A new breed of doctor? Lessons learned and changes made to library services for the MBBS program at the University of Queensland

November 2000 saw the graduation of the first cohort from the new MBBS Program at The University of Queensland. The fully integrated problem-based curriculum has provided many challenges and opportunities for The University of Queensland Library such as servicing an extensive remote student population, information technology issues and customer demand. In October 2000 all four years of the MBBS Program completed a survey on related issues such as the library's collection, web-based resources, information skills and evidence-based medicine. This paper focuses on the results of the survey, and the future directions of the library to ensure that the new doctors graduating from this program gain the essential attributes of life-long learning, information management and evidence-based principles.

Low level expression of human papillomavirus type 16 (HPV16) E6 in squamous epithelium does not elicit E6 specific B- or T-helper immunological responses, or influence the outcome of immunisation with E6 protein

Mice transgenic for E6/E7 oncogenes of Human Papillomavirus type 16 display life-long expression of E6 in lens and skin epithelium, and develop inflammatory skin disease late in life, which progresses to papillomata and squamous carcinoma in some mice. We asked whether endogenous expression of E6 induced a specific immunological outcome, i.e. immunity or tolerance, or whether the mice remained immunologically naive to E6. We show that prior to the onset of skin disease, E6 transgenic mice did not develop a spontaneous E6-directed antibody response, nor did they display T-cell proliferative responses to dominant T-helper epitope peptides within E6. In contrast, old mice in which skin disease had arisen, developed antibodies to E6. We also show that following immunisation with E6, specific antibody responses did not differ significantly among groups of EB-transgenic mice of different ages (and therefore of different durations and amounts of exposure to endogenous E6), and non-transgenic controls. Additionally, E6 immunisation-induced T-cell proliferative responses were similar in E6-transgenic and non-transgenic mice. These data are consistent with the interpretation that unimmunised Eb-transgenic mice that have not developed inflammatory skin disease remain immunologically naive to E6 at the B- and Th levels. There are implications for E6-mediated tumorigenesis in humans, and for the development of putative E6 therapeutic vaccines. (C) 2001 Elsevier Science B.V. All rights reserved.

Clinical practice guidelines for the psychosocial care of adults with cancer

Clinical practice guidelines are increasingly being developed in medical settings to provide evidence-based recommendations to guide the clinical care of patients. The development of Clinical practice guidelines for the psychosocial care of patients with medical illness is a newer initiative, and more complex as the target audience includes health care professionals from diverse backgrounds. In Australia, the National Breast Cancer Centre and National Cancer Control Initiative have collaborated to develop Clinical practice guidelines for the psychosocial care of adults with cancer, funded by the Australian Government Department of Health and Ageing. This paper outlines the development of these guidelines in the international context, gives an overview of their content, and describes strategies for their implementation and evaluation. Copyright (c) 2005 John Wiley C Sons, Ltd.

Merton's true self and the psychology of the dialogical self

Thomas Merton pursued a life-long quest to grasp the nature of the “true self.” This is the self that lives in and through Christ. Opposed to this is the false self that is expressive of infidelity. It is argued that the interaction between the true and false selves constitutes a dialogical process. The thesis of the essay is that this interaction expresses the dynamics associated with what some psychologists refer to as the “dialogical self.” The dialogical self is a model of the inner life that draws attention to the interpretive process required to deal with the many voices that get internalized in an engagement with the world.

Lifetime suicide risk in major depression: sex and age determinants

Background: Recent work has demonstrated that the lifetime suicide risk for patients with DSM IV Major Depression cannot mathematically approximate the accepted figure of 15%. Gender and age significantly affect both the prevalence of major depression and suicide risk, Methods: Gender and age stratified calculations were made on the entire population of the USA in 1994 using a mathematical algorithm. Sex specific corrections for under-reporting were incorporated into the design. Results: The lifetime suicide risks for men and women were 7% and 1%, respectively. The combined risk was 3.4%. The male:female ratio for suicide risk in major depression was 10:1 for youths under 25, and 5.6:1 for adults. Conclusions: Suicide in major depression is predominantly a male problem, although complacency towards female sufferers is to be avoided. Diagnosis of major depression is of limited help in predicting suicide risk compared to case specific factors. The male experience of depression that leads to suicide is often not identified as a legitimate medical complaint by either sufferers or professionals. Increasing help-accessing by males is a priority. Clinical implications: Patients with a history of hospitalisation; comorbidity, especially for substance abuse; and who are male, require greater vigilance for suicide risk. It may be that for males che threshold for diagnosing and treating major depression needs to be lowered. Limitations: This research is based on a mathematical algorithm to approximate a life-long longitudinal study that identifies community cases of depression. Our findings therefore rely on the validity of the statistics used. Extrapolation is limited to populations with an actual suicide rate of 17/100,000 or less and a lifetime prevalence of major depression of 17% or more. (C) 1999 Elsevier Science B.V. All rights reserved.

