards. The display monitor is currently, 16-colour VGA (video graphics adaptor) although it may shortly be necessary to go to one of the super VGA standards at 256 colours in order to introduce the facility for digital as well as analogue video Dictures. The overlay card which will be installed in the computer is currently specified as thc Vidcologic DVA 4000 board. This makes possible the mixing of the signals from the videodisc and the computer in
Figure 2. Maps and diagrams can be generated by video or computer graphics packages and integrated with text.
58
Longstaffe, Marshall and Whittlestone
Downloaded by [University of California, San Diego] at 18:44 25 March 2016
Figure 3. Questions can be asked in several ways. This illustrates the ’latent image’multiple choice question. When a user selects an option, a response appears. The illustration shows the screen after two different options have been selected. This type of question enables the responses to be ‘yes; ‘no’or ‘maybe: covering grey areas and incorporating an educational as well as an assessment function.
the editor to enter diseases is nearly complete. A n excellent relationship has been developed with the community of tropical medicine giving free access to many of the best image collections in the world. In 1992 it is intended to produce more attractive and sophisticated database search facilities, access thousands of new pictures and structure hundreds of new tutorials using recognized instructional design criteria. The software will be in a completed and stable form and will have been properly documented. Management and management strategies Structure
Figure 4. Authors are supplied with ‘templates‘within the authoring system, which guide them in both visual and instructional design.
order to maximize the educational effectiveness of the material. Although this delivery system sounds complex and expensive. it is designed to exploit the full potential of the videodisc package. It is intended to make it possible to use some of the facilities of the videodisc on simpler systems which lack an overlay card or even dispense with the computer. Progress so far
Currently there is a catalogue videodisc of 18000 still video images and some
moving footage. New images are being accessed and recorded daily. The database controlling these images has been designed and implemented although it needs some editing and adjustment. The authoring system, Video Interactive Program Author (VIPA), is in an advanced stage of development and is in daily use by a team of 15 authors and secretaries. Several hundred tutorials exist in incomplete form, and feedback from the authors is being used to make constant improvements and adjustments to the software. The Challenge option exists in a prototype form and
The Journal of Audiovisual Media in Medicine (1992) Vol. ISINo. 2
This project has been developed by a highly motivated and committed team. It is led by Dr Adrian Longstaffe, assisted by a Software Coordinator, Mr Michael Whittlestone and an Academic Coordinator, D r Jann Marshall. This management team has recently been augmented by a Visual Resources Manager. The Software Coordinator has charge over all hardware, software, programming and systems design aspects of the project. The Academic Coordinator has charge of all of the informational aspects of the project including the archive content, authors. subject experts and educational strategy. The Visual Resources Manager has specific charge of the archive itself, the databases, image location, acquisition and accession, visual quality, recording and copyright issues.
59
In addition to the central team which is divided between London and Bristol, there are subteams with specific tasks located in a number of other places. Examples of these are the core (shell) programming team in the Department of Informatics at St. Bartholomew’s Hospital, London, UK, the authoring system programmer in Leeds, UK, the expert system (Challenge) team at the University of Sheffield, UK, the pathology team in the University College and Middlesex Hospital Medical School, London, UK and other authors in Leeds and Liverpool, UK and hopefully soon in New York, USA.
Downloaded by [University of California, San Diego] at 18:44 25 March 2016
Strategies
The team Leadership reports to a small and supportive Monitoring Group led by the Director of the Wellcome Trust, Dr Bridget Ogilvie. It consists of representatives of the Trust, the project itself and consultants in Tropical Medicine and Medical Informatics. This short chain of command, together with the active involvement and support of the sponsoring body, is one of the principal factors in the success of the project. Links with the Medical Education and Informatics Group at St. Bartholomew’s Hospital and the Computers in Teaching Initiative Centre for Medicine are especially important. Also crucial is the existence of a 25% contingency factor in the budget - a vital necessity in such a complex and innovative area. The project management consults at every stage of development in a number of different areas such as software, education, visual presentation, epidemiology and medical coding. It does this by a number of mechanisms. There is an Advisory Group consisting of a number of interested and prominent teachers in tropical medicine who meet on an
60
occasional basis to evaluate and discuss content and educational approach. Reference is made to individuals from this group on a relatively frequent basis. Second, there are a number of ‘Expert Groups’. These are informal groups of three or more experts convened to solve specific problems. Some of these groups may meet only once and others such as the Software Group meet regularly throughout the duration of the project. Another factor contributing to success involves the profile of the project and the atmosphere of support in the tropical medical community which has enabled the management to draw on the expertise and enthusiasm of a pool of extremely talented people. The Visual Presentation Group boasts no less than two Heads of Medical Illustration from London hospitals. Beyond the expert groups the project is again fortunate to be able to call on the services of a number of individual consultants in the areas of medicine, education, visual presentation and software design. One of the most important tasks of the project management in this consultancy process is to maintain the balance between the needs and viewpoints of the specialists and the solutions that are practicable in terms of the development of the project as a whole.
learning targets and efficiency of the learning process. The project is currently designing a study of this type and a number of groups worldwide have offered their services. The philosophy in this respect is to do a number of smaller evaluations rather than a few large ones. The other side of the evaluation coin is formative evaluation. This is used on a continuous basis in every single aspect of the project. The work started with the idea of structuring a prototype body of teaching material on one disease and then getting this evaluated in a number of different ways. In practice, it has been found that a more workable method is to divide this complex process into a number of smaller tasks. These are then prototyped and evaluated independently, allowing changes to be made in the course of a number of small iterative cycles rather than a single large one. Examples of these divisions include: academic content; instructional design; screen presentation; and, in the case of the Challenge system, clinical acceptability. All of these are presented at intervals to experts and modified accordingly. Although this is a necessarily untidy and at times ulcer-provoking process, those working on the project feel that it is effective.
Evaluation strategies
Acknowledgements
Something probably common to all leaders of projects of this type is that, while they all agree that evaluation is a good thing, most feel that they have insufficiently grasped this particular nettle. One tends to think of evaluation in terms of formally conducted summative studies with control groups of students and in-depth analyses of attitude, motivation, time spent in reaching
This project could not exist without the extreme dedication of the entire team and the generosity of the senior management and Trustees of the Wellcome Trust. The project has enormous potential and its success so far has been entirely dependent on the high calibre of the people involved, both on the team and in the community of tropical medicine.
Longstaffe, Marshall and Whittlestone
