Mortality in the Victorian asylum: was it so high? Standardised Mortality Rate compared with historical methods.

Mortality is closely linked to age, sex, and social and historical context. Standardised Mortality Rates (SMR) address these contextual factors by comparing mortality in a population under study with that in people of the same age and sex, the same period in history and from a similar cultural context. We use records from the Hatton Asylum and contemporaneous census data in order to calculate SMR in the asylum population, showing rates that were about 2.

Impact of Preference Signals on Interview Selection Across Multiple Residency Specialties and Programs.

Program signaling is an innovation that allows applicants to express interest in specific programs while providing programs the opportunity to review genuinely interested applicants during the interview selection process. To examine the influence of program signaling on "selected to interview" status across specialties in the 2022 Electronic Residency Application Service (ERAS) application cycle. Dermatology, general surgery-categorical (GS), and internal medicine-categorical (IM-C) programs that participated in the signaling section of the 2022 supplemental ERAS application (SuppApp) were included.

Perceived Discrimination in Australia During the COVID-19 Pandemic: a Longitudinal Study.

Objectives: There have been global reports of increased discrimination during the COVID-19 pandemic relative to the pre-pandemic era, though this has not been well explored within Australia. The aim of the study was to characterise discriminatory behaviour experienced by groups previously identified as most at risk of experiencing discrimination (i.e.

Mentoring Award: Importance, Availability and Association With Mentoring Outcomes.

Intrinsic and extrinsic awards may motivate mentors and thus strengthen the organizational mentoring climate (OMC). Several institutions offer extrinsic awards for mentoring to recognize exceptional mentorship by individuals who support junior faculty in their career development. Mentees, peers, or institutions may nominate mentors for these awards.

Coping styles and mental health in response to societal changes during the COVID-19 pandemic.

Background: Psychosocial responses to infectious disease outbreaks have the potential to inflict acute and longstanding mental health consequences. Early research across the globe has found wide ranging psychological responses to the current COVID-19 pandemic. Understanding how different coping styles can be effective in mitigating mental ill health would enable better tailored psychological support.

A critical narrative review of transfer of basic science knowledge in health professions education.

Context: 'Transfer' is the application of a previously learned concept to solve a new problem in another context. Transfer is essential for basic science education because, to be valuable, basic science knowledge must be transferred to clinical problem solving. Therefore, better understanding of interventions that enhance the transfer of basic science knowledge to clinical reasoning is essential.

Flexible assertive community treatment (FACT) model in specialist psychosis teams: an evaluation.

The impact of flexible assertive community treatment (FACT) has been observed in people previously supported by assertive community treatment (ACT) teams, but its effect on those previously with a community mental health team (CMHT) has not been studied in the UK. An observational study was conducted of 380 people from 3 CMHTs and 95 people from an ACT team, all with a history of psychosis, following service reconfiguration to 3 FACT teams. People previously with a CMHT required less time in hospital when the FACT model was introduced.

Entrustable Professional Activities: A Faculty Development Workshop for Adding EPAs Into Your Medical Trainee's Assessment Portfolio.

Introduction: The last 3 decades have seen significant changes in medical education and corresponding assessment of medical trainees. Competency-based medical education provided a more comprehensive model than the previous time-based process but remained insufficient. Introduced in 2005, entrustable professional activities (EPAs) offer a more robust curriculum development and assessment process, especially in regard to clinician-oriented workplace-based assessments.

A 10-year service evaluation of an assertive community treatment team: trends in hospital bed use.

Background: Studies of assertive community treatment (ACT) have shown various benefits, including reduced hospital bed use. In the UK, this finding was not replicated by randomised controlled trials (RCTs), which lacked fidelity to the model. Conversely, observational studies, while limited by their inherent weakness in implying causality, have shown lower bed use.

Hypertonic saline and desmopressin: a simple strategy for safe correction of severe hyponatremia.

Background: Prompt correction of severe hyponatremia is important, but correction also must be limited to avoid iatrogenic osmotic demyelination. Expert opinion recommends that serum sodium level not be increased by more than 10-12 mEq/L in any 24-hour period and/or 18 mEq/L in any 48-hour period. However, inadvertent overcorrection is common, usually caused by the unexpected emergence of a water diuresis.

Olanzapine-induced rhabdomyolysis.

We present a case of possible olanzapine-induced rhabdomyolysis in the absence of other features of neuroleptic malignant syndrome (NMS). There is evidence to suggest that there are different underlying pathophysiological mechanisms for rhabdomyolysis occurring alone, in contrast to when it presents as part of NMS. This has possible implications for drug rechallenge which is discussed.

Role of dynamic external fixator in the management of fractures of distal end of radius.

The intra-articular fracture of radius has been an enigma for orthopaedic surgeons since time immemorial. It is a dilemma as to when to use the fixator, when to mobilise after fixator or simply treat it by conservative means. Numerous fixators are in vogue depending on the preference of the surgeon--in the present prospective study the results of dynamic external fixator--which, based on the principle of ligamentotaxis, were evaluated over a 3-year period and the results showed that although excellent radiological results were seen in 90% of the cases yet only 75% of the cases had a excellent functional result.

Arthroscopic evaluation of refractory knee pain.

The aim of this study was to evaluate the conditions of the articular cartilage and other intra-articular structures in patients with refractory knee pain. A total of 50 patients were taken up for this study based on specific inclusion criteria. Arthroscopy was done using a 30 degrees scope and was introduced most commonly via anterolateral approach after a thorough clinical and radiological evaluation of the affected joint.

Giant cell tumour of talus with osteosarcomatous transformation in a young male: a case report.

A case of osteosarcomatous transformation in a benign giant cell tumour is described. Spontaneous malignant transformation is rare in a giant cell tumour with only 17 cases reported in the literature till date. In addition, a giant cell tumour arising in the bones of the hands and feet is in itself a rarity.

Isolated tuberculosis of talus without ankle and subtalar joint involvement.

This case has been reported because of its rarity and atypical clinical presentation. An 8-year-old boy presented with a gradually increasing swelling localised on the antero-medial aspect of the foot haemogram, erythrocyte sedimentation rate (ESR), Mantoux and X-ray chest were normal. An irregular lytic lesion of the talus was seen on the x-ray of the affected part.

The effect of auxiliary conditions on intestinal unstirred layer diffusion modelled by numerical simulation.

Estimation of intestinal unstirred layer thickness usually involves inducing transmural potential difference changes by altering the content of the solution used to perfuse the small intestine. Osmotically active solutes, such as mannitol, when added to the luminal solution diffuse across the unstirred water layer (UWL) and induce osmotically dependent changes in potential difference. As an alternative procedure, the sodium ion in the luminal fluid can be replaced by another ion.

Hip instability in newborns in an urban community.

Background: It is important to recognize congenital dislocation of the hip early so that it can be treated effectively and secondary changes prevented. There is little data on the incidence of this condition in India and we, therefore, studied this problem in a large maternity and paediatric centre in New Delhi.

Methods: Six thousand and twenty-nine consecutive newborns were examined for neonatal hip instability by an orthopaedic surgeon and a paediatrician.

Biological characteristics of Salmonella weltevreden typing phages.

The important biological characteristics of Salmonella weltevreden (3, 10 : r :Z6) typing phages were studied. On the basis of these, the phages could be classified into three groups: phages phi I and phi II, phages phi III, phi IV and phi VI, and phage phi V.