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PubMed2004

The correlates and consequences of newspaper reports of research on sex differences.

Correlates and consequences of newspaper accounts of research on sex differences were examined. In Study 1, articles from high-circulation newspapers were coded for the degree to which biological factors were used to explain sex differences. Results showed that political conservatism and traditional attitudes toward gender roles coded from other newspaper sections predicted greater use of biological explanations than did political liberalism and less traditional attitudes toward gender roles. In Studies 2 and 3, participants read a fictional newspaper article reporting research on a gender difference that cited either biological or sociocultural factors as explaining the difference. Results showed that exposure to biological explanations significantly increased participants' endorsement of gender stereotypes. Moreover, exposure to social explanations significantly increased participants' belief in the mutability of human behavior. Together, these studies show that political ideology influences how the popular press reports research findings and that such reporting in turn affects readers' beliefs and attitudes.

Attitude↗
PubMed1991

The impact of the appearance of the anaesthetist on the patient's perception of the pre-operative visit.

The clinician's appearance is often considered a symbol which identifies and defines specific characteristics of the individual. Opinion of both lay and medical personnel on appropriate clothing inclines towards formal dress. Our aim was to assess the effect of the anaesthetist's appearance during a ward visit on the patient's evaluation of either the visit or the anesthetist himself. In our sample of 66 patients we found no evidence that the style of dress (formal: suit and tie, informal: jeans and open-necked shirt) affected that evaluation. However, when 138 patients were asked to rate the desirability of items of clothing for a male hospital doctor they expressed a preference for traditional clothing; a suit was rated as desirable and jeans as one of the four most undesirable items. We conclude that despite the conservatism of expressed opinions, the clothing worn by the anaesthetist is irrelevant to the patient's satisfaction with the visit.

Adolescent↗
PubMed1985

Phylogenetically more conservative epitopes among monoclonal antibody-defined antigenic sites of human transferrin are involved in receptor binding.

Of eight monoclonal antibodies raised against human transferrin, one (H.TF-14) cross reacted with pig and rabbit transferrins and one (H.TF-1) showed cross-reactivity with horse and dog transferrins. While rabbit and pig transferrins exhibited the same patterns of binding to MOLT-3 cell receptors as human and horse transferrins, binding of mouse and dog transferrins was weaker and bovine and carp transferrins gave entirely negative results. The results of these competitive binding experiments were confirmed by a biological test in which bovine transferrin had no effect on the growth of MOLT-3 cells when added to a serum-free medium. The observed correlation between cross-reactivity of anti-transferrin monoclonal antibodies and the binding abilities of transferrins to the MOLT-3 cell receptors may be associated with the conservatism of the part of the transferrin molecule recognized by the cell receptor.

Animals↗
PubMed2004

Desquamative interstitial pneumonia, respiratory bronchiolitis and their relationship to smoking.

AIMS: Respiratory bronchiolitis (RB) and desquamative interstitial pneumonia (DIP) are closely associated histological patterns of interstitial pneumonia, although there are no studies on the extent of individual histological parameters. Furthermore, the term smoking related-interstitial lung disease (SR-ILD) has been proposed as a term to encompass patients with both these histological patterns who give a history of smoking, though it is not well defined how this term relates to historical cases of DIP. The aim of this study was to compare histological parameters in cases of DIP and RB and then to review in detail clinical, imaging and histological data for DIP in relation to a history of smoking. METHODS AND RESULTS: Forty-nine cases were reviewed, 24 with RB and 25 with DIP; five cases of DIP were re-classified as RB on review due to bronchocentricity of the infiltrate. There was a significantly greater extent of interstitial fibrosis (P = 0.02), lymphoid follicles (P < 0.001) and eosinophilic infiltration (P < 0.0001) in patients with DIP compared with RB. In addition, the extents of these three parameters were significantly interrelated. Patients with DIP had a lower incidence of smoking (60%) when compared with patients with RB-ILD (93%) (P < 0.005). Further analysis of smokers versus never-smokers with DIP showed no difference in histological parameters, extent of haemosiderin deposition or the number of CD1a+ macrophages between the two groups, nor were there any differences in clinical data to suggest other aetiologies. Follow-up high-resolution computed tomography data from patients with DIP suggested that a pattern of fibrotic non-specific interstitial pneumonia (NSIP) may develop in the long term in both smokers and never-smokers. CONCLUSION: There are significant differences in the extent of interstitial fibrosis, lymphoid follicles and eosinophilic infiltration between DIP and RB, as well as a much lower incidence of smoking in patients with DIP. Whether the lower reported incidence of smoking in DIP reflects referral bias or conservatism in giving a history of smoking remains uncertain, as neither histological parameters nor clinical data indicate a difference between smokers and never-smokers with DIP. Nevertheless, some cases of DIP are likely to remain idiopathic and unrelated to RB, though still have a good prognosis. Furthermore, they may evolve into a pattern resembling fibrotic NSIP. Therefore, whilst SR-ILD is appropriate in the correct clinical setting, the distinction between the histological patterns of RB and DIP remains appropriate.

