A view of paediatric outcomes research

No Abstract. South African Medical Journal Vol. 95(10) 2005: 785-78

Private-sector caesarean sections in perspective

No Abstract

Is registrarship a different experience for women?

Objective. To detennine differences between male and female registrars in their subjective perceptions and experience of a paediatrics registrar training programme.Design. Cross-sectional survey.Setting. University-affiliated teaching hospitals.Participants. Thirty-nine paediatrics registrars.Results. Of the 39 respondents, 18 (46%) were women. Men were older than women (30A v. 29.1 years, p = 0.049). There were no gender differences in the number of hours worked per week (65.7 v. 67.8 hours, P = 0.384) or participation in the training programme. Success rates in postgraduate paediatrics examinations were also similar for the two groups (85% v. 76%, P = 0.486). Male registrars were more likely to have 'moonlighted' (43% v. 6%, P =0.011). FIfty-nine per cent of female registrars believed that they had been disadvantaged in their careers because of their gender, 28% felt that more was expected of a woman registrar and 22% of the female trainees claimed to have been subjected to sexual harassment. The majority (82%) of women registrars contemplated taking time off from practising clinical paediatrics in the Mure (postregistrarship), mainly for child-bearing purposes. Female respondents criticised both the academic department and the hospital authorities for discriminatory practices, such as the awarding of home loans to men and women who were breadwinners only. The findings suggest that women registrars do feel disadvantaged and discriminated against, and highlight the need for flexible, creative programmes that recognise the needs and aspirations of female registrars and, indeed, all women in academic medicine

A review of selection criteria used by medical scheme advisers to approve or deny procedures with a cosmetic component

Objective. To review and apply statistical tests to the selection criteria used by two medical advisers to approve or deny applications for three common cosmetic or reconstructive procedures within a large group of medical schemes.Design. A retrospective descriptive study which applied multiple regression analysis, frequency analysis, comparison of means and simple correlations to the data sets for three procedures.Setting. Administrative records from the clinical files of medical advisers and the administrator's claims database.Subjects. Data were reviewed for 1 143 members who, between January and December 1996, submitted applications for breast reduction, excimer laser refractive surgery, or otoplasty.Main outcome measures. The primary outcome measure was the statistical relationship between medical advisers' selection criteria and final decision. In addition, the financial implications of these cosmetic/reconstructive procedures were assessed.Results. For the three procedures reviewed there was a statistically significant relationship behveen 5 of 13 preoperative criteria requested and the medical advisers' opinion. Excimer laser surgery was generally approved on the basis of the refractive error (myopia> -3.00; astigmatism > -1.5 dioptres); otoplasty was generally approved for children aged :≤ 12.years; and breast reduction was usually covered for women with a sternal-nipple distance > 29.0 cm and with a cup size ≥ DD. The other data submitted were similarly distributed between the approved and denied groups.Conclusions. Review of medical advisers' decisions is important in an era of protocols, guidelines and 'standard operating procedures'. Selection criteria for approval of applications for medically necesssary cosmetic/reconstructive surgery must be reviewed and revised to provide a reliable, reproducible and statistically valid process

Screening for abdominal aortic aneurysm - a pilot study in six medical schemes

No Abstract

Experimental analysis of impacts with large elastic deformations. Part 1: linear motion

A measurement system is presented which uses a small number of sensors to capture relevant information by a limited number of measurements during a high-speed impact between two lightweight bodies. Two laser Doppler vibrometers and a piezoelectric accelerometer are arranged to capture data from which the variation of deformations, velocities and forces over time during an impact can be determined. The golf club - ball impact is chosen as an example. Large elastic deformations are measured on the golf ball during the impact and these can be related to the variation of the impact force over time. This information leads to greater understanding of the relationship between two impacting bodies and can be used in the validation of analysis by techniques such as finite element modelling

Developments in laser Doppler accelerometry (LDAc) and comparison with laser Doppler velocimetry

This paper outlines the principles and early development of an interferometric technique for remote measurement of vibration acceleration — laser Doppler accelerometry (LDAc). One of the key advantages of LDAc over laser Doppler velocimetry (LDV) is its ability to measure extremely high vibration accelerations and shocks, effectively without limit, and this point is expanded upon in the paper. Early LDAc development showed how unwanted, velocity-dependent optical beats could occur on the photodetector but novel use of a frequency shifting device, whose primary purpose was for direction discrimination, was successful in isolating the required acceleration-dependent beat. A problem remained in the rate at which the velocity-dependent and acceleration-dependent beats broadened during target motion. In a further development, it was possible to 'select’ a back reflection to produce a velocity-dependent beat that was NOT modulated in the presence of target motion. The acceleration-dependent beat could then be demodulated and preliminary results are given to demonstrate this outcome