Australasian Medical Journal
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Perception of tomorrow’s Health-Care connoisseur and front-runners of their educational environment utilizing DREEM inventory in Bahasa Melayu version, the native language of Malaysia
No full textBackgroundThere have been a lot of reports throughout the world that medical students were abused during their undergraduate education and clerkship training. Thereafter, calls for intensifying the evaluation of medical and health schools’ curricula based on students’ perceptions of their educational environment. Several studies, methods, and instruments were developed including the Dundee Ready Education Environment Measure (DREEM) inventory, to evaluate the medical educational environment in last five decades. The DREEM inventory has been translated into minimum eight different native tongues namely Arabic, Chinese, Japanese, Persian, Portuguese, Spanish, Swedish, and Turkish.AimsThe objective of this study was to assess the educational environment of the UniSZA undergraduate medical program from the students’ perspective utilizing the DREEM inventory translated in Bahasa Melayu. Methods This was a descriptive cross-sectional survey conducted among the medical students of session 2015-2016 to assess educational environment of the Faculty of Medicine, UniSZA. The study was conducted from December 2015 to January 2016. Universal sampling technique was adopted.Results A total of 277 (95.5 per cent) out of 290 students responded to the questionnaire; among them 27.4 per cent were male and 72.6 per cent were female respondents. The overall mean DREEM scores for both preclinical and clinical students were 67.41±24.06. The scores for pre-clinical and clinical were 64.02±25.10 and 69.65±23.15 respectively; however, no statistically significant (p=0.57) differences was observed between two phases. A significant difference was observed between gender of the respondents in students’ perceptions of teachers (p=0.005) and students’ social self-perceptions (p=0.046).ConclusionThe study respondents demanded teachers training program targeting active learning methods
Pre-operative immunonutrition therapy in upper gastrointestinal cancer patients
No full textBackgroundPre-operative immunonutrition for upper gastrointestinal cancer patients is provided in a number of Australian tertiary hospitals. However, previous studies yielded inconsistent results; limited information on patient acceptance of pre-operative supplementation is likely to be an as yet unexplored contributing factor.AimsTo determine patient acceptance of a pre-operative immunonutrition supplement protocol and to compare post-operative outcomes pre- and post-implementation of the protocol.Methods A retrospective review of medical records was undertaken for upper gastrointestinal cancer surgery patients pre- and post-implementation of a pre-operative immunonutrition protocol. Endpoints noted were surgery type, timing of attendance at the pre-admission clinic, post-operative complications, intensive care unit admissions, diet progression and length of stay. Patient feedback on the immunonutrition protocol and supplement acceptability was obtained via interview.Results The audit identified 74 patients as having undergone upper gastrointestinal cancer surgery (36 patients pre- and 38 patients post-implementation). Less than half of the post-implementation patients attended the pre-admission clinic as per protocol. Infectious and non-infectious complication rates were similar between the two groups. Number of days until patients received full diets post-operatively were 0.80 days shorter post-implementation, but not statistically significant. Patients in the post-implementation group with infective complications spent significantly longer time nil by mouth than those who did not incur complications (26.15 vs 17.13 days, p=0.024). Length of stay was 1.5 days shorter in the post-implementation group but not statistically different.ConclusionWe found no difference in post-operative outcomes; however, the pre- and post-implementation comparison was limited by poor adherence to the protocol as a consequence of late attendance at pre-admission clinic. Of those who did attend as planned, patient acceptance was high. Future studies incorporating prospective, quantitative pre-operative immunonutrition intake are needed
Bio-behavioural HIV survey in prisons on men and women in Burkina Faso.
