bluuebunny/crossref_metadata_2025 huggingface dataset:
The physiological condition of pine trees in the Prebaikalia (East Siberia)
Authors: Mikhailova T. A.
Published: March 2003

Summary The condition of Scots pine (Pinus sylvestris) forests polluted by complex industrial emissions in the Prebaikalia region (East Siberia) is described using an eco‐physiological approach. Prebaikalia is one of the largest industrial areas of Russia. On 54 study plots the following needle parameters were measured: percentage of defoliation, protein nitrogen, nonprotein nitrogen, soluble carbohydrates, starch, aluminium, cadmium, calcium, copper, fluorine, iron, lead, magnesium, manganese, mercury, potassium, sodium, sulphur and zinc. The physiological condition of the pine tree stands was recorded on the basis of the protein nitrogen/nonprotein nitrogen ratio and the percentage of defoliation. Both parameters showed significant correlations with the accumulation of most pollutants. Five main damage classes were identified by a cluster analysis. The spatial distribution of these damage classes within the region is presented in a map.
Lesion development in stems of rough‐ and smooth‐barked Eucalyptus nitens following artificial inoculations with canker fungi
Authors: Yuan Z. Q. , Mohammed C.
Published: March 2003

A study of lesion development in stems of Eucalyptus nitens following artificial inoculations with canker fungi was carried out on 16‐year‐old plantation trees. In a first trial cambium bark wounds on smooth‐ and rough‐barked trees were inoculated with the mycelium of nine species of canker fungi, including Endothia gyrosa. In a second trial spores or mycelium of E. gyrosa were applied directly onto undamaged or superficially wounded bark surfaces. Infection subsequent to artificial inoculation via wounding (whatever the wounding technique or type of inoculum) resulted in significantly larger external lesions (mean lesion area up to 35.6 cm2 20 months after inoculation) on smooth bark compared with those on rough bark (up to 19.0 cm2). Microscopic studies of infected rough and smooth bark suggest that, once smooth bark is compromised by wounding and artificial inoculation, the particular anatomical structure of smooth bark may offer less mechanical resistance to post‐penetration hyphal spread in comparison with rough bark. It is suggested that at a pre‐penetration stage under natural conditions spores of E. gyrosa more easily infect rough bark via cracks associated with this type of bark but not present in smooth bark.
Development of Melampsora ciliata rust on nursery‐grown poplars in north‐western Himalayas
Authors: Sharma R. C. , Khan Y. , Sharma S. , Malhotra R.
Published: March 2003

Development of leaf rust (Melampsora ciliata) in different species, hybrids and cultivars of poplar (Populus spp.) was studied in nursery‐grown plants. Five different criteria were used to assess the disease development. The mean disease index on 10 August was 9.4% which increased to 70.0% on 10 October. The lowest disease index (5.5%) was recorded in P. yunnanensis whereas the maximum was recorded in P. × euramericana‘Rubra‐Poiret’ (59.5%). The apparent infection rate per unit per day was highest in P. nigra × P. trichocarpa (9.7 × 10–2) whereas the minimum occurred in P. maximowiczii × P. berolinensis‘Oxford’ (3.3 × 10–2). The area under the disease progress curve was a maximum in P. × euramericana‘Rubra‐Poiret’ (26.7) and a minimum in P. yunnanensis (1.6). Complete defoliation by the first half of October occurred in P. nigra × P. trichocarpa, which also had the maximum apparent infection rate and area under the disease progress curve. Inoculum production was highest in P. nigra × P. trichocarpa and lowest in P. maximowiczii × P. berolinensis‘Oxford’.
Needle nutrient status of Sirococcus shoot blight‐diseased and healthy Norway spruces
Authors: Anglberger H. , Sieghardt M. , Katzensteiner K. , Halmschlager E.
Published: March 2003

In this study the needle nutrient status of Sirococcus shoot blight‐diseased and healthy Norway spruces (Picea abies) was investigated. Element contents were determined in the current year and 3‐year‐old needles collected in December 2000 from 72 mature trees randomly distributed in the investigated stand. Half of the trees were severely affected by Sirococcus conigenus and had a reduced crown whereas the other trees were unaffected and vigorous. Compared with the uninfected trees, contents of Mg, Ca, P and Mn were significantly lower in the current year and 3‐year‐old needles of diseased trees. Furthermore, analyses of the nutrient contents of needles from severely affected trees revealed insufficient Mg and Ca supply and enhanced N/Mg and N/Ca ratios, when compared with threshold values. The results of this study suggest that imbalanced tree nutrition either has a significant impact on the expression of Sirococcus disease symptoms or fungal infection itself is affecting needle nutrient contents.
Nursing staff satisfaction on a mental health unit
Authors: Farrell Gerald A. , Dares Gerry
Published: March 2003

