bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between urinary tract infection and postmicturition wiping habit
Authors: PERSAD SUNIL , WATERMEYER SEAN , GRIFFITHS ANTHONY , CHERIAN BINA , EVANS JANET 
Published: December 2009

AbstractUrinary tract infections are common in pregnancy. In pregnancy urinary tract infections have an associated risk of premature labour. This study looks at the incidence of urinary tract infections and the method of perineal hygiene used after urination. Wiping back to front is associated with a greater risk of developing urinary tract infection than wiping front to back.
Static and dynamic MRI features of the levator ani and correlation with severity of genital prolapse
Authors: ANSQUER YAN , FERNANDEZ PEDRO , CHAPRON CHARLES , FREY CATHERINE , BENNIS MALIKA , ROY CARINE , SALOMON LAURENCE , MANDELBROT LAURENT , CARBONNE BRUNO 
Published: December 2009

AbstractBackground. To describe the static and dynamic MRI features of the levator ani, and evaluate whether they are associated with the MRI evaluation of the severity of genital prolapse. Methods. Static and dynamic MRI of 40 patients, referred for evaluation prior to genital prolapse surgery, were reviewed retrospectively. Prolapse severity was evaluated on MRI at maximal straining by descent of the bladder neck under the pubococcygeal line for the anterior compartment, by descent of the uterine cervix under the pubococcygeal line for the middle compartment, and by anterior bulging of the rectum for the posterior compartment. For evaluation of the levator ani, the following parameters were recorded: (1) at rest: thinning or defects in both puborectalis and iliococcygeus muscles, (2) at rest and at straining: urogenital hiatus length and width, M line, iliococcygeal and levator plate angles. The levator ani features were tested for potential associations with the MRI evaluation of prolapse severity. Results. Bladder neck descent at straining was correlated with the levator plate angle at rest (p = 0.001), and with the hiatus length at rest (p = 0.02), and at straining (p = 0.008). Uterine cervix descent at straining was correlated with the hiatus length (p = 0.0005), and width (p = 0.014) at straining, M line (p = 0.002) and levator plate angle (p = 0.007) at straining, whereas anterior rectal bulging at straining was paradoxically inversely correlated with the hiatus width at rest (p = 0.04). Conclusion. In a population of women with genital prolapse, MRI evaluation of the levator ani was associated with MRI evaluation of the severity of genital prolapse.
Informed consent: attitudes, knowledge and information concerning prenatal examinations
Authors: DAHL KATJA , KESMODEL ULRIK , HVIDMAN LONE , OLESEN FREDE 
Published: December 2009

AbstractBackground. Providing women with information enabling an informed consent to prenatal examinations has been widely recommended. Objective. The primary purpose of this review is to summarise the current knowledge of the pregnant woman's expectations and attitudes concerning prenatal examinations, as well as the knowledge possessed by pregnant women undergoing prenatal examinations. Second, we explore their reasons for accepting or declining available screening tests. Results. More than 90% of the pregnant women expressed a positive attitude toward screening procedures in pregnancy. Most often (70–96%), the pregnant women were found knowledgeable about the procedural and practical aspects, but were more seldom (31–81%) able to correctly identify the purpose of tracing fetal malformations. Some 29–65% were not familiar with the existence of a false negative result, and 30–43% were found unaware of the possibility of a false positive result. The risk of miscarriage in relation to amniocentetesis [AC] is unknown to 11–53%. Uptake rates are associated with attitudes toward prenatal examinations, but no knowledge of the test offered. A total of 88% considered their health care provider an important source of information, and 57% stated that this information has influenced their decision. Conclusions. Pregnant women favor prenatal examinations, but the choice of participation does not seem to be based on insight to enable full informed consent. Health care providers are perceived as an essential source of information.
Use of preoperative serum CA‐125 levels for prediction of lymph node metastasis and prognosis in endometrial cancer
Authors: HOON CHUNG HYUN , WEON KIM JAE , PARK NOH‐HYUN , SONG YONG‐SANG , KANG SOON‐BEOM , LEE HYO‐PYO 
Published: December 2009

