Internal medicine journal
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Internal medicine journal · Oct 2009
Comparative StudyThe development and implementation of the pathway for improving the care of the dying in general medical wards.
The majority of deaths in Australia occur in general hospital wards and most are neither sudden nor unexpected. The Pathway for Improving the Care of the Dying (PICD) is an adaptation of the Liverpool Care Pathway to the Australian healthcare setting (or 'to Australian conditions') and is designed to help ensure a 'good death' for patients dying outside the palliative care system. PICD consists of a series of prompts, guidelines, revised medical and nursing care plans and a number of medication algorithms.
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Internal medicine journal · Oct 2009
Comparative StudyExamination of opioid prescribing in Australia from 1992 to 2007.
Opioid prescribing is controversial with evidence of both significant under-utilization and over-utilization. There is some evidence to support efficacy for chronic non-malignant pain, but community and individual harms are increasingly reported. ⋯ Opioid use is increasing. There is a pressing need for co-ordinated assessment of efficacy and harms to facilitate quality usage of opioids.
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Internal medicine journal · Sep 2009
Understanding organ donation in the collaborative era: a qualitative study of staff and family experiences.
Despite the success of the Breakthrough Collaborative Methodology (BCM) in increasing organ donation rates there has been little published evidence on the effect of the BCM on the wider attitudes and experiences of those involved in organ donation. This study sought to identify whether the National Organ Donation Collaborative in Australia had any additional influence on improving the experiences of staff and family members in the organ donation process. ⋯ This study identified valuable insights into the processes by which family members and intensive care unit staff deal with the actual processes of donation. Findings suggest that the process for families is far more complex than a simple agreement or refusal to donate. This study suggests that we should not assume that 'rates' of donation in Australia would increase merely through administrative programmes or marketing campaigns.
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Internal medicine journal · Sep 2009
Historical ArticleMedicinal use of leeches in the texts of ancient Greek, Roman and early Byzantine writers.
Blood-letting was a common therapeutic method in antiquity; many means were used to draw blood, including the application of leeches. In this paper, ancient Greek, Roman and Byzantine authors up to the 7th century AD were studied, a research that provided us with references that may be divided into two groups: those related to the medicinal use of leeches, and those related to cases in which leeches were swallowed and had to be removed. ⋯ In the second group, brief reference is made to the problems caused by swallowing leeches, and to the methods used to expel them from the human organism. The earliest references to the medicinal use of leeches may be found in the writings of Theocritus (3rd century BC), Nicander (2nd century BC) and Horace (1st century BC, while the phenomenon of swallowing a leech is first mentioned in one of the Epidaurian 'iamata' dating to the 4th century BC.