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BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e045822
Author(s):  
Lynn V Monrouxe ◽  
Peter Hockey ◽  
Priya Khanna ◽  
Christiane Klinner ◽  
Lise Mogensen ◽  
...  

IntroductionThe assistant in medicine is a new and paid role for final-year medical students that has been established in New South Wales, Australia, as part of the surge workforce management response to the COVID-19 pandemic. Eligibility requires the applicant to be a final-year medical student in an Australian Medical Council-accredited university and registered with the Australian Health Practitioner Regulation Agency. While there are roles with some similarities to the assistant in medicine role, such as assistantships (the UK) and physician assistants adopted internationally, this is completely new in Australia. Little is known about the functionality and success factors of this role within the health practitioner landscape, particularly within the context of the COVID-19 pandemic. Given the complexity of this role, a realist approach to evaluation has been undertaken as described in this protocol, which sets out a study design spanning from August 2020 to June 2021.Methods and analysisThe intention of conducting a realist review is to identify the circumstances and mechanisms that determine the outcomes of the assistant in medicine intervention. We will start by developing an initial programme theory to explore the potential function of the assistant in medicine role through realist syntheses of critically appraised summaries of existing literature using relevant databases and journals. Other data sources such as interviews and surveys with key stakeholders will contribute to the refinements of the programme theory. Using this method, we will develop a set of hypotheses on how and why the Australian assistants in medicine intervention might ‘work’ to achieve a variety of outcomes based on examples of related international interventions. These hypotheses will be tested against the qualitative and quantitative evidence gathered from all relevant stakeholders.Ethics and disseminationEthics approval for the larger study was obtained from the Western Sydney Local Health District (2020/ETH01745). The findings of this review will provide useful information for hospital managers, academics and policymakers, who can apply the findings in their context when deciding how to implement and support the introduction of assistants in medicine into the health system. We will publish our findings in reports to policymakers, peer-reviewed journals and international conferences.


2021 ◽  
Author(s):  
S.N. Yadav ◽  
N. Ahmed ◽  
A.J. Nath ◽  
P.K. Boro

The haematological analysis is one of the essential diagnostic and prognostic tools for the health practitioner. Routine hematology consists of erythrocyte, leucocyte and platelet parameters estimation. Erythrocyte parameters (RBC, RDW, haemoglobin, haematocrit, MCV, MCH, MCHC) estimation plays a crucial role in identifying anemia and several other acute and chronic conditions. Accurate and precise haematology results depend on correct blood collection procedures, suitable anticoagulants, proper storage and effective blood transport. The individual reference value variance can be due to age, sex, stress, diet, body condition, hydration status and reproductive status. Automatic haeamtology analyzer can yield quick and accurate results provided the sample is free from any artifacts. In conclusion, the accuracy of the result of automatic haematology analyzer in canine medicine is impeded by the lack of precise and rapid comparison procedure, instability and complexity of blood cells. Therefore the findings of the automatic haemotolyzer should always be corroborated with the clinical findings and another laboratory test.


2021 ◽  
Vol 107 (2) ◽  
pp. 25-31 ◽  
Author(s):  
Christine Gee ◽  
Anne Tonkin ◽  
Sharon Gaby ◽  
Veronika Urh ◽  
Sarah Anderson ◽  
...  

ABSTRACT A sexual boundary violation by a health practitioner has an immense impact on a patient, and the trust and confidence in the health care system and the health care regulator are negatively affected. The Australian Health Practitioner Regulation Agency (Ahpra) and the Medical Board of Australia (MBA) in 2017 commissioned an independent review in response to a specific high-profile case of multiple physician-patient* sexual boundary violations. In response to recommendations for process improvement, Ahpra and the MBA worked to transform the regulatory management of sexual boundary notifications.The purpose of this paper is to explore the structural and cultural changes that have been made to manage sexual boundary violation notifications and lessons learned through the process. Three factors — specialized decision-making, training for investigators and policy and cultural changes — were identified as key elements of the change process. Since the changes in 2017, the rate of immediate regulatory action taken in response to sexual boundary notifications has increased substantially, with a higher proportion of decisions resulting in suspension of a physician’s registration. Further work on the experience of those who are part of the notification process and supporting people to share their stories and experiences through the notification and tribunal process is ongoing.


2021 ◽  
Author(s):  
Elizabeth Ann Driscoll

Governments are faced with a variety of challenging issues that have proven difficult to manage, one of which is providing safe food to its citizens. Recognizing this, and in response to several high-profile food safety crises in the late 1990s, food retailers created the Global Food Safety Initiative (GFSI), a private food safety regulatory approach. Certification to a GFSI-benchmarked private standard is often required through customer-supplier contracts, and as a result, food producers in the global agri-food supply chain may be subject to both the public and a private food safety regulatory approach. This dissertation uses Webb’s (2005) sustainable governance framework, which maintains that public, private, and civil sectors’ institutions, processes, rule instruments and actors have regulatory capabilities in support of public policy objectives, to explore whether or not the GFSI auditor, an actor in the GFSI-system, supports the public heath objectives of the state. Three primary research questions were developed to pursue this inquiry. First, on a functional level, can the GFSI auditor can be considered a public health practitioner analogous to the government’s food safety inspector? Second, do GFSI auditors view themselves as public health practitioners? Third, do other actors in the GFSI-system consider GFSI auditors to be public health practitioners? Using a mixed methods investigative approach, this dissertation presents the following conclusion: though the GFSI auditor can be characterized as a public health practitioner who supports the state’s public health objectives, neither the auditors themselves nor other actors, e.g. representatives of Certification Bodies, Certification Programme Owners, etc., in the GFSIsystem who participated in this research characterize the GFSI auditor as a public health practitioner. The final chapter of this dissertation discusses the public health and policy study significance of this investigation, provides policy recommendations to both the public and private institutions and actors involved governing food safety in Canada intended to strengthen the overall public health system by recognizing the role that GFSI auditors have in promoting public health objectives, and opportunities for further research.


