Medicine and Health Sciences Commons^™

An Analysis Of Major Issues For Culturally-Minded Professionals In Women's Health Care, Victoria Clark

Victoria Clark

Reducing The Waiting List For New Referrals To The Ent Outpatient Department, Jana Crowley

Jana Crowley

Spirituality In Nursing Practice, Regina Conway-Phillips

Regina Conway-Phillips

No abstract provided.

Attitudes Towards Anorexia Nervosa: Volitional Stigma Differences In A Sample Of Pre-Clinical Medicine And Psychology Students, Amy Bannatyne, Peta Stapleton

Peta B. Stapleton

Background:

Anorexia nervosa (AN) is a highly stigmatised condition, with treatment often involving multidisciplinary care. As such, understanding and comparing the attitudes of emerging mental health and medical professionals towards AN, within the content of sex-based differences, is pertinent to facilitate the development of targeted stigma interventions.

Aims:

Examine the volitional stigmatisation of AN in emerging medical and mental health professionals.

Method:

Participants (N = 126) were medical (n = 41) and psychology students (n = 85) who completed a range of attitudinal outcome measures (e.g. Causal Attributions Scale, Eating Disorder Stigma Scale, Opinions Scale, Characteristics Scale and Affective Reaction …

Asking Questions, Seeking Improvements, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

The author connects the rapid growth of scientific journals to the inquisitiveness of committed health professionals and their persistent efforts to improve patient care.

Preventing And Treating Narcotic Addiction — A Century Of Federal Drug Control, David Courtwright

David T. Courtwright

A Randomised Controlled Trial Of A Blended Learning Education Intervention For Teaching Evidence-Based Medicine, Dragan Ilic, Rusli Bin Nordin, Paul Glasziou, Julie Tilson, Elmer Villanueva

Paul Glasziou

Background: Few studies have been performed to inform how best to teach evidence-based medicine (EBM) to medical trainees. Current evidence can only conclude that any form of teaching increases EBM competency, but cannot distinguish which form of teaching is most effective at increasing student competency in EBM. This study compared the effectiveness of a blended learning (BL) versus didactic learning (DL) approach of teaching EBM to medical students with respect to competency, self-efficacy, attitudes and behaviour toward EBM. Methods: A mixed methods study consisting of a randomised controlled trial (RCT) and qualitative case study was performed with medical students undertaking …

Treatment Of Asthma Exacerbations With The Human-Powered Nebuliser: A Randomised Parallel-Group Clinical Trial, M Therese Lysaught, Christopher J. Hallberg, Rene Antonio Najarro, Fausto Cea Gill, Clara Villatoro, Ana Celia Diaz De Uriarte, Lars E. Olson

M. Therese Lysaught

Aims: The aim of this study was to compare a low-cost, human-powered nebuliser compressor with an electric nebuliser compressor for the treatment of mild to moderate asthma exacerbations in adults and children. Methods: This was a non-blinded, parallel-group, equivalence study, with 110 subjects between 6 and 65 years of age, conducted in the emergency department of a district hospital in Ilopango, El Salvador. Participants were assigned by random allocation to receive a 2.5-mg dose of salbutamol from the experimental human-powered nebuliser or the electric nebuliser control. All assigned participants completed treatment and were included in analysis. The study was not …

Characterization Of A Human Powered Nebulizer Compressor For Resource Poor Settings, Christopher J. Hallberg, M Therese Lysaught, Christopher E. Zmudka, William K. Kopesky, Lars E. Olson

M. Therese Lysaught

Respiratory disease accounts for three of the ten leading causes of death worldwide. Many of these diseases can be treated and diagnosed using a nebulizer. Nebulizers can also be used to safely and efficiently deliver vaccines. Unfortunately, commercially available nebulizers are not designed for use in regions of the world where lung disease is most prevalent: they are electricity-dependent, cost-prohibitive, and not built to be reliable in harsh operating conditions or under frequent use. To overcome these limitations, the Human Powered Nebulizer compressor (HPN) was developed. The HPN does not require electricity; instead airflow is generated manually through a hand-crank …

Clinical Research Priorities In Emergency Medicine, Gerben Keijzers, Ogilvie Thom, David Taylor, Jonathan Knott

Gerben Keijzers

To determine the clinical research priorities of Fellows of the Australasian College for Emergency Medicine (ACEM) in order to inform the strategic research agenda specific to multicentre clinical research. Methods: An anonymous survey of all ACEM Fellows (FACEMs) listed on the ACEM researcher database was conducted between January and March 2013. Results: Of 108 FACEMs invited to participate, 54 (50%) responded. Over half of respondents (61%) had a higher research degree but only a minority (24%) had funded research positions. The top research categories identified as priorities were resuscitation, trauma, cardiology, ED ultrasound, acute behavioural disturbance and geriatrics. The most …

