scholarly journals Practice of community-service doctors in the assessment and medico-legal documentation of common physical assault cases

2018 ◽  
Vol 60 (1) ◽  
pp. 47
Author(s):  
L Fouché ◽  
J Bezuidenhout ◽  
C Liebenberg ◽  
A O Adefuye
Keyword(s):  
Community Service ◽  
Forensic Medicine ◽  
Medical Practitioner ◽  
Physical Assault ◽  
Criminal Prosecution ◽  
Clinical Forensic Medicine ◽  
Undergraduate Medical Students ◽  
Cross Sectional ◽  
Medical Practitioners ◽  
Survey Tool

Background: In South Africa, allegations of physical assault are managed primarily at the primary healthcare level, where they are attended to by medical officers or community service doctors (CSDs). However, reports that the knowledge and skills provided at undergraduate level are not sufficient to equip these CSDs to deal with evidence in medico-legal examinations in various settings, including in cases of patients who allege being the victims of common physical assault or assault with intent to inflict grievous bodily harm, have been documented in the literature. This study investigates the practice of CSDs in relation to the assessment and medico-legal documentation of allegations of common assault, with a view to identifying gaps in their knowledge of clinical forensic medicine. Method: The study was a cross-sectional descriptive study. A questionnaire with quantitative sections that used an adapted Likert scale was used to gather data. An electronic survey tool was employed to target 150 CSDs countrywide. Percentages are used to display results. Results: A response rate of 59.3% was achieved and results indicate that clinical forensic training in the undergraduate medical programme does not prepare CSDs sufficiently for the task of managing the medico-legal examination and documentation of allegations of assault by patients. Conclusions: The courts rely heavily on medico-legal documentation for success in criminal prosecution. Any substantial flaw in the documentation, including inadequate observations and/or notes made by a medical practitioner, may make proving guilt very difficult. This study revealed an important gap in the knowledge and practice of clinical forensic medicine by CSDs and suggests that the current curriculum should be adapted to allow adequate training of undergraduate medical students in the area of clinical forensic medicine. Appropriate undergraduate training will ensure that medico-legal documentation is completed accurately and that medical practitioners help ensure the administration of justice. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2018; DOI: 10.1080/20786190.2017.1364014

scholarly journals Medico-legal documentation of rape or sexual assault: are community-service doctors equipped for the task?

2018 ◽  
Vol 60 (1) ◽  
pp. 46
Author(s):  
Lamaine Fouche ◽  
Johan Bezuidenhout ◽  
Chantelle Liebenberg ◽  
Anthonio Oladele Adefuye
Keyword(s):  
Sexual Assault ◽  
Community Service ◽  
Clinical Forensic Medicine ◽  
Undergraduate Training ◽  
Undergraduate Medical Students ◽  
Survey Tool ◽  
Electronic Survey ◽  
Forensic Practice ◽  
Hands On ◽  
Proper Training

Background: Following upon two-year internship, community-service doctors make mistakes when they deal with evidence of medico-legal examinations in various settings. These mistakes result in alleged perpetrators being released by courts. This study investigated undergraduate clinical forensic medicine training, based on experiences and opinions of community-service doctors. This article focuses on incidents of alleged rape cases only. Methods: The study was a quantitative retrospective cohort study that made use of a questionnaire with an adapted Likert scale. An electronic survey tool was employed to target 150 community-service doctors throughout South Africa. Percentages are used to display results. Results: A response rate of 59.3% was achieved. Although 80% of the participants reported that they had undergraduate training on how to manage alleged rape or sexual assault cases, only 11.4% of the participants had hands-on exposure to an alleged rape case during their undergraduate training. In addition, the majority of the participants (77.1%) never had undergraduate training on how to complete the J88 form. These findings indicate that clinical forensic training in the undergraduate medical programme does not adequately prepare community-service doctors to meet the challenges of clinical forensic practice. The current curriculum should be adapted to address these shortcomings. Conclusions: Perpetrators cannot be convicted if evidence collected cannot stand up in court. Proper training of undergraduate medical students prior to their community-service posting will ensure that medico-legal documentation is completed correctly, leading to the presentation of credible evidence in a court of law in order to ensure successful conviction of alleged perpetrators. Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2018; DOI: 10.1080/20786190.2017.1348046

scholarly journals Medico-legal aspects regarding drunk driving: experience and competency in practice of community service doctors

