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1.
BMC Med Educ ; 24(1): 997, 2024 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-39272053

RESUMO

BACKGROUND: Medical education offers the foundational base for future healthcare professionals, with basic sciences playing a pivotal role in providing essential knowledge and skills for clinical practice. However, the long-term retention and application of this knowledge in clinical practice remain a significant challenge. This systematic review synthesised global evidence from diverse studies on the short / long-term retention and clinical application of basic sciences among medical doctors. METHODS: A comprehensive search was conducted across six databases, including Web of Science, Scopus, Medline, CINAHL, Emcare, and Informit. The review included studies that encompassed a variety of study designs, participant groups, and educational interventions. The Quality Assessment with Diverse Studies (QuADS) tool was utilised to assess the quality of the reviewed studies. RESULTS: A total of 10 studies were included in the review. The findings revealed that rehearsals significantly optimise the retention of basic science knowledge among medical practitioners. Retention varied by discipline, with medical practitioners retaining more knowledge in anatomy (mean scores ranging from 45.0 to 82.9%), while microbiology had the lowest retention score (39.1%). Factors influencing retention included age, gender, and curriculum type. Educational interventions such as targeted courses, integration of basic sciences with clinical skills, generative retrieval and continuous quality improvement in the curriculum were found to enhance both knowledge retention and clinical reasoning. The concept of 'encapsulated knowledge' demonstrates that integrated basic science knowledge helps in synthesising clinical presentations, reducing the need for detailed recall as clinical experience increases. The reviewed studies primarily involved interns and surgeons, leaving a significant gap in research for specialties like internal medicine and primary care/ general practice. CONCLUSION: Detailed retention of basic science knowledge may diminish over time; however, the conceptual framework remains essential for ongoing learning and clinical reasoning. This review's findings highlight the need for specialised educational interventions to improve long-term retention. Continuous professional development and targeted educational techniques are vital for maintaining clinical competence and applying basic science knowledge effectively throughout a medical career. Further research is needed to address gaps in specialty-specific knowledge application and the impact of different instructional methods.


Assuntos
Competência Clínica , Humanos , Currículo , Educação Médica , Retenção Psicológica
2.
BMC Med Educ ; 24(1): 809, 2024 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-39075437

RESUMO

BACKGROUND: Basic sciences are crucial for clinical medicine, yet studies focusing on their perceived utility among general practitioners (GPs) are sparse. Considering the broad scope of GPs' practice, an in-depth understanding of basic sciences is fundamental for making informed clinical decisions. This study evaluated GP registrars' retention and perceptions of the utility of basic sciences in clinical practice. METHODS: Using sequential explanatory mixed methods study design, knowledge retention was assessed by a multiple-choice question (MCQ) examination followed by interviews on the perception of the relevance and utility of basic sciences among GP registrars at James Cook University's (JCU) General Practice Training (GPT) program. Descriptive and inferential statistical analyses were conducted on the MCQ exam data, while thematic analysis was employed for the qualitative interview data. RESULTS: Sixty-one GP registrars participated in the MCQ exam, while 11 of them were involved in the interviews. The highest mean score was obtained in biochemistry (75.1 ± 2.23) while the lowest mean score was in anatomy (56.07 ± 3.16). Key performance predictors included the formative clinical examination scores (ß = 0.83, 95% CI: 0.45 to 1.2, p < 0.001) and gender (ß = -9.7, 95% CI: -17 to -2.3, p = 0.011). The qualitative data analysis revealed five themes, including the backbone of clinical medicine, varying utility over time and by specialty, clinical synthesis integrates encapsulated knowledge, professional pressures hinder revisitation of knowledge and knowledge renewal enhances updates. CONCLUSION: Basic sciences were considered relevant in clinical practice. Development of continuing professional development (CPDs) sessions and clinically relevant online resources were measures proposed to enhance the retention of knowledge. Future research could focus on innovative educational strategies for GPs.