Adult↗
PubMed1991

Attitudes and interests of students and applicants from two branches of the British nursing profession.

The attitudes and interests of psychiatric students and applicants are compared with general nursing students and applicants using the Attitudes to Treatment Questionnaire (ATQ), the Wilson-Patterson Attitude Inventory (WPAI) and the Direction of Interest Questionnaire (DIQ). The student groups are also examined in respect of changes in attitude (ATQ) and interests (DIQ) during their training. Results indicate significant differences between nurse applicants for attitudes to treatment and direction of interest, the psychiatric applicants being more liberal in their attitudes to treatment and less practical in their interests. Similarly, psychiatric students demonstrated more liberalism in their attitudes to treatment as well as less conservatism than general students. No differences emerged for students in terms of direction of interest. Differences within groups occurring during training were complex. The implications of these findings are discussed and some suggestions made for further research.

Adolescent↗
PubMed1991

Student nurses' attitudes to psychiatry: the influence of training and personality.

Fifty-one second-year students completed the Attitudes to Treatment Questionnaire (ATQ), the Conservatism Scale (CS), the Defence Style Questionnaire (DSQ) and an open-ended questionnaire before and after components of their psychiatric training programme, which included a 1-week placement in a psychiatric hospital. CS scores indicated that the nurses were moderately conservative. ATQ scores and CS scores correlated significantly, with the more conservative nurses reporting more traditional attitudes to psychiatric nursing. ATQ scores fell significantly after psychiatric hospital placement, indicating more progressive attitudes. Mean scores on the DSQ were within normal limits, although men scored significantly higher than women on the Immature Defences Scale immediately after placement. The open-ended questionnaire revealed mainly positive comments about the psychiatric hospital placement. Almost half the nurses expressed surprise at the relaxed, informal atmosphere on the wards, and as many stated that personal interaction with the patients rapidly removed any stereotyped attitudes that they held previously. Over 40% of nurses stated that the patients were much less aggressive or dangerous than they had expected, although nearly 20% said they were concerned about the levels of aggression that they observed.

Adult↗
PubMed1996

A model of clinical supervision for nurses undertaking short placements in mental health care settings.

This paper presents a model of supervision developed from the experience of supervising undergraduate general nursing students undertaking clinical experience in psychiatric wards. Supervision structures and methods are presented and the theoretical under-pinnings of the supervision model are discussed. Our experience of using the model over the past 5 years suggests that it has the potential to allow students to gain a good understanding of individual patients within a short time span and to engage with them as active collaborators in care. The supervision model can also assist students to develop the knowledge and insights needed to gain the respect of senior colleagues, and the confidence to challenge the professional conservatism that often characterizes psychiatric wards.

Clinical Competence↗
PubMed1987

Attitudes to social issues in medicine: a comparison of first-year medical students with first-year students in non-medical faculties.

