Mentoring for population health in general practice divisions.

This paper describes the implementation and evaluation of a three-way model of service development mentoring. This population health mentoring program was funded by the Commonwealth Department of Health and Ageing to enable staff from eight Divisions of General Practice in South Australia to gain a sound understanding of population health concepts relevant to their workplace. The distinguishing features of service development mentoring were that the learning was grounded within an individual's work setting and experience; there was an identified population health problem or issue confronting the Division of General Practice; and there was an expectation of enhanced organisational performance.

Pattern and severity of early childhood caries.

Objectives: The aim of this study was to investigate the association between selected social and behavioural variables and the pattern and severity of early childhood caries (ECC) within a community child population.

Methods: A cross-sectional sample of 2515 children aged 4-5 years were examined in a preschool setting using decayed, missing, filled teeth/surface (dmft/dmfs) indices and a self-administered questionnaire was used to obtain information regarding social, demographic, birth, infant feeding, oral and general health attitudes. Children with caries (847) were divided into anterior or posterior caries pattern groups and severe (dmfs score > or =6) or non-severe (dmfs score <6) caries groups.

A clinical pathway for bronchiolitis is effective in reducing readmission rates.

Objective: To examine the use of a clinical pathway in the management of infants hospitalized with acute viral bronchiolitis.

Study Design: A clinical pathway with specific management and discharge criteria for the care of infants with bronchiolitis was developed from pathways used in tertiary care pediatric institutions in Australia. Two hundred and twenty-nine infants admitted to hospital with acute viral bronchiolitis and prospectively managed using a pathway protocol were compared with a retrospective analysis of 207 infants managed without a pathway in 3 regional and 1 tertiary care hospital.

Opportunities for health promotion in the Queensland women's prison system.

Objective: To compare the health of Queensland women prisoners with that of community women using the target areas of public health promotion identified by Health Determinants Queensland as a framework.

Methods: Data from the Queensland Women Prisoners' Health Survey was compared with published community data in each of the target areas.

Results: Queensland women prisoners had poorer nutrition, did less exercise, had higher rates of smoking and had a greater prevalence of asthma and diabetes than women in the community.

Tutoring in problem-based learning medical curricula: the influence of tutor background and style on effectiveness.

Background: Evidence for the superiority of particular characteristics in PBL tutors in medical curricula is generally inconclusive. Most studies have investigated the effectiveness of content experts compared with that of non-experts as measured either by student satisfaction or academic achievement. A few have compared academic staff tutors with student tutors.

General practitioner, specialist providers case conferences in palliative care--lessons learned from 56 case conferences.

Objective: To describe the utility and acceptability to general practitioners and palliative care staff of case conferences in palliative care.

Method: Research focussed on case conferences conducted between GPs and staff of three specialist palliative care units (in an inner urban, outer metropolitan and regional setting), at the time of referral of patients to the service. Telephone interviews were conducted with all GPs who participated in a case conference, and focus groups were conducted with palliative care staff.

Psychological interventions for overweight or obesity.

Background: Overweight and obesity are global health problems which are increasing throughout the industrialised world. If left unchecked, they will continue to contribute to the ever increasing noncommunicable disease burden.

Objectives: To assess the effects of psychological interventions for overweight or obesity as a means of achieving sustained weight loss.

Deep dermal burn injury results in scarless wound healing in the ovine fetus.

Early to mid-term fetuses heal cutaneous incisional wounds without scars; however, fetal response to burn injury has not been ascertained. We present a fetal model of thermal injury and subsequent analysis of fetal and lamb response to burn injury. A reproducible deep dermal burn injury was created in the fetus by application of water at 66 degrees C for 7 seconds, and at 82 degrees C for 10 seconds to the lamb.

Sustained secretion of ciliary neurotrophic factor to the vitreous, using the encapsulated cell therapy-based NT-501 intraocular device.

The objective of this study was to evaluate the in vivo secretion profile of ciliary neurotrophic factor (CNTF) from either of two genetically engineered cell lines contained in the encapsulated cell therapy (ECT)-based NT-501 device. ECT devices were loaded with either a low or high CNTF-secreting cell line and implanted into rabbit eyes for 1, 3, 7, 14, 30, 60, 90, 135, 180, or 365 days. After explantation, the vitreous was sampled and devices were allowed to incubate in endothelial serum-free medium for 24 h at 37 degrees C.

Haemochromatosis--a future focus for continuing education in general practice.

Introduction: This study aimed to assess the educational needs of general practitioners with regards to the diagnosis and management of hereditary haemochromatosis.

Methods: A questionnaire was mailed to all 216 GPs in a suburban division of general practice, with a response rate of 91 (42.1%).

The association between student characteristics and the development of clinical reasoning in a graduate-entry, PBL medical programme.

This study sought to assess the extent to which the entry characteristics of students in a graduate-entry medical programme predict the subsequent development of clinical reasoning ability. Subjects comprised 290 students voluntarily recruited from three successive cohorts of the University of Queensland's MBBS Programme. Clinical reasoning was measured once a year over a period of three years using two methods, a set of 10 Clinical Reasoning Problems (CRPs) and the Diagnostic Thinking Inventory (DTI).