AbstractBackground. The purpose of this study was to evaluate the predictive value of preoperative serum CA‐125 levels in the assessment of disease extent and clinical outcome of endometrial cancer. Method. This retrospective study evaluated 92 women with pathologically proven endometrial carcinoma scheduled for treatment that had preoperative serum CA‐125 levels between January 1999 and February 2006. The association of preoperative serum CA‐125 with a variety of histopathologic factors was evaluated. Statistical analysis was performed using φ2/Fisher's exact test and a logistic regression. Survival was studied with the Kaplan–Meier method and Cox regression models. Results. Elevated serum CA‐125 levels were significantly correlated with advanced‐stage disease (p<0.001), lymph node metastases (p<0.001), increased depth of myometrial invasion (p = 0.001), and positive peritoneal cytology (p = 0.026). Multivariate analyses using logistic regression showed that lymph node metastases had the most significant effect on the elevation of preoperative serum CA‐125 levels (p = 0.004). Patients with a serum CA‐125 ≤28.5 U/ml had a significantly better five‐year disease‐free survival than those with an elevated level in this study: 85.6% versus 60.0% (p = 0.004). Conclusions. The preoperative serum CA‐125 level appears to be a significant independent predictor of lymph node metastasis and prognosis after surgical intervention. Therefore, preoperative serum CA‐125 may be a useful tool, in the clinical setting, for optimal individualized patient management.
Acute Psychiatric Beds: Distribution and Staffing in NSW and ACT
Authors: Rosenman Stephen 
Published: December 2009

This study examined the availability and staffing of acute psychiatry beds in NSW and ACT. “Gazetted” acute psychiatry hospitals (which take compulsory admissions under mental health law) were polled directly for bed numbers, occupancy and staffing for the year 1990–1991. The NSW Department of Health provided beds numbers for non-gazetted and private hospitals. Four analyses sequentially reallocated beds according to the origin of patients to estimate acute bed availability and use by regional populations. Socio-demographic determinants of acute admission rates were measured. Acute “gazetted” beds averaged 13.2 per 100,000 population but ranged from 6.9 to 49.1 per 100,000 when cross-regional flows were considered. “Non-gazetted” beds raised the provision to 15.5 per 100,000 and private beds raised provision further to 24.5 per 100,000. Inner metropolitan provision was higher than rural or provincial provision. The only determinant of the admission rate to gazetted beds was the number of available beds. Bed availability did not affect either bed occupancy or referral of patients to remote hospitals. Nursing staffing of gazetted units was reasonably uniform, although smaller units had significantly more nurses per bed. Medical staffing was highly variable and appears determined by staff availability. The average provision of acute psychiatric beds approximates lowest levels seen in international models for psychiatric services. Average occupancy rates suggest that there is not an overall shortfall of acute psychiatric beds, but uneven bed distribution creates barriers to access. Referral of patients to remote hospitals is not related to actual bed provision in the regions, but appears to reflect attitudes to ensuring local care. Recommendations about current de facto standards are made. Current average nursing and medical staffing standards are reported.
The Paper Trail to Mental Health
Authors: Ellard John 
Published: December 2009

Objective: The aim of this article was to examine the concept of mental health and the policies that have been advanced to improve the wellbeing of the population. Conclusions: In the last century there have been many changes in the phenomena of psychiatric disorder, the management of those disorders and the outcomes. All of the changes have largely been due to the efforts of those working pragmatically at the coalface. There is little to suggest that the plans and programs advanced in the last half century have achieved more than enhancing the status of those who advance them. Conclusion: It is difficult to define mental health and equally difficult to develop a comprehensive program that will benefit the whole field.
The Blue Card: A Hand-Held Health Record Card for Mental Health Consumers with Comorbid Physical Health Risk
Authors: Brunero Scott , Lamont Scott , Myrtle Lucy , Fairbrother Greg 
Published: December 2009