The present study set out to assess the level of nurses’ job satisfaction in an acute in‐patient mental health setting. All but one (n = 22) of the full‐time nursing staff employed on the unit took part in the study. Unlike many previous studies where the level of job satisfaction was assessed using predetermined questionnaire items but without providing an understanding for workers’ choices, the present study sought an estimation of what job characteristics nurses saw as important, an estimation regarding their current satisfaction with each characteristic and, importantly, the reasons behind their choices.
The psychiatric consultation‐liaison nurse: Towards articulating a model for practice
Authors: Sharrock Julie , Happell Brenda
Published: March 2003

ABSTRACT:

Psychiatric consultation‐liaison nursing (PCLN) has experienced considerable growth in the past decade in Australia. In spite of this growth, a model for PCLN practice has not been adequately developed and articulated. The aim of this paper is to begin the process of articulating a model for PCLN practice in order to redress the paucity of literature in this area. The paper includes a brief history of PCLN; articulation of the components of the PCLN role, namely consultation, liaison and culture brokering; the impact of PCLN on quality improvement; and the importance of research articulation for the development of the PCLN role.
HOSPITAL ADMISSION AND MORTALITY DIFFERENTIALS OF ASTHMA BETWEEN URBAN AND RURAL POPULATIONS IN NEW SOUTH WALES
Authors: Tong Shilu , Drake Peter
Published: March 2003

It remains unclear whether there are any differentials in hospital admission and mortality rates of asthma between urban and rural populations. An observational study was conducted, based on patient hospital records, to examine the distribution of asthma admissions and mortality in New South Wales. Data on all reported cases of asthma were obtained from New South Wales hospitals between 1989 and 1994. Information on deaths of asthma was collected between 1983 and 1992. The hospital admission rates of asthma varied from 4.8 per 1000 in 1990 to 5.4 per 1000 in 1992 for rural population, and from 3.0 per 1000 in 1991 to 3.4 per 1000 in 1992 for urban population. The hospital admission rates were 51.2–69.1% higher for rural residents than urban dwellers. The mortality rates of asthma ranged from 4.8 per 100 000 in 1983 to 8.0 per 100 000 in 1985 for rural population, and from 3.8 per 100 000 in 1983 to 6.0 per 100 000 in 1989 for urban population. The mortality rates of asthma were 3.62–42.85% higher for rural residents than urban dwellers. These results indicate that the non‐age‐adjusted hospital admission and mortality rates of asthma were considerably higher in rural populations than in urban populations in New South Wales.
A COMPARISON OF A HOSPITAL OUTPATIENTS DEPARTMENT AND GENERAL PRACTICE IN REMOTE QUEENSLAND
Authors: Veitch P. C. , Wallace D. A. , Doolan T.
Published: March 2003

A survey of all ambulant patients attending the hospital outpatients’ department and the private general practice in a remote town in Queensland sought information on patients’ reasons for attending. Patients handed the completed questionnaires to their practitioner, who indicated the type of visit and the focus of the encounter. There was little difference between the facilities in terms of patient demographics, except that males accounted for a higher proportion of encounters at the Outpatients’ Department (OPD), mainly as emergency encounters. Excluding emergency encounters, patients appeared to perceive the facilities as alternative practices. The practitioners’ reports suggested some differences in practice and/or experience between the two facilities, which were in line with commonly held perceptions about OPD and private general practice. The data suggest that the similarities between the two facilities may outweigh the differences. Moreover, the differences between rural hospital practice and rural general practice should be seen as providing the opportunity for more rounded training, rather than mutually exclusive forms of practice.
PSYCHOSOCIAL PROFILE OF PREGNANT ADOLESCENTS IN A LARGE AUSTRALIAN REGIONAL AREA
Authors: Smith Mavis M. , Grenyer Brin F. S.
Published: March 2003

A psychosocial profile was developed of 122 pregnant adolescents attending a public hospital antenatal clinic in a large regional Australian area. Participants completed the Rosenberg Self‐Esteem Scale and the Support Behaviours Inventory and were interviewed to obtain psychosocial and demographic information. Results revealed that those who were most likely to have either or a combination of poor self‐esteem, lack of social support, be unemployed or smoke, were more likely to be living alone or with friends, not have a partner or have a partner for a shorter period, have a partner who was older, have previous children, have not planned their pregnancy and have less education. The degree of social support was significantly associated with self‐esteem. Over half of the sample smoked, and over half were unemployed. These results underscore the importance of addressing psychosocial factors in the implementation of care for the pregnant adolescent.
AVAILABILITY OF APPROPRIATELY PACKAGED INFORMATION ON SEXUAL HEALTH FOR PEOPLE WHO ARE LEGALLY BLIND
Authors: Hayes Beth
Published: March 2003

Access to information on sexual health by legally blind people is an area of study hitherto neglected. Research carried out during 1997 confirmed an almost complete absence of appropriately packaged information for this subgroup in the community. Rural people are even more disadvantaged than their metropolitan counterparts.
A STUDY OF POSTDIAGNOSIS BREAST CANCER CONCERNS FOR WOMEN LIVING IN RURAL AND REMOTE QUEENSLAND. PART I: PERSONAL CONCERNS
Authors: McGrath Pam , Patterson Carla , Yates Patsy , Treloar Sue , Oldenburg Brian , Loos Colleen
Published: March 2003

