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Ellis R, Scrimgeour D, Cleland J, Lee A, Brennan P. 50 A Cross-Sectional Study Examining the Association Between MRCS Performance and Surgeons Receiving Fitness to Practice Sanctions. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
Fitness to practice (FtP) investigations by the General Medical Council (GMC) can be one of the most stressful experiences in a surgeon’s career. Demographic factors are known to alter the likelihood of GMC investigation. Despite this there are no studies assessing risk factors in surgeons for FtP sanctions. Thus, we used the newly created Intercollegiate Membership of Royal College of Surgeons (MRCS) examination database to identify risk factors for and the prevalence of GMC sanctions in early-career surgeons.
Method
FtP sanction data contained in the GMC list of registered medical practitioners (LRMP) database was linked at person-level to all UK graduates who had attempted MRCS Part A or Part B between September 2007 and January 2020. Data were anonymised by the Royal College of Surgeons of England prior to analysis.
Results
f 11,660 candidates who had attempted the MRCS within the study period only 31 (0.3%) candidates had GMC FtP sanctions within the last two years. Of these, 12 had active conditions on their registration, 7 had active undertakings and 14 had warnings. Candidate demographics were similar between cohorts and there were no significant differences between MRCS performance identified.
Conclusions
In this, the largest study of MRCS candidates to date, the prevalence of active FtP sanctions in early-career surgeons was 0.3%, significantly lower than the prevalence of sanctions across more experienced UK surgeons (0.9%). These data highlight early-career surgeons as a low-risk group for disciplinary action and should reassure patients and medical professionals of the rarity of FtP sanctions.
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Affiliation(s)
- R Ellis
- Urology Department, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
- Intercollegiate Committee for Basic Surgical Examinations, London, United Kingdom
| | - D Scrimgeour
- Department of Colorectal Surgery, Aberdeen Royal Infirmary, Aberdeen, United Kingdom
- Intercollegiate Committee for Basic Surgical Examinations, London, United Kingdom
| | - J Cleland
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, United Kingdom
| | - A Lee
- Department of Medical Statistics, University of Aberdeen, Aberdeen, United Kingdom
| | - P Brennan
- Intercollegiate Committee for Basic Surgical Examinations, London, United Kingdom
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2
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Ellis R, Scrimgeour D, Cleland J, Lee A, Brennan P. 238 MRCS Performance Predicts Surgical Career Outcomes. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aim
Successful completion of the MRCS examination is mandatory for progression into higher surgical (registrar) training in the UK. National selection for training programmes is a highly competitive process. Despite this, the ranking of applicants does not currently include MRCS performance scores. This offers a unique opportunity to compare two independent assessments of surgical trainees to establish whether MRCS performance can predict future surgical career outcomes and competitiveness in training.
Method
All UK candidates who attempted MRCS between 2007-2020 were matched to career outcome data using the GMC list of registered medical practitioners and anonymised (n = 2910). Chi-squared tests determined associations with first attempt MRCS pass/fail outcomes. Multinomial regression models were developed to establish the predictive power of success at MRCS in determining surgical specialty and training deanery choices.
Results
There was statistically significant variability in MRCS Part A pass rates, ranging from 55.1%-76.7% between surgical specialties (P=0.001) but no significant variability in Part B pass rates (P=0.655). There was significant variability in Part A and Part B pass rates between training deaneries (P=0.010 and P=0.036 respectively). Pass rates ranged from 59.9%-77.7% for Part A and 70.1%-85.0% for Part B between training deaneries. Those in more competitive specialties and training deaneries performed better in MRCS in terms of first attempt pass rate, scores and number of attempts taken to pass.
Conclusions
MRCS performance is an early predictor of surgical career choice and competitiveness. Trainees who perform well at MRCS are more likely to enter competitive surgical specialties and training deaneries.
