Abstract. Objectives:The pharmacotherapy of Parkinson's disease (PD) is often challenging as clinicians have to find a favourable balance between the efficacy on motor symptoms and side effect profiles of different dopaminergic medications. We aimed to assess the available evidence on the role of dopamine agonist monotherapy as an alternative to Levodopa in the treatment of motor symptoms of PD, along with the role of dopamine antagonists in the treatment of PD-related psychosis. Methods: We performed a systematic literature review using the databases MEDLINE, EMBASE, PsycINFO and the Cochrane Library Central register of controlled trials. Two searches were performed, 'Search 1' extracting trials on dopamine agonists, and 'Search 2' on atypical antipsychotics. Eligible studies were Double-blind Randomised Controlled Trials (RCTs) using the Unified Parkinson's Disease Rating Scale (UPDRS) and the Brief Psychiatric Rating Scale (BPRS) as outcome measures for Search 1 and 2, respectively. Results: 16 relevant RCTs were extracted from the search results. Overall, dopamine agonists were shown to significantly improve UPDRS scores, with a mean percentage improvement of 14.4% compared to −1.9% in the control arm (P value < 0.05). However, their side effect profile illustrated they were associated with twice the incidence of psychotic symptoms in comparison to the controls. The results on the efficacy of atypical antipsychotics for the treatment of PD-related psychosis were not significant. Conclusions: This evidence-based review confirmed that dopamine agonists can be an effective and safe treatment as monotherapy in PD, however psychotic symptoms remain a significant side effect. Atypical antipsychotics may not be relied upon for the correction of these symptoms due to inconsistent results about their efficacy.

Objectives: To determine if patients allow medical students to perform less invasive procedures compared to more invasive procedures, and how this is related to patient demographics and previous experience with medical students. Methods: A cross-sectional survey was conducted in six areas of Birmingham, UK. All members of the general public over the age of 18 were eligible, excluding non-English speaking people and those with cognitive impairments. Respondents were asked to rank their willingness for medical students to perform history taking/examinations and clinical procedures of varying degrees of invasiveness. Results: We received a total of 293 responses. For both history taking/examinations and clinical procedures, people were more willing to allow medical students to perform less invasive procedures rather than more invasive procedures. White and older people were more willing to allow all history taking/examinations procedures; additionally, women were more willing to allow history taking. White, female, and older participants were more willing to allow blood pressure measurement; whilst older people and those with previous experience were more willing to allow venepuncture. No significant associations were found for intubation. Conclusions: The public is less willing for medical students to perform more invasive procedures. This may severely limit opportunities to attain clinical competencies.

Shereef et al.: Willingness and attitudes of the general public towards the involvement of medical students in their healthcare. BMC Proceedings 2012 6(Suppl 4):P51.