Prevalence of Alcohol Consumption in Emergency department presentations (PACE) in Queensland, Australia, using alcohol biomarkers ethanol and phosphatidylethanol: an observational study protocol

IntroductionAlcohol use in patients presenting to the emergency department (ED) is a significant problem in many countries. There is a need for valid and reliable surveillance of the prevalence of alcohol use in patients presenting to the ED, to provide a more complete picture of the risk factors and inform targeted public health interventions. This PACE study will use two biomarkers, blood ethanol and phosphatidylethanol (PEth), to determine the patterns, presence and level of alcohol use in patients presenting to an Australian ED.Methods and analysisThis is an observational prevalence study involving the secondary use of routinely collected blood samples from patients presenting to the Royal Brisbane and Women’s Hospital (RBWH) Emergency and Trauma Centre (ETC). Samples will be tested for acute and medium-term alcohol intake using the two biomarkers blood ethanol and PEth respectively, over one collection period of 10–12 days. Descriptive statistics such as frequencies, percentages, means, SD, medians and IQRs, will be used to describe the prevalence, pattern and distribution of acute and medium-term alcohol intake in the study sample. The correlation between acute and medium-term alcohol intake levels will also be examined.Ethics and disseminationThis study has been approved by the RBWH Human Research Ethics Committee (reference, LNR/2019/QRBW/56859). Findings will be disseminated to key stakeholders such as RBWH ETC, Australasian College for Emergency Medicine, Royal Australasian College of Surgeons, Statewide Clinical Networks, and used to inform clinicians and hospital services. Findings will be submitted for publication in peer-reviewed journals and presentation at appropriate conferences.

Collaborative research in Australasian plastic surgery

Many specialist groups have developed clinical trial initiatives in response to the growing need for more collaborative research, and these are proliferating in multiple countries across the globe. The Royal Australasian College of Surgeons (RACS), under the direction of Professor John Windsor, established the clinical trials network of Australia and New Zealand (CTANZ). CTANZ supports the Australasian clinical trials in plastic, reconstructive and aesthetic surgery (ACTPRAS) research group which has already facilitated two multicentre, international, collaborative studies.

Speaking Up and Speaking Out: Gender Diversity in the Scientific Programme of the Royal Australasian College of Surgeons Annual Scientific Congress

Background Disparities in gender representation at medical meetings have been documented despite women representing half of medical school graduating classes. Lack of role models is touted as one of a myriad of factors that perpetuate gender imbalance, particularly in the field of surgery. We evaluated the trend in gender distribution of participants at the Royal Australasian College of Surgeons (RACS) Annual Scientific Congress (ASC) and whether there was a correlation between the gender distribution of the organising committee and speakers and chairpersons invited to attend. Methods RACS ASC programmes from 2013 to 2018 were retrospectively analysed, examining the gender distribution of speakers, chairpersons and conveners. Trend analysis of distribution was performed, and a generalized linear mixed model was used to investigate the effect of the gender of the conveners on gender of session chairpersons and speakers. Results Between 2013 and 2018, there were non-significant increases in female speakers invited to speak from 14.9 to 21.7% (p = 0.064) and female conveners appointed from 11 to 19% (p = 0.115), but there was a significant increase in female chairs from 9.6 to 21.6% p < 0.001). Female conveners were 3 times more likely to invite female speakers than male conveners (p < 0.001) and were 20 times more likely to invite female chairs than male conveners (p < 0.001). Conclusion Visible role models are important in the pursuit of gender equity in surgery in order to break down stereotypes and the hidden curriculum. Intentional effort is required to achieve parity, and such efforts could include appointing more women to organising committees of scientific meetings.

There’s Something Wrong

The role of the occupational physician, and relationships with employers and insurers. New Zealand’s Accident Compensation Commission and its role as a state insurer. The need for system change in order not only to prevent health and disability but to improve people’s health. Case example showing the role of the health and safety manager and the effect of the sick note on return to work. The views of the chair of Council of the Royal College of General Practitioners (RCGP) on the relationship between GP and patient. The conflict of interest between GPs and occupational physicians. Author’s research to elucidate the problem, working with the Trades Union Congress and the Department for Work and Pensions, resulting in a consensus statement and editorial in The BMJ. Author’s work on the Policy and Advocacy Committee of the Australasian Faculty of Occupational and Environmental Medicine of the Royal Australasian College of Physicians. Launch of position statement, ‘Realising the Health Benefits of Work’, in 2010. Work with Helen Kelly, President of the New Zealand Council of Trade Unions, and the concept of ‘good work’. Dame Carol Black and the Black Review, Working for a Healthier Tomorrow. The constraint of short appointment times for GPs in the UK: RCGP’s aim to increase appointment times from the current 10 minutes to 15 minutes by 2030.

Introduction

‘Congratulations on a great Congress, David. But most of all, thank you, for permission to practise medicine how I’ve always known I should. I’ve wanted to work to a more holistic model, but I’ve been afraid of how my colleagues would react.’ The Royal Australasian College of Physicians (RACP) Congress 2019 in Auckland was the pinnacle of my professional career to date, and that moment made it all worthwhile. It was a milestone on my journey as a doctor. But it was much more than that....

Advanced Trainee-Led Physician Clinical Examination Workshop: Improving Training and Culture

Background: Near-to-peer teaching involves more experienced learners acting as tutors for junior colleagues and has significant theoretical benefits for both teachers and learners [1-3]. Aim: Development, implementation, and assessment of a weekend examination preparation workshop by Royal Australasian College of Physicians Advanced Trainees (ATs) for Basic Physician Trainees (BPTs), using a near-to-peer framework. Methods: A two-day offsite course was designed by ATs. Day 1 - subspecialty short-case demonstrations, followed by small-group examination practice. Shared downtime was organized for the evening. Day 2 - two exemplar long-case presentations by ATs with consultant examiner feedback, followed by interactive small-group sessions focusing on presenting long-cases. Results: A post-course survey was completed by 72% of BPTs (13/18) and 88% of ATs (8/9). Responses demonstrated that all BPTs would recommend this workshop to peers. 84% (11/13) found the course material very useful. 62% (5/8) ATs felt their leadership and teaching skills had significantly improved. BPTs reported that the AT long-case demonstrations were highly useful. Negative feedback included the venue, course timing, and lack of patients with clinical signs. Conclusion: This innovative AT-led examination preparation workshop significantly enhanced training culture and candidate well-being. ATs benefited with increased confidence in their ability to lead and teach.