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Affiliation(s)
- R Ellis
- Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
- Intercollegiate Committee for Basic Surgical Examinations, London, United Kingdom
| | - D Scrimgeour
- Department of Colorectal Surgery, Aberdeen Royal Infirmary, Aberdeen, Aberdeen, United Kingdom
| | - J Cleland
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - A Lee
- Department of Medical Statistics, University of Aberdeen., Aberdeen, United Kingdom
| | - P Brennan
- Intercollegiate Committee for Basic Surgical Examinations, London, United Kingdom
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3
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Ellis R, Scrimgeour D, Cleland J, Lee A, Brennan P. 51 The Impact of Disability on Performance in the Intercollegiate Membership of the Royal College of Surgeons examination (MRCS). Br J Surg 2021. [DOI: 10.1093/bjs/znab258.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
The number of clinicians with disabilities is increasing, however there is no data on the performance of doctors with registered disabilities in the postgraduate environment. If we are to ensure diversity and equality within the workforce, we must first identify whether attainment differences exist in markers of performance. To address this, we assessed the impact of disabilities on performance in the MRCS.
Method
All UK medical graduates who had attempted MRCS Part A (n = 9,597) and Part B (n = 4,562) between 2007-2017 with linked disability data in the UK Medical Education Database (https://www.ukmed.ac.uk) were included. Univariate analysis identified associations with MRCS performance and logistic regression models identified independent predictors of success.
Results
Candidates with registered disabilities (n = 635) had lower MRCS Part A pass rates (46.3% vs 59.8% (p < 0.001)) but similar Part B pass rates (68.2% vs 70.9% (p = 0.339)). They were nearly twice as likely to fail Part A (odds ratio 0.55 [95% Confidence Interval 0.46-0.64]). When prior academic attainment (A-Levels and medical school performance) was accounted for, there was no statistically significant difference in the likelihood of MRCS success (p>0.05). Pass rates were similar for candidates with specific learning difficulties and those with other registered disabilities (p>0.05).
Conclusions
This is the first study to assess the impact of disability status and type on performance at a postgraduate medical examination. It appears that candidates with registered disabilities performed less well in formal, written examinations generally. Although our data indicate that current MRCS testing accommodations are fair, enabling performance unrestricted by disability.
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Affiliation(s)
- R Ellis
- Urology Department, Nottingham University Hospitals, Nottingham, United Kingdom
- Intercollegiate Committee for Basic Surgical Examinations, London, United Kingdom
| | - D Scrimgeour
- Department of Colorectal Surgery, Aberdeen Royal Infirmary, Aberdeen, United Kingdom
- Intercollegiate Committee for Basic Surgical Examinations, London, United Kingdom
| | - J Cleland
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - A Lee
- Department of Medical Statistics, University of Aberdeen, Aberdeen, United Kingdom
| | - P Brennan
- Intercollegiate Committee for Basic Surgical Examinations, London, United Kingdom
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Ellis R, Scrimgeour D, Brennan P, Lee A, Cleland J. 191 Performance at Medical School and Foundation Programme Selection Can Predict Success in The MRCS Examination. Br J Surg 2021. [DOI: 10.1093/bjs/znab135.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Background
Identifying factors that predict success in the Membership of the Royal College of Surgeons (MRCS) examination can aid trainees’ exam preparation and help deaneries identify candidates likely to require additional support. We assessed whether performance at Medical School and UK Foundation Programme selection (Educational Performance Measurement (EPM) and Situational Judgement Test (SJT)) predicted MRCS success.
Method
We analysed data from the UKMED Database for UK graduates who had attempted MRCS Part A (n = 1,975) and Part B (n = 630) between 2013-2017. Univariate analysis examined the relationship between performance and the likelihood of passing MRCS at first attempt. Logistic regression identified independent predictors of MRCS success.
Results
Each additional EPM decile increased the chances of passing MRCS by 52% for Part A (odds ratio 1.52 [95% confidence interval 1.46-1.60]) and 27% for Part B (1.27 [1.18-1.38]). Each EPM point awarded for degrees increased the likelihood of passing Part A by 29% (1.29 [1.12-1.48]). SJT score was not a statistically significant independent predictor of MRCS success (P>0.05).
Conclusions
This is the first study to investigate the relationship between UK medical school performance and postgraduate surgical exam success. Higher ranked students are more likely to succeed in the MRCS compared to their lower ranked peers.
