Ethnography and the Australian drug field: emaciation, appropriation and multidisciplinary myopia

In this paper, I provide a critical commentary on the current state of drug ethnography in Australia. I identify and discuss funding problems and the appropriation of ethnography by qualitative and quantitative researchers, both of which undermine the credibility and potential contribution of ethnography to the Australian drug field. I also interrogate the much-heralded but little-scrutinised idea of ‘multidisciplinary drug research’, drawing on examples of non-drug multidisciplinary research to argue that, while multidisciplinary drug research is a worthy goal, the research vision offered by advocates of such research is frequently an intellectually impoverished one. I conclude by suggesting possible ways to strengthen Australia's capacity to conduct both stand-alone ethnographic drug research and high-quality multidisciplinary drug research involving ethnography.

Evaluation of advanced breast cancer multidisciplinary team meatings

Background: Multidisciplinary team meetings (MDMs) have become an important decision-making forum in oncology. These meetings bring together expertise from each relevant field to improve continuity of care and health care outcomes for cancer patients. However there is a lack of evidence demonstrating the effectiveness of MDT meetings in improving cancer patient outcomes. The aim of this study was to explore the perceived value and potential usefulness of multidisciplinary team meetings for patients with advanced breast cancer (ABC).

Methods: ABC MDMs have been conducted since 2002 at two sites of Eastern Health, the second largest health service in Melbourne. Attendees were invited to complete a confidential questionnaire in November 2007 that comprised seven areas aimed to assess their judgment of how well the MDMs have improved patient management, including medical recommendations, psychosocial care, palliative care, community care, and team development. Average scores were calculated for improvement of each area.

Results: A total of 16 (69%) health practitioners participated in the survey, with main representation from nursing (37%), allied health (25%) and medicine (19%). Preliminary results indicate that the broad areas members reported the meeting had improved patient outcomes were in palliative care and medical management. Specific areas of perceived improvement were medical outcomes for patients; early referral to palliative care services; confirmation of diagnosis; referral to supportive care; and appropriateness of palliative care referrals. Conversely, the area that had least improved was community care, as there was no input from GPs or community services other than palliative care. Attendance by GPs and radiologists were considered important for further improving medical outcomes for patients.

Conclusions: This study demonstrates the perceived value of the MDT approach in the care of ABC patients, particularly in improving patient outcomes. The next stage of this research is to conduct a survey of ABC patient satisfaction level.

Knowledge-in-practice in the caring professions : multidisciplinary perspectives

Contents:  Ideas of knowledge in practice / Struan Jacobs -- Information, knowledge, and wisdom in medical practice / P. B. Greenberg -- The practice of the psychiatrist / Alex Holmes -- Social work knowledge-in-practice / Heather D'Cruz -- Disability : a personal approach / Lisa Chaffey -- Knowledge in the making : an analytical psychology perspective / Joy Norton -- Knowledge to action in the practice of nursing / Alison Hutchinson, Tracey Bucknall -- The risky business of birth / Frances Sheean and Jennifer M. Cameron -- Skills for person-centred care : health professionals supporting chronic condition prevention and self-management / Sharon Lawn and Malcolm Battersby -- Knowledge and reasoning in practice : an example from physiotherapy and occupational therapy / Megan Smith ... [et al.] -- Using knowledge in the practice of dealing with addiction : an ideal worth aiming for / Peter Miller.

Avian color vision and coloration : multidisciplinary evolutionary biology

A fundamental issue in biology is explaining the diversity of coloration found in nature. Birds provide some of the best-studied examples of the evolution and causes of color variation and some of the most arresting color displays in the natural world. They possess perhaps the most richly endowed visual system of any vertebrate, including UV-A sensitivity and tetrachromatic color vision over the 300-700-nm waveband. Birds provide model systems for the multidisciplinary study of animal coloration and color vision. Recent advances in understanding avian coloration and color vision are due to recognition that birds see colors in a different way than humans do and to the ready availability of small spectrometers. We summarize the state of the current field, recent trends, and likely future directions.

Multidisciplinary team developed and implemented protocols to assist mechanical ventilation weaning : a systematic review of literature

Aim: The aim of this review was to determine if ventilation-weaning protocols developed and implemented by multidisciplinary teams (MDTs) reduced the duration of mechanical ventilation in adult intensive care patients compared to usual care.

Method: A systematic review was conducted to review published research studies from January 1999 to June 2009 to identify and analyse the best available evidence on MDT-based weaning protocols in adult intensive care patients. All relevant studies based on electronic searches of MEDLINE, EMBASE, CINAHL, the Cochrane Controlled Trials Registry and the Cochrane Database of Systematic Reviews were included. Where possible data were pooled and a meta-analysis performed. A narrative synthesis of data was conducted to provide a critical appraisal of nonrandomised controlled trials included in the review.

Results: Three pre- and postinterventional studies were identified for inclusion in this review. Results show equivocal support for weaning protocols developed and implemented by MDTs for reducing duration of mechanical ventilation.

Conclusion: Communication and organizational processes must be addressed for multidisciplinary protocols to be effective. Due to methodological limitations of included studies, large randomised controlled trials are required to provide high-level evidence of the effects of MDT-based protocols on duration of mechanical ventilation.

Does multidisciplinary care enhance the management of advanced breast cancer? : evaluation of advanced breast cancer multidisciplinary team meetings

Purpose: To assess the contribution of the advanced breast cancer (ABC) multidisciplinary team meetings (MDMs) to patient care and clinical outcomes.

Methods: Members of ABC MDMs at two health services completed questionnaires in November 2007. The questionnaire asked about the performance of the MDMs and their contribution to improvement in patient care in five domains: medical management, psychosocial care, palliative care, care in the community, and benefits for team members. A final section covered the perceived value and importance of the MDM in patient management. Descriptive statistics (frequencies, mean, and standard deviation) were used to summarize the performance, improvement, and importance scores.

Results: A total of 27 multidisciplinary team members (73%) completed the questionnaire. The MDM performed best in medical management (mean performance score out of 5 [M] = 3.78) and palliative care (M = 3.77). These were also the areas that were most improved through the MDM. Benefits to team members and care in the community (both M = 3.05) ranked lowest by both measures. The MDM provided the most benefit for patient management in the areas of "awareness of services available" (M = 4.32), "efficiency of referrals" (M = 4.27) and "supportive care for patients" (M=4.27). "Awareness of services available," "psychological care for patients," and "continuity of care" were considered the most important (M = 4.64).

Conclusion: The study provides evidence that MDMs make an important contribution to the logistical and medical management of patients with advanced breast cancer.

The advancing science by enhancing learning in the laboratory (ASELL) project : the first Australian multidisciplinary workshop

Most science educators and researchers will agree that the laboratory experience ranks as a major factor that influences students’ attitudes to their science courses. Consequently, good laboratory programs should play a major role in influencing student learning and performance. The laboratory program can be pivotal in defining a student's experience in the sciences, and if done poorly, can be a major contributing factor in causing disengagement from the subject area. The challenge remains to provide students with laboratory activities that are relevant, engaging and offer effective learning opportunities.

The Advancing Science by Enhancing Learning in the Laboratory (ASELL) project has developed over the last 10 years with the aim of improving the quality of learning in undergraduate laboratories, providing a validated means of evaluating the laboratory experience of students and effective professional development for academic staff. After successful development in chemistry and trials using the developed principles in physics and biology, the project has now expanded to include those disciplines. This paper will discuss the activities of ASELL and provide a report about the first ASELL science workshop held at the University of Adelaide in April 2010, present some views of academic and student delegates, and make comparisons with other workshops.
Introduction