A discussion of cases in the 2001 RCPA-AQAP chemical pathology case report comments program

Aim: We present a descriptive analysis of the 10 case reports distributed in the Royal College of Pathologists of Australasia (RCPA) and the Australasian Association of Clinical Biochemists (AACB) Chemical Pathology Patient Report Comments Program to assess the quality of interpretative commenting in clinical biochemistry in 2001. Method: Participants were asked to comment on a given set of biochemistry results attached with brief clinical details. All responses received were translated into key phrases and graphically presented on a histogram. An expert panel was asked to evaluate the appropriateness of the key phrases and to propose a suggested composite comment. Results: While the majority of comments received were felt to be acceptable by the expert panel, some comments were felt to be inappropriate or misleading. As comments on laboratory reports may affect clinical management of patients, it is important that these comments reflect accepted practice and current guidelines. Conclusion: The Patient Report Comments Program may play an important role in continuing education and possibly in quality assurance of interpretative commenting.

Social communication in older age: Lessons from people with aphasia

Lessons on social communication in older age are drawn from the stories and qualitative case reports of three older people who have aphasia following stroke. Descriptive accounts of participant responses to qualitative interviews and stimulated recall of natural conversations, together with information from a social network diary, provide evidence of aspects of social communication relevant to the older person with aphasia. The perspectives of individuals and common themes relating to social communication with family and friends, the experience of aphasia, and living with aphasia in older age are presented. The prominence of conversations and the role of storytelling and of humor within the daily social communication of older people are illuminated. Key words: aphasia, older people, social communication

Characteristics of banana fruit from nearby organic versus conventional plantations: A case study

This case study reports the post-harvest qualities of conventionally versus organically grown banana fruit from nearby plantations in the Dominican Republic. The comparison involved six repeated harvests over the transition from cooler to hotter seasons. Green mature Cavendish 'Grande Naine' banana fruit were shipped to the UK. They were triggered to ripen with ethylene gas and kept under simulated retail conditions. Fruit mass, colour, firmness and flavour parameters were measured every second day over 12 d of shelf life. Sensory comparisons were conducted on four of the six harvest times. Significant differences (P<0.05) in measured quality attributes between conventionally and organically grown fruit were few and marginal. Moreover, any differences were inconsistent across harvest-times and during shelf life. Thus, organically and conventionally grown product had almost identical qualities. Sensory comparison confirmed that there was no flavour difference. This case study provides data that challenge a general perception that organic bananas have better flavour than conventional bananas.

Traumatic tear of tibialis anterior during a Gaelic football game: A case report

Reports of traumatic injury to the anterior lower leg muscles are scarce, with only a handful of reports of traumatic injury to the tibialis anterior. A database search of Medline, Cinhal, and Sports Discus only revealed three such cases, and they did not result from a direct sporting injury. This report documents the case of a traumatic rupture of tibialis anterior muscle in a young female Gaelic football player. It details the surgical repair and management of tibialis anterior muscle and the physiotherapy rehabilitation to full function.

Self-determination theory: A case study of evidence-based coaching

The coach is central to the development of expertise in sport (Bloom, 1985) and is subsequently key to facilitating adaptive forms of motivation to enhance the quality of sport performance (Mallett & Hanrahan, 2004). In designing optimal training environments that are sensitive to the underlying motives of athletes, the coach requires an in-depth understanding of motivation. This paper reports on the application of self-determination theory (SDT; Deci & Ryan, 1985; Ryan & Deci, 2000) to coaching elite athletes. Specifically, the application of SDT to designing an autonomy-supportive motivational climate is outlined, which was used in preparing Australia's two men's relay teams for the 2004 Olympic Games in Athens.

Shadowing experiences and the extension of communities of practice: A case study of women education managers

Recent developments in workplace learning have focused on relational and social network views of learning that introduce practitioners to the norms, values and assumptions of the workplace as well as the learning processes through which knowledge is acquired. This article reports on a qualitative study of a mentoring programme designed to assist women education managers gain promotion by broadening their networks and stimulating insights into the senior management positions for which they were being prepared. The findings are that members reflexively assess and reassess goals and values to demystify knowledge and resolved cognitive dissonance in these processes. Moreover, this article shows that women participants learn from the networks, and that the networks learn from the participant in a reciprocal and informal way. The article concludes that organizational learning programmes must focus on enabling such networks to flourish.

Remunerating private psychiatrists for participating in case conferences

ABSTRACT : BACKGROUND : On 1 November 2000, a series of new item numbers was added to the Medicare Benefits Schedule, which allowed for case conferences between physicians (including psychiatrists) and other multidisciplinary providers. On 1 November 2002, an additional set of numbers was added, designed especially for use by psychiatrists. This paper reports the findings of an evaluation of these item numbers. RESULTS : The uptake of the item numbers in the three years post their introduction was low to moderate at best. Eighty nine psychiatrists rendered 479 case conferences at a cost to the Health Insurance Commission of $70,584. Psychiatrists who have used the item numbers are generally positive about them, as are consumers. Psychiatrists who have not used them have generally not done so because of a lack of knowledge, rather than direct opposition. The use of the item numbers is increasing over time, perhaps as psychiatrists become more aware of their existence and of their utility in maximising quality of care. CONCLUSION : The case conferencing item numbers have potential, but as yet this potential is not being realised. Some small changes to the conditions associated with the use of the item numbers could assist their uptake.

Conversation repair and adult cochlear implantation: A qualitative case study

Conversation breakdown and repair has been suggested to be a common site of the disability arising from acquired hearing impairment in adults. This qualitative case study reports on certain consequences of the use of general versus specific conversation repair initiators for the resolution of repair sequences. The 47 repair sequences analysed in this paper arose in a single 20-minute free and unstructured conversation between an adult bilateral cochlear implantee and his wife, audio-recorded in a clinic setting. The repairs analysed in this paper were undertaken in response to either general (n = 18) or specific (n = 29) repair requests. No difference was found in the number of turns taken to resolve repairs in response to general or specific repair requests. Qualitative analysis demonstrated that uttering the repair initiator in the immediate vicinity of the miscommunicated portion of talk provided the primary cue to the conversation partner about the location and the content of what had been misunderstood. These preliminary findings imply a change to rehabilitation counselling offered to familiar communication partners. Copyright © 2006 John Wiley & Sons, Ltd.

Problem-based learning: a case study in providing e-health education using the Internet

The current trend among many universities is to increase the number of courses available online. However, there are fundamental problems in transferring traditional education courses to virtual formats. Delivering current curricula in an online format does not assist in overcoming the negative effects on student motivation which are inherent in providing information passively. Using problem-based learning (PBL) online is a method by which computers can become a tool to encourage active learning among students. The delivery of curricula via goal-based scenarios allows students to learn at different rates and can successfully shift online learning from memorization to discovery. This paper reports on a Web-based e-health course that has been delivered via PBL for the past 12 months. Thirty distance-learning students undertook postgraduate courses in e-health delivered via the Internet (asynchronous communication). Data collected via online student surveys indicated that the PBL format was both flexible and interesting. PBL has the potential to increase the quality of the educational experience of students in online environments.