2018 ◽  
Vol 60 (2) ◽  
pp. 63-69
Author(s):  
L. Fouché ◽  
J. Bezuidenhout ◽  
C. Liebenberg ◽  
A. O. Adefuyea
Keyword(s):  
Community Service ◽  
Forensic Medicine ◽  
Medical Training ◽  
Blood Alcohol Concentration ◽  
Drunk Driving ◽  
Legal Aspects ◽  
Criminal Prosecution ◽  
Clinical Forensic Medicine ◽  
Blood Samples ◽  
Medical Graduates

Background: Drunk driving has been reported to increase the risk of road traffic accidents associated with death and severe injury. In South Africa, an increase in blood alcohol concentration of as little as 0.01 g per 100 ml above the legal limit may warrant criminal prosecution or the denial of an insurance claim for damages. However, multiple court cases have been withdrawn because of the incompetence of officials at various stages of the investigation. The scope of the mistakes range from poor scene handling to the incorrect handling of blood samples at the laboratory to eventual laboratory testing of blood samples. Using a group of community service doctors (CSDs) as a cohort study group, this study investigated the competency of medical graduates in relation to the medico-legal aspects of drunk driving.Methods: A self-administered questionnaire-based study was done with 150 CSDs. The questionnaire was administered in Afrikaans and English and was dispatched electronically via e-mail. All potential participants were contacted telephonically to obtain verbal consent. Results are displayed as percentages.Results: A response rate of 59.3% was achieved. The results obtained in this study confirm that some CSDs lack competency in handling medico-legal aspects relating to drunk driving, and are thus unable to serve the communities they have been assigned to adequately. Their lack of skills and knowledge suggests that the present undergraduate Clinical Forensic Medicine curriculum is inadequate.Conclusion: It would be beneficial to revise the curriculum for Clinical Forensic Medicine in undergraduate medical training to address the gap in knowledge and practice of various demands of forensic medicine required from new medical graduates and CSDs.

scholarly journals The Migraine-Anxiety Comorbidity Among Migraineurs: A Systematic Review

2021 ◽  
Vol 11 ◽  
Author(s):  
Leila Karimi ◽  
Tissa Wijeratne ◽  
Sheila Gillard Crewther ◽  
Andrew E. Evans ◽  
Deena Ebaid ◽  
...  
Keyword(s):  
Systematic Review ◽  
Anxiety Disorders ◽  
Psychiatric Symptoms ◽  
Medical Practitioner ◽  
Population Based ◽  
Small Sample ◽  
Cross Sectional ◽  
Medical Practitioners ◽  
Co Morbidity ◽  
Cross Sectional Studies

Background: Migraine is recognized as a neurological condition that is often associated with comorbid psychiatric symptoms such as anxiety, depression, bipolar disorder and/or panic disorder. Though some studies have demonstrated the link between migraine and anxiety disorders, there are no systematic reviews that have been published in this area to summarize the evidence. The aim of the present study is to systematically review the literature associated with comorbidity of migraine and anxiety disorders among migraineurs compared to non-migraineurs.Methods: The present systematic review included population-based, cohort and cross-sectional studies if they were reporting the frequency of migraine with either anxiety or depression as diagnosed by a medical practitioner according to the International Classification of Headache Disorders (ICHD-2/3).Results: Eight eligible studies from 2060 relevant citations were included in the review. All participants were migraine patients from both primary care and outpatient settings, as well as tertiary headache and anxiety centers, and were compared to non-migraineurs. The results of the systematic review showed that there is a strong and consistent relationship between migraine and anxiety. The co-morbidity of co-occurrence for migraine and anxiety has an average OR of 2.33 (2.20–2.47) among the prevalence and cross sectional studies and an average RR of 1.63 (1.37–1.93) for two cohort studies; The major limitations of included studies were small sample sizes and a lack of adjusting of confounding factors.Conclusion: The results highlight the need for inclusion of an anxiety screening tool during initial assessments of migraine patients by medical practitioners and/or physicians and may explain why some anxiolytic medications work better than others for migraine mitigation.