The findings presented in this paper are part of a research project designed to provide a preliminary indication of the support needs of postdiagnosis women with breast cancer in remote and isolated areas in Queensland. This discussion will present data that focuses on the women’s expressed personal concerns. For participants in this research a diagnosis of breast cancer involves a confrontation with their own mortality and the possibility of a reduced life span. This is a definite life crisis, creating shock and needing considerable adjustment. Along with these generic issues the participants also articulated significant issues in relation to their experience as women in a rural setting. These concerns centred around worries about how their partner and families cope during their absences for treatment, the additional burden on the family of having to cope with running the property or farm during the participant’s absence or illness, added financial strain brought about by the cost of travel for treatment, maintenance of properties during absences, and problems created by time off from properties or self‐employment. These findings accord with other reports of health and welfare services for rural Australian and the generic literature on psycho‐oncology studies of breast cancer.
Interpractitioner Communication: Telephone Consultations Between Rural General Practitioners and Specialists
Authors: Hollins Jane , Veitch Craig , Hays Richard
Published: March 2003

The results of a study that sought to investigate the utility of and satisfaction with telephone consultations from the perspective of general practitioners and specialists are reported. Semi‐structured interviews with rural general practitioners and specialists were used to elicit information about their most recent telephone consultations. The telephone was found to be an important means of communication for rural practitioners, primarily in terms of organising referrals. General practitioners tended to called specialists who they knew and appeared to have fairly well‐formed networks of specialists who they called for most of their concerns. Trust is an important element of interpractitioner communication as it increases understanding and confidence in the reliability of the information exchanged. Good working relationships ensure that rural general practitioners have an accessible source of acceptable specialist support.
Evaluation of a Pilot Project to use Computers in a Rural General Practice Term
Authors: Teague Michele , Talbot Jane , Ward Alison M.
Published: March 2003

In 1998, the Department of General Practice (Faculty of Medicine and Dentistry, University of Western Australia) ran a pilot project to use computers in a sixth year rural general practice term. Students were provided with a laptop computer to take into rural and remote areas throughout Western Australia during their 4‐week clinical attachment. An email mailing list was set up for course participants to share experiences and complete set learning activities specifically related to rural general practice. An evaluation of this pilot project found that students felt less isolated on rural attachments, course outcomes were improved and rural preceptors were more involved in the programme. The development of a teaching and learning programme that involves the use of computers in rural general practice for undergraduate students has the potential to improve the quality of their medical education.
Learning Issues for Nurses in Renal Satellite Centres
Authors: Wellard Sally , Bethune Elizabeth
Published: March 2003

The introduction of ‘satellite’ dialysis centres has increased local access to renal services for patients living in rural and remote areas across Australia and is, therefore, consistent with rural health policies. Rural health strategies also aim to maintain and improve the skills of health professionals through regular review of the scope of their practice and evaluation of the education required. Yet, the results of the present national study of nurses working in satellite dialysis centres indicate that, for many, the context of practice influences their ability to access ongoing professional education to support and extend their nursing practice. The present study showed that there was a range of educational backgrounds among nurses working in rural ‘satellite’ centres with reportedly limited access to specific dialysis‐related professional development. In the present paper we report on factors that influence the ability of nurses working in satellite dialysis centres to access ongoing professional education.
Non‐Governmental Organisations to Combine for Work on Chronic Disease in Aboriginal Peoples, Torres Strait Islanders and Rural and Remote Populations
Authors: Field Pat , Gregory Gordon
Published: March 2003

As a result of the National Health Priority Area Report on Cardiovascular Health and in particular, its remote and indigenous section, a consortium of five organisations ran a national workshop in Townsville in October 1999 on heart disease in Aboriginal peoples, Torres Strait Islanders and rural and remote populations. One of the priority areas identified at this workshop was the need for a more coordinated approach to chronic diseases and for the formation of an alliance of non‐government organisations (NGOs) to work towards this and to undertake a lobbying and advocacy role. A meeting of a wide range of NGOs working in chronic disease, led by the National Heart Foundation of Australia, was held in Sydney in May 2000. At the Sydney meeting it was agreed that an alliance of NGOs could be formed for the development of a chronic disease strategy for Aboriginal peoples, Torres Strait Islanders and rural and remote populations. The NGOs drafted a ‘Statement of Intent’, which would inform their work on both heart disease and on broader work to address chronic preventable disease in the target populations. There is a considerable amount of procedural work to be done before the proposed alliance becomes a reality but the prospect of closer collaboration between the NGOs working in chronic disease has much to offer, especially for the population groups that were the focus of the Townsville workshop. This ‘alliance’ initiative comes at a time when there are national and State/Territory moves on broader aspects of what could become a ‘national chronic disease prevention and management strategy’.
Nursing Research in Practice: The Case Study Revisited
Authors: Keyzer Dirk M.
Published: March 2003

This paper makes reference to some of the many issues and problems surrounding nursing research in the context of the rural and remote areas of Australia. The focus is on the use of case studies as an appropriate methodology for small‐scale research projects and for students preparing for examinations at higher degree levels. Throughout this paper, the term rural will be used to denote rural and remote area nursing. This is for convenience and does not deny the special qualities of rural or remote area nursing.
The needs of cancer patients and their families from rural and remote areas of Queensland
Authors: Clavarino Alexandra M. , Lowe John B. , Carmont Sue‐Ann , Balanda Kevin
Published: March 2003

Abstract: This study examines the impact of travelling for treatment on cancer patients and their families. Twenty‐eight consecutive cancer patients, who were receiving radiation therapy treatment and 19 family carers, completed a structured needs assessment questionnaire and an in‐depth interview.

