Medicine and Health Sciences Commons^™

Academic Analytics In A Medical Curriculum: Enabling Educational Excellence, Martin Olmos, Linda Corrin

Graduate School of Medicine - Papers (Archive)

The developing field of academic analytics seeks to turn data from educational systems into actionable intelligence for the improvement of teaching and learning. This paper reports on the implementation of analytics in a new medical school with an integrated curriculum and clinical focus. Analytics addressed two challenges in the curriculum: providing evidence of appropriate curriculum coverage and assessing student engagement and equity while on clinical placement. This paper describes the tools and approaches used, and outlines the lessons learnt. These lessons include the risk of a simplistic use of visualisations, their potential to generate important questions, the value of a …

A Study Of Psychiatric And Physical Morbidity Among Residents Of Old Age Home, Vaishali Hedge, Srinivas Kosgi, Satheesh Rao, Nagesh Pai, Shankarappa Mudgal

Graduate School of Medicine - Papers (Archive)

Aims/objectives: To determine the frequency of psychiatric and physical morbidity and also to look into the association between psycho- social factors, morbidity and disability among residents of old age home. Materials and Methods: Study was conducted at an old age home where two hundred and forty five residents were screened using short psychiatric evaluation schedule (SPES).Hundred and ten residents scoring ≥ 4 on SPES suggestive of psychopathology were further evaluated. Information regarding socio-demography, past & present medical and psychiatric illness history was collected. Each individual’s detailed physical examination findings were recorded and Mini-International Neuropsychiatric Interview (MINI), social support scale, disability …

Assessing The Quality, Suitability And Readability Of Internet-Based Health Information About Warfarin For Patients, Sayeed Nasser, Judy Mullan, Beata Bajorek

Graduate School of Medicine - Papers (Archive)

Background
Warfarin is a high-risk medication where patient information may be critical to help ensure safe and effective treatment. Considering the time constraints of healthcare providers, the internet can be an important supplementary information resource for patients prescribed warfarin. The usefulness of internet-based patient information is often limited by challenges associated with finding valid and reliable health information. Given patients’ increasing access of the internet for information, this study investigated the quality, suitability and readability of patient information about warfarin presented on the internet.
Method
Previously validated tools were used to evaluate the quality, suitability and readability of patient information …

Prevalence Prescription: Prescribing Practices Of Clozapine In Australia Between 2005 2010, Shae-Leigh C. Vella, Nagesh Brahmavar Pai

Graduate School of Medicine - Papers (Archive)

Clozapine is an anti-psychotic used to treat refractory schizophrenia. This study reviews the rates of clozapine prescription for refractory schizophrenia in a region of Australia and compares the prescribing patterns to the estimated prevalence rates of refractory schizophrenia in the region. Utilising a pharmacoepidemiological approach; the results indicated that only 8.4% of the individuals estimated to be suffering from refractory schizophrenia in the region were prescribed clozapine between 2005 and 2010, with only 4.1% continuing clozapine to the conclusion of the study. In conclusion it is evident that clozapine is widely under-prescribed in this area of Australia.

The Longitudinal Relationship Between Depression Symptoms And Disability For Older Adults: A Population-Based Study, Chun-Min Chen, Judy Mullan, Yung-Yu Su, David Atherton Griffiths, Irene Kreis, Herng-Chia Chiu

Graduate School of Medicine - Papers (Archive)

Background. Although depressive symptoms in older adults are common, their relationship with disability and the influence of disability on the development of depressive symptoms over time is not well understood. This longitudinal study investigates the change trajectories of both depressive symptoms and disability, as well as their associations over time. Methods. Participants included 442 community-dwelling older adults living in Taiwan, aged 65 years or older, who completed six waves of survey interviews. Depression was scored with the Short Psychiatric Evaluation Schedule and disability with the instrumental and physical activities of daily living measure during each consecutive data collection wave. The …

Patient Perceptions Of Anaesthesia Research Priorities - A Failed Study, Natalie A. Smith, D Martin

Graduate School of Medicine - Papers (Archive)