Do Smartsite Antireflux Valves Limit The Flow Rate Of 0.9% Normal Saline Through Intravenous Cannulas?, David Liu, Gerben Keijzers

Gerben Keijzers

The aim of the study was to determine whether the placement of a SmartSite antireflux valve between a bag of fluid with line giving set and an intravenous cannula decreases the flow rate. Fluid flow rates were compared in paired experiments with and without an antireflux valve using a pressure infuser or allowing fluid to flow by gravity only for four different sizes of intravenous cannulas (20–14 G). Antireflux valves significantly decreased the fluid flow rates for all cannula sizes, irrespective of whether a pressure infuser was used. The decrease in the flow rate was most marked for larger cannulas …

Clinical Research Priorities In Emergency Medicine. Results Of A Consensus Meeting And Development Of A Weighting Method For Assessment Of Clinical Research Policies, Ogilvie Thom, Gerben Keijzers, Suzanne Davies, David Taylor, Jonathan Knott, Paul Middleton

Gerben Keijzers

Introduction: There is limited evidence regarding clinical research priorities in emergency medicine outside of some special interest groups. The ACEM Clinical Trials Group undertook a consensus meeting with the aim of developing a reproducible weighting matrix for assessing clinical research priorities. Methods: A session at the ACEM annual scientific meeting was dedicated to this meeting. Results from a survey of the ACEM researcher database were presented, along with a proposed weighting matrix. After discussion and adjustment, consensus was achieved on the matrix. Results: It was agreed that the following criteria be used in the matrix: research category and sub-category priority …

Medical Professionalism Across Cultures: A Challenge For Medicine And Medical Education, Vikram Jha, Michelle Mclean, Trevor Gibbs, John Sanders

Michelle McLean

Background: The recognition of medical professionalism as a complex social construct makes context, geographical location and culture important considerations in any discussion of professional behaviour. Medical students, medical educators and practitioners are now much more on the move globally, exposing them to cultural and social attitudes, values and beliefs that may differ from their own traditional perceptions of professionalism. Aims and Methods: This paper uses the model of the intercultural development continuum and the concept of ‘‘cultural fit’’ to discuss what might transpire when a student, teacher or doctor is faced with a new cultural environment. Using our own experiences …

European Society For The History Of The Human Sciences (Eshhs), Conference 2014, Oulu (Finland), Paper: “Dangerous Passions. The Construction And Cultural And Social Impact Of The ‘Psychiatric’ Framework Of The Passions In France (1790-1830)”, July 22-25 (23th), 2014., Marco Solinas

Marco Solinas

Numerous excellent works have been written on the formation process of ‘psychiatry’ and its concomitant impact on society and culture at the end of the eighteenth century and in the first three decades of the nineteenth century, in particular with regard to France. From Gladys Swain to Dora Weiner, from Jacques Postel to Jan Goldstein, from Jackie Pigeaud to Juan Rigoli, the issue has been analysed in depth and from a variety of different perspectives. However, despite constantly and inevitably resurfacing in these studies, no particular attention has been paid to the passions and emotions drawn up by nascent psychiatry. …

Development And Validation Of The Ace Tool: Assessing Medical Trainees' Competency In Evidence Based Medicine, Dragan Ilic, Rusli Bin Nordin, Paul Glasziou, Julie Tilson, Elmer Villanueva

Paul Glasziou

Background: While a variety of instruments have been developed to assess knowledge and skills in evidence based medicine (EBM), few assess all aspects of EBM - including knowledge, skills attitudes and behaviour - or have been psychometrically evaluated. The aim of this study was to develop and validate an instrument that evaluates medical trainees' competency in EBM across knowledge, skills and attitude. Methods. The 'Assessing Competency in EBM' (ACE) tool was developed by the authors, with content and face validity assessed by expert opinion. A cross-sectional sample of 342 medical trainees representing 'novice', 'intermediate' and 'advanced' EBM trainees were recruited …

Which Lipid Measurement Should We Monitor? An Analysis Of The Lipid Study, Paul Glasziou, Les Irwig, Adrienne Kirby, Andrew Tonkin, R J. Simes

