MB ChB Research Articles

Dr Catherine Chisholm, 'children's physician': Her work for child welfare and feminist networking in Manchester.

Catherine Chisholm BA MB ChB MD FRCP CBE (1879-1952) is celebrated as the first woman to qualify in medicine from Manchester University in 1904 and is remembered for founding the Manchester Babies Hospital in 1914 (later renamed in 1935 as the Duchess of York Hospital for Babies). She was indefatigable in her pursuit to improve the education and status of women doctors; the first woman member and president of the British Paediatric Society; first woman president of the Manchester Medical Society and was mainly responsible for establishing the Medical Women's Federation in 1917. Her career was a complex mixture of medical and social networks that linked her work as a children's physician to the Manchester Public Health Committee, Liberal politics and feminist groups. These networks played an important role in Dr Chisholm's successful career and are at the centre of this paper.

Professor Linda Cardozo OBE MB ChB MD FRCOG, 15 September 1950-21 September 2023.

Professor Linda Cardozo OBE MB ChB MD FRCOG, 15 September 1950-21 September 2023.

Changes in the empathy levels of a group of undergraduate medical students: A longitudinal study

Background. The concept of empathy in students has gained significant attention in medical education. Whether implementing formal educational interventions to promote long-term and effective empathy levels leads to sustained increased empathy levels in students, is however less clear. Objectives. The study aimed to evaluate the trajectory of medical students’ self-perceived empathy levels during their 6-year MB ChB degree. Methods. A longitudinal, prospective study was conducted over 4 years. A cohort of 292 medical students was invited to participate. Participants completed the Jefferson Scale of Empathy for Students (JSE-S) at three intervals during their studies. The students attended two workshops related to empathic patient interactions during this time. The JSE-S mean score by age and gender was compared, making use of a linear regression model. Results. A total of 119 students completed the study. Students’ total empathy levels were similar during the first and the last measuring point (110), but there was a significant rise in the intermediate measuring point (113.3). When the male and female cohorts’ scores were interpreted separately, both genders demonstrated a similar pattern to the total score, although females’ JSE-S scores were higher than the males. Conclusion. The results of the study confirm that educational interventions can increase students’ self-perceived empathy levels; however, we suggest that students require reinforcement and multiple opportunities to practise and observe empathic communication with patients to sustain high levels of empathy. Follow-up sessions to specifically target the promotion of empathy should be implemented; otherwise the long-term effect of educational interventions might be limited.

MB ChB fifth-year student response to e-learning in orthopaedic surgery during COVID-19

Background. With the onset of the COVID-19 pandemic and the subsequent country-wide lockdown, South African (SA) universities were forced to quickly adapt to teaching that minimised or eliminated in-person contact. The pandemic period necessitated rapid changes to the way in which learning occurs and resulted in significant shifts in the academic environment. There is limited evidence in the literature to support e-learning in undergraduate orthopaedic training. This is the first study of its kind evaluating e-learning in orthopaedic surgery in a middle-to-low-income country.Objectives. To identify the University of Cape Town fifth-year MB ChB cohort’s attitudes towards the e-learning component of blended learning during the COVID-19 pandemic. It also aimed to investigate whether e-learning facilitates comparable levels of confidence and results among students and face-to-face methods.Methods. Multi-year cross-sectional survey analysis was completed by retrospectively analysing the students’ end-of-block evaluations and end-of-block marks. Responses from the cohorts between 2016 and 2020 were compared.Results. Regarding course definition, workload, course organisation, intended preparation and course presentation, the 2020 cohort’s responses were similar to those of previous years. The 2020 cohort agreed that the e-learning material was relevant; this response was higher than in previous years. They also agreed that the online practical sessions were useful and that the course stimulated more interest. Significantly, they also strongly agreed that the online course was easier to attend and participate in than in previous years. The 2020 cohort perceived the end-of-block assessment to be somewhat unreasonable; however, this cohort yielded similar grades compared with previous cohorts. Subjectively, the students’ responses to e-learning were positive, as many of them welcomed the usefulness and stimulation of online media as a study tool. Students felt that more time should be made available to work through online material and that there was incongruity between the content taught and the content of the end-of-block assessments.Conclusion. Subjectively, the students’ responses to e-learning were positive, as many of them welcomed the usefulness and stimulation of online media. With comparable outcomes in terms of student confidence and final marks (compared with traditional teaching only), it further encouraged a move towards formulating a novel blended learning curriculum. With these positive findings, we were able to explore the possibilities of developing an e-learning course curriculum incorporating international blended learning practices, using locally sourced SA evidence-based literature to provide orthopaedic teaching relevant to our unique setting.