Objective: We aimed to determine the effectiveness of a hand-held record (the ‘Blue Card’) for seriously mentally ill consumers by investigating effects on consumer knowledge of physical health risk factors, consumer involvement in care and communication with healthcare professionals. Method: Consumers were given and educated in the use of the Blue Card, which contained information regarding their physical health. Consumers completed a pre- and post-knowledge questionnaire and commented on the effectiveness of the Blue Card with respect to their knowledge of physical health risks. Results: Statistically significant improvements in consumer knowledge were shown at the 3-month follow-up, with high retention of the Blue Card being demonstrated. Consumers that used the card described their use of the card positively. Conclusions: The results are very encouraging. Further studies of this low-cost intervention are warranted to establish its effectiveness and utility.
Hallucinations in Adolescent Inpatients with Post-Traumatic Stress Disorder and Schizophrenia: Similarities and Differences
Authors: Jessop Mary , Scott James , Nurcombe Barry 
Published: December 2009

Objective: This study compares the phenomenology of hallucinations in a series of hospitalized adolescents diagnosed with post-traumatic stress disorder (PTSD) and schizophrenia. Methods: Subjects admitted to a tertiary adolescent inpatient unit were screened for hallucinations. Those reporting hallucinations were asked standardized questions relating to these experiences. Hallucinations in subjects with a primary diagnosis of schizophrenia or PTSD were compared. Results: Hallucinations in both schizophrenia and PTSD have similar form and content. Frequent, vivid, realistic, external hallucinations occurred in both disorders. Hallucinations in PTSD were usually derogatory and related to self-harm, but not direct reflections of traumatic events. Patients with PTSD reported greater emotional distress, self-harm and suicidal ideation than those with schizophrenia. Conclusions: This case series suggests that the phenomenology of hallucinations in adolescents with schizophrenia and PTSD is similar.
The Wild West: Rural and Remote Psychiatry Training in North Western Australia
Authors: Balaratnasingam Sivasankaran 
Published: December 2009

Objective: The author reflects on his rural psychiatric training in North Western Australia, having gained over 2 years’ experience as a basic and advanced trainee in this setting. The unique rewards and benefits of rural training are discussed along with the challenges of working in an isolated setting with resource constraints. Conclusions: Rural and remote training remains a stimulating and professionally satisfying experience that is under-utilized by many trainees. In spite of most training requirements being able to be met in this setting, trainees are reluctant to undertake this valuable and enjoyable training experience. Trainees are encouraged to consider this opportunity to be upskilled and getting involved on a more personal level with patients, families and general practitioners, thereby enhancing their clinical skills and shaping their professional identity as future psychiatrists.
The Brain and Mind Research Institute: A Unique Campus for the Integration of Clinical and Basic Neurosciences in Australia
Authors: Hickie Ian , Bennett Maxwell 
Published: December 2009

Objective: The aim of this paper is to describe the conceptual and practical development of the Brain and Mind Research Institute (BMRI) at the University of Sydney. Method: The key conceptual framework of the BMRI is reviewed and contrasted with other biomedical institutes. The major timelines for appointment of key personnel, development of infrastructure and implementation of clinical capacities are presented. Results: The BMRI has developed over 15000 square metres of designated basic research and clinical space. This is thanks to major investments by the University of Sydney, the Australian and NSW governments and the wider community. Conclusion: Amelioration of the burden of disease due to disorders of the brain and mind may result from a conceptual and practical move away from the traditional emphasis on single disorders or narrow research platforms.
Developing Integrated Models of Care Within the Youth Alcohol and Other Drug Sector
Authors: Lubman Dan I. , Hides Leanne , Elkins Kathryn 
Published: December 2009