Paul Glasziou

Objectives: To evaluate the optimal lipid to measure in monitoring patients, we assessed three factors that influence the choice of monitoring tests: (1) clinical validity; (2) responsiveness to therapy changes and (3) the size of the long-term ‘signal-to-noise’ ratio. Design: Longitudinal analyses of repeated lipid measurement over 5 years. Setting: Subsidiary analysis of a Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) study—a clinical trial in Australia, New Zealand and Finland. Participants: 9014 patients aged 31–75 years with previous acute coronary syndromes. Interventions: Patients were randomly assigned to 40 mg daily pravastatin or placebo. Primary and secondary outcome measures: We …

Complementary And Alternative Medicine: Attitudes And Use Among Health Educators In The United States, Ping Johnson, Jennifer Priestley, Kandice Porter, Jane Petrillo

Jennifer L. Priestley

Background: Interest in and use of complementary and alternative medicine (CAM) in the United States is increasing. However, CAM remains an area of nascency for researchers and western practitioners. Purpose: The purpose of this study was to examine U.S. health educators' attitudes toward CAM and their use of common CAM therapies. Methods: A cross-sectional online survey was conducted among members of a professional health educator listserv. Results: Health educators generally have positive attitudes toward CAM and about 90% have used at least one CAM therapy in the last 12 months. Differences in CAM attitudes and use were significant, with females …

A Survey Of Complementary And Alternative Medicine Knowledge Among Health Educators In The United States, Ping Johnson, Jennifer Priestley, Roy Johnson

Jennifer L. Priestley

Background: Complementary and alternative medicine (CAM) is popular among U.S. health care consumers, but no study has examined how much health educators know about CAM. Purpose: To examine the knowledge of basic CAM concepts and common CAM therapies among health educators in the U.S. Methods: An online survey was conducted among 1,299 health educators with valid e-mails on a professional listserv. The response rate was 39%. The 16-item CAM knowledge scale yielded a Cronbach's alpha of .71. Results: Participating health educators were most knowledgeable about chiropractic and massage therapy, familiar with the general definition of CAM, understood whether acupuncture is …

An Assessment Of The Bhutanese Traditional Medicine For Its Ethnopharmacology, Ethnobotany And Ethnoquality: Textual Understanding And The Current Practices, Phurpa Wangchuk, Stephen G. Pyne, Paul A. Keller

Paul Keller

Ethnopharmacological relevance : This study involves the assessment of the Bhutanese traditional medicine (BTM) which was integrated with the mainstream biomedicine in 1967 to provide primary health care services in the country. It caters to 20-30% of the daily out-patients within 49 traditional medicine units attached to 20 district modern hospitals and 29 Basic Health Units in the country. Aim of the study : This study presents the ethnopharmacological, ethnobotanical and the ethnoquality concepts in relation to mainstream Tibetan medicine and describes the current practices of BTM. Materials and methods : Experienced BTM practitioners (Drung-tshos and Smen-pas) were selected using …

Has Novelty In Healthcare Gone A Little Stale?, Ray Moynihan

Ray Moynihan

Extract: Although drugs are essential, the roar of their marketing distorts decision making in favour of the newest and most expensive pills at the expense of older ones or of non-drug approaches. New diagnostic technologies offer undreamt of opportunities to detect ever earlier signs of illness, but they have also brought the increasingly recognised risk of overdiagnosis. Much has been written about how promotion can drive inappropriate use of valuable technologies, but does our deep love affair with novelty deserve more scrutiny?

Increasing Medical Students' Capacity To Practice Evidence-Based Medicine Through Improving Student Participation And Interest In Journal Club, Warren C. Rich, Judy Mullan, Kathryn M. Weston, Peter L. Mclennan

Judy Mullan

Research indicates that graduating doctors believe they are deficient in the skills needed to become evidence-based practitioners. To address this the University of Wollongong’s new Graduate School of Medicine has embedded research and critical analysis (RCA) skills into the case-based curriculum. A key component of the RCA curriculum is improving the medical students’ critical appraisal skills by participating in Journal Club during their first phase of the course. Feedback from the first two student cohorts participating in Journal Club suggested that it was not important or interesting. To increase the level of interest, enthusiasm and participation in Journal Club peer-assessment …

"Taking Care Of Yourself" -A Student Programme For Personal And Professional Development Using Reflective Journaling In The University Of Wollongong Graduate School Of Medicine, Lyndal Parker-Newlyn, Coralie Wilson, Peter Kelly

Coralie J Wilson

No abstract provided.

"Taking Care Of Yourself" -A Student Programme For Personal And Professional Development Using Reflective Journaling In The University Of Wollongong Graduate School Of Medicine, Lyndal Parker-Newlyn, Coralie Wilson, Peter Kelly

Peter Kelly

No abstract provided.