Saving life and limb.

Academic Emergency MedicineEarly View REFLECTION Saving life and limb Folafoluwa O. Odetola MB ChB, MPH, Corresponding Author Folafoluwa O. Odetola MB ChB, MPH [email protected] orcid.org/0000-0001-8001-9630 Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Michigan Health System, Ann Arbor, MI, USA Correspondence Folafoluwa O. Odetola, Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Michigan Health System, G030W, 2800 Plymouth Road, Ann Arbor, MI 48109, USA. Email: [email protected]Search for more papers by this author Folafoluwa O. Odetola MB ChB, MPH, Corresponding Author Folafoluwa O. Odetola MB ChB, MPH [email protected] orcid.org/0000-0001-8001-9630 Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Michigan Health System, Ann Arbor, MI, USA Correspondence Folafoluwa O. Odetola, Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Michigan Health System, G030W, 2800 Plymouth Road, Ann Arbor, MI 48109, USA. Email: [email protected]mich.eduSearch for more papers by this author First published: 06 January 2023 https://doi.org/10.1111/acem.14657 Funding information: None. Supervising Editor: Dr. Brian Zink. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Early ViewOnline Version of Record before inclusion in an issue RelatedInformation

John Nelson Norman MB ChB, MD, PhD, DSc, FRCS (Edin, Glas), FFOM, C Biol, Fi Biol, FRSB Born: 16 May 1932 Died: 27 September 2022

John Nelson Norman MB ChB, MD, PhD, DSc, FRCS (Edin, Glas), FFOM, C Biol, Fi Biol, FRSB Born: 16 May 1932 Died: 27 September 2022

594. An Open-Label Study in Healthy Volunteers to Determine the Absolute Bioavailability of, the Effect of Food and Dosing by Nasogastric Tube upon the Pharmacokinetics of a Single Oral Dose of Olorofim (OLO)

Abstract Background OLO is a novel antifungal active vs. Aspergillus (including azole-resistant strains), resistant moulds (e.g., Lomentospora prolificans), and dimorphic moulds. Information on absolute bioavailability and effect of food upon the pharmacokinetics (PK) of OLO when administered as a 30 mg tablet, including feasibility of alternative enteral delivery, is required for appropriate guidance on dosing. Methods Healthy male and female subjects in Cohorts A and B (6/cohort; high carbohydrate /low fat meals at 8 and 24 h for Cohort A and low carbohydrate/high fat meals for Cohort B ) participated in 3 treatment periods; single doses of 150 mg OLO as a 2-h IV infusion, a fasted PO dose (after overnight fast), and a fed single PO dose (30 min after starting a high fat breakfast). Healthy subjects in Cohort C participated in 2 treatment periods and received fasted single doses of 150 mg OLO either PO as intact tablets or via NG tube (tablets dispersed in water). PK sampling was performed for 120 h after each dose, with at least 10 days between dosing occasions per subject. Results The absolute bioavailability of a fasted single PO dose of OLO was found to be 67%. Administering OLO in the presence of food resulted in slight reduction in overall exposure, with an approximate 30% reduction in Cmax (Table 1). Multiple post-dose OLO peaks were observed for most subjects regardless of dose route or fed state; peaks typically coincided with meal times (Figure). OLO systemic exposure was similar for intact tablets given PO and tablets dispersed in water given via NG tube (Table). Statistical Analysis of Olorofim PK parameters for Cohorts A, B and C Conclusion OLO (30 mg tablet) has good oral bioavailability and based upon the minimal impact of a high-fat breakfast upon overall exposure, can be administered with or without food. No dose adjustment is needed if switching from oral dosing with intact tablets to dosing tablet in water via NG tube. Disclosures Karen Cornelissen, PhD, F2G: Employee Paul A. Newell, MB BS, AstraZeneca: Stocks/Bonds|F2G: Stocks/Bonds John H. Rex, MD, Advent Life Sciences: Operating Partner|Advent Life Sciences: Ownership Interest|AMR Action Fund: Advisor/Consultant|AstraZeneca: Stocks/Bonds|Basilea Pharmaceutica: Advisor/Consultant|Bugworks Research, Inc.: Advisor/Consultant|F2G, Limited: Employee|F2G, Limited: Stocks/Bonds|Forge Therapeutics: Advisor/Consultant|GlaxoSmithKline: Advisor/Consultant|Pfizer Pharmaceuticals: Honoraria|Sumitovant: Advisor/Consultant Samuel Israel, MBBS, Labcorp: Eemployee James Bush, MB ChB, PhD, Labcorp: Employee (Salaried)|Labcorp: Stocks/Bonds.

