Diphtheria and Australian public health: bacteriology and its complex applications, c. 1890-1930.

During the 1890s, the childhood infectious disease of diphtheria became closely identified with the emerging science of bacteriology and the new laboratory-based public health.' Along with the organisms causing typhoid fever and tuberculosis, the Klebs-Loeffler bacillus was one of the earliest to be clearly isolated (in 1883) and causally linked to disease. Compared with other illnesses, such as scarlet fever, diphtheria had a clear bacteriological presence and an apparently simple mode of action, and, despite ongoing debate over the laboratory data in the 1880s and 1890s, many physicians and public health officials saw possibilities for engineered intervention into its spread and progress. Particularly after the widely-publicized failure of tuberculin in the early 1890s, and the success of antitoxin therapy for diphtheria from 1894, the management of diphtheria came to stand for new bacteriological modes of infectious disease control and prevention. For example, in 1896 a contributor to the Journal of State Medicine wrote: "Preventive Medicine has become more and more lost in Bacteriology. To many a micro-organism is allsufficient; they would summarily dispose of Diphtheria in three simple steps-examine all mouths, find Klebs-Loeffier bacillus, isolate the subject"

Media coverage of health issues and how to work more effectively with journalists: a qualitative study

<p>Abstract</p> <p>Background</p> <p>The mass media has enormous potential to influence health-related behaviours and perceptions. Much research has focused on how the media frames health issues. This study sought to explore how journalists in Australia select and shape news on health issues.</p> <p>Methods</p> <p>The study involved semi-structured interviews with 16 journalists from major Australian print, radio and television media organisations reporting on avian influenza and pandemic planning. Journalists, including reporters, editors and producers, were interviewed between October 2006 and August 2007. Thematic analysis was used to draw out major lessons for health communicators.</p> <p>Results</p> <p>Journalists routinely attempted to balance different, sometimes competing, aims amidst significant operational constraints. They perceived the most trusted sources on health issues to be respected and independent doctors. Specialist health and medical reporters had a more sound technical knowledge, channels to appropriate sources, power within their organisations, and ability to advocate for better quality coverage.</p> <p>Conclusions</p> <p>An awareness of how to work with the media is essential for health communicators. This includes understanding journalists' daily routines, being available, providing resources, and building relationships with specialist health reporters.</p

Writing the risk of cancer: Cancer risk in public policy

In this paper we examine how cancer risk is written in cancer policy documents from the English speaking OECD nations. We offer an audit of the multiple ways in which cancer risk is conceptualised and presented in health policy and professional contexts with the long term aim of comparing this with lay conceptualisations. Our study sampled cancer policy documents produced by six nations, the World Health Organization and the International Union for Cancer Control since 2000 and analysed them iteratively through questions and codes. Whilst the documents contained a comprehensive range of concepts and locations for cancer risk, our analysis found two predominant representations: firstly, well established metaphors that depict cancer as uniformly dreadful and life threatening; and secondly, through a concentration on five behavioural risk factors (tobacco smoking, drinking alcohol, inadequate nutrition, sun exposure and physical inactivity) and one bodily state (overweight). We discuss the implications of this dual focus and of other tensions within ideas about cancer risk that we identified for risk communication

Joe Pawsey and the Founding of Australian Radio Astronomy

This open access book is a biography of Joseph L. Pawsey. It examines not only his life but the birth and growth of the field of radio astronomy and the state of science itself in twentieth century Australia. The book explains how an isolated continent with limited resources grew to be one of the leaders in the study of radio astronomy and the design of instruments to do so. Pawsey made a name for himself in the international astronomy community within a decade after WWII and coined the term radio astronomy. His most valuable talent was his ability to recruit and support bright young scientists who became the technical and methodological innovators of the era, building new telescopes from the Mills Cross and Chris (Christiansen) Cross to the Parkes radio telescope. The development of aperture synthesis and the controversy surrounding the cosmological interpretation of the first major survey which resulted in the Sydney research group's disagreements with Nobel laureate Martin Ryle play major roles in this story. This book also shows the connections among prominent astronomers like Oort, Minkowski, Baade, Struve, famous scientists in the UK such as J.A. Ratcliffe, Edward Appleton and Henry Tizard, and the engineers and physicists in Australia who helped develop the field of radio astronomy. Pawsey was appointed the second Director of the National Radio Astronomy Observatory (Green Bank, West Virginia) in October 1961; he died in Sydney at the age of 54 in late November 1962. Upper level students, scientists and historians will find the information, much of it from primary sources, relevant to any study of Joseph L. Pawsey or radio astronomy. This is an open access book