Professor Steven Shafer alerted conference delegates at a recent international meeting to the value of considering topics for future research in terms of what the most important questions are that remain to be solved1. He quoted from an issue of Science magazine, in which the editors reported questions they thought pointed to the greatest current scientific knowledge gaps2. Two of the top 25 related to anaesthesia in a broad sense: the biological basis of consciousness and how memories are stored and retrieved. Others have noted the relevance of asking patients what they considered research priorities to be3,4. We designed a …

Reducing Olanzapine-Induced Weight Gain Side-Effect By Using Betahistine: A Study In The Rat Model, Chao Deng, Jiamei Lian, Nagesh Brahmavar Pai, Xu-Feng Huang

Graduate School of Medicine - Papers (Archive)

Olanzapine is effective at treating multiple domains of schizophrenia symptoms. However, it induces serious metabolic side effects. Antipsychotic drug’s antagonistic affinity to histamine H1 receptors has been identified as a main contributor for weight gain/obesity side effects. This study therefore investigated whether a combined treatment of betahistine (a H1 receptor agonist and H3 receptor antagonist) could reduce the body weight/obesity induced by olanzapine. Female Sprague Dawley rats were treated orally with olanzapine (1 mg/kg, t.i.d.) and/or betahistine (2.67 mg/kg, t.i.d.), or vehicle for two weeks. Rats treated with olanzapine exhibited significant body weight gain and increased food intake. Co-treatment of …

'If My Arms And Legs Aren't Dropping Off I'Ll Wait To See My Usual Gp!' An Analysis Of Older Patients' Attitudes To Registrars Informed By Agency Theory, Andrew D. Bonney, Sandra C. Jones, Donald C. Iverson, Christopher A. Magee

Graduate School of Medicine - Papers (Archive)

Continuity of care and trust are important in older patient-doctor relationships which impacts older patient willingess to consult registrars for chronic disease management.

A Systematic Review Of The Quality Of Life Of Carers Of Children With Cleft Lip And/Or Plate, Shae-Leigh C. Vella, Nagesh B. Pai

Graduate School of Medicine - Papers (Archive)

Caring for an infant or child requires a significant amount of time, energy and resources; this burden is further increased when the infant or child has a chronic condition or disability. Prior research has demonstrated that caregiving for a child with special needs impacts upon parents or carers mental health, well-being and quality of life. This article systematically reviews the literature pertaining to the impact of caring for a child with cleft lip and /or palate upon parental quality of life. A search of four databases was conducted with a number of key terms; the titles, abstracts and finally the …

A Phase Ii Clinical Trial Of A Dental Health Education Program Delivered By Aboriginal Health Workers To Prevent Early Childhood Caries, Fiona Blinkhorn, Ngiare Brown, Ruth Freeman, Gerry Humphris, Andrew Martin, Anthony Blinkhorn

Graduate School of Medicine - Papers (Archive)

Background: Early Childhood Caries (ECC) is a widespread problem in Australian Aboriginal communities causing severe pain and sepsis. In addition dental services are difficult to access for many Aboriginal children and trying to obtain care can be stressful for the parents. The control of dental caries has been identified as a key indictor in the reduction of Indigenous disadvantage. Thus, there is a need for new approaches to prevent ECC, which reflect the cultural norms of Aboriginal communities. Methods/Design. This is a Phase II single arm trial designed to gather information on the effectiveness of a dental health education program …

Learning Analytics: A Case Study Of The Process Of Design Of Visualizations, Martin M. Olmos, Linda Corrin

Graduate School of Medicine - Papers (Archive)

The ability to visualize student engagement and experience data provides valuable opportunities for learning support and curriculum design. With the rise of the use of learning analytics to provide "actionable intelligence" [1]on students' learning, the challenge is to create visualizations of the data which are clear and useful to the intended audience. This process of finding the best way to visually represent data is often iterative, with many different designs being trialled before the final design is settled upon. This paper presents a case study of the process of refining a visualization of students' learning experience data. In this case …

An Investigation Into Factors Affecting Electron Density Calibration For A Megavoltage Cone-Beam Ct System, Jessica R. Hughes, Lois C. Holloway, Alexandra Quinn, Andrew Fielding

Graduate School of Medicine - Papers (Archive)

