Australasian Medical Journal
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Book review: Reconstruction medical practice: Engagement, professionalism and critical relationships in health care
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Reviewing the review process: Identifying sources of delay
Get PDFBackgroundThe process of manuscript review is a central part of scientific publishing, but has increasingly become the subject of criticism, particularly for being difficult to manage, slow, and time consuming - all of which contribute to delaying publication.AimsTo identify potential sources of delays during manuscript review by examining the review process, and to identify and propose constructive strategies to reduce time spent on the review process without sacrificing journal quality.Method Sixty-seven manuscripts published in the Australasian Medical Journal (AMJ) were evaluated in terms of duration of peer review, number of times manuscripts were returned to authors, time authors spent on revision per review round, manuscripts containing grammatical errors reviewers deemed as major, papers where instructions to authors were not adhered to, and the number of reviews not submitted on time.ResultsThe median duration of the review process was found to be 74 days, and papers were on average returned to authors 1.73 times for revision. In 35.8% of papers, instructions to authors were not adhered to, whilst 29.8% of papers contained major grammatical errors. In 70.1% of papers reviewers did not submit their reviews on time, whilst the median time spent on revision by authors per review round was found to be 22 days. ConclusionThis study highlights the importance of communication before and during review. Reviewers should be thoroughly briefed on their role and what is expected of them, whilst the review process as well as the author's role in preventing delays should be explained to contributors upon submission
Antiobiotic Resistance in Catheterised Patients
No full textBackground Microbial biofilms pose a public health problem for persons requiring indwelling medical devices, as micro-organisms in biofilms are difficult to treat with antimicrobial agents. Thus the present study includes biofilm formation and antibiotic resistance pattern of uropathogens in hospitalised patients with catheter associated urinary tract infections (UTI). Method This prospective analysis included 100 urine samples from catheterised patients with symptoms of UTI over a period of six months. Following identification, all isolates were subjected to antibiotic sensitivity using modified Kirby-Bauer disc diffusion method. Detection of biofilms was done by tube adherence method and Congo red agar method. Results E.coli was found to be the most frequently isolated uropathogen 70%, followed by Klebsiella pneumoniae 16%, Pseudomonas aeruginosa 4%, Acinetobacter spp 2%, coagulase negative Staphylococci 6% and Enterococci spp 2%. In the current study 60% of strains were in vitro positive for biofilm production. Biofilm positive isolates showed 93.3%, 83.3%, 73.3% and 80% resistance to nalidixic acid, ampicillin, cephotaxime and cotrimoxazole, respectively, compared to 70%, 60%, 35%, 60% resistance showed by biofilm non-producers for the respective antibiotics. Approximately 80% of the biofilm producing strains showed multidrug resistant phenotype ConclusionE.coli was the most frequent isolate, of which 63% were biofilm producers. The antibiotic susceptibility pattern in the present study showed quinolones were the least active drug against uropathogens. The uropathogens showed the highest sensitivity to carbapenems. The next best alternatives were aminoglycosides. Significant correlation between biofilm production and multi-drug resistance was observed in our study
Exercise Training in Type 2 Diabetes Mellitus
No full textThe Maori and Pacific Islands peoples of New Zealand suffer a greater burden of type 2 diabetes mellitus (T2DM) and associated comorbidities than their European counterparts. Empirical evidence supports the clinical application of aerobic and resistance training for effective diabetes management and potential remission, but few studies have investigated the effectiveness of these interventions in specific ethnic cohorts. We recently conducted the first trial to investigate the effect of prescribed exercise training in Polynesian people with T2DM. This article presents the cultural considerations undertaken to successfully implement the study. The research procedures were accepted and approved by cultural liaisons and potential participants. The approved methodology involved a trial evaluating and comparing the effects of two, 16-week exercise regimens (i.e. aerobic training and resistance training) on glycosylated haemoglobin (HbA1c), related diabetes markers (i.e. insulin resistance, blood lipids, relevant cytokines and anthropometric and hemodynamic indices) and health-related quality of life. Future exercise-related research or implementation strategies in this cohort should focus on cultural awareness and techniques to enhance participation and compliance. Our approach to cultural consultation could be considered by researchers undertaking trials in this and other ethnic populations suffering an extreme burden of T2DM, including indigenous Australians and Americans.
Coaching Older Adults and Carers
Get PDFBackgroundFrail older people who are considering movement into residential aged care or returning home following a hospital admission often face complex and difficult decisions. Despite research interest in this area, a recent Cochrane review was unable to identify any studies of interventions to support decision-making in this group that met the experimental or quasi-experimental study design criteria. AimsThis study tests the impact of a multi-component coaching intervention on the quality of preparation for care transitions, targeted to older adults and informal carers. In addition, the study assesses the impact of investing specialist geriatric resources into consultations with families in an intermediate care setting where decisions about future care needs are being made. Method This study was a randomised controlled trial of 230 older adults admitted to intermediate care in Australia. Masked assessment at 3 and 12 months examined physical functioning, health-related quality of life and utilisation of health and aged care resources. A geriatrician and specialist nurse delivered a coaching intervention to both the older person and their carer/family. Components of the intervention included provision of a Question Prompt List prior to meeting with a geriatrician (to clarify medical conditions and treatments, medications, ‘red flags’, end of life decisions and options for future health care) and a follow-up meeting with a nurse who remained in telephone contact. Participants received a printed summary and an audio recording of the meeting with the geriatrician.ConclusionThe costs and outcomes of the intervention are compared with usual care. Trial registration: Australian New Zealand Clinical Trials Registry (ACTRN12607000638437)
Primary Tubercular Mastopathy
Get PDFPrimary breast tuberculosis is a rare entity in the developed world but is slightly more common in the developing world. All lesions that clinically, pathologically and imaging wise appear benign but do not respond to routine antibiotics, must be worked up for possible tubercular aetiology especially when they present as plain oedema, induration or as non-healing ulcers. Imaging has a role in defining the extent, deciding the type of management and duration of follow-up. This article highlights the clinical and sonographic imaging findings in one such case which was followed up for a period of one year.