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Affiliation(s)
- R Ellis
- Centre for Healthcare Education Research and Innovation, University of Aberdeen, Aberdeen, United Kingdom
- Urology Department, Nottingham University Hospitals, Nottingham, United Kingdom
- Intercollegiate Committee for Basic Surgical Examinations, Royal Colleges of Surgeons, United Kingdom
| | - D Scrimgeour
- Intercollegiate Committee for Basic Surgical Examinations, Royal Colleges of Surgeons, United Kingdom
- Department of Colorectal Surgery, Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| | - P Brennan
- Intercollegiate Committee for Basic Surgical Examinations, Royal Colleges of Surgeons, United Kingdom
| | - A Lee
- Department of Medical Statistics, University of Aberdeen, Aberdeen, United Kingdom
| | - J Cleland
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Ellis R, Scrimgeour D, Cleland J, Lee A, Brennan P. 220 Choice of UK Medical School Predicts Success in The Intercollegiate Membership of The Royal College of Surgeons (MRCS) Examination. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Background
UK medical schools vary in terms of factors such as mission, specific curricula and pedagogy. As relatively little is understood about the impact of these differences at a post-graduate level, we examined the relationship between medical school and MRCS success.
Method
Using the UKMED database we analysed data on UK medical graduates who attempted MRCS Part A (n = 9729) and MRCS Part B (n = 4644) between 2007-2017. Univariate analysis characterised the relationship between medical school and first attempt MRCS success. Logistic regression modelling identified independent predictors of MRCS success.
Results
MRCS pass rates differed significantly between medical schools (P < 0.001). Trainees from standard-entry 5-year programmes were more likely to pass MRCS at first attempt compared to those from extended (Gateway) courses ((Part A (Odds Ratio (OR) 3.72 [95% Confidence Interval (CI) 2.69-5.15]); Part B (OR 1.67 [1.02-2.76])). Non-graduates were more likely to pass Part A (OR 1.40 [1.19-1.64]) and Part B (OR 1.66 [1.24-2.24]). Russell Group graduates were more likely to pass MRCS Part A (OR 1.79 [1.56-2.05]) and Part B (OR 1.24 [1.03-1.49])).
Conclusions
Medical programme and medical school are associated with MRCS success. Further research is needed to tease out the relationship between individual factors, medical school and MRCS performance.
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Affiliation(s)
- R Ellis
- Centre for Healthcare Education Research and Innovation, University of Aberdeen, Aberdeen, United Kingdom
- Urology Department, Nottingham University Hospitals, Nottingham, United Kingdom
- Intercollegiate Committee for Basic Surgical Examinations, RCS, United Kingdom
| | - D Scrimgeour
- Intercollegiate Committee for Basic Surgical Examinations, RCS, United Kingdom
- Department of Colorectal Surgery, Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| | - J Cleland
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - A Lee
- Department of Medical Statistics, University of Aberdeen, Aberdeen, United Kingdom
| | - P Brennan
- Intercollegiate Committee for Basic Surgical Examinations, RCS, United Kingdom
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Scrimgeour D, Cleland J, Lee A, Brennan P. Which Factors Predict Performance in the Intercollegiate Membership of The Royal College of Surgeons (MRCS) Examination? Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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7
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Scrimgeour D, Cleland J, Lee A, Griffiths G, Brennan P. Does the Intercollegiate Membership of The Royal College of Surgeons (MRCS) Examination Predict Performance in the General and Vascular Higher Surgical Training Selection Process? Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
OBJECTIVE To review the primary orchidopexy failure rate and outcome of repeat orchidopexy in a tertiary paediatric surgical centre and identify risk factors. METHODS A prospectively collected and validated audits system was used to identify all boys having a repeat orchidopexy from August 1990 to December 2008 (18 years). RESULTS In total, 1538 boys underwent orchidopexy with 1886 testicles operated on. Of these 348 (22.6%) patients had bilateral cryptorchidism. A need for repeat orchidopexy was identified in 31 boys resulting in a primary failure rate of 1.6% over the 18 years. Unilateral orchidopexy as the primary operation had a 1.5% failure rate. The failure rate for bilateral cryptorchidism was 1.87% per testicle rising to 1.93% per testicle when the primary operation was synchronous bilateral orchidopexy. Orchidopexy failure occurred in 9 patients (1.97%) who were under 24 months, 15 (2.67%) who were between 24 and 72 months and 7 (0.8%) over 72 months at time of first operation. CONCLUSION Possible risk factors for primary orchidopexy failure are bilateral operation and older age at time of operation. Failure in achieving a satisfactory scrotal position (and testicular loss) following orchidopexy has been postulated as a potential surgical standard for revalidation of paediatric surgeons. This study adds important contemporary data to inform that process.