Objective: The aim of this paper is to describe an initiative in Victoria, Australia, aimed at improving the detection and management of co-occurring mental health issues within the youth Alcohol and Other Drug (AOD) sector. Conclusions: Over the past 4 years, in partnership with local youth AOD services, we have developed a successful service model that addresses co-occurring mental health issues within the youth AOD sector. However, such capacity-building requires the full support of workers and senior management, and a cultural shift whereby the assessment and management of mental health issues are seen as a priority and core service issue. The capacity-building process was facilitated by embedding experienced mental health clinicians within each service to support and implement the initiative. This model offered learning opportunities through the modelling of relevant skills and the provision of ‘on-the-job’ training. Such approaches demonstrate that integrated models of care can be delivered within youth AOD services, although further research is needed to determine their effectiveness.
Patient and Staff Perspectives on the Use of Seclusion
Authors: El-Badri Selim , Mellsop Graham 
Published: December 2009

Objectives: This paper investigates the perceptions and experience of patients and staff on the use of seclusion in psychiatric services. Method: A purpose designed questionnaire was distributed to staff and patients in a general adult mental health service. Results: Staff and patients both attributed more negative than positive feelings to patients’ experience of seclusion. Conclusions: Monitoring and evaluation of the use of seclusion may be insufficient to prevent or ameliorate its emotional impact. More comfortable alternatives to seclusion need to be utilized whenever possible.
Suicide and Reputation Damage
Authors: Pridmore Saxby , McArthur Milford 
Published: December 2009

Aim: This paper uses the public record to explore the relationship between reputation damage and suicide. Method: The public record of the last 20 years was examined for examples of individuals without evidence of mental disorder who suffered actual or threatened reputation damage and suicided shortly thereafter. Results: Fifteen individual cases were identified; 18 additional cases, less comprehensively detailed, were mentioned in reports of The Wood Royal Commission and Operation Auxin. All cases were male. Of the 15 individual cases, the average age was 55 years, with a range of 40 to 76 years. The available details of the 18 additional cases were consistent with these findings. Conclusion: Middle-aged males without clear evidence of mental disorder, who suffer actual or threatened reputation damage, may be at increased risk of suicide. Naming and shaming needs to be conducted with caution.
Set up to Fail? Consumer Participation in the Mental Health Service System
Authors: Stewart Sarah , Watson Sandy , Montague Roslyn , Stevenson Caroline 
Published: December 2009

Objective: The aim of this paper is to present the findings of a survey of consumers of mental health services who are working (in either paid or unpaid positions) in NSW Health and in the Non Government Organisation sector in NSW. Method: A survey was distributed through the NSW Consumer Advisory Group newsletter to elicit the roles and assess the training needs of consumer employees, as well as those who were working in voluntary capacities as consumer representatives, within the mental health system in NSW. Results: Many mental health consumers have been placed in the untenable position of being engaged in representation and/or advocacy roles with unclear job descriptions and no training. The majority of consumers want a code of ethics and performance standards for consumer workers. Conclusions: The rhetoric of consumer participation is not matched by effective and timely strategies that ensure that consumer involvement is underpinned by relevant training and supportive infrastructure. The goal of meaningful consumer participation in mental health services, as outlined in policy, is yet to be achieved.
Personality, Gender and Medico-Legal Matters in Medical Practice
Authors: Nash Louise , Daly Michele , Johnson Maree , Coulston Carissa , Tennant Chris , van Ekert Elizabeth , Walter Garry , Willcock Simon , Walton Merrilyn 
Published: December 2009