No full textBackgroundDespite the severity of the human immunodeficiency virus (HIV) epidemic in Burkina Faso, data on specific groups are scant especially concerning prisoners. AimsThe objective of this study was to determine HIV prevalence and risky behavior in Burkina Faso prisons in order to assist in HIV prevention and AIDS case management decision making among prisoners. Methods This was a cross-sectional study carried out from September 3–10, 2014 among 18 years aged and over prisoners, in prisons of each of the 13 administrative regions of Burkina Faso with prisoners’ informed consent. Data were collected using a questionnaire that covered general informations on HIV/autoimmune insufficiency syndrome (AIDS) and sexually transmitted infections (STIs), coupled with blood samples collection, for HIV laboratory analysis purpose.Results A total of 1,079 prisoners participated in this study. The participation rate for interviews was and blood samples collections were 100 per cent. The majority of participants (97.8 per cent) were men, among whom 9.7 per cent reported a history of STIs. Nearly 50 per cent of these took no precautions to avoid infecting their sexual partners. Implementation of HIV/AIDS prevention and control activities in prisons was low (43.2 per cent). Condom use was also low (11.2 per cent). HIV infection Screening was insufficient: only two out of five prisoners had at least one HIV screening. HIV screening opportunities was uncommon and prisoners pointed out the lack of organization of screening campaigns in prisons. HIV prevalence was nearly 3 per cent. ConclusionThe exposure level of prisoners to HIV transmission prevention interventions was low. Specific measures are needed to increase condom use for HIV/AIDS and STIs prevention in prisons
Multicultural environment in higher education: The knowledge and perceptions of medical teachers of UNIKL RCMP, Malaysia
No full textBackgroundA clear majority of teaching staff in UniKL-RCMP are expatriates with different cultural backgrounds, and the university currently accepting international students with a different cultural background in addition to the local culturally diverse students.AimsThe purpose was to determine the knowledge and awareness of the lecturers of Faculty of Medicine regarding multiculturalism and the importance in the medical profession.Methods This was a cross-sectional study. A questionnaire was developed based on the relevant demographic information and knowledge and awareness of the cultural issues and the validity was discussed with a survey expert.Results A total of 43 teachers took part in the survey. The respondents were mostly male, expatriate and had very fewer experiences in teaching students of different cultural background. The most important thing affecting teachers’ competence was their experience in teaching students of different culture, and the teachers with experience in teaching in a multicultural environment felt more competent than the ones without experience. Gender or teaching experience did not have a significant impact on their feeling of competence. However, the teachers believed that training on special education program might have helped them more than their educational background to help develop the cultural competence of the students from different cultural backgrounds.ConclusionThis study showed that teachers need more training and experiences of the multicultural education program and to facilitate the development of cultural competence of students with cultural diversity, which should be taken into consideration in the faculty development activities
Willingness to pay for highly active antiretroviral (HAART) drugs and HIV treatment monitoring tests among People Living with HIV/AIDS
Get PDFBackgroundThe HIV treatment programme in Nigeria is from international donors and this may come to an end soon. AimsTo assess the willingness to pay for antiretroviral drugs and HIV treatment monitoring test among people living with HIV/AIDS in Enugu state, Nigeria.Methods A descriptive cross sectional study design was used. A two stage sampling technique was used to select 400 people who were receiving antiretroviral treatment in two of eight comprehensive treatment centres in Enugu, Nigeria. Willingness to pay was elicited via the contingent valuation method. Results Mean age of respondents was 36.6±10.0 years and male, female ratio of 1:1.2. The median willingness to pay for antiretroviral drugs and HIV treatment monitoring test was 500 Naira (USD 3.1) per month. Majority, 85.3 per cent were willing to pay however only a minor proportion, 1.8 per cent were willing to pay the actual amount for the services Predictors of respondents willingness to pay included being in low socio-economic group, (AOR 0.3, 95 per cent CI:0.2-0.7) and being on salaried employment, (AOR 3.0, 95 per cent CI:1.1-8.9). ConclusionMajority of people living with HIV/AIDS were willing to pay for antiretroviral drugs and HIV treatment monitoring tests but only a minor proportion were willing to pay the actual cost of services. This may adversely affect continuity of treatment and enrolment of new patients into the treatment programme. In-order to sustain the gains of the HIV treatment programme and achieve optimal treatment outcomes for patients on treatment in Nigeria there may be the need to subsidize antiretroviral treatment services for people living with HIV/AIDS
Initial experience with contrast-enhanced ultrasonography in follow up assessment of small breast cancer treated by cryoablation
Get PDFBackgroundCryoablation (CA) is a nonsurgical focal therapy for small tumours. To detect residual or relapsed tumour after CA of renal cancer, contrast-enhanced imaging is generally used to identify tumour blood flow, but no definitive criteria are established for such follow-up after CA of breast cancer.AimsThe aim of this study was to compare the usefulness of contrast-enhanced ultrasonography (CEUS) and magnetic resonance (MR) imaging for assessing residual tumours and local relapse following CA of small breast cancers.Methods We enrolled 4 patients treated by CA at our institution between January 2015 and December 2016 for luminal A breast cancer with maximum tumour size of 1.5cm and neither distant metastasis nor metastatic findings in sentinel lymph node biopsy, who underwent CEUS and MR imaging before CA. In addition to our standard postoperative follow-up for breast cancer, these patients underwent CEUS every 3 months and MR imaging every 6 months after CA.Results Six months after CA, no patient showed enhancement at the lesion site on MR imaging, but there were two with continued enhancement on CEUS. They underwent vacuum-assisted breast biopsy under US guidance followed by histopathological examination of tissue that identified no malignancy.ConclusionOur findings of focal enhancement within ablated breast tissue in CEUS after CA is likely attributable to the much higher sensitivity of CEUS to that of other modalities to even slight vascularization. Further investigation in more patients is needed to clarify the utility of CEUS to detect residual or relapsed tumour after CA of small breast cancer