Assuntos
Competência Clínica , Medicina Geral , Humanos , Masculino , Medicina Geral/educação , Feminino , Avaliação Educacional , Clínicos Gerais/educação , Adulto , Atitude do Pessoal de Saúde , Pesquisa Qualitativa
3.
Ther Adv Infect Dis ; 11: 20499361241261269, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38883922

RESUMO

Background: Recently recognized by the World Health Organization as a neglected tropical disease, Noma, an acute and destructive gangrenous disease affecting the gums and facial structures within the oral cavity, has a high mortality rate if untreated. Objectives: To investigate the prevalence and impact of Noma among internally displaced populations in Northeastern Nigeria. Design: A retrospective study. Methods: This retrospective study investigates the prevalence and impact of Noma among internally displaced populations in Northeastern Nigeria. Noma is endemic in Northern Nigeria, Africa, and its occurrence has been linked to extreme poverty, malnutrition, poor hygiene, and inadequate healthcare - conditions exacerbated by the ongoing Boko Haram conflict. Results: The retrospective descriptive cross-sectional analysis of 17 cases reveals a median age of 8 years, with most of the patients being children who suffer significant social stigmas, such as difficulties in speaking, eating, and social integration, including reduced school attendance and marital prospects. Conclusion: The study highlights the urgent need for comprehensive research into the etiology of Noma and its socio-economic impact. It emphasizes the necessity for early and effective intervention strategies, particularly in conflict-stricken areas with limited healthcare access.

4.
Adv Exp Med Biol ; 1451: 355-368, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38801590

RESUMO

Monkeypox (mpox), a zoonotic disease caused by the monkeypox virus (MPXV), poses a significant public health threat with the potential for global dissemination beyond its endemic regions in Central and West Africa. This study explores the multifaceted aspects of monkeypox, covering its epidemiology, genomics, travel-related spread, mass gathering implications, and economic consequences. Epidemiologically, mpox exhibits distinct patterns, with variations in age and gender susceptibility. Severe cases can arise in immunocompromised individuals, underscoring the importance of understanding the factors contributing to its transmission. Genomic analysis of MPXV highlights its evolutionary relationship with the variola virus and vaccinia virus. Different MPXV clades exhibit varying levels of virulence and transmission potential, with Clade I associated with higher mortality rates. Moreover, the role of recombination in MPXV evolution remains a subject of interest, with implications for understanding its genetic diversity. Travel and mass gatherings play a pivotal role in the spread of monkeypox. The ease of international travel and increasing globalization have led to outbreaks beyond African borders. The economic ramifications of mpox outbreaks extend beyond public health. Direct treatment costs, productivity losses, and resource-intensive control efforts can strain healthcare systems and economies. While vaccination and mitigation strategies have proven effective, the cost-effectiveness of routine vaccination in non-endemic countries remains a subject of debate. This study emphasizes the role of travel, mass gatherings, and genomics in its spread and underscores the economic impacts on affected regions. Enhancing surveillance, vaccination strategies, and public health measures are essential in controlling this emerging infectious disease.


Assuntos
Surtos de Doenças , Saúde Global , Monkeypox virus , Mpox , Viagem , Mpox/epidemiologia , Mpox/virologia , Mpox/transmissão , Humanos , Surtos de Doenças/prevenção & controle , Monkeypox virus/genética , Monkeypox virus/patogenicidade , Animais , Doenças Raras/epidemiologia , Doenças Raras/genética , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/transmissão , Doenças Transmissíveis Emergentes/virologia , Doenças Transmissíveis Emergentes/prevenção & controle , Saúde Pública , Feminino , Zoonoses/epidemiologia , Zoonoses/transmissão , Zoonoses/virologia , Masculino
5.
Front Cell Infect Microbiol ; 14: 1360586, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38510963

RESUMO

Monkeypox virus (MPXV) is the etiological agent of monkeypox (mpox), a zoonotic disease. MPXV is endemic in the forested regions of West and Central Africa, but the virus has recently spread globally, causing outbreaks in multiple non-endemic countries. In this paper, we review the characteristics of the virus, including its ecology, genomics, infection biology, and evolution. We estimate by phylogenomic molecular clock that the B.1 lineage responsible for the 2022 mpox outbreaks has been in circulation since 2016. We interrogate the host-virus interactions that modulate the virus infection biology, signal transduction, pathogenesis, and host immune responses. We highlight the changing pathophysiology and epidemiology of MPXV and summarize recent advances in the prevention and treatment of mpox. In addition, this review identifies knowledge gaps with respect to the virus and the disease, suggests future research directions to address the knowledge gaps, and proposes a One Health approach as an effective strategy to prevent current and future epidemics of mpox.