The emphasis on academic achievement in medical student selection has given rise to the fear that students entering medicine may comprise a homogeneous group with tendencies towards academic and scientific pursuits rather than humanistic and person-oriented health care. The Attitudes to Social Issues in Medicine (ATSIM) scale was administered to first-year Australian medical students and first-year students in other faculties including students with significantly lower academic performance measured by high school examination scores. The medical student group was found to be less conservative towards general social issues than students enrolled in commerce and science faculties and scored equally with arts students. Greater conservatism was, however, apparent in those areas which most closely affect the doctor's role. Medical students were less positive than other student groups in their attitudes towards increased government control of the medical profession, the contribution of allied health professionals and the importance of social aspects of illness. On attitudes to issues such as prevention and doctor-patient relationships which do not challenge the knowledge base or traditional role and status of the medical profession, however, medical students demonstrate equal or greater concern compared with other student groups.

Attitude of Health Personnel↗
PubMed1992

Teaching bioethics to medical students: the Newcastle experience.

Over the past two decades in the USA, bioethics has become an accepted component of medical education, whereas in Australia, 10 years or even less would encompass the history of most existing programmes. Given the legendary conservatism of medical schools in Australia and the intractability of the medical curriculum, this is still a remarkable achievement. But does the teaching of bioethics change the thinking and/or decision-making behaviour of medical students or practitioners exposed to such courses? Those involved know only too well how difficult such courses are to design and evaluate since the connection between ethics education and practice is not known and may never be demonstrated to the satisfaction of critics. Critics not only seek answers to the questions of whether the teaching of bioethics makes a difference, which is a fair question, but they also seek answers to the question of whether bioethics should be taught in medical schools. Can bioethics be taught? Whose bioethics is being taught? What does the trained bioethicist contribute? Some of these questions arise from misunderstanding and some reflect the still too dominant view in medical schools which divides disciplines into those which provide 'practical skills', and those which contribute only theoretical and therefore peripheral knowledge. The authors will address these questions in the light of their experience at Newcastle, Australia, where the Faculty of Medicine has been teaching bioethics for over a decade.

Attitude of Health Personnel↗
PubMed2005

Parallels in the evolution of the two largest New and Old World seed-beetle genera (Coleoptera, Bruchidae).

This study provides the first phylogenetic analysis of a large sample of the two largest genera of seed-beetles, Acanthoscelides Schilsky and Bruchidius Schilsky, which mostly feed on legumes (Fabaceae). The goal of this study was to investigate evolutionary patterns in relation to biogeography and host-plant associations. We used three mitochondrial molecular markers and parsimony and Bayesian inference methods to reconstruct the phylogeny of 76 species. In addition, we critically reviewed host-plant records in the literature for these two bruchid genera. Our results demonstrated the existence of two major clades, one New World and one largely Old World, which generally correspond to the two genera. Yet, current classification of several species is erroneous, so that both genera as currently defined are paraphyletic. We highlighted a strong trend toward specialization (with high taxonomic conservatism in host-plant use) exhibited by the two studied genera. However, we showed the existence of several host shifts during the evolution of this group of bruchids. Our phylogenetic hypotheses and our evaluation of host-plant associations both suggest that the two genera have undergone parallel evolution, as they have independently colonized similar host plants in their respective areas of distribution. Our estimation of divergence times indicated a more ancient origin for bruchids than that suggested by the fossil records. Interestingly, the suggested timing of diversification is consistent with the hypothesis of a radiation that could have occurred contemporaneously with the diversification of their legume hosts.

Animals↗
PubMed2006

Parallel evolution of larval morphology and habitat in the snail-killing fly genus Tetanocera.

In this study, we sequenced one nuclear and three mitochondrial DNA loci to construct a robust estimate of phylogeny for all available species of Tetanocera. Character optimizations suggested that aquatic habitat was the ancestral condition for Tetanocera larvae, and that there were at least three parallel transitions to terrestrial habitat, with one reversal. Maximum likelihood analyses of character state transformations showed significant correlations between habitat transitions and changes in four larval morphological characteristics (cuticular pigmentation and three characters associated with the posterior spiracular disc). We provide evidence that phylogenetic niche conservatism has been responsible for the maintenance of aquatic-associated larval morphological character states, and that concerted convergence and/or gene linkage was responsible for parallel morphological changes that were derived in conjunction with habitat transitions. These habitat-morphology associations were consistent with the action of natural selection in facilitating the morphological changes that occurred during parallel aquatic to terrestrial habitat transitions in Tetanocera.