There is a growing interest in the use of megavoltage cone-beam computed tomography (MV CBCT) data for radiotherapy treatment planning. To calculate accurate dose distributions, knowledge of the electron density (ED) of the tissues being irradiated is required. In the case of MV CBCT, it is necessary to determine a calibration-relating CT number to ED, utilizing the photon beam produced for MV CBCT. A number of different parameters can affect this calibration. This study was undertaken on the Siemens MV CBCT system, MVision, to evaluate the effect of the following parameters on the reconstructed CT pixel value to ED calibration: …

A Qualitative Analysis Of Medical Students Views Of Their First Psychiatry Rotation, Nagesh Brahmavar Pai, Shae-Leigh C. Vella, Kerry Dawes

Graduate School of Medicine - Papers (Archive)

Objective: The importance of student's perspectives in informing curricula and pedagogy has long been recognised. However, student's perspectives are rarely reported in the academic literature. Therefore this study explores and reports on medical student's perspectives of their first psychiatry clinical rotation in a 'new' era medical school in Australia. Method: Seventy-three graduate entry medical students completed a semi-structured questionnaire about their experiences during a mental health rotation. The responses were analysed and coded into thematic categories. Results: The following thematic categories were evident; staff, breadth of experience, attitudes towards mental health, course materials and structure, and professional development. Conclusion: The …

Why Do Surgeons Leave Germany?, Hans Dieter Dahl

Graduate School of Medicine - Papers (Archive)

Introduction: The topic of migrating doctors and in particular surgeons is not confined to Germany. Many countries, amongst them Australia, simply do not train enough doctors to be self-sufficient. Germany is different. It has excellent university facilities and a well-defined and structured medical curriculum. Junior surgeons have a very high exposure to patients and procedures as compared to Australia. Yet increasing numbers of students and potential surgeons are leaving Germany. Why is this?

Materials and methods: In a mix of personal experience, literature review and reasoning the problems of retaining junior surgeons shall be demonstrated. Experiences from fellow colleagues working …

Virtual Communities Of Practice In Medicine, Stephen Barnett

Graduate School of Medicine - Papers (Archive)

No abstract provided.

Dietary Fish Oil Preserves Cardiac Function In The Hypertrophied Rat Heart, Peter L. Mclennan, Mahainda Y. Abeywardena, Julie A. Dallimore, Daniel Raederstorff

Graduate School of Medicine - Papers (Archive)

Regular fish or fish oil intake is associated with a low incidence of heart failure clinically, and fish oil-induced reduction in cardiac remodelling seen in hypertrophy models may contribute. We investigated whether improved cardiac energy efficiency in non-hypertrophied hearts translates into attenuation of cardiac dysfunction in hypertrophied hearts. Male Wistar rats (n 33) at 8 weeks of age were sham- operated or subjected to abdominal aortic stenosis to produce pressure-overload cardiac hypertrophy. Starting 3 weeks post-operatively to follow initiation of hypertrophy, rats were fed a diet containing 10% olive oil (control) or 5% fish oil (ROPUFA30 (17% EPA, 10% DHA)) …

Cautiousness In Young Rural And Semi-Rural Drivers: Are There Influencing Factors?, Patricia J. Knight, Donald C. Iverson, Mark F. Harris

Graduate School of Medicine - Papers (Archive)

All drivers have to be prepared for driving with changed conditions, either intrinsic or external to the vehicle. This study explores factors influencing the cautiousness while driving of high school students in a rural and small semirural town community in New South Wales. Perceptions of caution in response to a range of different conditions including driving with passengers, bad weather, driving an unfamiliar car, poor road conditions, driving in heavy traffic and darkness - all conditions which have the potential to affect driving style or speed - were reported. Many of the young rural students reported having started to drive …

Alpha-Casein As A Molecular Chaperone, Teresa M. Treweek

Graduate School of Medicine - Papers (Archive)

Alpha-casein, more specifically known as α_S-casein, is a predominant milk protein with important nutritional properties. α_S-Casein, composed of two individual gene products, α_S1- and α_S2-casein, has been described in the past few decades as having molecular chaperone properties. In performing as molecular chaperones, α_S-casein and its purified constituent proteins, α_S1- and α_S2-casein, stabilise a wide range of proteins from milk and non-milk sources against aggregation and precipitation under conditions of stress (e.g. heat, reduction). Investigations into the chaperone action of α_S-casein have revealed that …