Both patients and carers reported moderate to high levels of unmet psychological need. Carers were found to have higher levels of anxiety than patients, although both groups had higher anxiety levels than the general population. Taking more responsibility for household tasks and organising new living arrangements for the family were the most frequently identified demands of a dual burden of caring. Nearly 40% of carers reported some disruption to their schedule and half reported experiencing financial difficulties. The qualitative interviews highlight the disruption that parents and children experience under the present system, particularly in relation to the demands of family life and the need to maintain some level of continuity and security for children.
Leber’s idiopathic stellate neuroretinitis: Differential diagnosis and approach to management
Authors: Casson RJ , O’Day J , Crompton JL
Published: March 2003

Background: Leber’s idiopathic stellate neuroretinitis (LISN) is a relatively uncommon clinical entity that is characterized by optic disc oedema and associated macular hard exudates. A broad range of causes can produce such a fundus appearance.

Methods: The clinical experience of the authors is combined with a review of the pertinent literature to describe the features of LISN and its differential diagnosis.

Conclusion: A knowledge of the potential causes of neuroretinitis is important in order to formulate an effective management strategy.
A randomized phase II trial of interferon‐α2b versus 5‐fluorouracil after trabeculectomy*
Authors: Gillies Mark C , Brooks Anne Mv , Young Stephanie , Gillies Bill , Simpson Judy M , Goldberg Ivan
Published: March 2003

Purpose: The aim of the present study was to investigate the safety and potential efficacy of subconjunctival interferon‐α2b (IFN‐α), either alone or in combination with 5‐fluorouracil (5‐FU), in reducing the risk of failure of glaucoma surgery.

Methods: A prospective, masked randomized phase II study was undertaken in which patients received three subconjunctival injections per week for 3–4 weeks postoperatively. Three treatments were compared: (i) IFN‐α (1 × 106 IU per dose); (ii) 5‐FU (5 mg per dose); and (iii) alternating IFN‐α and 5‐FU (BOTH). The primary outcome measures were: (i) rate of successful control of intra‐ocular pressure without further surgery; and (ii) the incidence of side effects.

Results: Fifty‐seven patients undergoing glaucoma surgery with an increased risk of failure were evaluated, including 23 patients (40%) undergoing trabeculectomy combined with extracapsular cataract extraction as well as other conventional high‐risk groups. With 53 patients (93%) completing 2 years follow up, there was no significant difference in success rates among the three groups. Intra‐ocular pressure was controlled without further surgery in 79% of patients (95% confidence interval (CI): 61, 97%) receiving IFN‐α, in 89% of patients (76, 100%) receiving 5‐FU and in 89% of patients (76, 100%) receiving BOTH. Side effects were similar among the three groups.

Conclusions: These results are consistent with a beneficial effect of IFN‐α2b given either alone or in combination with 5‐FU after glaucoma filtering surgery. However, the lack of a clear and substantial benefit over conventional anti‐fibrotic therapy does not support the further clinical evaluation of these treatments.
Late presentation of a unilateral sporadic retinoblastoma in a 16‐year‐old girl
Authors: Park JJ , Gole GA , Finnigan S , Vandeleur K
Published: March 2003

Background: Retinoblastoma is the commonest intraocular tumour of childhood with the majority of cases being diagnosed before 5 years of age. Late presentation of retinoblastoma is rare.

Case history: A healthy 16‐year‐old Caucasian girl presented with a 1‐day history of blurred vision in the left eye. Examination revealed an inferonasal mass in the left retina with an overlying haemorrhage and vitreous seeding. Imaging studies revealed a 5‐mm densely calcified opacity. Other investigations, including cerebral spinal fluid examination, bone marrow aspirate trephine, toxocara serology and serum protein studies, were normal. After considering the differential diagnoses such as toxocariasis and Coat’s disease, a diagnosis of late‐presenting retinoblastoma was made. The patient subsequently underwent enucleation with a primary orbital implant. The diagnosis was confirmed histopathologically.

Conclusion: Late presentation of retinoblastoma is uncommon but can be a cause of acute visual impairment in the non‐paediatric age group. Retinoblastoma should be considered in the differential diagnosis of a fundal mass in any age group.
Trauma-Induced Dissociative Amnesia in World War I Combat Soldiers
Authors: van der Hart Onno , Brown Paul , Graafland Mariëtte
Published: March 2003

Objective: This study relates trauma-induced dissociative amnesia reported in World War I (WW I) studies of war trauma to contemporary findings of dissociative amnesia in victims of childhood sexual abuse.