Spatial learning ability of rats following differing levels of exposure to alcohol during early postnatal life

Rats exposed to a relatively high dose (7.5 g/kg body weight) of alcohol on either the fifth or tenth postnatal day of age have been reported to have long-lasting deficits in spatial learning ability as tested on the Morris water maze task. The question arises concerning the level of alcohol required to achieve this effect. Wistar rats were exposed to either 2, 4 or 6 g/kg body weight of ethanol administered as a 10% solution. This ethanol was given over an 8-h period on the fifth postnatal day of age by means of an intragastric cannula. Gastrostomy controls received a 5% sucrose solution substituted isocalorically for the ethanol. Another set of pups raised by their mother were used as suckle controls. All surgical procedures were carried out under halothane vapour anaesthesia. After the artificial feeding regimes all pups were returned to lactating dams and weaned at 21 days of age. The spatial learning ability of these rats was tested in the Morris water maze when they were between 61-64 days of age. This task requires the rats to swim in a pool containing water made opaque and locate and climb onto a submerged platform. The time taken to accomplish this is known as the escape latency. Each rat was subjected to 24 trials over 3 days of the test period. Statistical analysis of the escape latency data revealed that the rats given 6 g/kg body weight of ethanol had significant deficits in their spatial learning ability compared with their control groups. However, there was no significant difference in spatial learning ability for the rats given either 2 or 4 g/kg body weight of ethanol compared with their respective gastrostomy or suckle control animals. We concluded that ethanol exposure greater than 4 g/kg over an 8-h period to 5-day-old rats is required for them to develop long-term deficits in spatial learning behaviour. (C) 1998 Elsevier Science Inc.

Exploring the learning potential of an artificial life simulation

CULTURE is an Artificial Life simulation that aims to provide primary school children with opportunities to become actively engaged in the high-order thinking processes of problem solving and critical thinking. A preliminary evaluation of CULTURE has found that it offers the freedom for children to take part in process-oriented learning experiences. Through providing children with opportunities to make inferences, validate results, explain discoveries and analyse situations, CULTURE encourages the development of high-order thinking skills. The evaluation found that CULTURE allows users to autonomously explore the important scientific concepts of life and living, and energy and change within a software environment that children find enjoyable and easy to use.

The long-term effects of cooperative learning on children's behaviour and interactions

This study investigates the long-term effects of training in small-group and interpersonal behaviours on children's behaviours and interactions as they worked in small groups two years after they were initially trained. Forty-eight third grade children, who had been trained two years previously in cooperative group behaviours, were assigned to the Trained condition and 44 third grade children who had not previously been trained were assigned to the Untrained condition. The children in the trained and untrained groups were reconstituted from the pool of students who had participated previously in either trained or untrained group activities. The results showed that there was a long-term training effect with the children in the Trained groups demonstrating more cooperative behaviour and providing more explanations in response to requests for help than their untrained peers.

Amylases in enzyme detergents and their effects on a simulated long-life dairy dessert

Enzyme detergents used in the food industry contain proteinase as the major enzyme but amylase may be present, either by design or inadvertently. Three commercial enzyme detergents and 3 enzyme preparations used in detergents were assayed for alpha-amylase activity by the Ceralpha method using the Megazyme kits. The amylase activities of the detergents varied from 3.2x 10(-6) to 32x 10(-6) mumoles ml(-1) h(-1) while the enzyme preparations had much higher activities ranging from 0.05 to 8.06 mumoles ml(-1) h(-1). When added aseptically to a simulated dairy dessert (2% starch solution) and stored for 42 days, the enzyme detergents caused an increase in viscosity; enzyme preparations at low concentrations caused an initial increase in viscosity followed by a decrease; and enzyme preparations at high concentrations caused an immediate decrease in viscosity. The increase in viscosity corresponded to formation of a distinct network of starch granules while the decrease in viscosity was characterised by a marked decrease in size of the granules and little or no network of granules. Decreases in viscosity corresponded to increases in reducing sugars but samples which increased in viscosity showed no measurable reducing sugars. The amylase activity in all sources was destroyed by heating at 75degreesC for 15 min at pH 1.8.