Animals↗
PubMed1980

The ligand specificity of the (adenosine 3',5'-monophosphate)-binding site of yeast glyceraldehyde-3-phosphate dehydrogenase. Interaction with adenosine derivatives and pharmacologically-active compounds.

The high-affinity cAMP-binding site of form-II yeast glyceraldehyde-3-phosphate dehydrogenase has a marked specificity for adenosine derivatives, such ligands including N6-substituted adenosine derivatives active as cytokinins n plant systems and adenine nucleotides. Of a wide range of nucleotides and nucleosides examined only adenosine derivatives bind to the cAMP binding site. A variety of antimitotic compounds (including colchicine, colcemid and phenylcarbamate derivatives), adrenergic receptor antagonists (alprenolol and propranolol) and non-steroidal anti-inflammatory agents (notably indomethacin and flufenamic acid) displace cAMP from glyceraldehyde-3-phosphate dehydrogenase. Colchicine, colcemid, N6-furfuryladenosine, indomethacin, flufenamic acid and propranolol inhibit cAMP binding to the enzyme in an apparently competitive fashion. Given the evolutionary conservatism and abundance of glyceraldehyde-3-phosphate dehydrogenase, the affinity of the cAMP-binding site of this enzyme for a variety of structurally-disparate pharmacologically-active compounds compromises simple one-site interpretations of physiological responses to these agents.

Adenosine↗
PubMed1985

Determination of the complete amino-acid sequence of porcine miniplasminogen.

The complete amino acid sequence of porcine miniplasminogen (Mr 37 600), comprising 341 residues, was determined by automated Edman degradation in a liquid-phase or solid-phase sequenator. Selected fragments were produced by cleavage with 2-(2-nitrophenylsulfenyl)-3-methyl-3'-bromoindolenine (BNPS-skatole), cyanogen bromide, hydroxylamine, Staphylococcus aureus protease or trypsin or with combinations thereof and by activation with urokinase. The sequence obtained was compared with the known sequences of human and bovine miniplasminogen, indicating that the porcine molecule apparently contains the same structural and functional domains as the protein of the other two species. Porcine miniplasminogen has a sequence homology of 83% with human and of 79% with bovine miniplasminogen; 74% of the amino acids are identical in all three species. The results show a higher degree of evolutionary conservatism in the structurally and/or functionally vital regions of the molecule (active site residues, kringle 5).

Amino Acid Sequence↗
PubMed2005

More vein, less plastic.

Use of arteriovenous fistulas, grafts and central venous catheters for haemodialysis access varies considerably, because of perceived patient variables and preferences of surgeons, nephrologists and dialysis staff. Evidence clearly indicates that the arteriovenous fistula is superior to other methods of access in terms of patient survival, flow rates, patency, infection rates, expense and ease of maintenance. Strategies to increase the use and longevity of fistulas for definitive haemodialysis access include vein preservation, early referral for fistula surgery, preoperative clinical and ultrasound assessment of the venous and arterial systems, access surveillance, good cannulation technique, and aggressive conservatism in surgical and/or radiological correction of fistula problems.

Arteriovenous Shunt, Surgical↗
PubMed1977

Recent advances in general surgery.

In order to give an overview of recent advances in general surgery, it is necessary to define: (i) what is general surgery; (ii) what is recent; and (iii) what constitutes an advance. General surgery appears to have entered an era of conservatism. This is particularly evident in the surgery of breast cancer, peptic ulceration, varicose veins, liver trauma, portal hypertension, upper gastrointestinal bleeding, and hiatal hernia. Controlled clinical trials in surgery have become popular. The following are considered to be advances: parenteral nutrition, suction drainage, control of Gram-negative sepsis, bypass surgery for pathological obesity, and a discriminatory approach to transplant surgery.

Anti-Bacterial Agents↗
PubMed1981

Colorectal injuries.

Forty-two cases of colorectal injury occurring over a five-year period at the Princess Alexandra Hospital are described. The ratio of penetrating trauma to blunt trauma was approximately 2:1. There are a number of alternative methods of survival management available. The indications and problems associated with each are discussed. Surgeons should match the appropriate treatment to the individual problem, with the emphasis on conservatism.