Method: Key diagnostic studies of post-traumatic amnesia in WW I combatants are surveyed. These cover phenomenology and the psychological dynamics of dissociation vis-à-vis repression.

Results: Descriptive evidence is cited for war trauma-induced dissociative amnesia.

Conclusion: Posttraumatic amnesia extends beyond the experience of sexual and combat trauma and is a protean symptom, which reflects responses to the gamut of traumatic events.
How is Psychiatry Taught to Australian and New Zealand Medical Students?
Authors: O'Connor Daniel W. , Clarke David M. , Presnell Ian
Published: March 2003

Objective: This study aimed to describe the amount, format and content of psychiatry teaching programs in all 12 Australian and New Zealand medical schools.

Method: A structured questionnaire which included definitions and coding instructions was completed by class coordinators for the years of 1995 or 1996. Missing and inconsistent data were checked by coordinators and results were confirmed by heads of department.

Results: Most departments of psychiatry taught throughout the undergraduate course. Only three made no contribution to pre-clinical teaching. The time devoted to clinical tuition ranged from 279 to 454 h per university with a mean of 353 h. Clinical attachments occupied most time (mean = 70%), followed by small group teaching (mean = 19%) and lectures (mean = 11%). Medical schools varied greatly in the attention given to history taking and mental state examination, psychological therapies and the sub-specialties of child and aged psychiatry. Clinical attachments were mostly to adult inpatient units. Private psychiatric hospitals and clinics were used infrequently as were consultation-liaison psychiatry services and primary care.

Conclusion: There is a need to broaden the clinical experience of students to better equip them for future medical practice. There appears to be a serious mis-match between the settings in which most students are taught and the settings in which most will work later as non-psychiatric practitioners. It was disappointing that psychological therapies received so little attention given the central place of counselling in modern medical practice.
Mental Health and Maori Development
Authors: Durie Mason
Published: March 2003

Objective: The objective of this paper is to illustrate trends in Maori health, examine earlier health policies and to suggest avenues for improved mental health.

Method: Several sources of historical and contemporary data have been reviewed and there has been some analysis of mental health policies as they relate to Maori. The interplay between culture, socioeconomic circumstances and personal health has been used as a context within which strategic directions are discussed.

Results: Five strategies are highlighted: the promotion of a secure cultural identity, active Maori participation in society and the economy, improved mental health services, workforce development, autonomy and control. It is recommended that mental health services should be more closely aligned with primary health care, Maori youth, Maori-centred frameworks, and evidence-based practices.

Conclusions: Improvements in Maori mental health require broad approaches which are consistent with Maori aspirations and coordinated across the range of sectoral and disciplinary interests. Active Maori participation in the process and the retention of a cultural base will be critical if the current trends are to be reversed.
Megavitamin and Dietary Treatment in Schizophrenia: A Randomised, Controlled Trial
Authors: Vaughan Kevin , McConaghy Nathaniel
Published: March 2003

Objective: The aim of this study was to assess the efficacy of adjunctive megavitamin and dietary treatment in schizophrenia.

Method: Arandom allocation double-blind, controlled comparison of dietary supplement and megavitamin treatment, and an alternative procedure was given for 5 months to 19 outpatients with a diagnosis of schizophrenia. In addition to usual follow-up, the experimental group received amounts of megavitamins based on their individual serum vitamin levels plus dietary restriction based on Radioallergosorbent (RAST) tests. The control group received 25 mg vitamin C and were prescribed substances considered allergenic from the RAST test.

Results: Five months of treatment showed marked differences in serum levels of vitamins but no consistent self-reported symptomatic or behavioural differences between groups.

Conclusions: This study does not provide evidence supporting a positive relationship between regulation of levels of serum vitamins and clinical outcome in schizophrenia over 5 months.
Children who are Cruel to Animals: A Revisit
Authors: Luk Ernest S. L. , Staiger Petra K. , Wong Lisa , Mathai John
Published: March 2003

Objective: There is a paucity of research regarding children who are cruel to animals (CTA). Previous studies have suggested that being CTAis linked with recurrent aggression in adulthood. In this report, children with persistent conduct problems who are CTA are examined.

Method: Aclinic-referred sample of 141 children and a community sample of 36 children between the ages of 5–12 were assessed using a test battery of questionnaires for parents, teachers and the child on mental health symptoms, self-perception, demographics and psychosocial factors. Forty of the clinic-referred children and one of the community group were rated by their parents as sometimes or definitely cruel to animals. The CTA, non-CTAand community samples were compared.

Results: The CTA group had more conduct symptoms compared with the non-CTA group. However, the older CTA group unexpectedly reported a higher self-esteem compared with the non-CTA group. There was no significant difference between the two clinic-referred groups in gender, attention deficit hyperactivity disorder and internalising symptoms, and psychosocial factors.

