Is there a Significant Difference in Surgery and Outcomes between Unipolar and Bipolar Hip Hemiarthroplasty? A Retrospective Study of a Single Institution in Singapore

Objective: The aim was to compare outcomes differences between unipolar and bipolar hip hemiarthroplasty in one institution for the local geriatric population. Methodology: A retrospective review of 291 patients aged 70 and above who underwent hip hemiarthroplasty for neck of femur fracture from February 2004 to November 2006 was performed. Results: Operative time was lower in the unipolar group. There was no statistically significant difference between the groups in terms of superficial wound infection, d

Counselling changes in sexual functioning for women with breast cancer

As women with breast cancer are living longer, issues beyond survivorship like the much neglected sexual functioning and issue of quality of life have become increasingly important. Experiences of significant alterations in sexual functioning need to be addressed. However, these sexual issues are often not acknowledged in our traditional medical model of health care delivery. This paper briefly reviews the changes in sexual functioning after a diagnosis of breast cancer, with implication for clinical practice and medical curicula

Baseline adjustment for statistical efficiency on clinical controlled trial

In a clinical controlled trial involving repeated measures of continuous outcomes such as quality of life, distress, pain, activity level at baseline and after treatment, the possibilities of analyzing these outcomes can be numerous with quite varied findings. This paper examined four methods of statistical analysis using data from an outcome study of a clinical controlled trial to contrast the statistical power on those with baseline adjustment. In this study, data from a CCT with women with breast cancer were utilized. The experiment (n=67) and control (n=74) were about equal ratio. Four method of analysis were utilized, two using ANOVA for repeated measures and two using ANCOVA. The multivariate between subjects of the combined dependents variables and the univariate between subjects test were examined to make a judgement of the statistical power of each method. The results showed that ANCOVA has the highest statistical power. ANOVA using raw data is the least power and is the worst method with no evidence of an intervention effect even when the treatment by time interaction is statistically significant. In conclusion, ANOVA using raw data is the worst method with the least power whilst ANCOVA using baseline as covariate has the highest statistical power to detect a treatment effect other than method. The second best method as shown in this study was in using change scores of the repeated measures.

Do medical lecturers need to be specially trained in teaching?

Over the years, the emphasis on research practices in healthcare has received more recognition than the emphasis on teaching practices. Also, in contrast to the strong focus on aligning care-giving practices with evidence of effectiveness; aligning educational practices with evidences of effectiveness has continued to be neglected. This creates a chasm that hinders the delivery of effective health practices. Many challenges in the current healthcare delivery system warrant a call for a revamp of health professionals’ education, and for a greater focus in effective teaching, assessment and supervision. This paper highlights the current challenges in health professional education (as revealed by the Institute of Medicine, IOM, 2003). It focusses on fi ve key issues for promoting teaching excellence, and supports the move for new lecturers to be educationally trained so that ‘teaching for learning’ becomes current, effective and enjoyable. More importantly, the vision for health professional education that “all health professionals are educated to deliver patient-centred-care as members of an interdisciplinary team, emphasising evidence-based practice, quality improvement approaches, and informatics” can be attained. This vision has important implication for medical lecturers as it means they have to be better educated to teach in order to be prepared to meet the demands of a reformed healthcare system.