Assuntos
Monkeypox virus , Mpox , Humanos , Monkeypox virus/genética , Mpox/epidemiologia , Surtos de Doenças , Ecologia , Genômica
8.
AJOG Glob Rep ; 3(3): 100241, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37396341

RESUMO

OBJECTIVE: This study aimed to assess the prognostic accuracies of Doppler ultrasound measures in predicting adverse perinatal outcomes for pregnancies complicated with preexisting or gestational diabetes mellitus. DATA SOURCES: An online database search of MEDLINE, Cochrane, Embase, CINAHL, Scopus, and Emcare from inception to April 2022 was conducted. STUDY ELIGIBILITY CRITERIA: Studies reporting singleton, nonanomalous fetuses of women with either preexisting (type 1 or 2 diabetes mellitus) or gestational diabetes mellitus during pregnancy were included. In addition, the included studies assessed cerebroplacental ratio and middle cerebral artery and/or umbilical artery pulsatility index in the prediction of either: preterm birth, cesarean delivery for fetal distress, APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) score <7 at 5 minutes, neonatal intensive care unit admission (>24 hours), acute respiratory distress syndrome, jaundice, hypoglycemia, hypocalcemia, or neonatal death. METHODS: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed and 610 articles were identified, of which 15 were included. Two authors independently extracted prognostic data from each article and assessed the study applicability and risk of bias using the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies-2) scoring criteria. RESULTS: A total of 15 studies were included in the review and comprised prospective (n=10; 66%) and retrospective (n=5; 33%) cohorts. Sensitivity and positive predictive values varied widely across each Doppler measurement. Umbilical artery sensitivities were higher than those of cerebroplacental ratio and middle cerebral artery for hypoglycemia, jaundice, neonatal intensive care unit admission, respiratory distress, and preterm birth. Cerebroplacental ratio was the most reported index test; however, prognostic accuracy was worse than that of umbilical artery and middle cerebral artery Doppler across all adverse perinatal outcomes. Significant risk of bias was present in 14 (94%) studies, with substantial heterogeneity observed across studies in terms of study design and outcomes assessed. CONCLUSION: Abnormal umbilical artery pulsatility index may be of more clinical value in predicting adverse perinatal outcomes compared with cerebroplacental ratio and middle cerebral artery pulsatility index in diabetic pregnancies. Further evaluation of umbilical artery Doppler measurements in diabetic pregnancies using standardized variables across studies is required for broader clinical application. The significant association between abnormal Doppler measurement and hypoglycemia may warrant further investigation.

10.
Intern Med J ; 53(4): 540-549, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-34668307

RESUMO

BACKGROUND: There is an absence of clinically relevant epidemiological data in regional Australia pertaining to haematological malignancies. AIM: To determine the incidence and geographical variation of haematological malignancies in North Queensland using a clinically appropriate disease classification. METHODS: Retrospective, observational study of individual patient data records of all adults diagnosed with a haematological malignancy between 2005 and 2014 and residing within The Townsville Hospital Haematology catchment region. We report descriptive summaries, incidence rates and incidence-rate ratios of haematological malignancies by geographic regions. RESULTS: One thousand, five hundred and eighty-one haematological malignancies (69% lymphoid, 31% myeloid) were diagnosed over the 10-year study period. Descriptive data are presented for 58 major subtypes, as per the WHO diagnostic classification of tumours of haemopoietic and lymphoid tissues. The overall median age at diagnosis was 66 years with a male predominance (60%). We demonstrate a temporal increase in the incidence of haematological malignancies over the study period. We observed geographical variations in the age-standardised incidence rates per 100 000 ranging from 0.5 to 233.5. Our data suggest an increased incidence rate ratio for haematological malignancies in some postcodes within the Mackay area compared with other regions. CONCLUSION: The present study successfully reports on the incidence of haematological malignancies in regional Queensland using a clinically meaningful diagnostic classification system and identifies potential geographic hotspots. We advocate for such contemporary, comprehensive and clinically meaningful epidemiological data reporting of blood cancer diagnoses in wider Australia. Such an approach will have significant implications towards developing appropriate data-driven management strategies and public health responses for haematological malignancies.