Gender disparity of changes in heart rate during the six-minute walk test among patients with chronic obstructive airway disease
Get PDFBackgroundChronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality worldwide. Clarify; COPD is the fifth leading cause of death and disease burden globally. AimsThe purpose of this study is to compare the gender disparity of changes in heart rate during 6-minute walk test (6MWT) among patients with chronic obstructive airway disease (COPD). We also aimed to assess the relationship between change in heart rate and body mass index (BMI). MethodsWe randomly selected 59 elderly subjects with COPD (made up of 45 men and 14 women). The selected patients all had Medical Research Council (MRC) dyspnea index of ≥3. All patients in this study had informed written consent and carried out the 6 minute walk tests (6MWT) according to standards. Data analysis was carried out with SPSS version 21.0 software and Excel 2016 with level of significance taken as p < 0.05. We used of ANOVA to identify difference in the means among three or more groups. ResultsAs the BMI range is 15–50 while the mean BMI was 26±00 include the standard deviation has been observed overweight in all patients with COPD. There was significant difference in the distance covered during the 6MWT between men and women (Men=397.00, Women=375.00) at p < 0.001. Also, we can be seeing lowest significant different in heart rate basic (Mean Square=0.0) and oxygen saturation at rest (Mean Square=2.0) in value p < 0.00 between men and women.ConclusionIn this study, distance, SPO2, resting heart rate and 1-minute heart rate variables were evaluated for assessing exercise capacity and then the amount of breathlessness and exercise in patients with COPD
How sociodemographic features impact subjects' opinion on packages leaflets of medicines?
Get PDFBackgroundPackages leaflets (PLs) are essential for the safe use and efficacy of medicines.AimsTo quantify the opinion of users of medicines on PLs through the application of a self-administered Likert scale, taking into consideration subjects’ sociodemographic data.Methods Participants were enrolled from two Portuguese regions: urban/littoral (Lisbon) and rural/interior (Centre). 503 participants were included: 53 per cent males, 45 per cent 12 years of schooling). A questionnaire was used to collect the sociodemographic data. A Likert scale was self-administered to rate the characteristics of 12 randomized PLs (6 from prescription medicines and 6 from over-the-counter medicines) (August-December 2014). An invitation was send to several institutions (e.g., municipal councils). The inclusion criteria were: agreeing, be capable of reading/writing, and be more than 17 years old.Results In the Likert scores obtained, no significant differences were found related to region, sex, marital status, age group (≥65 years and other), and employment status of participants. By contrast, significant differences were found related to education (2=42.747; p 12 years of schooling, more regular reading habits (2 or more books/year), higher income and less frequent medicines use, showed a more negative global opinion on PLs.ConclusionSociodemographic data are important to understand users’ opinion on PLs. It seems that more educated subjects are more demanding. A lower socio-economic status positively influenced the participants’ opinion, with subjects’ poorer education being a relevant factor in this population. A higher frequency of taking medicines also positively contributed to a better opinion, probably due to a greater familiarity with PLs
The urban-rural divide: Hypertensive disease hospitalisations in Victoria 2010–2015
Get PDFBackgroundHypertension is present in 23–32 per cent of Australians, making it one of the most prevalent diseases in the country. It is the greatest risk factor for cardiovascular disease, the leading cause of death in Australia and it affects rural populations at a higher rate than urban residents.AimsThe aims of this study were to investigate the differences in hypertensive disease hospitalisations across rural and urban Victoria, and to determine predicting variables.MethodsHospital admission data from 1 July 2010 to 30 June 2015 were obtained through the Victorian Admitted Episodes Dataset and other organisations. Data included various patient demographics for each hospital admission entry. The rates of hospitalisation for each Local Government Area were analysed. Further regression analysis was undertaken to examine the association between hypertensive disease hospitalisation and various predictor variables.ResultsFrom 2010–2015 11,205 hypertensive disease hospital admissions were recorded of which 64.8 per cent were female, 74.7 per cent admissions were at urban hospitals, and 65.0 per cent were public patients. Hospitalisation rates were consistently higher in rural areas than in urban areas, and rural residents on average stayed in hospital for longer. Significant predictor variables for hypertensive disease hospitalisation included various indicators of socioeconomic disadvantage, GPs per 1,000 population and GP attendance per 1,000 population.ConclusionHypertensive disease hospitalisation in Victoria continues to rise and rates of hospitalisation of rural Victorians continue to be higher than their urban counterparts. Females were hospitalised almost twice as often as males. Further research is required to identify the specific factors that impede access to health services, particularly in the identified high-risk populations
