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Biomedical subjects

B Sweet

Publications and source records attributed to B Sweet.

18 recordsLinked to original sources

Midwifery in Indonesia: a professional snapshot.

In 1988, Indonesia had the highest maternal mortality rate in South East Asia, but the Government's commitment to reducing this has already demonstrated a measure of success. Initiatives include: use of voluntary healthcare workers (kaders) in the local community family planning initiatives raising awareness of the status of women in society by the appointment of a Minister for Women's Affairs. The commitment of both the government and midwives to promoting safe motherhood in Indonesia should make a significant contribution to achieving the WHO aim of halving the maternal mortality rate by the year 2000.

Female↗

Behavioural assessment of the effectiveness of a communication programme for medical students.

This study evaluated the effectiveness of a communication programme taught to medical students at the University of Melbourne in their preclinical years. The effectiveness of the programme was assessed by comparing videotaped history-taking interviews completed by a cohort of first-year clinical students in 1986, who had not undertaken the communication programme, with a similar cohort of first-year clinical students in 1992 who had undertaken the programme. The students from the 1986 cohort who had not undertaken communication training in their preclinical course completed their videotaped interviews as part of the experimental evaluation of a consulting skills training programme carried out in 1986-87. A comparison of ratings given by two experimentally naive, independent observers revealed that the 1992 student cohort demonstrated some significantly better skills at questioning and facilitating communication with patients. By contrast, the 1986 student cohort showed significantly greater skills at maintaining relevance in their interviews and greater capacity to explore patients' psychosocial concerns. These data suggest that students acquire the most effective interview skills when interacting with patients during their clinical training.

Australia↗

Lectures and skills workshops as teaching formats in a history-taking skills course for medical students.

The consulting skills acquired by medical students during their training are an important determinant of their ability to conduct adequate and efficient clinical interviews. These skills comprise: the acquisition of medical knowledge and the ability to apply this; and communication skills required to obtain full, accurate clinical histories from patients and to be able to give to patients the information they need to comply with prescribed regimens. Until recently, consulting skills training has certainly not had a high profile in medical curricula, despite evidence that students do not gain sufficient expertise during their medical training. A history-taking skills course within the Austin Hospital Clinical School, utilizing mass lecture and small-group skills workshops is described. Independent evaluation of students' videotaped interviews with patients, completed before training, after mass lectures and following small-group workshops, showed that students trained in consulting skills demonstrated significant improvements in interview skills and techniques, compared with a similar group of students for whom training followed the more traditional model. Whilst there were some improvements after mass lectures, most significant gains in history-taking skills were obtained following skills workshops. Ongoing evaluation of these students will determine if these short-term improvements in consultation skills persist over their clinical training and internship.

Clinical Clerkship↗

A communication skills programme for increasing patients' satisfaction with general practice consultations.

The research literature on patient perceptions of general practice consultations shows that, while patients are generally satisfied with the treatment they receive from doctors, they report less satisfaction with the amount and clarity of information they receive and doctors' expression of caring and respect. In the surgery, inadequate information transmission during the interaction also has the effect of increasing the level of anxiety reported by patients after their consultations. A communication skills programme was developed, incorporating variables from both the emotional and cognitive domains of the consultation. A group of GPs undertook training in this programme. It was hypothesized that patients of the trained doctors would report greater satisfaction and less anxiety, compared with patients of untrained general practitioners. Subsequent randomized interviews with patients of the trained doctors showed that these patients were significantly more satisfied with their consultations. Patients of the trained doctors also reported less state anxiety immediately following their consultations, as measured using the State-Trait Anxiety Inventory. Attempts by doctors to communicate more effectively in consultations therefore increased patients' positive feelings and reduced anxiety.

Adolescent↗

Plasma alpha 1-acid glycoprotein levels in pregnancy.

One hundred and five determinations of plasma alpha 1-acid glycoprotein (alpha 1AG) levels in 96 women with normal pregnancies were done by an enzyme-linked immunosorbent assay developed in this laboratory. Plasma alpha 1AG levels in pregnant women of all trimesters and 4-10 weeks post-partum period do not differ significantly from those obtained from healthy women of child bearing age. In nine women whose pregnancies were complicated by acute inflammation, plasma levels of alpha 1AG were significantly higher. These findings suggest that in normal pregnancy, alpha 1 AG levels in the plasma remain unchanged. But, pregnancy does not obscure alpha 1 AG response to acute inflammation.

Female↗

Multiple myeloma with massive Bence Jones proteinuria and preservation of renal function.

The case history of a patient having multiple myeloma with a remarkably high level of Bence Jones proteinuria (more than 20 g/day) is presented. The patient has responded well to therapy, and at no stage has he shown impairment of renal function as determined by creatinine clearance studies. A review of published reports has shown that such marked Bence Jones proteinuria at presentation is rare and is usually accompanied by renal impairment and a short survival. Additional presentation data from selected patients in the MRC First Myelomatosis Trial is presented. This suggests a higher incidence of marked Bence Jones proteinuria, and underlines the lack of correlation between the quantity excreted and the degree of renal impairment. The mechanisms by which Bence Jones protein may cause renal damage are discussed.

Bence Jones Protein↗