2021 ◽  
Author(s):  
Elizabeth Ann Driscoll

Governments are faced with a variety of challenging issues that have proven difficult to manage, one of which is providing safe food to its citizens. Recognizing this, and in response to several high-profile food safety crises in the late 1990s, food retailers created the Global Food Safety Initiative (GFSI), a private food safety regulatory approach. Certification to a GFSI-benchmarked private standard is often required through customer-supplier contracts, and as a result, food producers in the global agri-food supply chain may be subject to both the public and a private food safety regulatory approach. This dissertation uses Webb’s (2005) sustainable governance framework, which maintains that public, private, and civil sectors’ institutions, processes, rule instruments and actors have regulatory capabilities in support of public policy objectives, to explore whether or not the GFSI auditor, an actor in the GFSI-system, supports the public heath objectives of the state. Three primary research questions were developed to pursue this inquiry. First, on a functional level, can the GFSI auditor can be considered a public health practitioner analogous to the government’s food safety inspector? Second, do GFSI auditors view themselves as public health practitioners? Third, do other actors in the GFSI-system consider GFSI auditors to be public health practitioners? Using a mixed methods investigative approach, this dissertation presents the following conclusion: though the GFSI auditor can be characterized as a public health practitioner who supports the state’s public health objectives, neither the auditors themselves nor other actors, e.g. representatives of Certification Bodies, Certification Programme Owners, etc., in the GFSIsystem who participated in this research characterize the GFSI auditor as a public health practitioner. The final chapter of this dissertation discusses the public health and policy study significance of this investigation, provides policy recommendations to both the public and private institutions and actors involved governing food safety in Canada intended to strengthen the overall public health system by recognizing the role that GFSI auditors have in promoting public health objectives, and opportunities for further research.


2021 ◽  
Vol 50 (6) ◽  
pp. 416-421
Author(s):  
Ruby Grant ◽  
Anthony KJ Smith ◽  
Meredith Nash ◽  
Lyndsay Newett ◽  
Richard Turner ◽  
...  

2021 ◽  
Author(s):  
JuliaB Ho

With the recent legalization of cannabis in Canada on October 17, 2018, the opportunity for emerging tech to complement and improve the cannabis experience is vast. The legalization of an industry that has been operating in the dark for decades means ample newfound opportunity for government and corporate-funded collaboration, development and research. A specific area of opportunity for growth within the cannabis sector is through personalization. Personalization is often performed via artificial intelligence—specifically machine learning—to develop a customized experience for users on various platforms. This is usually with the intention of targeted marketing. And while mass data collection serves the user by streamlining content to their assumed preferences, which then often directs them to businesses and products, product-tailoring still has vast potential for growth. Though a medical document for cannabis from a health practitioner may include broadband components to look out for, like “THC” and “CBD”, or even suggest ratios of those cannabinoids there is typically no specification on strain type and best consumption methods. Because the effects that cannabis has on a user varies from individual to individual and is dependent on not only their biometrics, but the various other terpenes and cannabinoids that exist in each strain beyond THC and CBD, cannabis users are missing out on opportunities to make the most of their use. Especially for those interested in cannabis to relieve specific symptoms, testing the vast amount of strains that exist and being able to identify the ideal product would be an arduous task on one’s own. Jibed is an app that would use the aggregation of user data to prescribe the most suitable strain of cannabis for that individual based on their specific conditions and body metrics. As the majority of the target audience (cannabis users in Canada) are already logged on to a multitude of data collecting apps (music, health, social, etc.), there is no shortage of data. The app would consider all the implications of the data, from one’s health to mood deduced from the music they're listening to -- just to name some -- in order to achieve optimal prescriptions.


2021 ◽  
Author(s):  
JuliaB Ho

With the recent legalization of cannabis in Canada on October 17, 2018, the opportunity for emerging tech to complement and improve the cannabis experience is vast. The legalization of an industry that has been operating in the dark for decades means ample newfound opportunity for government and corporate-funded collaboration, development and research. A specific area of opportunity for growth within the cannabis sector is through personalization. Personalization is often performed via artificial intelligence—specifically machine learning—to develop a customized experience for users on various platforms. This is usually with the intention of targeted marketing. And while mass data collection serves the user by streamlining content to their assumed preferences, which then often directs them to businesses and products, product-tailoring still has vast potential for growth. Though a medical document for cannabis from a health practitioner may include broadband components to look out for, like “THC” and “CBD”, or even suggest ratios of those cannabinoids there is typically no specification on strain type and best consumption methods. Because the effects that cannabis has on a user varies from individual to individual and is dependent on not only their biometrics, but the various other terpenes and cannabinoids that exist in each strain beyond THC and CBD, cannabis users are missing out on opportunities to make the most of their use. Especially for those interested in cannabis to relieve specific symptoms, testing the vast amount of strains that exist and being able to identify the ideal product would be an arduous task on one’s own. Jibed is an app that would use the aggregation of user data to prescribe the most suitable strain of cannabis for that individual based on their specific conditions and body metrics. As the majority of the target audience (cannabis users in Canada) are already logged on to a multitude of data collecting apps (music, health, social, etc.), there is no shortage of data. The app would consider all the implications of the data, from one’s health to mood deduced from the music they're listening to -- just to name some -- in order to achieve optimal prescriptions.


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