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Affiliation(s)
- L A McIntosh
- Department of Surgical Paediatrics, Royal Aberdeen Children's Hospital, Westburn Road, Aberdeen AB25 2ZN, UK
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9
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Richards C, Scrimgeour D. Delayed life-threatening splenic rupture after endoscopic ultrasound evaluation of a pancreatic tumor. Endoscopy 2010; 41 Suppl 2:E264. [PMID: 19866420 DOI: 10.1055/s-0029-1215198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- C Richards
- Department of Surgery, NHS Forth Valley, Stirling, UK.
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10
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Scrimgeour D. Chronic intermittent diarrhoea and fatigue. Aust Fam Physician 2001; 30:897. [PMID: 11676320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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11
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Scrimgeour D. Japanese encephalitis. Aust Fam Physician 2001; 30:601, 606. [PMID: 11458591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
A young couple come to see you for a pretravel consultation. They are planning to spend a month backpacking in Thailand over December and January. They have read about Japanese encephalitis in travel books and seek your advice on the need for vaccination against this disease.
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12
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Scrimgeour D. Deep vein thrombosis and air travel. Aust Fam Physician 2001; 30:277, 284. [PMID: 11301769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Mary is a 55 year old woman on hormone replacement therapy. She is flying to the UK with her husband in a few weeks time, and is concerned about the recent media attention given to the 'economy class syndrome'. Mary's sister developed a similar problem after surgery some years ago. She is worried that she might be at risk of developing a clot during her flight and asks your advice.
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Abstract
Community health surveys take place in many Aboriginal communities. We considered these surveys to determine their potential to contribute to Aboriginal health in the 1990s. Community health surveys--also known as health audits, community health screenings or check-ups--usually consist of a team of health professionals travelling to an Aboriginal community to measure a wide variety of parameters on as many of the people in the community as possible. For the individual participant, community health surveys represent a sporadic screening program which should meet the World Health Organization's criteria for screening. From the population health perspective, these surveys represent prevalence surveys which may contribute little new knowledge regarding Aboriginal health and do not, of themselves, change the urgent need for preventive health programs. Community health surveys should meet minimum scientific standards (i.e. have a clearly stated aim and use valid measurements and statistical techniques) and should incorporate practically feasible protocols and services for the follow-up of individuals with screen-detected abnormalities. They must have ethical and community approval and incorporate genuine consultation and feedback of results to the Aboriginal communities involved, in order for them to be justified.
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Affiliation(s)
- D B Mak
- Kimberley Public Health Unit, Health Department of Western Australia
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14
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Affiliation(s)
- K Tsey
- Menzies School of Health Research, Alice Springs, NT
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15
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Skov S, Bowden F, McCaul P, Thompson J, Scrimgeour D. Managing HIV. Part 6: People living with HIV. 6.6 HIV and isolated Aboriginal communities. Med J Aust 1996; 165:41-2. [PMID: 8676779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Aboriginal communities and their health services should prepare together and in advance for caring for an HIV-infected person. Good social support will be the keystone to successful clinical management. Health care workers must look to Aboriginal people for the lead in developing appropriate responses.
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Affiliation(s)
- S Skov
- Tri-State STD/HIV Project, Alice Springs, Australia
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16
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Affiliation(s)
- D Scrimgeour
- Menzies School of Health Research, Alice Springs, NT
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17
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Abstract
Attempts to improve the nutritional status of Aboriginal people through nutritional education programs should be informed by an understanding of contemporary patterns of food procurement, preparation and distribution. This paper describes the results of a survey of food-purchasing behaviour in a central-Australian Aboriginal community. Every transaction occurring in each food outlet in the community over a two-week period was recorded and the data analysed. The results show that women play a much greater role than men in food purchasing, that there is a significant recourse to takeaway foods, that there is a cycle of expenditure determined by distribution of pension and Community Development Employment Project cheques, and that children have sufficient disposable income to be able to provision themselves from the food outlets, so that much of their food consumption is not determined by adult members of their family.
