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This study describes the quantitative aspects of metaphor in academic publications. In particular, we analyze the frequency of metaphor types and source domains in medical papers written by native and non-native speakers of English. The data have been collected from selected published articles on cancer and tissue engineering. The method combines a manual procedure with a semantic tagger and keyness statistics in Wmatrix software for metaphor identification. The results show that while the distribution of metaphor is relatively stable across tissue engineering and cancer articles written by native and non-native speakers, indirect metaphor is more often used than other types of metaphor. Moreover, the findings indicate that some metaphorical source domains are specifically used for a particular topic and that some are more frequently exploited by native speakers of English than by non-native speakers. This study has implications for English for Academic Purposes (EAP) pedagogy and the development of metaphorical awareness activities as it may set the ground for future corpus studies that analyze metaphor properties in academic registers.

Objective: To evaluate the suitability and acceptability of virtual training post accreditation visits conducted online for medical specialist training in ophthalmology in Australia and New Zealand. Methods: A two-phase study (pilot and implementation) was conducted. In the pilot phase, an open-ended observation proforma was used by the authors to independently record their observations, which were later compared and discussed until consensus was achieved. All participants were asked to complete an online survey. A document analysis of accreditation documents was conducted. Observation data were broken down into themes and triangulated with online survey and document analysis results. In the implementation phase, the inspections were observed by one of the authors (SK) and the observation notes were discussed with other authors to obtain a contextual and consensual view. A document analysis of all accreditation-related documentation was undertaken. The documents included in the document analysis were planning and scheduling records, interview and inspection notes, training post inspection fact and document notices and accreditation reports. Finally, a post-inspection focus group of all inspectors was conducted. Results: The accreditation interviews adequately addressed all relevant issues with high levels of robustness and reliability. Participants found it more difficult to discuss complex issues virtually compared with onsite visits. The virtual accreditation reports were not any different to what would be expected if a face-to-face accreditation visit had been conducted; however, it was not possible using the virtual inspection to determine the appropriateness of facilities and clinic layout to support and facilitate trainee learning and supervision. Conclusions: Virtual accreditation of training posts in medical specialist training is viable in limited circumstances where there are no known complex training post-related issues and the site has not made substantial changes to clinic and theatre layout, equipment and facilities since the previous accreditation. What is known about the topic? All medical specialist colleges in Australia and New Zealand accredit the sites where training is delivered, usually by conducting periodic face‐to‐face visits. What does this paper add? This paper provides evidence that in limited circumstances, it is possible to accredit training posts virtually. What are the implications for practitioners? This paper provides an outline of issues to consider when planning virtual accreditation of training posts in medical specialist education. [ABSTRACT FROM AUTHOR]

Australia and New Zealand (ANZ) have had complete population cancer incidence registration for decades and are beginning to develop clinical data systems to collect details of staging and treatment. Sadly, this bounty of statistical data is often under utilized and occasionally abused. Many are unaware of the data and statistical services available from their local cancer registry. To promote the use of ANZ population cancer data, the following paper describes the principal statistics that are available and identifies common problems with their use. [ABSTRACT FROM AUTHOR]

In December 1974 questionnaires concerning postgraduate education were sent to all New Zealand medical practitioners. This paper refers to the replies from house-surgeons/registrars and from specialists. Fifty-seven percent of the house surgeons/registrars replied to their questionnaire. Nearly 70 percent of those who chose general practice expected to train vocationally for this discipline wholly in New Zealand, compared with nearly 60 percent of pathology/radiology and undecided candidates, and 20 to 35 percent of medical surgical and O and G candidates. On the average the house officers will expect full-time continuing medical education (CME) for about three weeks every one to three years and local CME for about three hours each week. Seventy percent of GP candidates and 30 percent of specialist candidates expected and full-time CME to be in New Zealand. Fifty-six percent of the specialists gave information. Only 14 percent had trained solely in New Zealand and 80 to 90 percent of physician and surgeon groups had trained beyond Australasia. Full-time CME amounted to about five days each year and local CME to about two hours each week. New Zealand CME was not rated highly, but visiting overseas specialists were regarded as essential by most respondents, as was travel overseas for vocational training and CME. Learning methods most preferred were reading, lectures followed by small group discussions and plenary sessions, and small groups using member expertise. Television, tapes and films were poorly regarded.

