THE UNDERGRADUATE: Social Dance in an Occupational Therapy Programme

This article contains a rationale for chosing dance as a group activity and an account of some of the factors influencing the inclusion of a dance group in an occupational therapy programme.     

The role of culture in the general practice consultation process

In this paper, we will examine the importance of culture and ethnicity in the general practice consultation process. Good communication is associated with positive health outcomes. We will, by presenting qualitative material from an empirical study, examine the way in which communication within the context of a general practitioner (GP) consultation may be affected by ethnicity and cultural factors. The aim of the study was to provide a detailed understanding of the ways in which white and South Asian patients communicate with white GPs and to explore any similarities and differences in communication. This paper reports on South Asian and white patients' explanations of recent videotaped consultations with their GP. We specifically focus on the ways in which issues of ethnic identity impacted upon the GP consultation process, by exploring how our sample of predominantly white GPs interacted with their South Asian patients and the extent to which the GP listened to the patients' needs, gave patients information, engaged in social conversation and showed friendliness. We then go on to examine patients' suggestions on improvements (if any) to the consultation. We conclude, by showing how a non-essentialist understanding of culture helps to comprehend the consultation process when the patients are from Great Britain's ethnicised communities. Our findings, however, raise generic issues of relevance to all multi-racial and multi-ethnic societies.     

Assessing Cultural Life Skills of American Indian Youth

While the global United States society emphasizes independence and emancipation from parents and families as appropriate transition tasks for adolescents in foster care, American Indian communities tend to stress interdependence and continuing youth, family, and community connections. The purpose of this naturalistic collective case study is to describe cultural life skills needed by American Indian youth to leave foster care and successfully transition into adulthood. Three Northern Plains Native reservations and two urban Indian communities participated. The research team partnered with the American Indian gatekeepers, elders, youth, and professional staff in efforts to embrace qualitative methods, considered the best way to legitimate and liberate Native ways of knowing. Findings take into account the subtleties of vast diversities among America’s First Nations’ people and support the importance of positive cultural influences in youth identity development.

Verbal communication between students in multidisciplinary health teams

The study reported here was connected with the influence of two variables—the context in which communication occurs, and the concept availability of various health professionals—upon the verbal interaction of various health professionals. Specifically, the verbal output of health professionals in groups consisting entirely of their own professional peers (i.e. all nurses, or all medical students) was compared with that of professionals in multidisciplinary health teams. The study, in attempting to delineate possible barriers to effective verbal interaction, has important implications for the functioning of multidisciplinary health teams.     

A scoring technique for computerized patient management problems

A scoring technique was developed for computerized patient management problems, based on an external criterion group of practising paediatricians. The technique was used successfully to score the 1974 computerized patient management problems examination, taken by paediatric candidates as part of the certification process required by the Royal College of Physicians and Surgeons of Canada. Statistical analysis indicated there was significant agreement between practising paediatricians' and candidates' responses. Comparison of responses of both groups suggested that differences between candidates and practising paediatricians were due to different approaches to the content of the problem, rather than a defect of scoring. The technique will be revised as computerized examinations are increasingly adopted by other medical specialties.     

An indication for a process dimension in medical problem-solving

Several recent studies have concluded that medical problem-solving, as evidenced in a written simulation, is heavily influenced by the medical content of the particular case. The method employed in these studies did not allow process and content aspects to be separated, so the contribution of each could not be independently assessed. The present study employed a method that allowed such a separation.
Medical students were required to write problem lists, to order laboratory tests and to choose a final diagnosis for each of five casts. They were given corrective feedback after each part (e.g. after writing problem lists they were given the correct problem list) so that all students were working with the same information as they began each section of the case. The results on factor analysis showed more similarity in performance on the same aspect of problemsolving across different clinical cases than on the different processes within a given case. The present study clarifies some issues, but more work is needed to define further the specific processes in problemsolving.     

Effect of active metabolites of chlordiazepoxide and diazepam,alone or in combination with alcohol,on psychomotor skills related to driving

Summary Interaction of the main metabolites of diazepam and chlordiazepoxide with alcohol was measured in two subacute double-blind cross-over experiments on 40 healthy, young volunteers. The drugs were administered for two week periods. The variables measured were choice reaction time and accuracy, eye-hand co-ordination, divided attention, flicker fusion, proprioception and nystagmus. Chlordiazepoxide lactam, methyloxazepam and oxazepam significantly enchanced the alcohol-induced impairment of psychomotor skills, whereas N-desmethyldiazepam did so only exceptionally in certain subjects in the choice reaction test. It is concluded that diazepam-alcohol interaction on psychomotor skills is mainly due to the parent compound. No correlation between the serum level of the agents and the changes in performance were found.     

Computer-terminal operating and communication aid for the severely handicapped

A communication aid that is suitable for use by the severely handicapped such as those suffering from high-level spinal injury has been developed. The system is based on the assembly of ASCII coded characters by means of a 2-level input employing a short cut. It has been used with a teletype computer terminal and a typewriter.     

Acute and Subacute Effects of Diazepam on Psychomotor Skills: Interaction with Alcohol

Abstract Effects of diazepam and alcohol on psychomotor skills were measured in two trials. In the first one, 200 healthy students volunteered for a double-blind single-dose study. Three doses of diazepam (5, 10 and 20 mg) and alcohol (0.5, 0.8 and 1.2 g/kg) were used alone and combined to construct dose-response graphs. All doses of alcohol impaired divided attention while co-ordinative skills were impaired by the 1.2 g/kg dose. Diazepam alone did not impair reactive or co-ordinative skills whereas the combinations of diazepam and alcohol did so. To further elucidate the subacute effects, a double-blind randomized study was conducted administering 2 and 10 mg of diazepam t.i.d. for two weeks to 18 healthy volunteers. The psychomotor tests were performed on the 7th and 14th days of drug administration, and 0.5 g/kg of alcohol was given on either day. Diazepam 2 mg, alone or with alcohol, did not differ from placebo. 10 mg of diazepam slightly increased reaction times but not reaction mistakes, and impaired both co-ordination and attention. Alcohol did not enhance diazepam effects. We suggest that a development of tolerance to diazepam may compensate the deleterious interaction of the agents found in acute studies.