Assuntos
Neoplasias Hematológicas , Neoplasias , Adulto , Humanos , Masculino , Idoso , Feminino , Estudos Retrospectivos , Queensland/epidemiologia , Neoplasias Hematológicas/epidemiologia , Neoplasias/epidemiologia , Incidência
11.
Vaccines (Basel) ; 10(11)2022 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-36366387

RESUMO

Efforts to control the COVID-19 pandemic have expanded to the vaccination of children and adolescents. This systematic review assesses the utility of the BNT162b2 (Pfizer-BioNTech) vaccine in children and adolescents aged 5-18 years, considering its effectiveness against COVID infection, hospital and intensive care admission and duration of effectiveness after vaccination. Six databases were searched following the PRISMA guidelines. Pooled estimates and 95% confidence intervals (CIs) were calculated using meta-analysis. Fifteen studies were included in the systematic review, while 12 studies were included in the meta-analysis. Evidence suggests that the two-dose vaccination regime provided high effectiveness of 92% (95% CI, 86-96) against COVID infection. Vaccination also conferred high protection against hospitalisation (91%) and intensive care admission (85%). The vaccine was highly protective against the Delta variant of the virus, but showed a lower protection against the Omicron variant. Most adverse effects were transient and mild, commonly including pain at the injection site, fatigue and headache. Current findings are suggestive of waning immunity over time; however, further research is needed to investigate the relevance of booster doses in this age group. In summary, the Pfizer-BioNTech BNT162b2 vaccine demonstrated high levels of protection against COVID-19 infection and its complications while maintaining an adequate safety profile in children and adolescents.

12.
Biomolecules ; 12(10)2022 10 12.
Artigo em Inglês | MEDLINE | ID: mdl-36291674

RESUMO

Heat tolerance and exertional heat stroke (EHS) are rare health conditions that have been described and characterised but have never been genetically solved. Knowledge of the role of single nucleotide polymorphisms (SNPs) in heat shock proteins (HSPs) genes and their associations with heat tolerance and EHS is limited. This pilot study aimed to identify SNP in HSPA1B, HSP90AA2 and DNAJA1 genes and their associations with heat tolerance and EHS history in a quasi-experimental design. Participants comprised Australian Defence Force members (ADF) who had a history of EHS and the general population. Genomic DNA samples were extracted from the venous blood samples of 48 participants, sequenced and analysed for SNP. Forty-four per cent (44%) of the participants were heat intolerant, and 29% had a history of EHS. Among participants with a history of EHS, there was an association between heat tolerance and HSPA1B SNP at the g.31829044 locus. However, there were no associations between HSPA1B and HSP90AA2 SNP and heat tolerance. All participants had the same distribution for the DNAJA1 SNP. In conclusion, the findings indicate an association between the HSPA1B genetic variant at the g.31829044 locus and heat tolerance among ADF participants with a history of EHS. Further research with a larger number of military participants will shed more light on the associations between HSP genes and heat tolerance.


Assuntos
Polimorfismo de Nucleotídeo Único , Termotolerância , Humanos , Proteínas de Choque Térmico/genética , Sequenciamento de Nucleotídeos em Larga Escala , Projetos Piloto , Austrália , Genótipo , DNA , Proteínas de Choque Térmico HSP70/genética
13.
Viruses ; 14(6)2022 06 13.
Artigo em Inglês | MEDLINE | ID: mdl-35746754

RESUMO

Several neglected infectious pathogens, such as the monkeypox virus (MPXV), have re-emerged in the last few decades, becoming a global health burden. Despite the incipient vaccine against MPXV infection, the global incidence of travel-related outbreaks continues to rise. About 472 confirmed cases have been reported in 27 countries as of 31 May 2022, the largest recorded number of cases outside Africa since the disease was discovered in the early 1970s.


