Angela Jacques

Perceptions by medical students of their educational environment for obstetrics and gynaecology in metropolitan and rural teaching sites

Background: Medical student education in Western Australia is expanding to secondary level metropolitan hospitals and rural sites to accommodate workforce demands and increasing medical student numbers. Aims: To determine if students’ perceptions of the teaching environment for obstetrics and gynaecology differ between tertiary, secondary level metropolitan hospitals and rural sites, and to determine if students’ perceptions of their learning environment are associated with improved academic performance. Method: An evaluation was conducted of medical students’ perceptions of their learning environment during an obstetrics and gynaecology program at a variety of sites across metropolitan and rural Western Australia. The evaluation was based on the Dundee Ready Education Environmental Measure (DREEM) questionnaire. Results: There were no significant differences in students’ perceptions of their learning environment between the tertiary hospital, combined programs involving a tertiary and secondary metropolitan hospital, rural sites with a population of more than 25,000 and rural sites with a population less than 25,000 people. Perceptions were similar in male and female students. The overall mean score for all perceptions of the learning environment in obstetrics and gynaecology were in the range considered to be favorable. Higher scores of perceptions of the learning environment were associated positively with the measures of academic achievement in the clinical, but not written, examination. Conclusion: Medical students’ perceptions of their learning environment in obstetrics and gynaecology were not influenced by the geographical site of delivery or their gender but were positively related to higher academic achievement. Providing appropriate academic and clinical support systems have been put in place the education of medical students can be extended outside major hospitals and into outer metropolitan and rural communities without any apparent reduction in perceptions of the quality of their learning environment.

Prevalence and risk factors for parent-reported recurrent otitis media during early childhood in the Western Australian Pregnancy Cohort (Raine) Study

To describe the prevalence and risk factors of recurrent otitis media (rOM) in an urban Australian population at 3 years of age.

Cohort Profile: The Western Australian Pregnancy Cohort (Raine) Study-Generation 2

Cohort Profile: The Western Australian Pregnancy Cohort (Raine) Study–Generation 2 Leon Straker,* Jenny Mountain, Angela Jacques, Scott White, Anne Smith, Louis Landau, Fiona Stanley, John Newnham, Craig Pennell and Peter Eastwood School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia, School of Population Health, University of Western Australia, Perth, WA, Australia, Maternal Fetal Medicine Service, King Edward Memorial Hospital, Perth, WA, Australia, School of Medicine and Pharmacology, University of Western Australia, and Department of Health, Government of Western Australia, Perth, WA, Australia, Telethon Kids Institute, Perth, WA, Australia, School of Women’s and Infant’s Health and Centre for Sleep Science, School of Anatomy, Physiology and Human Biology, University of Western Australia, Perth, WA, Australia.

A Western Dietary Pattern Is Associated with Poor Academic Performance in Australian Adolescents

The aim of this study was to investigate cross-sectional associations between dietary patterns and academic performance among 14-year-old adolescents. Study participants were from the Western Australian Pregnancy Cohort (Raine) Study. A food frequency questionnaire was administered when the adolescents were 14 years old, and from the dietary data, a ‘Healthy’ and a ‘Western’ dietary pattern were identified by factor analysis. The Western Australian Literacy and Numeracy Assessment (WALNA) results from grade nine (age 14) were linked to the Raine Study data by The Western Australian Data Linkage Branch. Associations between the dietary patterns and the WALNA (mathematics, reading and writing scores) were assessed using multivariate linear regression models adjusting for family and socioeconomic characteristics. Complete data on dietary patterns, academic performance and covariates were available for individuals across the different analyses as follows: n = 779 for mathematics, n = 741 for reading and n = 470 for writing. Following adjustment, significant negative associations between the ‘Western’ dietary pattern and test scores for mathematics (β = −13.14; 95% CI: −24.57; −1.76); p = 0.024) and reading (β = −19.16; 95% CI: −29.85; −8.47; p ≤ 0.001) were observed. A similar trend was found with respect to writing (β = −17.28; 95% CI: −35.74; 1.18; p = 0.066). ANOVA showed significant trends in estimated means of academic scores across quartiles for both the Western and Healthy patterns. Higher scores for the ‘Western’ dietary pattern are associated with poorer academic performance in adolescence.

Protective benefit of predominant breastfeeding against otitis media may be limited to early childhood: results from a prospective birth cohort study.

To examine the long‐term effects of predominant breastfeeding on incidence of otitis media.

Early anesthesia exposure and the effect on visual acuity, refractive error, and retinal nerve fiber layer thickness of young adults

OBJECTIVE To investigate whether being anesthesia administered at least once in early life influenced 3 main proxies of visual function: visual acuity, refractive error, and optic nerve health in young adulthood. STUDY DESIGN At age 20 years, participants of the Western Australian Pregnancy Cohort Study had comprehensive ocular examinations including visual acuity, postcycloplegic refraction, and multiple scans of the optic disc. We identified individuals who had at least 1 procedure requiring anesthesia during the first 3 years of life (between 1990 and 1994) and compared their visual outcomes with nonexposed individuals. We excluded 40 participants with strabismus or other ophthalmic disease or surgery and 136 with non-European background. RESULTS Of 834 participants, 15.2% (n = 127) were exposed to anesthesia at least once before age 3 years. In both exposed and nonexposed groups, median visual acuity (measured using the logarithm of the minimum angle of resolution [LogMAR] chart) was -0.06 LogMAR in the right eye and -0.08 LogMAR in the left eye (P > .05). Median spherical equivalent refractive error was +0.44 diopters (IQR -0.25, +0.63) and +0.31 diopters (IQR -0.38, +0.63) in the exposed and nonexposed group, respectively (P = .126). No difference was detected in mean global retinal nerve fiber layer thickness of the 2 groups (100.7 vs 100.1 μm, P = .830). CONCLUSIONS We were unable to demonstrate an association of exposure to anesthesia as a child with reduced visual acuity or increased myopia or thinning of retinal nerve fiber layer. These findings support the view that anesthesia is unlikely to impair visual development, but further work is needed to establish whether more subtle defects are present and repeated exposures have any effects.

Good‐quality diet in the early years may have a positive effect on academic achievement

The aim of this study was to investigate the associations between early diet and academic performance during childhood.

Does after-hours in-house senior physician cover improve standard of care and outcomes in high-risk preterm neonates? A retrospective cohort study

Aim:  To compare the standard of care and outcomes to discharge for inborn high‐risk preterm (gestation <32 weeks) neonates admitted to the neonatal intensive care unit (NICU) before and after adopting an after‐hours in‐house senior physician cover roster (ISPCR). The ISPCR involved the presence of a consultant neonatologist or neonatal fellow in the NICU until 11 pm.

Does otitis media in early childhood affect later behavioural development? Results from the Western Australian Pregnancy Cohort (Raine) Study

To examine the relationship between early life episodes of otitis media and later behavioural development with adjustment for confounders.