Clinical anatomy is usually defined as anatomy applied to patient care. The question is asked whether students of a new horizontally and vertically integrated medical curriculum recognize the subject as the basis for clinical examination. A clinical anatomy practicum was developed in the special activity, "Introduction to Clinical Medicine," held in the second year of the Pretoria medical curriculum. The practicum was conducted on a station basis to anatomically prepare the student for the inspection, palpation, percussion, and auscultation of the cardiovascular, respiratory, abdominal, and urogenital systems. A total of 23 stations consisting of eight cardiovascular, seven respiratory, and eight abdominal/urogenital stations were designed. Standardized patients, cadavers, skeletons, prosected specimens, x-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI), multimedia programs, and clinical case studies were used as resources. A Likert-type questionnaire was used for student evaluation of the practicum. Most students realized the importance of surface anatomy for a family physician. More than two-thirds thought the practicum improved their understanding of the anatomical basis for clinical examination. The minority of students were stimulated to do further reading on clinical examination. The students' response to their ability to integrate the clinical examination with the radiological anatomy was average. Most students were continuously aware of the appropriateness of the practicum for their future career. We conclude that medical students recognize the importance of anatomy as the basis for clinical examination when exposed to an appropriate integrated presentation format.

Causal agents for workers' compensation claims and physical injury have largely been identified as physical demands. We proposed an integrated theory of physical injury (i.e. musculoskeletal disorder symptoms [MSDs]) and workers' compensation claims, which combined psychosocial and physical mechanisms. A random, population-based sample of 1095 Australian workers completed a telephone interview on two occasions 12 months apart. As expected, the physical mechanism was confirmed; physical demands were related to MSDs, which in turn predicted workers' compensation claims. Further, a novel psychosocial mechanism was confirmed. Psychosocial safety climate (PSC; perceptions about the organisation's climate for psychological health) was a precursor to psychosocial risks (e.g. harassment, violence, bullying and work pressure). In turn, these psychosocial risks were related to emotional exhaustion, MSDs and then workers' compensation claims. Evidence was therefore provided for psychosocial-physical processes in explaining MSDs and workers' compensation for claims for physical injury. Occupational health and safety legislators and policy makers should be aware that, beyond physical demands, factors usually associated with risk for mental stress claims (e.g. harassment, bullying, and violence) may additionally manifest in physical health problems and workers' compensation injury claims. Focusing on modifying the PSC in an organisation, "the cause of the causes", may be an effective injury prevention and intervention strategy.

The aim of this study was to determine whether the ultrastructure of the non-neoplastic myometrial portion (host myometrium) of fibromyomatous uteri is normal or abnormal when compared to that of fibromyomata and normal myometria. Myometrial samples from 23 normal and 54 fibromyomatous uteri were examined at the ultrastructural level using standard electron microscopy techniques. Ultrastructural abnormalities of certain cellular organelles were noted in myocytes of fibromyomata but not in those of normal or host myometria. The sarcolemmal dense bands of host myometrial myocytes were of significantly greater length than those of normal myometria, but not significantly different to those of fibromyomata. Consequently, the numbers of caveolae in host myometria and fibromyomata are conceivably decreased in comparison to normal myometria. Host myometria can be, therefore, considered to be structurally abnormal. The specific structural abnormality noted may affect calcium metabolism in these tissues by causing a decrease in the cellular calcium extrusion mechanism and thus raising intracellular calcium concentrations. Such an abnormality may provide an answer, in terms of contraction abnormalities, for the unexplained infertility that occurs in a small percentage of symptomatic myomatous patients.

Objective In this article, we investigate therapist views on their experiences using a technological adjunct (goACT) to traditional, face‐to‐face psychotherapy. goACT is a web‐based mobile interactive software application that facilitates an interactive platform, allowing therapists to connect with their clients between face‐to‐face psychotherapy sessions. Method Participants were six provisional psychologists and seven patients. Data were collected at two post‐therapy focus groups in order to qualitatively understand therapist experience of goACT as a therapy adjunct. Data were analysed utilising thematic analysis. Results Four main themes emerged: (1) “discretional use of goACT” linked to therapist preferences and client suitability; (2) “therapist concerns” linked to boundaries, workload, technological glitches, and therapeutic risks; (3) “goACT expands the parameters of therapy” through increased opportunities to provide care and connection with patients and increased access to the process of therapy; and (4) “goACT enhances therapy” through reciprocal responsibility and guided empowerment. Therapists in this study were more open to the use of technology in therapy than has been reported in previous research and did not find that it affected their workload. Conclusion Therapists indicated that when aligned to the specific needs of individual patients, an advanced mobile and web‐based interactive software application (goACT) has the potential to enhance engagement, rapport, and patient empowerment in face‐to‐face psychotherapy.

No abstract