Adolescent↗
PubMed2000

The use of evidence-based medicine in the practice of consultant physicians. Results of a questionnaire survey.

BACKGROUND: Information is lacking about the extent to which Australasian physicians apply methods of evidence-based medicine (EBM) in routine practice. AIMS: To assess the frequency and predictors of use of EBM methods in a sample of consultant physicians in adult medicine. METHODS: Self-administered questionnaires were distributed to a convenience sample of 545 physicians from October 1998 to January 1999. RESULTS: One hundred and eleven questionnaires were returned (20% response rate). Ninety-eight (88%) respondents formulated five or less clinical questions per week; 69 (62%) undertook five or more evidence searches per week, the majority as MEDLINE searches involving therapeutic topics. Respondents identified insufficient time (74%), limited search skills (41%), and limited access to evidence (43%) as search impediments. In determining evidence quality, 37% frequently relied on global impressions, while 22% frequently applied explicit critical appraisal (p=0.008). Efficiency of literature searches was rated on average as good/very good by 18%, fair by 52% and poor by 30%. As a result of EBM, 47% frequently had confidence in pre-existing decisions increased, 39% gained improved knowledge, and 5% altered clinical decisions. Frequently encountered inhibitors to changing practice were personal conservatism (40%), organisational constraints (40%), and interdisciplinary tensions (39%). Perceived weaknesses of EBM included: limited applicability to individual patients (26%); evidence deficiencies (25%); and too time consuming (13%). In making EBM more attractive, one third requested reliable evidence sources at the point of care. CONCLUSIONS: The application of EBM to routine practice by physicians is constrained by deficient EBM skills, limited access to evidence, lack of time, and cognitive and environmental factors. Targeted education in EBM and systems that quickly deliver high-quality evidence at the point of care are needed in realising the full potential of EBM to improve care.

Australia↗
PubMed1995

A force of magical activity: the introduction of insulin treatment in Britain 1922-1926.

The discovery of insulin by Banting and Best in 1992 is the subject of many papers and one authoritative book (Bliss M. The Discovery of Insulin. Chicago: University of Chicago Press, 1982. See also Bliss M. Rewriting medical history: Charles Best and the Banting and Best myth. J Med Hist 1993; 48: 253-274.). This paper charts the introduction of insulin in England and examines its effects on medical practice. Before 1922 there were few effective drugs and only one (thyroid extract) which had to be taken continuously. Insulin was radically different; it restored weight and vigour and allowed survival in diabetic coma and after surgery but was potentially dangerous because of the possibility of hypoglycaemia, had to be given by injection, and the dose varied with the amount of food and exercise. The immediate questions to be answered after the supply of insulin was assured were how could such a powerful drug be kept out of the hands of ignorant people (a phrase used by The Times), who would administer it, and who would supervise the treatment? Within a year further problems were identified. Should the aims of treatment be the same as those in the starvation era? Could the diet be liberalized? How much biochemical monitoring was necessary? I set the scene by describing how, from Minkowski's announcement (1889) that pancreatectomy caused severe diabetes, most clinicians and physiologists believed that the pancreas (and specifically the islets of Langerhans) produced an internal secretion which controlled carbohydrate metabolism. After Murray's (1891) demonstration that myxoedema could be cured by thyroid extract, it was assumed that diabetes would soon yield in the same way. Yet by the beginning of the First World War most experts were pessimistic about isolating the hypothetical internal secretion and had pinned their hopes on starvation treatment. In the decade before the introduction of insulin the management of diabetes was grim; patients were kept in hospital for weeks or months, while their calorie intake and glucose excretion was meticulously recorded. They were in the wards of physicians with a strong interest in biochemistry whose forte was analysing urine not looking after patients. When the Medical Research Council set up a multicentre trial of insulin in late 1922 they enrolled the physician biochemists who produced the early publications and became the experts. The narrow views and innate conservatism of these doctors with the inflexibility of the system in (London) teaching hospitals meant that insulin treatment became a straightjacket for many patients.(ABSTRACT TRUNCATED AT 400 WORDS)

Canada↗