Joe Pawsey and the Founding of Australian Radio Astronomy

This open access book is a biography of Joseph L. Pawsey. It examines not only his life but the birth and growth of the field of radio astronomy and the state of science itself in twentieth century Australia. The book explains how an isolated continent with limited resources grew to be one of the leaders in the study of radio astronomy and the design of instruments to do so. Pawsey made a name for himself in the international astronomy community within a decade after WWII and coined the term radio astronomy. His most valuable talent was his ability to recruit and support bright young scientists who became the technical and methodological innovators of the era, building new telescopes from the Mills Cross and Chris (Christiansen) Cross to the Parkes radio telescope. The development of aperture synthesis and the controversy surrounding the cosmological interpretation of the first major survey which resulted in the Sydney research group's disagreements with Nobel laureate Martin Ryle play major roles in this story. This book also shows the connections among prominent astronomers like Oort, Minkowski, Baade, Struve, famous scientists in the UK such as J.A. Ratcliffe, Edward Appleton and Henry Tizard, and the engineers and physicists in Australia who helped develop the field of radio astronomy. Pawsey was appointed the second Director of the National Radio Astronomy Observatory (Green Bank, West Virginia) in October 1961; he died in Sydney at the age of 54 in late November 1962. Upper level students, scientists and historians will find the information, much of it from primary sources, relevant to any study of Joseph L. Pawsey or radio astronomy. This is an open access book

Schools are open during the coronavirus outbreak but should I voluntarily keep my kids home anyway, if I can? We asked 5 experts

We asked five experts to answer the question: schools are staying open but should I voluntarily keep my kids home anyway, if I can

Should I stay or should I go? Patient understandings of and responses to source-isolation practices

Isolation of patients, who are colonised or infected with a multidrug-resistant organism (source-isolation), is a common practice in most acute health-care settings, to prevent transmission to other patients. Efforts to improve the efficacy of source-isolation in hospitals focus on healthcare staff compliance with isolation precautions. In this article we examine patients’ awareness, understandings and observance of source-isolation practices and directives with a view to understanding better the roles patients play or could play in transmitting, or limiting transmission, of multidrug-resistant organisms (MRO). Seventeen source-isolated adult surgical patients and two relatives participated in video-reflexive ethnography and interviews. We learned that, although most of these patients wanted to protect themselves and others from colonisation/infection with a MRO, they had a limited understanding of what precautions they could take while in isolation and found it difficult to obtain ongoing information. Thus, many patients regularly left their source-isolation rooms without taking appropriate precautions and were potentially contributing to environmental contamination and transmission. Some patients also interacted with other patients and their personal belongings in ways that exposed other patients, unnecessarily, to colonisation/infection risk. By not providing patients with adequate information on infection risk or how they could contribute to their own safety or that of others, they are denied the opportunity to fully engage in their healthcare. To improve the efficacy of source-isolation and contact precautions in general, patient care providers should consider colonised or infected patients as active partners in reducing transmission and involve patients and relatives in regular, ongoing conversations about transmission prevention

Empathy and affect: what can empathied bodies do?

While there has been much interest in the apparent benefits of empathy in improving outcomes of medical care, there is continuing concern over the philosophical nature of empathy. We suggest that part of the difficulty in coming to terms with empathy is due to the modernist dichotomies that have structured Western medical discourse, such that doctor and patient, knower and known, cognitive and emotional, subject and object are situated in oppositional terms, with the result that such accounts cannot coherently encompass an emotional doctor, or a patient as knower, or empathy as other than a possession or a trait. This paper explores what, by contrast, a radical critique of the Cartesian world view, in the form of a Deleuzean theoretical framework, would open up in new perspectives on empathy. We extend the framework of emotional geography to ask what happens when people are affected by empathy. We suggest that doctors and patients might be more productively understood as embodied subjects that are configured in their capacities by how they are affected by singular ‘events’ of empathy. We sketch out how the Deleuzean framework would make sense of these contentions and identify some possible implications for medical education and practice. Keywords: Empathy, Medicine, Affect, Philosophy, Subjectivit

