Online medical diagnosis - harnessing a 'world-wide' audience

The expansion of interactive websites on the internet has led to a wide range of online tools in the health sector which assist with self diagnosis or to facilitate patient and clinician understanding. With the increasing recent use of crowd sourcing for fund-raising, suspect identification and IT tasking, it was only a matter of time until health also started to make use of the wider community for diagnosis, whether only a specific segment or a wider general call. With over 7,000 known rare diseases there is a large market of people who either suffer from an undiagnosed condition or one which has been misdiagnosed. Two such new emerging health websites are CrowdMed and FindZebra.

CrowdMed promotes its' function by stating:  

“Instead of relying on individual physicians, CrowdMed harnesses the collective intelligence of hundreds of Medical Detectives (MD’s) to produce astonishingly accurate diagnostic suggestions in just hours. As a CrowdMed Medical Detective (MD), you can use your personal experience, intuition, and online research skills to help solve the world's most difficult medical cases. You can not only win cash, prizes, and status, but also help save lives"

CrowdMed does not require a medical degree or any health qualifications at all. Participants on the website bet on a patient's diagnosis from lists of suggestions and the top three are given to a patient to discuss with their physician.

In contrast, FindZebra provides an index of articles from rare disease databases. The website contains a condition of use stating:

"FindZebra should only be used by medical professionals. Although the articles indexed by the system have been written by medical professionals or reviewed by medical associations, it is strongly recommended that, as a patient, you consult your local health care provider. FindZebra does not replace professional health care, and cannot be held responsible for erroneous use of the information provided through the system".

As with all website data, it is a case of buyer beware. Both these websites can be found by clicking the links below:

CrowdMed

FindZebra

Theatre Review - One Man, Two Guvnors - Sydney Theatre Company 2013 Season

Owain Arthur and Edward Bennett on stage

As part of the Sydney Theatre Company's 2013 season, the National Theatre of Great Britain staged  'One Man, Two Guvnors' with the original British cast from London's West End. The play written by Richard Bean is partly based on the 18th Century Italian comedy The Servant of Two Masters by Carlo Gondoli. The play's story is cented on a knockabout servant and dogsbody character Francis who, always looking for an opportunity finds himself with two masters, one of whom is really a woman pretending to be her murdered brother, with the other master being her lover, who happens to be the murderer.  The Goldoni plot has been readapted to be 1960s Brighton in England and features a mix of British humour and slapstick recognisable from the antics in Fawlty Towers, Monty Python and Benny Hill.  Owain Arthur's command of the stage and ad libbing as the character of Francis provides the almost seamless continuity whilst Rosie Wyatt and Edward Bennett as the two Guvnors provide contrasts as well as foils for their servant. The performance in two parts is punctuated with musical mood accompaniment and a well selected period repertoire by the young band, The Craze. 

Hitching a ride - compromising the earth's waterways and ocean ecosystems

Container ship in port

The movement of ocean and water organisms around the globe as a result of hitching a ride on the ships traversing the seas is not a new problem nor is it one which the general public have not heard about. However the scale, extent and failure to act when solutions actually exist, is almost certainly a fact which is not so well known. Cargo ships and tankers require ballast water to avoid capsizing mainly when offloading cargo but also when carrying lighter loads - the water is up taken in one port and often discharged in another port, thousands of kilometres away. A large ship can carry up to 60,000 tonnes of ballast and more than 7 billion tonnes of ballast water is transported around the world each year in which an estimated 7,000 different species of seeds spores, plankton, bacteria, eggs and larvae hitch a ride into new surroundings. The impacts can be dramatic with examples being the European zebra mussel arriving in the Great lakes of North America, Chinese mitten crabs in Europe, Asian Kelp in Southern Australia, Mediterranean mussels in Southern Africa and dinoflagellates spreading across the world (the sources of 'red tides'). The Mediterranean has 900 alien species which originated from ballast water.

Efforts have been made to reach an international agreement through the UN Convention on Ballast Water in 2004 which requires ships to install kits to eliminate biological hitchers in their ballast water. The International Maritime Organisation has certified 20 commercial treatment systems which will do the task utilising various combinations of biocides, electrolysis, heat, ozone, irradiation or filtration systems. However for the treaty to come into effect, requires at least 30 nations representing 35% of the world's merchant shipping tonnage.  To date ratification nations only account for 29%  with the well known 'flags of convenience' countries - Panama, Bahamas, Malta and Cyprus - avoiding the issue. Nor have the US, UK, Germany, Italy and Japan ratified the treaty. The cost of taking no action is both economic as well as environmental for the invading species can cause significant negative impact - the Black Sea was devastated and its commercial fishing destroyed by the comb jellyfish  whilst the European zebra mussel blocked irrigation channels and water pipes in North America costing billions of dollars of restoration work. Inaction therefore is not really an option.

How the public perceive professions in Australia - nurses at the top and car salesmen at the bottom

The issue of reputation, trust and ethics and the public's perception of various professions is always a  survey exercise which provides few surprises and, in practice, reinforces opinions commonly reflected in social situations. In this sense people actually do state what they think with little camouflage or sugar coating. Roy Morgan have released the latest survey results of the public's perception of the honesty and ethical standards of various professions - the survey has been an annual exercise since 1979. Car salesmen remain at the bottom of the survey, a position which has not changed once over the 30 years since the survey commenced. Nurses remain in the no 1 position which has remained unchanged since that profession was first added to the list, 19 years ago.

Respondents were asked: “As I say different occupations, could you please say — from what you know or have heard - which rating best describes how you, yourself, would rate or score people in various occupations for honesty and ethical standards (Very High, High, Average, Low, Very Low)?”

Roy Morgan Image of Professions Survey 2013

1	Nurses	2	Doctors
3	Pharmacists	4	Engineers
5	Teachers	6	Dentists
7	High Court Judges	8	Supreme Court Judges
9	Police	10	Univerity Lecturers
11	Accountants	12	Ministers of Religion
13	Bank Managers	14	Lawyers
15	Public Servants	16	Public opinion pollsters
17	Directors of Public Companies	18	Financial Planners
19	Business Executives	20	Newspaper journalists
21	TV reporters	22	Talk-back radio announcers
23	Stock brokers	24	Union leaders
25	Federal Members of Parliament	26	Insurance brokers
27	State Members of Parliament	28	Real Estate Agents
29	Advertising people	30	Car salesmen