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Affiliation(s)
- T Rowse
- Menzies School of Health Research, Alice Springs
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18
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Scrimgeour D, Rowse T, Knight S. Food-purchasing behaviour in an Aboriginal community. 2. Evaluation of an intervention aimed at children. Aust J Public Health 1994; 18:67-70. [PMID: 8068799 DOI: 10.1111/j.1753-6405.1994.tb00198.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The previously described survey of food-purchasing behaviour in a central-Australian Aboriginal community demonstrated that children have sufficient disposable income to provision themselves directly from food outlets. Subsequently, a community-based intervention project developed strategies to provide healthier choices for these children. Two years after the initial survey, a follow-up survey was conducted in which all food purchases by children under the age of 15 in the community were recorded over a two-week period. The results demonstrate an improvement in the quality of foods and beverages purchased by children at the time of the second survey.
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Affiliation(s)
- D Scrimgeour
- Menzies School of Health Research, Alice Springs
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19
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Scrimgeour D. Ethics are local: engaging cross-cultural variation in the ethics for clinical research. Soc Sci Med 1993; 37:957-8. [PMID: 8211313 DOI: 10.1016/0277-9536(93)90153-u] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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20
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Abstract
The evaluation of the Healthy Aboriginal Life Team's (HALT) petrol-sniffing prevention programs at Yuendumu, Kintore and the Pitjantjatjara Lands first required a specification of program outcome--which was not changed in the enumerated prevalence of petrol sniffing, but alteration in parental perceptions of the relevance and effectiveness of families' nurturant authority over recalcitrant youngsters. The evaluation then proceeded by a series of interviews with resident or ex-resident adults (Aboriginal and non-Aboriginal) of Yuendumu, Kintore, Kiwirrkurra, Ernabella, Indulkana and Fregon. Adults articulated their efficacy in different ways in each place. Some favoured the conclusion that HALT had helped them, others clearly identified HALT as an obstacle to or a distraction from the implementation of other preventive and curative community-based action. We discerned a ferment of cultural adjustment in the distribution of authority over children among parents and welfare agencies. We caution against finding in HALT's successes a model procedure for benign interventions into such cultural adjustment.
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Affiliation(s)
- S Bryce
- Consultant to Nganampa Health Council, Alice Springs
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21
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Scrimgeour D, Irving AD. Perforated jejunal diverticulitis. Br J Clin Pract 1989; 43:165-6. [PMID: 2590631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Perforated jejunal diverticulitis is very rare. We describe two cases seen in one surgical unit in a four month period. The problems in early diagnosis are discussed and the need for prompt surgical intervention emphasised if mortality is to be reduced.
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Abstract
In a series of 72 consecutive elective and emergency colectomies with primary anastomosis, all pre- and perioperative mechanical preparation of the bowel was omitted and the patient covered only by a single peroperative intravenous dose of cefuroxime and metronidazole. No anastomotic dehiscence was clinically apparent and wound infection was noted in only 8.3 per cent of patients.
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23
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Gunn A, Scrimgeour D, Potts RC, Mackenzie LA, Brown RA, Beck JS. The destruction of peripheral-blood lymphocytes by extracorporeal exposure to ultraviolet radiation. Immunology 1983; 50:477-85. [PMID: 6629418 PMCID: PMC1454250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Venous blood from healthy adult human donors was circulated through a wholly extracorporeal circuit for periods up to 140 min without apparent damage to the lymphocytes. However, when the blood was exposed to short-wave ultraviolet radiation (UVC; lambda, 254 nm), separated mononuclear cells showed a depressed response to mitogen stimulation: the magnitude of this effect was related to the duration of exposure. This depression cannot be attributed to change in blood pH, partial pressures of oxygen and carbon dioxide, temperature of cell trauma. Plasma from irradiated blood was less satisfactory than non-irradiated plasma for the support of growth of phytohaemagglutinin-stimulated lymphocytes in culture, probably because of depletion of essential nutrients, and there was little evidence for the generation of growth-inhibitory humoral factors. The UVC-irradiated lymphocytes had normal ultrastructure when removed from the extracorporeal circuit, but underwent apoptosis and necrosis during the first day of tissue culture with or without mitogen stimulation.
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