Floating hip with floating acetabulum and bilateral pelvic fractures: a case report

Orthopedic and Traumatology Department, Sohag University Hospitals (SUH), Sohag University, Sohag, Egypt Financial Disclosure: The authors report no conflicts of interest. Correspondence to Wael Salama, MB ChB, MSc, PhD, MD, Orthopedic Department, Faculty of Medicine, Sohag University, 82524, Sohag, EgyptTel: +00393270332807; fax: +2 934602963;e-mail: [email protected].

Obituary: Samuel J. Machin MB ChB FRCP FRCPath, 26 March 1949 – 2 October 2021

On Saturday 2 October, we were saddened to learn of the death of Professor Samuel (Sam) Machin after a short, final illness. Sam was a larger than life character who had a certain vision about how haematology should be and strived to achieve modernization. Through his distinguished career, he was involved with many of the National and International societies and committees involved in haematology and standardization. Sam studied medicine at Sheffield University from 1966 to 1971. He received his haematology training at Manchester Royal Infirmary before taking a Senior Registrar post at the Middlesex Hospital Medical School. In 1979, he joined Jos Vermylen and others at the Department of Vascular and Haemostasis Research, KU, Leuven. It was here where he commenced his career in haemostasis and thrombosis, researching on platelets, prostacyclin and haemolytic uraemic syndrome. Returning to London, he was appointed Consultant Haematologist (the youngest at the time to achieve that post in the UK) and worked with Professor Jimmie Stewart. Sam’s career progressed with his achievements leading to his appointment as Professor of Haematology at The Middlesex and later University College London (UCL). A large number of scientists and junior doctors received expert training in the Department, many obtaining MD and/or PhD. Almost without exception, trainees whom Sam mentored and supported have gone on to become consultants, professors, heads of department and divisions in hospitals, universities, the National Blood Service and industry. He took an active role in organizing the UCL Haemostasis Training Course, which helped haematologists from many parts of the world to obtain Fellowship of the Royal College of Pathologists. In 1981, Sam founded what was to become the Haemostasis Research Unit at UCL and directed research in many aspects of haemostasis and thrombosis. His primary areas were platelet function, thrombotic thrombocytopaenia, antiphospholipid syndrome and the prothrombotic effects of combined oral contraceptives. He was also interested in laboratory automation and set up an analyser and reagent evaluations unit that studied most new haematology and coagulation systems. He understood the need to communicate and encouraged staff to present their data at conferences, and he co-authored over 400 peer-reviewed publications. Sam worked tirelessly in supporting the interests of many societies and organizations. He was President of the British Society for Haemostasis and Thrombosis (2001-03) and British Society for Haematology (2005-07), serving as treasurer from 1994 to 2000. He chaired the British Committee for Standardisation in Haematology, UK NEQAS Haematology Steering Committee (2006-11) and the International Council for Standardization in Haematology (2007-20). He was Treasurer of the International Society for Thrombosis and Haemostasis (ISTH) for the 2003 congress in Birmingham and Vice Chairman of the ISTH Scientific Standards Committee. In 2007, Sam led the reorganization and modernization of the International Council for Standardization in Haematology and remained as Chair of this body until 2020. His enthusiasm and energy resulted in the publication of more than 30 peer-review publications on standardization in haematology, including many guidance and recommendation documents. He was a supporter of laboratory haematology as a discipline. He encouraged the late Berend Houwen to develop further meetings on “Technical Innovations in Laboratory Hematology,” which later led to the formation of the International Society for Laboratory Hematology, of which Sam became a board member. He served on the Editorial Board of this journal (International Journal of Laboratory Hematology) and remained an active reviewer (even saying just 2 weeks prior to his death that he would like to receive more manuscripts). Sam enjoyed playing and watching sport, being passionate about cricket, hockey and rugby league. A kind and generous man, although sometimes controversial because he liked to speak his mind. He had a way of cutting through bureaucracy, side stepping obstacles and getting things done. He is survived by his wife Jean, son Robert and daughters Clare and Rowena as well as 5 grandchildren.

