bluuebunny/crossref_metadata_2025_split huggingface dataset:
Models of antenatal care and obstetric outcomes in Sydney South West
Authors: BAI Jun , GYANESHWAR Rajanishwar , BAUMAN Adrian 
Published: August 2010

Objectives:  To assess obstetric outcomes of different models of antenatal care.Methods:  The study was historical cohort analysis of population birth data of 67 675 singleton births delivered in all public hospitals in Sydney South‐west. Maternal and neonatal outcomes were compared for different models of antenatal care received. The care was provided within the hospitals in doctor's clinic, midwives’ clinic, birth centre, or by a team of midwives in the caseload midwifery. In the non‐hospital settings, the care was provided by private obstetricians or by the general practitioner (GP) as part of the GP Shared Care program. The data for those women who received no antenatal care were also analysed.Results:  This study provided information that the obstetric outcomes were very similar regardless of whether a woman received her antenatal care in the midwives’ clinic, the birth centre, under the GP Shared Care program or in the doctor's clinic in Sydney South‐west hospitals.Conclusions:  This study provides evidence for the view that different models of maternity care can be provided with good outcomes.
Successful but limited use of external cephalic version in Auckland
Authors: WISE Michelle R. , SADLER Lynn , ANSELL David 
Published: August 2010

Background: External cephalic version (ECV) can effectively reduce the chance of non‐cephalic presentation at birth and reduce caesarean section rate for breech presentation at term. It is recommended in New Zealand to offer ECV to all eligible women with breech presentation at term.Aim: This study aims to determine the ECV success rate at our hospital, factors that predict ECV success, and perinatal outcomes for women who had ECV, and to estimate the ECV attempt rate at our hospital.Methods: A prospective audit was performed of all women with singleton non‐cephalic presentation ≥ 36 weeks who attended the ECV clinic at National Women's Health in Auckland from July 2002 to January 2006.Results: Two hundred and fifty five women presented for ECV during the study period, and the ECV success rate was 59%. The strongest predictor of ECV success was an unengaged presenting part. Women with successful ECV had a vaginal birth rate of 67%. Three women needed to have an ECV attempt in order to prevent one caesarean section. We estimated that 26% of women with term breech presentation had an ECV attempt.Conclusions: ECV at National Women's Health is effective at reducing beech presentation at term and at restoring a caesarean section rate equivalent to that of cephalic singleton pregnancy at term. However, the low rate of referral should be addressed.
A prospective study of outcomes five years after hysterectomy in premenopausal women
Authors: FARQUHAR Cynthia Margaret , SADLER Lynn , STEWART Alistair W. 
Published: August 2010

Aims: To prospectively collect data five years after hysterectomy and compare with data of women who had not undergone hysterectomy.Methods: A prospective cohort study of five years of premenopausal women with and with out hysterectomy was undertaken. Multivariate analytical methods were used to control for differences between groups.Results: Comparing the prehysterectomy and five years post‐hysterectomy data, pelvic pain, abdominal pain, urinary frequency and depression scores were reduced five years following hysterectomy. Women in the non‐hysterectomy group were more likely to describe their health as good or very good (74%) than women in the hysterectomy group (56%) (P = 0.03).Conclusions: The long‐term health of women who undergo hysterectomy is not noticeably different from a group of women who do not undergo hysterectomy. In women undergoing hysterectomy, pelvic pain, urinary frequency and depression scores are reduced five years after hysterectomy compared to prehysterectomy.
Induction of labour: A comparison between controlled‐release dinoprostone vaginal pessary (Cervidil®) and dinoprostone intravaginal gel (Prostin E2®)
Authors: KHO Ee Min , SADLER Lynn , McCOWAN Lesley 
Published: August 2010