Clinical reasoning: the relative contribution of identification, interpretation and hypothesis errors to misdiagnosis.

The aim of this study was to identify and describe the types of errors in clinical reasoning that contribute to poor diagnostic performance at different levels of medical training and experience. Three cohorts of subjects, second- and fourth- (final) year medical students and a group of general practitioners, completed a set of clinical reasoning problems. The responses of those whose scores fell below the 25th centile were analysed to establish the stage of the clinical reasoning process--identification of relevant information, interpretation or hypothesis generation--at which most errors occurred and whether this was dependent on problem difficulty and level of medical experience.

Binomial sequential sampling plans for late instars of European corn borer (Lepidoptera: Crambidae), corn earworm (Lepidoptera: Noctuidae), and damaged kernels in sweet corn ears.

Late-season infestations of European corn borer, Ostrinia nubilalis (Hübner), and corn earworm, Helicoverpa zea (Boddie), were sampled to develop binomial sequential sampling plans for larval infestations and damaged kernels in sweet corn, Zea mays L., ears, near harvest. Fields were sampled to obtain a range of larval densities likely to be encountered over a range of infestation levels and field conditions.

Diagnostic accuracy of and patient satisfaction with telemedicine for the follow-up of paediatric burns patients.

Videoconferencing has become a routine technique for the post-acute burns care of children in Queensland. We compared the agreement between clinical assessments conducted via videoconference and assessments conducted in the conventional, face-to-face manner (FTF). A total of 35 children with a previous burn injury were studied.

Myeloma with predominant phalangeal involvement.

A case of plasma cell myeloma involving the middle phalanx of the ring finger is reported. This was a case of a non-secretory myeloma; however, monoclonal immunoglobulins were demonstrated by immunohistochemical studies. Plasma cell myeloma with phalangeal involvement is extremely rare: our literature search disclosed only two well-documented cases.

Social and behavioural determinants of early childhood caries.

Background: To investigate the association between selected social and behavioural (infant feeding and preventive dental practices) variables and the presence of early childhood caries in preschool children within the north Brisbane region.

Methods: A cross sectional sample of 2515 children aged four to five years were examined in a preschool setting using prevalence (percentage with caries) and severity (dmft) indices. A self-administered questionnaire obtained information regarding selected social and behavioural variables.

Familial growth and skeletal features associated with SHOX haploinsufficiency.

This study was designed to determine the intrafamilial effect of SHOX haploinsufficiency on stature, by comparing the growth and phenotype of 26 SHOX haploinsufficient individuals with 45 relatives and population standards. It confirmed that SHOX haploinsufficiency leads to growth restriction from birth to final height. Compared to unaffected siblings, the SHOX haploinsufficient cohort was 2.

Further evidence for the agreement between patients with stroke and their proxies on the Frenchay Activities Index.

Objective: To determine item, subscale and total score agreement on the Frenchay Activities Index (FAI) between stroke patients and proxies six months after discharge from rehabilitation.

Design: Prospective study design.

Setting/subjects: Fifty patient-proxy pairs, interviewed separately, in the patient's residence.

The clinical reasoning characteristics of diagnostic experts.

The aim of this study was to identify and describe the clinical reasoning characteristics of diagnostic experts. A group of 21 experienced general practitioners were asked to complete the Diagnostic Thinking Inventory (DTI)and a set of 10 clinical reasoning problems (CRP) to evaluate their clinical reasoning. Both the DTI and the CRPs were scored, and the CRP response patterns of each GP examined in terms of the number and type of errors contained in them.

A multicenter, randomized, double-blind, controlled trial of nebulized epinephrine in infants with acute bronchiolitis.

Background: The treatment of infants with bronchiolitis is largely supportive. The role of bronchodilators is controversial. Most studies of the use of bronchodilators have enrolled small numbers of subjects and have examined only short-term outcomes, such as clinical scores.

Reliability of scores between stroke patients and significant others on the Reintegration to Normal Living (RNL) Index.

Purpose: This study measured reliability between stroke patients' and significant others' scores on items on the Reintegration to Normal Living (RNL) Index and whether there were any scoring biases.

Method: The 11-item RNL Index was administered to 57 pairs of patients and significants six months after stroke rehabilitation. The index was scored using a 10-point visual analogue scale.

Abnormalities of the PTH-vitamin D axis and bone turnover markers in children, adolescents and adults with cystic fibrosis: comparison with healthy controls.

Abnormalities of calcium and vitamin D metabolism in cystic fibrosis (CF) are well documented. We tested the hypothesis that alterations in calcium metabolism are related to vitamin D deficiency, and that bone resorption is increased relative to accretion in patients with CF. Calcitropic hormones, electrolytes, osteocalcin (OC) and bone alkaline phosphatase (BAP), (markers of bone mineralisation), urinary deoxypyridinoline [total (t) Dpd, a marker of bone resorption] and lumbar spine bone mineral density (LS BMD), expressed as a z-score, were measured in 149 (81 M) CF and 141 (61 M) control children aged 5.