scholarly journals Associations between Australian clinical medical practitioner exposure to workplace aggression and workforce participation intentions

2016 ◽  
Vol 40 (1) ◽  
pp. 36 ◽  
Author(s):  
Danny J. Hills
Keyword(s):  
Patient Care ◽  
Medical Practitioner ◽  
Well Being ◽  
Workplace Aggression ◽  
Cross Sectional Survey ◽  
Workforce Participation ◽  
Cross Sectional ◽  
Medical Practitioners ◽  
The Impact ◽  
Clinical Workload

Objective The aim of the present study was to determine the association between clinician exposure to workplace aggression from any source in the previous 12 months and workforce participation intentions. Methods A cross-sectional survey, in the third wave of the Medicine in Australia: Balancing Employment and Life (MABEL) study, was conducted between March 2010 and June 2011. Respondents were a representative sample of 9449 Australian general practitioners (GPs) and GP registrars (n = 3515), specialists (n = 3875), hospital non-specialists (n = 1171) and specialists in training (n = 888). Associations between aggression exposure and workforce participation intentions were determined using logistic regression modelling. Results In adjusted models, aggression exposure was positively associated with a greater likelihood of intending to reduce clinical workload in the next 5 years (odds ratio (OR) = 1.15, 95% confidence interval (CI) 1.02–1.29) and intending to leave patient care within 5 years (OR = 1.20, 95% CI 1.07–1.35). When also accounting for well being factors, aggression exposure remained positively associated with intending to leave patient care within 5 years (OR = 1.13, 95% CI 1.00–1.27). Conclusions Exposure to workplace aggression presents a risk to the retention of medical practitioners in clinical practice and a potential risk to community access to quality medical care. More concerted efforts in preventing and minimising workplace aggression in clinical medical practice are required. What is known about the topic? Very few studies have addressed the impact of workplace aggression on workforce participation intentions of medical practitioners. What does this paper add? This paper provides evidence that exposure to workplace aggression from any source is associated with intentions to reduce clinical workload or leave patient care. What are the implications for practitioners? There is a need to prevent or minimise the risk of exposure to workplace aggression from any source because the impacts may extend beyond the known psychological or physical effects to practitioner decisions about ongoing participation in the provision of clinical services.

scholarly journals Knowledge, attitude and practices of rural medical practitioners on generic medicines

2019 ◽  
Vol 8 (7) ◽  
pp. 1652
Author(s):  
Susmitha Vemu ◽  
Triveni Manchu ◽  
Meenakshi Lella
Keyword(s):  
Economic Burden ◽  
Rural Areas ◽  
Generic Drugs ◽  
Medical Practitioner ◽  
Generic Medicines ◽  
Cross Sectional ◽  
Medical Practitioners ◽  
Guntur District ◽  
Amount Of Knowledge ◽  
Almost All

Background: An unqualified medical practitioner without any formal registration and practicing allopathic medicine in rural areas in India can be called Rural Medical Practitioner (RMP). RMPs enjoy a great deal of practice in rural areas by taking advantage of lacunae in the public health system. Government of India is currently popularising generic medicines, but still certain doubts exist even among doctors and how far the RMPs are aware of generic medicines is a big issue. They influence a lot of uneducated people, so the knowledge, attitude and practices they follow have a large impact on society.Methods: A cross sectional, prospective study was undertaken to assess the knowledge, attitude and the practices of 152 RMPs on generic medicines for a period of three months. A 23-item questionnaire was well designed, pre-validated and distributed to RMPs in and around Guntur district. The results were analysed using descriptive statistics.Results: 92% of the participants were aware of generic drugs. More than 80% believed that they are equivalent in terms of efficacy and safety to their branded counterparts and are available at reasonable prices. 95.4% RMPs believed that prescribing generic drugs will decrease the pharmaco-economic burden of the country. Almost all of them agreed on the need for the updates and education on generics by means of continuing medical education (CMEs).Conclusions: The participants had good amount of knowledge on generic drugs but there are concerns regarding quality and therapeutic efficacy of generic drugs. Proper awareness about the generic prescription practice may improve the patient compliance by reducing economic burden to the patients.