Grace Under Pressure: a drama-based approach to tackling mistreatment of medical students

A positive and respectful learning environment is fundamental to the development of professional identities in healthcare. Yet medical students report poor behaviour from healthcare professionals that contradict professionalism teaching. An interdisciplinary group designed and implemented a drama-based workshop series, based on applied theatre techniques, to help students develop positive professional qualities and interpersonal skills to deal with challenges in the healthcare setting. We piloted the workshops at the University of Sydney in 2015. Attendees completed evaluation questionnaires and participated in a focus group or interview. Of 30 workshop attendances, there were 29 completed questionnaires and three participants attended a focus group or interview. Workshop activities were rated as ‘very good’ or ‘good’ by 21/22; (95.5%). Thematic analysis of qualitative data highlighted the rationale for participation (to deal with bullying, prevent becoming a bully, learn social skills), workshop benefits (express emotions, learn about status dynamics and deconstructing personalities, empathy, fun), challenges (meeting participants’ expectations, participants’ need for further practice), and implications for medical education (need to develop awareness of others’ perspectives). Our research has shown that there is momentum to challenge mistreatment in medical education. While a multipronged approach is needed to generate systemic change, this pilot offers a positive and creative innovation. It helps students improve their interpersonal skills and sense of self to deal with challenges in the healthcare setting, including mistreatment

Verbatim Theater: Prompting Reflection and Discussion about Healthcare Culture as a Means of Promoting Culture Change

Problem: The mistreatment of medical and nursing students and junior health professionals has been reported internationally in research and the media. Mistreatment can be embedded and normalized in hierarchical healthcare workplaces, limiting the effectiveness of policies and reporting tools to generate change; as a result, some of those who experience mistreatment later perpetuate it. We used a novel, creative approach, verbatim theater, to highlight the complexity of healthcare workplaces, encourage critical reflection, and support long-term culture change. Intervention: Verbatim theater is a theater-for-change documentary genre in which a playscript is devised using only the words spoken by informants. In 2017, 30 healthcare students and health professionals were recruited and interviewed about their experience of work and training by the multidisciplinary Sydney Arts and Health Collective using semi-structured interviews. Interview transcripts became the primary material from which the script for the verbatim theater play ‘Grace Under Pressure’ was developed. The performing arts have previously been used to develop the communication skills of health professional students; this esthetic expression of the real-life effects of healthcare workplace culture on trainees and students was implemented to stimulate consciousness of, and dialogue about, workplace mistreatment in healthcare work and training. Context: The play premiered at a major Sydney theater in October 2017, attended by the lay public and student and practicing health professionals. In November 2017, three focus groups were held with a sample of audience members comprising healthcare professionals and students. These focus groups explored the impact of the play on reflection and discussion of healthcare culture and/or promoting culture change in the health workplace. We analyzed the focus group data using theoretical thematic analysis, informed by Turner’s theory of the relation between ‘social’ and ‘esthetic’ drama to understand the impact of the play on its audience. Impact: Focus group members recognized aspects of their personal experience of professionalism, training, and workplace culture in the play, Grace Under Pressure. They reported that the play’s use of real-life stories and authentic language facilitated their critical reflection. Participants constructed some learning as ‘revelation,’ in which the play enabled them to gain significant new insight into the culture of health care and opened up discussions with colleagues. As a result, participants suggested possible remedies for unhealthy aspects of the culture, including systemic issues of bullying and harassment. A small number of participants critiqued aspects of the play they believed did not adequately reflect their experience, with some believing that the play over-emphasized workplace mistreatment. Lessons Learned: Verbatim theater is a potent method for making personal experiences of healthcare workplace and training culture more visible to lay and health professional audiences. In line with Turner’s theory, the play’s use of real-life stories and authentic language enabled recognition of systemic challenges in healthcare workplaces by training and practicing health professionals in the audience. Verbatim theater provides a means to promote awareness and discussion of difficult social issues and potential means of addressing them