Dose titration with immediate-release opioids is currently recommended for acute pain. The Australian and New Zealand College of Anaesthetists and the Faculty of Pain Medicine released a statement in March 2018 supporting their use in the treatment of opioid-naïve patients; however, the impact of this statement on clinical practice is currently unknown. This retrospective cohort study was conducted to compare opioid prescribing patterns before and after the release of the recommendations. Data were collected on 184 patients (2017, n = 78; 2018, n = 106) admitted to the Prince of Wales Hospital in November 2017 and 2018, which consisted of demographic data, opioid prescriptions and discharge opioid information. The main outcome is the number of prescriptions of slow-release opioids in 2017 versus 2018 after the recommendations were published. Confounding factors were accounted for using logistic and multiple regression as appropriate. There was a 29% decrease in slow-release opioid prescriptions during hospitalisation (n = 31, 40% versus n = 12, 11%; P < 0.001) and 17% decrease at discharge (n = 20, 26% versus n = 9, 9%; P = 0.02) post-publication. After adjusting for confounders, the odds of slow-release opioids being prescribed postoperatively and at discharge reduced by 86% and 88%, respectively (postoperative period: odds ratio 0.14, P < 0.05; discharge: odds ratio 0.12, P < 0.05). In addition, orthopaedic patients were more likely to receive slow-release opioids, consistent with existing literature. As the use of slow-release opioids has been associated with increased harm and protracted opioid use compared to immediate-release opioids, it is hoped that wider dissemination of these recommendations and a change in prescribing practice can be a step towards overcoming the opioid crisis. [ABSTRACT FROM AUTHOR]

Surgery is a high‐status, distinctly embodied, profession, dominated by men and saturated with masculine ideals of individual heroism, manual skill and detachment. In this study, we focus on exploring how surgery both represses, but also requires, caring work, creating gendered contradictions for the women that enter its ranks. Based on interviews with eighteen female surgeons from Australia and New Zealand, we apply a 'rationality of caring work' lens to explore how they experienced these contradictions through training, socialization and in everyday interactions. Our findings show inter‐related mechanisms whereby female surgeons are required to become more independent and self‐reliant than comparable men, but also make up for the systemic lack of care shown to junior staff and students. In particular, their pregnancy and motherhood challenge the ideal of the detached, independent, heroic agent. We conclude by discussing how a 'rationality of caring' lens could help unpack the gendered contradictions women experience in other elite professions. [ABSTRACT FROM AUTHOR]

This study explored the approaches of respiratory and palliative medicine specialists to managing the chronic breathlessness syndrome in patients with severe chronic obstructive pulmonary disease. A voluntary, online survey was emailed to all specialists and trainees in respiratory medicine in Australia and New Zealand (ANZ), and to all palliative medicine specialists and trainees in ANZ and the United Kingdom (UK). Five hundred and seventy-seven (33.0%) responses were received from 1,749 specialists, with 440 (25.2%) complete questionnaires included from 177 respiratory and 263 palliative medicine doctors. Palliative medicine doctors in ANZ and the UK had similar approaches to managing chronic breathlessness, whereas respiratory and palliative medicine doctors had significantly different approaches (p < 0.0001). Both specialties most commonly recommended a combination of non-pharmacological and pharmacological breathlessness management strategies. Respiratory doctors focussed more on pulmonary rehabilitation, whereas palliative medicine doctors recommended breathing techniques, anxiety management and the handheld fan. Palliative medicine doctors (197 (74.9%)) recommended short acting oral morphine for breathlessness, as compared with 73 (41.2%) respiratory doctors (p < 0.0001). Respiratory doctors cited opioid concerns related to respiratory depression and lack of knowledge. Nineteen (10.7%) respiratory doctors made no specific recommendations for managing chronic breathlessness. Both specialties reported actively managing chronic breathlessness, albeit with differing approaches. Integrated services, which combine the complementary knowledge and approaches of both specialities, may overcome current gaps in care and improve the management of distressing, chronic breathlessness. [ABSTRACT FROM AUTHOR]

The article offers news briefs on medicine in Australia and New Zealand. Quality Improvement Collaboratives (QIC) may improve process of care but not necessarily its results. A summit titled 2020 held on April 19 to 20, 2008, promises much for health reform in Australia. Google health, a free service for patients wishing to have a personalized record, is already launched.