General Practice Training And Virtual Communities Of Practice - A Review Of The Literature, Stephen Barnett, Sandra C. Jones, Sue Bennett, Donald C. Iverson, Andrew D. Bonney

Graduate School of Medicine - Papers (Archive)

Background: Good General Practice is essential for an effective health system. Good General Practice training is essential to sustain the workforce, however training for General Practice can be hampered by a number of pressures, including professional, structural and social isolation. General Practice trainees may be under more pressure than fully registered General Practitioners, and yet isolation can lead doctors to reduce hours and move away from rural practice. Virtual communities of practice (VCoPs) in business have been shown to be effective in improving knowledge sharing, thus reducing professional and structural isolation. This literature review will critically examine the current evidence …

The Role Of Health Literacy And Social Networks In Arthritis Patient's Health Information-Seeking Behaviour: A Qualitative Study, Janette Ellis, Judy Mullan, Anthony Worsley, Nagesh Brahmavar Pai

Graduate School of Medicine - Papers (Archive)

Background. Patients engage in health information-seeking behaviour to maintain their wellbeing and to manage chronic diseases such as arthritis. Health literacy allows patients to understand available treatments and to critically appraise information they obtain from a wide range of sources. Aims. To explore how arthritis patients’ health literacy affects engagement in arthritis-focused health information-seeking behaviour and the selection of sources of health information available through their informal social network. Methods. An exploratory, qualitative study consisting of one-on-one semi-structured interviews. Twenty participants with arthritis were recruited from community organizations. The interviews were designed to elicit participants’ understanding about their arthritis and …

Connectgpr: Coast City Country Online Network For An Educational Community Of Training For Gp Registrars. A Case Study, Stephen Barnett, Tim Caton, Sandra C. Jones, Donald C. Iverson, Sue Bennett

Graduate School of Medicine - Papers (Archive)

Powerpoint-presentation

Role on online communities.

Effect on isolation and knowledge sharing.

What works: Community THEN, technology.

Framework: Barnett BMC Family Practice 2012.

Pilot Study: ConnectGPR

Early Driving Experience And Influence On Risk Perception In Young Rural People, Patricia J. Knight, Donald Iverson, Mark F. Harris

Graduate School of Medicine - Papers (Archive)

Young people, particularly males and those from a rural area, are over represented in road crashes; this occurs in vehicle dependent countries around the world, including Australia. The attitudes, experiences and behaviours of young drivers are some of the key factors which affect their potential to have an earlyon road driving experience that is crash free.

This paper considers the views of young people, some of whom were brought up on rural properties, and had significant, responsible roles in agricultural work, including task related driving from a very early age. This early responsibility and associated awareness of risk of injury …

Undone Science And Blind Spots In Medical Treatment Research, Tommy Cleary

Graduate School of Medicine - Papers (Archive)

Age-related Macular Degeneration (AMD) is a serious eye disease. Two similar drugs, Lucentis and Avastin, are available to slow the progression of wet AMD. Research has been carried out on the highly profitable drug Lucentis, so governments have licensed it for use, whereas equivalent research and formal licensing of Avastin for treatment of eye disease has been delayed and discouraged. This is a case illustrating the problem of undone science: research in socially beneficial areas may be neglected for commercial or political reasons.

Reanalysis And Simulation Suggest The Phylogenetic Microarray Does Not Accurately Profile Microbial Communities, David J. Midgley, Paul Greenfiled, Janet M. Shaw, Yalchin Oytam, Dongmei Li, Caroline Kerr, Phillip Hendry

Graduate School of Medicine - Papers (Archive)

The second generation (G2) PhyloChip is designed to detect over 8700 bacteria and archaeal and has been used over 50 publications and conference presentations. Many of those publications reveal that the PhyloChip measures of species richness greatly exceed statistical estimates of richness based on other methods. An examination of probes downloaded from Greengenes suggested that the system may have the potential to distort the observed community structure. This may be due to the sharing of probes by taxa; more than 21% of the taxa in that downloaded data have no unique probes. In-silico simulations using these data showed that a …

Whole Genome Characterization Of The Mechanisms Of Daptomycin Resistance In Clinical And Laboratory Derived Isolates Of Staphylococcus Aureus, Anton Y. Peleg, Spiros Miyakis, Doyle V. Ward, Ashlee M. Earl, Aileen Rubio, David R. Cameron, Satish Pillai, Robert C. Moellering, George M. Eliopoulos

Graduate School of Medicine - Papers (Archive)

Background

Daptomycin remains one of our last-line anti-staphylococcal agents. This study aims to characterize the genetic evolution to daptomycin resistance in S. aureus.