Assuntos
COVID-19 , Mpox , COVID-19/epidemiologia , Surtos de Doenças , Humanos , Mpox/epidemiologia , Monkeypox virus , Pandemias/prevenção & controle , Viagem , Doença Relacionada a Viagens
14.
BMC Med Educ ; 22(1): 89, 2022 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-35139831

RESUMO

BACKGROUND: Perceived readiness for practice can help mitigate the stress and uncertainty associated with transitioning from university into the workforce. This study aimed to identify factors influencing the readiness for clinical practice among final-year medical, dental, and pharmacy students at an Australian regional university. METHODS: The study utilised a sequential explanatory mixed-methods approach with surveys administered for the quantitative phase and interviews/focus groups for the qualitative phase. Descriptive statistics and inductive thematic analysis were utilised for the quantitative and qualitative data, respectively. Triangulation of findings from both phases facilitated in-depth understanding of the factors that influenced participants' self-perceived readiness for clinical practice. RESULTS: From the three disciplines, 132 students completed the survey and 14 participated in the focus groups and interviews. Students felt most prepared in their patient-centred capabilities, core skills, and advanced consultation skills, and least prepared in their system-related capabilities and clinical care skills. Themes identified as essential enablers and confidence builders in relation to workforce readiness in all three disciplines were: gained knowledge and skills, value of clinical placement experiences, support from peers, family and staff. However, students felt their work-readiness was impaired by heavy academic workloads and poor knowledge of health care systems, which affected skills development. Participants suggested additional support in health care system and clinical governance, mental healthcare, and induction to placement sites to further improve their work readiness. CONCLUSIONS: The findings of this study suggest that improving work-readiness of healthcare students requires alignment of learning needs to real-world practice opportunities, ensuring support systems are appropriate, and early familiarisation with the healthcare system.


Assuntos
Estudantes de Ciências da Saúde , Universidades , Austrália , Ocupações em Saúde , Humanos , Recursos Humanos
15.
Intern Med J ; 52(10): 1685-1690, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35112769

RESUMO

BACKGROUND: In Australia there is a shortage of rheumatologists potentially translating to poorer outcomes. A possible solution in this setting is telemedicine (TM). AIMS: To examine the utilisation and provider perceptions of TM in rheumatology in Queensland and explore the challenges faced when using TM before and during COVID-19. METHODS: A sequential mixed-methods study design was used. Rheumatologists completed a questionnaire on demographics, clinical practice, TM uptake, models of care and clinician perceptions of TM. The qualitative phase utilised purposeful sampling of active users of TM through in-depth semi-structured interviews. RESULTS: Thirty rheumatologists participated, with 76.7% identifying as active TM users. Use of TM was limited prior to COVID-19 with 80.9% examining less than five patients per week. Patient populations served by TM included capital city (53.3%), regional (63.3%) and rural/remote (23.3%). Most rheumatologists prescribed conventional or biological disease modifying agents (90% and 55%) through TM consultations. Barriers to TM use included low confidence in joint assessments, limited distribution of technology, access to administrative and peripheral clinical staff and lack of financial incentives. During the COVID-19 pandemic, a significant expansion of TM via telephone calls occurred and rheumatologists reported low confidence and satisfaction with this model. CONCLUSIONS: Familiarity with TM exists in this rheumatologist cohort; however, its use in routine practice is limited due to multiple barriers. The COVID-19 pandemic highlighted low confidence in telephone calls as a form of TM underlining the need for appropriate TM models of care for rheumatology practice.


Assuntos
COVID-19 , Reumatologia , Telemedicina , Humanos , Reumatologia/métodos , COVID-19/epidemiologia , Pandemias , Queensland/epidemiologia , Telemedicina/métodos
16.
Eur J Dent Educ ; 26(1): 182-196, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33825285

