Is the perception of odour pleasantness shared across cultures and ecological conditions? Evidence from Amazonia, East Africa, New Guinea, Malaysia and Poland.

What makes an odour pleasant or unpleasant? The inherent properties of the constituent chemical compounds, or the nose of the beholder, driven by idiosyncratic differences and culture-specific learning? Here, 582 individuals, including Tanzanian Hadza hunter-gatherers, Amazonian Tsimane' horticulturalists, Yali from the Papuan highlands and two industrialized populations (Poles, Malaysians), rated the pleasantness of 15 odour samples. We find considerable similarities in odour assessments across cultures, but our data do not fully support a claim regarding the universality of smell preferences. Despite cross-cultural similarities in olfactory assessments, probably driven by odour properties, we suggest that odour availability in ecological and cultural niches bears an undeniable effect on human odour preferences.

Lived experiences of healthcare. Putting the person in person centred care in the medical radiation sciences.

INTRODUCTION: Contemporary healthcare models recognise person-centred care (PCC) as a fundamental principle of quality, safe care. While substantial literature exists on PCC in healthcare generally, there is less evidence on how this relates to medical imaging and radiation therapy. Embedding patient-lived experiences of healthcare into healthcare education has promise in enhancing students' confidence in delivering PCC. Digital storytelling (DST) of patient-lived experiences can help improve reflection, understanding, critical thinking and empathy. METHODS: Authentic patient-lived experiences were extracted from students' clinical workbooks, transformed into first person vignettes and integrated into the curriculum. Students were invited to attend focus groups to explore the impact the activity had on the student. RESULTS: Thematic analysis identified three themes. (1) Enhancing PCC; (2) Mode of Delivery (Scaffolded Learning); and (3) Collaborative Learning. PCC was the strongest theme with students stating this is the first time they engaged in an activity focused on the psychosocial aspect of patient care. The majority of students indicated the mode of delivery was engaging and unique, whereby the vignettes were presented incrementally. Collaborative learning was identified by over half of the students where learning took place in a safe and supportive environment. CONCLUSION: This project explored students' perspectives of integrating patient-lived experiences into the curriculum via DST. Students who engaged with the activities felt better prepared to deliver quality safe PCC. IMPLICATIONS FOR PRACTICE: Providing healthcare students with opportunities to develop skills to deliver PCC before they enter the workforce can enhance their confidence in delivering effective PCC.

Metabolic-associated fatty liver disease and hepatocellular carcinoma: a prospective study of characteristics and response to therapy.

BACKGROUND AND AIM: The rising incidence of hepatocellular carcinoma (HCC) in Australia is related to increasing rates of metabolic-associated fatty liver disease (MAFLD). This study aimed to prospectively characterize the metabolic profile, lifestyle, biometric features, and response to treatment of HCC patients in an Australian population. METHOD: Multicenter prospective cohort analysis of newly diagnosed HCC patients at six multidisciplinary team meetings over a 2-year period. RESULTS: Three hundred and thirteen (313) newly diagnosed HCC patients with MAFLD (n = 77), MAFLD plus other liver disease (n = 57) (the "mixed" group), and non-MAFLD (n = 179) were included in the study. Alcohol-associated liver disease (ALD) (43%) and MAFLD (43%) were the most common underlying liver diseases. MAFLD-HCC patients were older (73 years vs 67 years vs 63 years), more likely to be female (40% vs 14% vs 20%), less likely to have cirrhosis (69% vs 88% vs 85%), showed higher ECOG, and were less likely to be identified by screening (29% vs 53% vs 45%). Metabolic syndrome was more prevalent in the MAFLD and mixed groups. The severity of underlying liver disease and HCC characteristics were the same across groups. While the MAFLD population self-reported more sedentary lifestyles, reported dietary patterns were no different across the groups. Dyslipidemia was associated with tumor size, and those taking statins had a lower recurrence rate. CONCLUSION: Equal to ALD, MAFLD is now the most common underlying liver disease seen in HCC patients in Australia. Future HCC prevention screening and treatment strategies need to take this important group of patients into consideration.

Doctor of medicine training: reflections on the UWI (Mona) experience / La formación postgraduada del doctor en medicina: reflexiones en torno a la experiencia de UWI (Mona)

Postgraduate Doctor of Medicine (DM) training at the University of the West Indies (UWI) has grown in response to the need to meet the regional requirements for high quality, competent clinical specialists. The progress of these programmes are examined from historical and health manpower development perspectives. More than 600 persons have been trained through the DM programmes at UWI, Mona and 89% of them continue to provide critical services in the region. Such statistics underscore the success of the programme in meeting the Caribbean Corporation in Health (CCH), UWI and Faculty of Medical Sciences (FMS) objectives. The relevance of the programme to the Caribbean's needs is manifestly clear. Curriculum changes including a mandatory research component for all DM degrees reflect the evolution of training programmes as they adjust to current expectations of modern clinical practice and new emphases on evidence-based medicine and policies. Nevertheless, challenges exist including the deterioration of the physical plant for training, availability of training posts and funding of research. Monitoring, evaluation and quality assurance of existing programmes are to be continued.

La formación postgraduada del doctor en medicina (DM) en la Universidad de West Indies (UWI) ha crecido en respuesta a la necesidad de satisfacer las demandas regionales de especialistas clínicos competentes, de alta calificación. Se examina el progreso de estos programas desde la perspectiva de la historia y el desarrollo de los recursos humanos en el campo de la salud. Más de 600 personas han recibido entrenamiento a través de los programas en UWI, Mona, y el 89% de ellos continúan proveyendo servicios críticos en la región. Estas estadísticas subrayan el éxito del programa en cuanto a satisfacer los objetivos de la Corporación para la salud en el Caribe (CCH), la Universidad de West Indies (UWI), y la Facultad de Ciencias Médicas (FCM). La importancia del programa para las necesidades del Caribe es claramente ostensible. Los cambios en el currículum incluyen un componente de investigación obligatoria. Todos los grados de DM reflejan la evolución de los programas de entrenamiento a medida que se ajustan a las expectativas del momento en relación con la práctica clínica moderna y los nuevos énfasis en las políticas y la medicina basada en la evidencia. No obstante, existen retos que incluyen el deterioro de la base material para el entrenamiento, la disponibilidad de puestos de trabajo para el entrenamiento, y los fondos para la investigación. El monitoreo, la evaluación, y el aseguramiento de la calidad de los programas existentes, deben continuar.