scholarly journals Knowledge and perception of massive open online courses among medical students of Perambalur district, Tamilnadu, India

2021 ◽  
Vol 8 (6) ◽  
pp. 2908
Author(s):  
Rakesh Kumar ◽  
S. Rajesh ◽  
K. Rajesh Kanna ◽  
S. Rohit Sujin
Keyword(s):  
Medical Students ◽  
Skill Acquisition ◽  
Information Technologies ◽  
Online Courses ◽  
Cross Sectional Study ◽  
Regular Classroom ◽  
Undergraduate Medical Students ◽  
Material Technology ◽  
Cross Sectional ◽  
Survey Tool

Background: Coronavirus outbreak has forced a prolonged closure of educational institutes all over world including India which have affected the regular classroom studies and skill acquisition by students. The aim of the study was to assess the knowledge and perception regarding mass open online courses (MOOC) among medical students.Methods: A web-based cross-sectional study using google form survey tool was conducted among undergraduate medical students. Questions were asked on demographic information, use and accessibility of information technologies, awareness and utilization of MOOC and barriers and motivations for course enrollment and completion.Results: Overall 224(54.9%) of medical students had ever heard about MOOC. Out of them, only 31.6% students had actually enrolled for any online course. Further, course completetion rate was only 11.6%. Age and year of study was significantly associated with enrolment to MOOC. Important motivation for enrolment were learning new thing, learning medicine and for better career prospects while common barriers were low internet speed and lack of time. Among those who completed the course, most of them had a satisfactory or very satisfactory level of satisfaction with regard to overall experience, quality of presented material, technology used, and video lectures.Conclusions: There is poor awareness and utilization of MOOC among medical students which can hamper their learning particularly in absence on regular classroom teaching. There is need of blended curriculum harnessing the advantages of MOOC platform which will aid students continue learning in difficult times.

36. VULVOVAGINAL CANDIDIASIS IN AUSTRALIA: LET'S TAKE A LOOK 'DOWN UNDER'

Sexual Health ◽  
2007 ◽  
Vol 4 (4) ◽  
pp. 298
Author(s):  
S. C. Hilmi ◽  
J. McCloskey ◽  
P. Tenni ◽  
J. Hughes
Keyword(s):  
Western Australia ◽  
Medical Diagnosis ◽  
Medical Practitioner ◽  
Signs And Symptoms ◽  
Medical Advice ◽  
Vulvovaginal Candidiasis ◽  
Contributing Factors ◽  
Chi Square ◽  
Cross Sectional ◽  
Medical Practitioners

Objectives: To determine: 1) The accuracy in patient self-diagnosis and medical diagnosis of vulvovaginal candidiasis (VVC) in Western Australia; 2) The contributing factors for self-diagnosing rather than seeking a medical diagnosis. Methods: A cross-sectional cohort community-based study, over a 13-month period, was conducted. All women wishing to purchase a topical antifungal product for their personal treatment of presumed VVC, from participating community pharmacies within a nominated division of general practice in Perth, Western Australia, were invited to participate in the study. Participants completed a detailed questionnaire prior to their immediate referral for evaluation and examination by an experienced medical practitioner, and underwent a range of laboratory tests to determine the cause of their symptoms. Chi-square testing for association was performed for univariate comparisons with that of culture proven VVC. Results: Ninety-four symptomatic women aged between 19 and 79 years were recruited. Of the 88 women who completed all aspects of the study, 41 (47%) were confirmed to have VVC by culture. The remaining 47 (53%) women either had another infectious cause (10 [11%]: urinary tract infection [4]; bacterial vaginosis [2]; chlamydia [2]; or genital herpes [2]) or their symptoms were not secondary to an infection (37 [42%]). Sixty-three percent of presumptive diagnoses made by medical practitioners were concordant with laboratory proven VVC. The women avoided seeking medical advice for a number of reasons. Conclusions: Over half of the study population self-diagnosed VVC incorrectly. The proportion of correct presumptive diagnoses made by medical practitioners was only slightly greater. Diagnosis based on presenting signs and symptoms alone could result in an incorrect diagnosis and a proportion of STIs being missed. Improving the management of VVC will be dependent on addressing factors influencing women's reluctance to seek medical advice and in addressing the current diagnostic processes. Over-the-counter antifungals, whilst convenient, may well compromise women's health.