RESUMO

INTRODUCTION: Clinical experience is a crucial component of dental education as it prepares students for real-world practice. Our study aimed to investigate the transition from preclinical to clinical training experiences of dental students at a regional Australian dental school. MATERIALS AND METHODS: A mixed-methods study was conducted using a survey and focus groups. Participants were dental students who recently transitioned into clinical training. Survey data were analysed quantitatively using descriptive statistics, whilst the qualitative data were thematically analysed using the conceptual framework of organisational socialisation theory (OST). RESULTS: Forty-eight of the 69 students in the cohort completed the survey and 10 participated in the focus groups. The quantitative findings revealed that the transition was perceived to be abrupt and associated with a heavy workload. However, orientation sessions and engaging in chairside teaching made transitioning into clinical studies easier. The qualitative findings revealed that the transition process occurred in three phases. In phase 1, participants navigated the educational and social challenges using developmental characteristics such as resilience and positivity. Lessons learnt in phase 1 were used to make necessary learning adjustments in phase 2 and this subsequently enhanced developmental growth in the final phase, which helped ease the transition. CONCLUSION: This study confirms that transitioning into clinical training can be complex. However, the educational and socialisation challenges associated with the transition can provide stimulating developmental learning opportunities that advance students' adjustments to the clinical environment with positive, empowering and motivational outcomes that facilitate a smooth transition.


Assuntos
Estudantes de Odontologia , Universidades , Austrália , Educação em Odontologia , Humanos , Aprendizagem
17.
Front Public Health ; 10: 1066589, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36589996

RESUMO

Background: Monkeypox (MPX) is endemic in Nigeria, but it was first reported in Adamawa state, North-Eastern Nigeria, in January 2022. There are currently 172 cases of MPX in Nigeria, with four reported deaths, and Adamawa has the second-highest case count. Therefore, this study was undertaken to evaluate the epidemiological profile of this viral disease. Methods: This is a cross-sectional study. The skin and blood samples were screened for the presence for Monkeypox virus (MPXV) and Varicella Zoster virus (VZV) DNA by real-time PCR; the clinical diagnosis was based on symptoms of visual signs of skin lesions and other clinical symptoms from January to July 2022. Results: A total of 33 suspected cases aged 1-57 years [26 (79%) males vs. 7 (21%) females] were screened for MPX and VZV. Twenty-four (72.7%) were positive (6.1% were MPX only, 39% were VZV only, and 27% were both MPX and VZV). Most cases of MPX (82%), VZV (69%) and MPX-VZV co-infection (78%) occurred in males. More than half (54%) of those infected were children and adolescents between 0 and 19 years. All patients experienced body rashes and itching, and other clinical symptoms included fever, headache, mouth sores, muscle aches and lymphadenopathy. Over 64 and 86% of patients had contact with livestock and rodents, respectively. Conclusion: MPXV, VZV and MPXV-VZV co-infections occurred predominantly among males and children in Adamawa state, Nigeria. Given the patient contact with rodents and livestock, further research on the animal reservoir is needed to highlight the transmission of MPXV in Adamawa.


Assuntos
Varicela , Coinfecção , Mpox , Feminino , Masculino , Varicela/diagnóstico , Varicela/epidemiologia , Coinfecção/epidemiologia , Estudos Transversais , Herpesvirus Humano 3/genética , Herpesvirus Humano 3/isolamento & purificação , Mpox/epidemiologia , Mpox/diagnóstico , Monkeypox virus/genética , Monkeypox virus/isolamento & purificação , Nigéria/epidemiologia , Humanos , DNA Viral , Reação em Cadeia da Polimerase em Tempo Real , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade
18.
Biology (Basel) ; 10(10)2021 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-34681165

RESUMO

Heat intolerance is the inability to withstand heat stress and this may occur due to exertional heat stroke (EHS). However, it is unknown if heat intolerance is associated with immune and hormonal disturbances. This study investigates haematological, biochemical and hormonal biomarkers related to heat intolerance and EHS in military and civilian volunteers. A quasi-experimental pre-and post-test design was used, with participants drawn from the Australian Defence Force (ADF) and the general populace. Blood samples were collected and analysed for biomarkers. Inferential statistics compared the biomarkers between the groups. Changes in alanine amino transaminase (p = 0.034), creatine kinase (0.044), cortisol (p = 0.041) and creatinine (p < 0.001) differed between the heat-intolerant and heat-tolerant groups. Participants with a history of EHS showed significant changes in creatinine (p = 0.022) and urea (p = 0.0031) compared to those without EHS history. Predictors of heat intolerance were increasing post-HTT creatinine and cortisol (OR = 1.177, p = 0.011 and OR = 1.015, p = 0.003 respectively). Conclusively, EHS history is associated with changes in creatinine and urea concentrations, while the predictors of heat intolerance are creatinine and cortisol. However, further exploration of other biomarkers, such as genetic polymorphism, is needed.