Perioperative Health Services Research: Far Better Played as a Team Sport.

Peden, Carol J. MB ChB, MD, MPH*,†; Ghaferi, Amir A. MD, MS‡; Vetter, Thomas R. MD, MPH§; Kain, Zeev N. MD, MBA‖,¶,# Author Information

Development of a baseline assessment tool to establish students’ foundational knowledge of life sciences at entry to university

Background. Universities in South Africa use the Grade 12 school-leaving examinations to measure whether students have the knowledge and skills needed to enter tertiary-level education. However, there is much discussion on the effectiveness of these assessments to measure the preparedness of students for their first year at university. To facilitate the appropriate teaching and learning of anatomy and physiology, there is a need to assess students’ baseline knowledge of life sciences at entry to their first year at university. Objectives. To develop and refine an anatomy and physiology foundational knowledge assessment (A&P foundational knowledge assessment), which looks back to the content of the Grade 12 life sciences curriculum and forward to the first-year anatomy and physiology curricula. Methods. Three hundred and seventy-one first-year students (occupational therapy, physiotherapy and MB ChB) wrote the A&P foundational knowledge assessment. Classic item and test analysis was done using Iteman 4.3 software (Assessment Systems Corp., USA). Results. The Kuder-Richardson formula 20 (KR-20) reliability score, which ranges from 0 to 1, was 0.64 for all the students. For MB ChB students, the KR-20 value was lower (0.57) compared with that for occupational therapy and physiotherapy students (0.66). The KR-20 scores for the 21 physiology and 16 anatomy items were 0.48 and 0.57, respectively. A KR-20 score of >0.50 is considered acceptable. The mean difficulty index (range 0 - 1) for physiology was 0.60, and the mean discrimination index was 0.15. For anatomy, the mean item difficulty index was 0.57 and mean discrimination index was 0.21. Conclusion. Based on the acceptable reliability value, the assessment was shown to be an effective instrument to measure students’ foundational knowledge in human anatomy and physiology, which is part of life sciences.

The Anesthesia Patient Safety Foundation Stoelting Conference 2019: Perioperative Deterioration-Early Recognition, Rapid Intervention, and the End of Failure-to-Rescue.

The Anesthesia Patient Safety Foundation Stoelting Conference 2019: Perioperative Deterioration-Early Recognition, Rapid Intervention, and the End of Failure-to-Rescue.

In memoriam: Mr Jimmy James (1940–2019). His contribution to the training of surgeons in Malawi and the College of Surgeons of East Central and Southern Africa (COSECSA) region

John “Jimmy” James MB ChB FRCS Ed passed on the 4th December 2019, the day we had our COSECSA annual general meeting in Kampala, Uganda. He died after a short battle with metastatic prostate cancer.

Not All COVID-19

Not All COVID-19

Building a Career in Cardiovascular Research: A Conversation With Barbara Casadei, MD, DPhil.

Building a Career in Cardiovascular Research: A Conversation With Barbara Casadei, MD, DPhil.

Medical Education and E-Learning During COVID-19 Pandemic: Awareness, Attitudes, Preferences, and Barriers Among Undergraduate Medicine and Nursing Students at Makerere University, Uganda.