The Doctor-Patient Relationship Revisited. An Analysis Of The Placebo Effect., Herbert M. Adler, Md, Van B. Hammett. Md

Herbert M. Adler

An overview of prescientific medicine, evolution, and individual human development is presented in an attempt to discover the generic factors operating in all interpersonal therapies. We hypothesize that the placebo effect rests on the universal human need for a group and, by symbolic extension, a system.

A Model Of Clinical Problem-Based Learning For Clinical Attachments In Medicine, Elizabeth Farmer, P Mccrorie, Sandra Holmes, Derek Macallan, Andrew Kent

Elizabeth Farmer

CONTEXT Problem-based learning (PBL) has been widely adopted in medical curricula for early-years training, but its use during clinical attachments has not been extensively explored.OBJECTIVES This study aimed to develop and evaluate a new model, 'clinical problem-based learning' (CPBL), to promote learning skills, attitudes and knowledge during clinical attachments.METHODS The CPBL model takes the principles of PBL and applies them to learning during clinical attachments. Real patient encounters are guided by a list of broadly defined case types to ensure curriculum coverage. By discussing history taking and examination in the context of differential diagnosis and problem listing, students generate learning …

Distress Levels And Self-Reported Treatment Rates For Medicine, Law, Psychology And Mechanical Engineering Tertiary Students: A Cross-Sectional Study, Catherine Leahy, Ray Peterson, Ian Wilson, Jonathon Newbury, Anne Tonkin, Deborah Turnbull

Ian G Wilson

Objective: The aim of this research was to assess tertiary student distress levels with regards to (i) comparisons with normative population data, and (ii) the effects of discipline, year level, and student characteristics. Self-reported treatment rates and level of concern regarding perceived distress were also collected. Method: Students from all six years of an undergraduate medical course were compared with samples from Psychology, Law and Mechanical Engineering courses at the University of Adelaide, Australia. Students participated in one of three studies that were either webbased or paper-based. All studies included Kessler ’ s Measure of Psychological Distress (K10), and questions …

Environmental Health Information Systems: More Than Just Gigabytes, Christopher R. Cook

Christopher Cook

Environmental health professionals are concerned about bites. Animal bites, mosquito bites, and tick bites to name a few. But what about bytes of data? Environmental health information systems (EHIS) are often the "silent partners" in an environmental health (EH) department's daily protection of public health. By Webster's dictionary definition, a silent partner is a cohort that does not have the right to participate in an organization's management process. The purpose of this study was to encourage public health officials to make EHIS full partners in their EH departments. Through the use of five surveys, this study was designed to increase …

Environmental Health Information Systems: More Than Just Gigabytes, Christopher R. Cook

Christopher Cook

Environmental health professionals are concerned about bites. Animal bites, mosquito bites, and tick bites to name a few. But what about bytes of data? Environmental health information systems (EHIS) are often the "silent partners" in an environmental health (EH) department's daily protection of public health. By Webster's dictionary definition, a silent partner is a cohort that does not have the right to participate in an organization's management process. The purpose of this study was to encourage public health officials to make EHIS full partners in their EH departments. Through the use of five surveys, this study was designed to increase …

The National Residency Exchange: A Proposal To Restore Primary Care In An Age Of Microspecialization, Glen Cheng

Glen Cheng

Healthcare deficiencies in the United States have long been perpetuated by a shortage of primary care providers. A core purpose of the Patient Protection and Affordable Care Act (PPACA) is to provide health insurance for America’s approximately fifty million uninsured. Implementation of universal health insurance, however, does not mean sufficient healthcare access for all, since the supply of physicians does not and will not meet demand. For reasons reviewed in this Article, the current physician shortage mainly impacts primary care providers. This shortage is particularly troubling because increased provision of primary care relative to specialty care has been associated with …

Techne Or Artful Science And The Genre Of Case Presentations In Healthcare Settings, Catherine Schryer, Lorelei Lingard, Marlee Spafford

Lorelei Lingard

This paper presents a qualitative study that investigated the role of case presentations in the socialization of medical and optometry students. Using the debate from classical rhetoric around the term techne (art or science), we observed that genre theory helps explain the way case presentations mediate the development of professional identity through the interaction of certain knowledge (techne 1), “savvy” knowledge (techne 2), and ethical reflection (phronesis). We noted that these mediated scenes of learning are necessary but problematic because they can lead students to yearn for certainty and to exclude outsiders (other healthcare providers, patients). Finally, our research challenges …