Methods

Whole genome sequencing was performed on a unique collection of isogenic, clinical (21 strains) and laboratory (12 strains) derived strains that had been exposed to daptomycin and developed daptomycin-nonsusceptibility. Electron microscopy (EM) and lipid membrane studies were performed on selected isolates.

Results

On average, six coding region mutations were observed across the genome in the clinical daptomycin exposed strains, whereas only two mutations on average were seen in the laboratory exposed pairs. All daptomycin-nonsusceptible strains had …

Microbiological And Molecular Characteristics Of Carbapenemase-Producing Klebsiella Pneumoniae Endemic In A Tertiary Greek Hospital During 2004-2010, A Zagorianou, Effrosyni Sianou, E Isoifidis, V Dimou, E Protonotariou, Spiros Miyakis, E Roilides, Danai Sofianou

Graduate School of Medicine - Papers (Archive)

We report 570 carbapenemase-producing Klebsiella pneumoniae (CPKP) clinical isolates in a 1,040-bed Greek tertiary hospital during 2004 to 2010. The first CPKP (VIM-producing) was isolated in September 2004. Despite initial containment, VIM producers have become endemic since 2006. KPC-producing K. pneumoniae was first isolated in August 2007 from a patient who came from Israel, spread rapidly, and outcompeted VIM. Overall, 267 (47%) VIM-producing and 301 (53%) KPC-producing strains were isolated, including 141 (24.7%) from patients with bacteraemia. Two isolates carrying both VIM and KPC were isolated in two consecutive months in 2009, but not since. The prevalence of CPKP increased …

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

Graduate School of Medicine - Papers (Archive)

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 …

A Scholarly Spin On Practice: The Impact Of Longitudinal Integrated Clerkships On The Development Of Academic Scholarship In General Clinical Practice, Judith N. Hudson, Kathryn M. Weston

Graduate School of Medicine - Papers (Archive)

All senior medical students at the University of Wollongong in Australia undertake a longitudinal integrated community-based clerkship in a regional or rural community. In addition to continuity of patient care and curriculum, the clerkship offers each student individualized professional development by experienced generalist practitioners. These practitioners predicted outcomes from their relationship with the long-term students, including a more scholarly approach to clinical practice (1). In 1990, Boyer outlined the concept of four domains of scholarship: discovery, integration, application and teaching (2). More recently, a working definition of clinical scholarship in academic medicine has been proposed 930. This paper describes the …

Risk Of Road Traffic Accidents In Patients Discharged Following Treatment For Psychotropic Drug Overdose: A Self-Controlled Case Series Study In Australia, Tharaka L. Dassanayake, Alison L. Jones, Patricia Michie, Gregory Carter, Patrick Mcelduff, Barrie J. Stokes, Ian Whyte

Graduate School of Medicine - Papers (Archive)

Background: Use of psychotropic drugs is known to impair driving and increase the risk of road traffic accidents. They are also the most common drugs taken in overdose in hospital-treated episodes of self-poisoning. Most patients who take psychotropic drug overdoses are discharged within 48 hours, while they still have possible subclinical drug effects. Objective: Using a self-controlled case series design, we aimed to determine whether patients with psychotropic drug overdose are at a higher risk of a traffic accident in the period following discharge compared with a control period not associated with hospital-treated drug overdose. Methodology: Using the New South …

Patient Perceptions Of Innovative Longitudinal Integrated Clerkships Based In Regional, Rural And Remote Primary Care: A Qualitative Study, Judith N. Hudson, Patricia J. Knight, Kathryn M. Weston

Graduate School of Medicine - Papers (Archive)

No abstract provided.