Conclusion: Being CTA is possibly a marker of a subgroup of conduct disorder which has a poor prognosis.
Sex Knowledge and Sexual Attitudes Among Medical and Nursing Students
Authors: McKelvey Robert S. , Webb John A. , Baldassar Loretta V. , Robinson Suzanne M. , Riley Geoff
Published: March 2003

Objectives: The aim of this study was to assess the relationship between background and sociodemographic variables, attitudes toward controversial aspects of human sexuality and sex knowledge among medical and nursing students.

Method: The study design was a questionnaire-based survey of medical and nursing students in Western Australia. Participants were first-through fifth-year medical students at the University of Western Australia and first-through third-year undergraduate nursing students at Edith Cowan University. Outcome measures were students' attitudes toward controversial aspects of human sexuality expressed on a five-point Likert scale and a modified version of the Kinsey Institute/Roper Organization National Sex Knowledge Test.

Results: A significant relationship was found between certain background and sociodemographic variables, sexual attitudes and sex knowledge. The background variable most strongly related to both attitudes and knowledge was frequency of attendance at religious services of any religious denomination during the past month, with those attending three or more times more likely to express negative attitudes and have lower sex knowledge scores. Lower sex knowledge was related to negative attitudes toward gay/lesbian/bisexual behaviour, masturbation, premarital sex and contraception. Other important background and sociodemographic variables related to negative attitudes were: never having experienced sexual intercourse; right-wing political orientation; lower family income; gender and ethnicity.

Conclusions: Negative attitudes toward controversial aspects of human sexuality and lower sex knowledge scores among medical and nursing students can be predicted on the basis of background and sociodemographic variables. Education aimed at increasing sex knowledge and modifying negative attitudes may increase students' ability to function more effectively as sexual history takers and sex counsellors.
Cognitive Changes Following Recovery from Depression in a Group Cognitive-Behaviour Therapy Program
Authors: Oei Tian P. S. , Sullivan Lyndall M.
Published: March 2003

Objective: We report on the changes in cognitions as a result of cognitive—behaviour therapy (CBT), in 35 recovered and 32 non-recovered mood disordered patients who had undergone a 12-week group CBT program for depression.

Method: An end-of-therapy cut-off score of 10 on the BDI was used to define recovered and non-recovered patients. ANOVA analyses were conducted to explore possible main effects of recovery status and time on various clinical measures, including cognitions and activity levels.

Results: Mean mood and activity self-rating measures were significantly higher for the recovered as compared to the non-recovered patients over the course of the program. Similarly, scores on the Automatic Thoughts Questionnaire (ATQ) for recovered patients were within the non-clinical range, in contrast to their non-recovered counterparts. In addition, recovered patients improved significantly in their Hopelessness scores, and there was a change in the expected direction in their Dysfunctional Attitudes Scale scores, although this was not significant.

Conclusion: These results are consistent with the proposition of cognitive theory (i.e. the remediation of negative cognition plays a significant role in recovery from depression during CBT).
Increasing Diagnosis of Nicotine Dependence in Adolescent Mental Health Patients
Authors: Sellman J. Douglas , Wootton Alexander R. , Stoner David B. , Deering Daryle E. , Craig Brian J.
Published: March 2003

Objective: The aim of this study was to investigate the routine recording patterns of patients' smoking by clinical staff of an adolescent mental health service over a 3-year period.

Method: A systematic examination of the clinical files of all patients who underwent an initial assessment or reassessment at the Youth Specialty Service (Mental Health; YSS) over a 2-month period (1 April-31 May) was carried out in 1996, 1997 and 1998. A range of data were collected including: demographics; diagnoses; amount of total information recorded and history of nicotine dependence.

Results: A stable historical record of cigarette smoking in the region of 30–40% across the 3 years sampled was found, but the rate of formal diagnosis of nicotine dependence rose from 3.6% in 1996 to 26.3% in 1998. This rise was in the context of relative stability over this time period of: size of reports and relevant sections (alcohol and drug history, cigarette smoking history); three other key diagnoses, major depression, conduct disorder and alcohol dependence; and demographic data. The rise in rate of diagnosis proceeded specific discussion within the clinical team about nicotine dependence.

Conclusions: Adolescent mental health settings are a key venue to address heavy and potentially chronic cigarette smoking, but nicotine dependence has been traditionally a neglected diagnosis in mental health patients. The rate of diagnosis is likely to rise when specific discussion is undertaken within clinical teams.
Early Developmental Experiences of Female Sex Workers: A Comparative Study
Authors: Potter Kathleen , Martin Judy , Romans Sarah
Published: March 2003

Objective: The aim of this paper is to explore the early family environment of a sample of female sex workers and compare the findings with a large community data set of similarly aged women.

Method: Sex workers recruited by a snowball method were given a semi-structured interview, which included the Parental Bonding Instrument. These results were compared to those from the Otago Women's Child Sexual Abuse (OWCSA) study.

