W Indian Med J
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The use of the subxiphoid pericardial window (SPW) in evaluating stable patients with cardiac proximity injuries is presented in a short case series. There were 11 patients with four positive and seven negative SPW. There was one false positive and no false negatives. Review of the literature on the use of the SPW as a diagnostic tool in evaluating cardiac proximity injuries shows the SPW to be a rapid and reliable method of detecting occult cardiac injuries, and is especially useful in areas where emergency echocardiography is not available.
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Comparative Study
Motivation for and concerns about entering a medical programme.
The motivation for and concerns about studying medicine and future career plans of students at the Faculty of Medical Sciences, The University of the West Indies (UWI), were studied using a cross-sectional survey that included Year 1 medical students at both the Mona (Jamaica) and St Augustine (Trinidad and Tobago) medical schools of the UWI. The data were collected using a self-administered questionnaire containing structured questions on demographics and family background, motivation for and concerns about studying medicine and future career preferences. A total of 193 students took part in the study, 103 from Mona and 90 from St Augustine (88% response rate). ⋯ Although the motives that students have reported are varied, there was a reasonable spread of desirable motives. This study provides a baseline for observing possible changes as students advance through medical training. A programme of study that strives to maintain these well-placed motives while providing opportunities for dealing with the concerns of the students will assist in creating caring, empathetic physicians for the Caribbean.
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In industrialized countries, there is growing attention to improving the quality of healthcare provided to patients with terminal or chronic illnesses as they near the end of their lives. Many patients in wealthy nations reportedly die in severe pain, but little has been documented about pain or suffering at the end of life in less economically developed nations. ⋯ In the absence of national or institutional policy on pain relief or end of life care, most of these patients and their caregivers seek spiritual comfort. This paper illustrates the need for health professionals and policy makers to do more to relieve suffering at the end of life.
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It has been recognized that there are gender disparities in the admission rates to psychiatric units. While the community prevalence of the major non-organic psychotic mental disorders are thought to have no gender bias, non-psychotic disorders such as depression are more commonly diagnosed in women. Gender differences in admission may indicate differences in severity or in presentation to psychiatric services and would have important implications for the targeting of preventative strategies. ⋯ Men are more likely to be diagnosed with substance use and psychotic disorders, while for women, major depression and non-psychotic illnesses are the main diagnoses. Community surveys are needed to determine whether this demographic pattern of admission reflects the population prevalence of these disorders. Reduction of admission rates will require interventions that are sensitive to gender differences in diagnosis among those admitted to psychiatric units.