Learning about life and death in early childhood

Inagaki and Hatano (2002) have argued that young children initially understand biological phenomena in terms of vitalism, a mode of construal in which life or life-force is the central causal-explanatory concept. This study investigated the development of vitalistic reasoning in young children's concepts of life, the human body and death. Sixty preschool children between the ages of 3 years, 7 months and 5 years, 11 months participated. All children were initially given structured interviews to assess their knowledge of (1) human body function and (2) death. From this sample 40 children in the Training group were taught about the human body and how it functions to maintain life. The Control group (n = 20) received no training. All 60 children were subsequently reassessed on their knowledge of human body function and death. Results from the initial interviews indicated that young children who spontaneously appealed to vitalistic concepts in reasoning about human body functioning were also more sophisticated in their understanding of death. Results from the posttraining interviews showed that children readily learned to adopt a vitalistic approach to human body functioning, and that this learning coincided with significant development in their understanding of human body function, and of death. The overall pattern of results supports the claim that the acquisition of a vitalistic causal-explanatory framework serves to structure children's concepts and facilitates learning in the domain of biology. (C) 2003 Elsevier Science (USA). All rights reserved.

A comparison of responses to group learning between first-year Asian and first-year Australian veterinary science students

Introduction - Group learning has been used to enhance deep (long-term) learning and promote life skills, such as decision making, communication, and interpersonal skills. However, with increasing multiculturalism in higher education, there is little information available as to the acceptance of this form of learning by Asian students or as to its value to them. Methodology - Group-learning projects, incorporating a seminar presentation, were used in first-year veterinary anatomical science classes over two consecutive years (2003 and 2004) at the School of Veterinary Science, University of Queensland. Responses of Australian and Asian students to survey forms evaluating the learning experience were analyzed and compared. Results - All students responded positively to the group learning, indicating that it was a useful learning experience and a great method for meeting colleagues. There were no significant differences between Asian and Australian students in overall responses to the survey evaluating the learning experience, except where Asian students responded significantly higher than Australian students in identifying specific skills that needed improving. Conclusions - Group learning can be successfully used in multicultural teaching to enhance deep learning. This form of learning helps to remove cultural barriers and establish a platform for continued successful group learning throughout the program.

Asymptomatic long-term survivors of coronary artery bypass surgery enjoy a quality of life equal to the general population

Background Health-related quality of life (HRQOL) among long-term survivors of coronary artery bypass surgery is an important outcome that has been little studied at the population level. Methods A postal survey was conducted in 1999 to 2000 in patients 6 to 20 years after coronary artery bypass graft (CABG) surgery in Western-Australia. A random stratified sample of 2500 was drawn from 8910 patients who had their first CABG surgery in 1980 to 1993. Health-related quality of life was measured with Short Form 36 and EuroQol visual analogue scale. Results Response was 82% (n = 2061). Health-related quality of life declined with age and was similar for men and women, although scores for women were worse for physical functioning. Compared with Australian population norms, the age- and sex-standardized scores of survivors of CABG were generally worse, mainly in the physical domain. Reported angina at the time of follow-up (33%), symptoms of heart failure equivalent to New York Heart Association (NYHA) classes II to IV (34%), and comorbidities such as diabetes and hypertension were associated with poorer HRQOL. For both men and women without angina or heart failure at follow-up, HRQOL was no different from that of the general population. Conclusion Overall, the quality of life among long-term survivors of CABG is worse than that of the general population, the difference being mainly attributable to recurrent symptoms and comorbidities. Quality of life for those without angina or heart failure at follow-up was equivalent to the population norms, providing an incentive to maximize efforts to abolish angina and ameliorate heart failure symptoms.