Results: The sex workers' families were of lower socioeconomic status and had experienced more parental separation than had the OWCSA families. The mothers of sex workers were more frequently the family's main wage earner. Sex workers described both parents as less caring than did the OWCSA women. They were significantly more likely than the OWCSA women to report childhood sexual abuse. The sex workers were more likely to have left home early, to have become pregnant before the age of 19 years and to not have completed tertiary study.

Conclusions: The sex workers studied came from families with more interpersonal difficulties during childhood and adolescence than did a control community sample of similarly aged women. The relevance and generalisability of this conclusion to the wider sex worker population is difficult to determine, given the non-random selection of this sex worker sample.
A Conceptual Review of Functioning: Implications for the Development of Consumer Outcome Measures
Authors: Fossey Ellie M. , Harvey Carol A.
Published: March 2003

Objective: Australia's National Mental Health Strategy aims to achieve improved consumer outcomes. The development and refinement of consumer outcome measures is targeted within the Second National Mental Health Plan. The National Standards for Mental Health Services identify measures of functioning, quality of life and satisfaction with services as relevant to assessing and monitoring consumer outcome. Consumers have described gauging their own recovery through the achievement of functional goals in everyday life. This paper reviews how functioning is viewed within the mental health field, and implications for developing better functional outcome measures.

Method: Literature describing the development of measures of functioning, principles of outcome measurement, and functional outcomes for people with severe mental illness was identified, using PsycLIT. A review yielded themes reflecting a number of assumptions about the concept of functioning.

Results: Functioning is inadequately defined, raising issues about what is focused on, and from whose viewpoint, each of which has implications for using measures of functioning to monitor consumer outcome. Conflation of dissimilar functional domains, and flawed assumptions about the importance of symptomatology in influencing functional outcome limit the sensitivity to meaningful change of functional measures. Consumer perspectives are relatively neglected in functional tool development.

Conclusions: A conceptual framework that recognizes lived experience and the interaction between persons and their environment is much needed to guide the development of functional outcome measures. Qualitative and quantitative research methodologies should be used to advance understanding of functioning and to address limitations of current approaches to functional outcome measurement.
Stalking: New Constructions of Human Behaviour
Authors: Mullen Paul E. , Pathé Michele , Purcell Rosemary
Published: March 2003

Objective: In the last decade stalking has emerged as a significant social problem, which now constitutes a specific form of criminal offence in most English-speaking nations. This paper examines why stalking has become a major social problem and why it should be of particular concern to mental health professionals.

Method: Using the extant literature, the history of the emergence of stalking as social, legal and behavioural science discourses is presented. An attempt is made to understand the social and cultural forces which shaped our current understanding of the phenomenon of stalking.

Results: Stalking flourishes in a variety of contexts; the social conditions conducive to such behaviour include greater instability in intimate relationships, a culture of blame and entitlement and a growing social anxiety that emphasizes vulnerability to crime and suspicion regarding the intentions of strangers. Stalking is now an established category whose utility is in directing social, legal and health energies to support victims and relieve stalkers of their burden of pursuit.

Conclusions: Stalking is a curious construction born of a range of tensions in contemporary culture but has proved to be a useful label and a useful concept. In part due to the emergence of the concept of stalking, laws are now available to protect, and services increasingly geared to support, the victims of persistent harassment.
Cognitive–Behavioural Therapy via Videoconferencing to a Rural Area
Authors: Cowain Taryn
Published: March 2003

Objective: This case report describes the use of cognitive–behavioural therapy via twoway, interactive audiovisual videoconferencing and identifies issues involved in using this form of technology to provide therapy.

Clinical picture: A 38-year-old married woman living in rural South Australia presented with panic disorder with agoraphobia and major depression. The patient had refused antidepressant treatment.

Treatment: The patient was treated with 12 sessions of cognitive–behavioural therapy delivered via videoconferencing.

Outcome: Anxiety and depressive symptoms resolved with concomitant improvement in function.

Conclusions: Providing this form of therapy via videoconferencing can be effective.
Assessing Stressful Life Events in Relation to Liability and Compensation
Authors: Tennant Christopher
Published: March 2003

Objective: The aim of this paper is to outline limitations in the assessment of the relationship between stressful experiences and psychological disorder in the medico-legal setting.

Method: A research-derived approach to more objectively assessing stressful life events and disorder is discussed in the light of limitations or biases which may arise in the evaluation of the clinical significance of stressors in psychological disorder particularly in a medico-legal context.

Results: There may be considerable bias in the assessment of stressful experiences in a medico-legal setting. In addition to the purely subjective approach used in the appraisal of stressful life events it may be useful to (i) apply common sense and population-based appraisal as an initial basis for assessing the significance of a stressor; (ii) use evidencebased findings to support the link between stressors and disorder; and (iii) apply recognized criteria of causality where applicable.