Given the dearth need for healthcare workers in the control of the ongoing COVID-19 pandemic, e-learning has been adopted in many settings to hasten the continuation of medical training. However, there is a paucity of data in low resource settings on the plausibility of online learning platforms to support medical education. We aimed to assess the awareness, attitudes, preferences, and challenges to e-learning among Bachelor of Medicine and Bachelor of Surgery (MBChB) and Bachelor of Nursing (B.NUR) students at Makerere University, Uganda. An online cross-sectional study was conducted between July and August 2020. Current MBChB and B.NUR students aged 18 years or older constituted the study population. Using Google forms, a web-based questionnaire was administered through the Makerere University mailing list and WhatsApp messenger. The questionnaire was developed using validated questions from previously published studies. Overall, 221 participants responded (response rate = 61%). Of the 214 valid responses, 195 (92.1%) were Ugandans, 123 (57.5% were male, and 165 (77.1%) were pursuing the MB ChB program. The median age was 23 (18 to 40) years. Ownership of computers, smartphones, and email addresses were at 131 (61.2%), 203 (94.9%), and 208 (97.2%), respectively. However, only 57 (26.6%) respondents had access to high or very high quality internet access. Awareness and self-reported usage of e-learning (MUELE) platforms were high among 206 (96.3%) and 177 (82.7%) respondents, respectively. However, over 50% lacked skills in using the Makerere University e-learning (MUELE) platform. About half (n = 104, 49%) of the students believed that e-learning reduces the quality of knowledge attained and is not an efficient method of teaching. Monthly income (P = .006), internet connectivity quality (P < .001), computer ownership (P = .015) and frequency of usage of academic websites or applications (P = .006) significantly affected attitudes towards e-learning. Moreover, internet costs and poor internet connectivity were the most important barriers to e-learning reported by 199 (93%) and 179 (84%) students, respectively. Sensitization and training of students and faculty on e-learning and use of existing learning platforms are important to improve the attitude and use of e-learning. Blended online and use of offline downloadable learning materials would overcome the challenges related to the variable quality of internet access in the country.

1670O - ADP-A2M4 (MAGE-A4) in patients with synovial sarcoma

1670O - ADP-A2M4 (MAGE-A4) in patients with synovial sarcoma

The impact of David Paintin's work

David Paintin, Hon FFSRH, MB ChB, FRCOG Emeritus Reader in Obstetrics and Gynaecology, University of London, London, UK 18 December 1930 –30 March 2019 David Paintin believed that women should...

Obituary: Peter Ormerod

Peter Ormerod has died at the age of 68. A past president of the British Thoracic Society (BTS), his research helped define drug treatment, public health measures and a national...

Measuring empathy in a group of South African undergraduate medical students using the student version of the Jefferson Scale of Empathy.

BackgroundPatient-centred care is a model of care that demands healthcare providers change their focus from the disease to the patient and his or her perceived physical and psycho-social needs. This model requires healthcare workers to listen actively and to have effective communication skills and well-developed levels of empathy.AimThe aim of this study was to determine the suitability of the Jefferson Scale for Empathy (JSE-S) as a valid test for empathy in third-year medical students at a South African university and also to determine the baseline level of empathy in this same group of students.SettingThe study took place at a medical school in the Western Cape, South Africa. This medical degree (MB ChB) is a 6-year programme. Students are first exposed to patients within their second year of training, but it is during their third-year that they start their clinical rotations. We wanted to test whether our empathy training would give students the necessary skills and enable them to establish good empathic communication habits in order to prevent a fall in empathy during this vulnerable period.MethodsThis article explores the suitability of the student version of the JSE-S as a valid test for empathy, within the South African medical school context. We briefly discuss the psychometrics and the scores against what is already known in countries like ours, specifically, developing nations where cultural and language differences exist in the student populations. Furthermore, we explore whether the JSE-S is a valid scale for pre- and post-intervention measurement of medical student empathy within our context and discuss the limitations of self-assessment. We also report on baseline levels of empathy in third-year medical students.ResultsTwo hundred and six third-year medical students (69% females) completed the JSE-S prior to the intervention. Females and students aged 25 years and older had significantly higher scores than males and those 22 years old or less. The mean JSE was 109.98 (SD = 12.54), which is lower than most internationally reported scores. The Cronbach’s alpha coefficient was 0.81, indicating scale reliability and consistency, but graded item response testing highlighted variance in three reverse-scored questions.ConclusionThe JSE-S is an appropriate and valid scale for measuring levels of empathy in undergraduate medical students in South Africa. However, language may need to be clarified in the negatively phrased items.