A review of pharmacist recommendations in an aged care facility

2011 ◽  
Vol 17 (1) ◽  
pp. 35 ◽  
Author(s):  
Hanan Khalil
Keyword(s):  
Drug Treatment ◽  
Improve Patient Safety ◽  
Symptom Control ◽  
Care Facility ◽  
Drug Efficacy ◽  
Medical Practitioner ◽  
Aged Care ◽  
Aged Care Facility ◽  
Cross Sectional ◽  
Medical Practitioners

The aim of this study was to analyse the types of and rationale for the clinical recommendations made by the pharmacist in a rural aged care facility to improve patient safety. The classes of drugs associated with the pharmacist’s recommendations were also identified. A related aim was to determine their degree of acceptance by medical practitioners. A retrospective, cross-sectional study design was used to review 56 aged care residents’ case notes over a 12-month period. The main outcome measures included: the types of and reasons for recommendations made by the pharmacist; classes of drugs associated with the pharmacist’s recommendations; and the implementation rate of the pharmacist’s recommendations by the medical practitioner. A total of 196 recommendations were made by the pharmacist to the residents’ existing medications. The main types of recommendations were alteration to residents’ monitoring (49%), discontinuation of drug treatment (19%) followed by initiation of drug treatment (17%). The main reasons for the recommendations were to reduce potential side-effects (45%), symptom control (32%) and to increase drug efficacy (19%). Analysis of medical practitioners’ case notes estimated that 70% of the pharmacist’s recommendations were being implemented by the residents’ medical practitioner. This case notes analysis reinforces the importance of doctor–pharmacist collaboration in the management of residents’ medications in aged care facilities.

scholarly journals High Prevalence of Pituitary Adenomas: A Cross-Sectional Study in the Province of Liège, Belgium

2006 ◽  
Vol 91 (12) ◽  
pp. 4769-4775 ◽  
Author(s):  
Adrian F. Daly ◽  
Martine Rixhon ◽  
Christelle Adam ◽  
Anastasia Dempegioti ◽  
Maria A. Tichomirowa ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Adenomas ◽  
Medical Practitioner ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
General Medical Practitioner ◽  
Medical Practitioners ◽  
Finding Study ◽  
Referral Hospitals ◽  
System Data

Abstract Context: Prevalence data are important for assessing the burden of disease on the health care system; data on pituitary adenoma prevalence are very scarce. Objective: The objective of the study was to measure the prevalence of clinically relevant pituitary adenomas in a well-defined population. Design: This was a cross-sectional, intensive, case-finding study performed in three regions of the province of Liège, Belgium, to measure pituitary adenoma prevalence as of September 30, 2005. Setting: The study was conducted in specialist and general medical practitioner patient populations, referral hospitals, and investigational centers. Methods: Three demographically and geographically distinct districts of the province of Liège were delineated precisely using postal codes. Medical practitioners in these districts were recruited, and patients with pituitary adenomas under their care were identified. Diagnoses were confirmed after retrieval of clinical, hormonal, radiological, and pathological data; full demographic and therapeutic follow-up data were collected in all cases. Results: Sixty-eight patients with clinically relevant pituitary adenomas were identified in a population of 71,972 individuals; the mean (± sd) prevalence was 94 ± 19.3 cases per 100,000 population (95% confidence interval, 72.2 to 115.8). The group was 67.6% female and had a mean age at diagnosis of 40.3 yr; 42.6% had macroadenomas and 55.9% underwent surgery. Prolactinomas comprised 66% of the group, with the rest having nonsecreting tumors (14.7%), somatotropinomas (13.2%), or Cushing’s disease (5.9%); 20.6% had hypopituitarism. Conclusion: The prevalence of pituitary adenomas in the study population (one case in 1064 individuals) was more than 3.5–5 times that previously reported. This increased prevalence may have important implications when prioritizing funding for research and treatment of pituitary adenomas.

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