19.
PLoS One ; 16(5): e0251634, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34032808

RESUMO

BACKGROUND: The transition experience into university can be challenging for health profession students as they are required to rapidly learn diverse and adaptable problem solving skills and advanced reflective thinking processes which are necessary to address complex patient-care problems, particularly in the face of uncertainty within a dynamic and rapidly evolving learning environment. METHODS: A mixed-methods study was conducted to identify factors influencing this transition for first-year medical, dental, and pharmacy students at a regional Australian university. The Student Adaption to College Questionnaire (SACQ) examined participants' levels of adjustment to university, while Schlossberg's 4 S transition model was utilised in a framework analysis of the focus group and interview responses. RESULTS: Complete survey responses were obtained from 198 students, 17 of whom also participated in focus group discussions or interviews. Mean adjustment ratings obtained from the SACQ responses were academic (6.09 ± 1.3) personal-emotional (5.53 ± 1.55), social (6.30 ± 1.38), and institutional attachment (6.96 ± 1.6). These results indicate that the personal and emotional aspects of this transition were more challenging for the students. Analysis of the qualitative data revealed that generally, for these highly motivated health-professions students, dropping out of university was not an option and this had a positive influence on their ability to adjust to their new learning environment. Nonetheless, the transition involved role change; school-leavers were excited about their newly found independence, while for mature-aged students, returning to university allowed them to pursue their lifelong dreams. Adjustment was more challenging for international, mature-aged and female students, with personal and social factors influencing the transition for each of these demographic groups. CONCLUSIONS: To facilitate smooth transition into university, tertiary education institutions must consider tailored on-going support strategies that promote social interaction among students with varied backgrounds and personal characteristics.


Assuntos
Ocupações em Saúde/educação , Percepção , Interação Social , Estudantes de Ciências da Saúde/psicologia , Adolescente , Adulto , Austrália , Emoções , Feminino , Grupos Focais , Humanos , Aprendizagem , Masculino , Personalidade , Pesquisa Qualitativa , Estudantes de Ciências da Saúde/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Universidades/estatística & dados numéricos , Adulto Jovem
20.
Medicina (Kaunas) ; 57(2)2021 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-33671414

RESUMO

Background and objectives: The Australian Defence Force (ADF) engages in combat-related activities in hot climatic conditions, which exposes ADF members to the threat of exertional heat illness (EHI). After an episode of EHI, the heat tolerance test (HTT) is conducted to determine heat tolerance. Heat intolerance is the inability to maintain thermal balance while exercising in a hot environment. This study investigated the predictive roles of individual characteristics (age, gender, aerobic capacity (VO2max) and body composition) on physiological responses to the HTT in a group comprising ADF personnel and civilian volunteers. Materials and Methods: A quasi-experimental design was used and 52 (38 males and 14 females) participants were recruited from the ADF and the general population for the HTT. Heat intolerance was defined following the standard criteria for the HTT (temperature and heart rate). Data were analysed using inferential statistics. Results: The mean age of the participants was 31.1 ± 11.6 years, and 44% (23 people: 19 males and 4 females) of the participants were heat intolerant. Independent samples T-test showed that body mass index (p = 0.011) and body fat% (p = 0.034) of heat-intolerant participants were significantly higher than their heat-tolerant counterparts. Body surface area to mass ratio (p = 0.005) and aerobic capacity (p = 0.001) were significantly lower in heat-intolerant participants. Regression analyses showed that age, gender, aerobic capacity and body fat% were significant (p < 0.001) predictors of heat tolerance outcomes, with R2 values ranging from 0.505 to 0.636. Conclusions: This study showed that aerobic capacity, body fat%, age and gender are predictors of heat intolerance among military and non-military populations. However, there may be a need for future studies to consider identifying other indicators such as clinical biomarkers of heat intolerance, which could be used to develop a more reliable HTT protocol.


Assuntos
Transtornos de Estresse por Calor , Militares , Adulto , Austrália , Demografia , Feminino , Temperatura Alta , Humanos , Masculino , Adulto Jovem
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