Objectives: The aim of this paper was to explore the relationship between the personality traits of Australian General Practitioners (GPs) and their gender, work practice arrangements, and history of medico-legal matters. Methods: A cross-sectional self report survey was mailed to 1239 GPs. There were 566 respondents (45.7% response rate to survey). The survey assessed personality traits (using the Eysenck Personality Questionnaire), demographic and practice information, and history of medico-legal matters with any medical defence organization. The number and type of medico-legal matters was also extracted from the UNITED Medical Protection database. Results: Male respondents had significantly higher psychoticism scores than females (p<0.001), and females had significantly higher neuroticism scores than males (p<0.01), as in community samples. However, for GPs who worked more than 48 hours per week, there were no gender differences in personality trait scores. Solo practitioners and non-solo practitioners did not differ on personality scores. Proceduralists and non-proceduralists did not differ on personality scores. However, a higher proportion of proceduralists experienced a medico-legal matter than non-proceduralists (p<0.001). There was a positive correlation between extraversion scores and doctors who attended peer review (p<0.001). There was no difference in the numbers of medico-legal matters for doctors who attended peer review. Males who self reported a medico-legal matter had higher neuroticism scores than the males who did not report medico-legal matters. This was not the case for females. For males, this pattern was not replicated when considering data from UNITED. Conclusions: The known demographic and practice factors that differ for doctors having a medico-legal matter are replicated here – being male, a proceduralist and working longer hours. There is not a consistent pattern regarding personality traits and medico-legal matters.
SSRIs and Depression in Children and Adolescents: The Imperative for Shared Decision-Making
Authors: Hetrick Sarah , Simmons Magenta , Merry Sally 
Published: December 2009

Objective: In the context of controversy and uncertainty about the role of selective serotonin reuptake inhibitors (SSRIs) for the treatment of depressive disorders in children and adolescents, we consider the evidence of the benefits and risks of this class of medication and the possible role of shared decision-making as a practical way to guide clinicians, young people and their families through treatment decisions. Conclusion: We suggest that there is an imperative for clinicians to engage young people in a process of shared decision-making, given the uncertainties about SSRI medication in this age group. Shared decision-making provides a way for clinicians to engage young people and ensure they receive the treatment required for this disorder, the potential outcomes of which are severe.
The Employment of Consumers in Mental Health Services: Politically Correct Tokenism or Genuinely Useful?
Authors: Nestor Paul , Galletly Cherrie 
Published: December 2009

Objective: The aim of this paper is to examine the role of consumers as service providers and to describe the successful employment of peer support workers in a public mental health service. Conclusions: The Peer Support Worker program in Adelaide, South Australia is consistent with evidence obtained from previous research in demonstrating the successful training and employment of consumers as peer workers in a public mental health service.
Dissemination and Implementation of the Royal Australian and New Zealand College of Psychiatrists’ Clinical Practice Guidelines
Authors: Codyre David , Wilson Andrew , Begg Juliette , Barton David 
Published: December 2009

Objective: The aim of this paper is to summarize information about the dissemination and implementation of the Royal Australian and New Zealand College of Psychiatrists’ clinical practice guidelines (CPGs) since their completion in 2003, and assess the effectiveness of these activities. Method: The dissemination and implementation activities undertaken from 2003 to the present are described. Data regarding the dissemination of the clinician and consumer-carer versions of the CPGs are presented. The results of a series of implementation pilots are summarized. Results: Available data suggest the CPGs have been widely disseminated through both the clinician and consumer-carer communities in Australia and New Zealand, and that the consumer-carer versions in particular continue to be in high demand. Evaluation of CPG implementation pilots, using tools that assist in bringing summary evidence into clinical practice, have suggested that such tools are acceptable, are a useful aid to implementing evidence-based practice, and have a positive impact on practice. Common barriers to implementing the evidence are highlighted. Conclusions: Summary consumer-carer versions of CPGs seem to be acceptable and useful to both consumer-carers and non-government mental health providers. Locally led implementation of CPGs using tools that summarize evidence and support its use in everyday practice has a positive impact, but also highlights system-level barriers to implementing evidence-based practice.
Being Bleuler: The Second Century of Schizophrenia
Authors: Kaplan Robert M. 
Published: December 2009

Objective: The aim of this paper is to examine the background to the emblematic psychiatric term, schizophrenia, the historical, cultural and social factors affecting the two men who defined modern psychiatric practice, and anticipate what lies ahead in the next century. Conclusions: The term schizophrenia was created by Swiss psychiatrist Eugene Bleuler and first used on 24 April 1908. The condition was first described by German psychiatrist Emil Kraepelin and called dementia praecox. After a century, it is impossible to think of the practice of psychiatry without schizophrenia.