Conclusions: Conflicting psychiatric opinions in the medico-legal setting may arise both from psychiatrists' positional biases, from the often complex relationships that may exist between stressors and depression, and from a failure to use evidence-based findings to support psychological explanations.
The Validity of the 12-Item General Health Questionnaire in Australia: A Comparison Between Three Scoring Methods
Authors: Donath Susan
Published: March 2003

Objective: To investigate the specificity and sensitivity of three different scoring methods of the 12-item General Health Questionnaire (GHQ-12) and hence to determine the best GHQ-12 threshold score for the detection of mental illness in community settings in Australia.

Method: Secondary data analysis of the 1997 Australian National Survey of Health and Wellbeing (n = 10 641), using the Composite International Diagnostic Interview as the gold standard for diagnosis of mental illness.

Results: The area under the Receiver Operating Characteristic (ROC) curve for the C-GHQ scoring method was 0.84 (95% CI = 0.83–0.86) compared with the area for the standard scoring method of 0.78 (95% CI = 0.76–0.80). The best threshold with C-GHQ was 3/4, with sensitivity 82.9% (95% CI = 80.2–85.5%) and specificity 69.0% (95% CI = 68.6–69.4%). The best threshold score with the standard scoring method was 0/1, with sensitivity 75.4% (95% CI = 72.5–78.4%) and specificity 69.9% (95% CI = 69.5–70.3%). These were also the best thresholds for a subsample of the population who had consulted a health practitioner in the previous 4 weeks.

Conclusion: In the Australian setting, the C-GHQ scoring method is preferable to the standard method of scoring the GHQ-12. In Australia the GHQ-12 appears to be a less useful instrument for detecting mental illness than in many other countries.
Family History of Schizophrenia and the Relationship of Stress to Symptoms: Preliminary Findings
Authors: Norman Ross M. G. , Malla Ashok K.
Published: March 2003

Objective: It has been hypothesized that patients with a diagnosis of schizophrenia who have a positive family history for schizophrenia will show greater reactivity of their symptoms to increasing levels of stress or negative affect than will patients without such a family history. In the past this hypothesis has only been tested through manipulations of negative affect in laboratory settings. In this paper we test this hypothesis using longitudinal clinical data.

Method: Data were derived from an earlier longitudinal study using monthly assessments of daily stressors (Hassles Scale) and symptom measures (the Scale for the Assessment of Positive Symptoms and the Scale for the Assessment of Negative Symptoms). We compared longitudinal stress to symptom relations in 12 patients with schizophrenia for whom a positive family history of schizophrenia could be identified with 12 matched schizophrenic patients without any known family history of psychiatric illness.

Results: There was evidence that patients with a family history of schizophrenia demonstrated a stronger relation between stress and total score on the Scale for the Assessment of Positive Symptoms. This difference appears to have primarily reflected a greater reactivity to stress of reality distortion symptoms in the positive family history group. The two groups did not differ in apparent reactivity to stress of the disorganization and psychomotor poverty dimensions of symptomatology.

Conclusions: The results of this study provide support from a naturalistic, longitudinal clinical study for the hypothesis that reactivity to stress of some symptoms of schizophrenia may vary as a function of family history of the disorder.
A 12-Month Follow Up of the Implementation of Clinical Indicators in a Consultation–Liaison Service
Authors: Holmes Alex C.N. , Judd Fiona K. , Yeatman Richard , Lloyd John H. , Dakis Jennifer , Cairns Fiona , Kiang Maria , Kerr Louise , Mckinnon Jonathan
Published: March 2003

Objectives: This paper reviews the use of clinical indicators in a consultation–liaison (C–L) service over a 12-month period at the Royal Melbourne Hospital, Melbourne, Australia.

Method: Clinical indicators and C–L data were collected during the 1999 calendar year. A review of the process was conducted during and after completion of the 12-month period.

Results: The system was found to be practical and useful. The use of clinical indicators led to the identification of problems and stimulated effective interventions. The use of the clinical indicators was associated with improvement in communication between C–L staff, parent units and practitioners providing follow-up.

Conclusions: The implementation of a database and clinical indicators was a useful addition to the C–L service. The use of clinical indicators was effective in improving clinical performance. These benefits need to be balanced against increased administrative burden.
Psychiatry has Much to Offer for Chronic Pain
Authors: Pridmore Saxby , Oberoi Gajinder , Harris Newman
Published: March 2003

Objective: The objective of this study was to make an argument in favour of the inclusion of psychiatrists on chronic pain clinic teams.

Method: The argument takes the form of answers to four central questions: (i) does pain involve an emotional experience; (ii) do psychiatric disorders accompany chronic pain; (iii) can psychiatric disorders present as chronic pain; and (iv) which patients present to pain units, and what do we know of their personalities?

Results: The affirmative case was substantiated in respect of the first three questions. In examining the last question, evidence indicates that patients who present to chronic pain units frequently have personality features that make assessment and therapy difficult.

Conclusions: Psychiatry is the field of medicine where practitioners have the most experience with emotional states and personality, and is the only field where they have specialized skills in the diagnosis and treatment of psychiatric disorders. Psychiatry has much to offer in chronic pain management and chronic pain management teams should include a psychiatrist. This conclusion has resourcing and training implications.