Background: There are various prostaglandin preparations available for inducing labour. Controlled‐release dinoprostone vaginal pessary is used in a number of centres in Australia and New Zealand.Aims: To compare the efficacy and safety of controlled‐release dinoprostone vaginal pessary (Cervidil®) with dinoprostone intravaginal gel (Prostin E2®) for induction of labour.Methods: Retrospective cohort study of 969 women who were induced using either 10‐mg controlled‐released dinoprostone vaginal pessary (n = 507) or intravaginal dinoprostone gel (n = 462) at National Women's Health, Auckland City Hospital. Study outcomes included induction to delivery interval, mode of delivery, rate of oxytocin augmentation and incidence of uterine hyperstimulation.Results: Induction to vaginal birth interval was longer among nullipara receiving the pessary compared to those receiving intravaginal gel (21.5 vs 17.8 h, P = 0.004). There was no difference in rates of oxytocin augmentation or in mode of birth between pessary and gel groups. There was a trend to more uterine hyperstimulation among women induced with the pessary compared with those induced with intravaginal gel (22 (4.5%) vs 11 (2.4%) relative risk (RR) 1.9 (0.9–3.9)). Hyperstimulation associated with an abnormal fetal heart pattern (14 (2.9%) vs 2 (0.4%), RR 6.5 (1.5–28.9)) or treated with tocolytics (9 (1.8%) vs 1 (0.2%), RR 8.4 (1.1–66)) was more common in women who received the pessary.Conclusion: Use of dinoprostone vaginal pessaries did not shorten time to delivery or improve any other birth outcome measured compared to dinoprostone intravaginal gel. Clinically significant hyperstimulation appeared more common following use of the pessary. Large randomised controlled trials are needed to confirm or refute these findings.
Obstetric management following traumatic tetraplegia: Case series and literature review
Authors: SKOWRONSKI Emma , HARTMAN Keith 
Published: August 2010

Objective: Pregnancy in tetraplegia is a rare event, with only sporadic cases reported. This case series describes seven pregnancies in five tetraplegic women, all with spinal cord injuries in the region of C6.Design: Retrospective case series.Setting: Sydney, Australia.Population: All tetraplegic women presenting to the obstetric service of a university teaching hospital, which also provides a regional spinal injury service, between 1981 and 2006.Methods: Hospital records of all patients were examined and information extracted regarding demographics, pregnancies and their complications, labour and delivery and neonatal data.Main outcome measures: Course, complications, management and outcomes of pregnancy in tetraplegic women.Results: Mean age at the time of injury was 22 years, and, at the time of pregnancy, 33 years. All patients suffered recurrent, and sometimes severe, urinary tract infections and episodes of autonomic dysreflexia during pregnancy. Frequent and sometimes lengthy hospital admissions were required for these and other reasons. Only two pregnancies required caesarean section and all entered labour spontaneously, at a mean of 37.9 weeks of gestation. Episodes of autonomic dysreflexia were aggressively managed using pre‐emptive epidural anaesthesia and sublingual nifedipine. All pregnancies resulted in normal, near‐term babies with no serious perinatal problems.Conclusions: Pregnancy and childbirth in tetraplegic women can be undertaken safely, usually with spontaneous onset of labour and vaginal delivery. However, hospitalisation for intercurrent problems is common. Management requires a multidisciplinary approach and is best undertaken in major centres with both obstetric and spinal cord injuries medical expertise.
How Infants Learn About the Visual World
Authors: Johnson Scott P. 
Published: August 2010

AbstractThe visual world of adults consists of objects at various distances, partly occluding one another, substantial and stable across space and time. The visual world of young infants, in contrast, is often fragmented and unstable, consisting not of coherent objects but rather surfaces that move in unpredictable ways. Evidence from computational modeling and from experiments with human infants highlights three kinds of learning that contribute to infants’ knowledge of the visual world: learning via association, learning via active assembly, and learning via visual‐manual exploration. Infants acquire knowledge by observing objects move in and out of sight, forming associations of these different views. In addition, the infant’s own self‐produced behavior—oculomotor patterns and manual experience, in particular—is an important means by which infants discover and construct their visual world.
From Perceptual Categories to Concepts: What Develops?
Authors: Sloutsky Vladimir M. 
Published: August 2010

AbstractPeople are remarkably smart: They use language, possess complex motor skills, make nontrivial inferences, develop and use scientific theories, make laws, and adapt to complex dynamic environments. Much of this knowledge requires concepts and this study focuses on how people acquire concepts. It is argued that conceptual development progresses from simple perceptual grouping to highly abstract scientific concepts. This proposal of conceptual development has four parts. First, it is argued that categories in the world have different structure. Second, there might be different learning systems (subserved by different brain mechanisms) that evolved to learn categories of differing structures. Third, these systems exhibit differential maturational course, which affects how categories of different structures are learned in the course of development. And finally, an interaction of these components may result in the developmental transition from perceptual groupings to more abstract concepts. This study reviews a large body of empirical evidence supporting this proposal.
Knowledge as Process: Contextually Cued Attention and Early Word Learning
Authors: Smith Linda B. , Colunga Eliana , Yoshida Hanako 
Published: August 2010

AbstractLearning depends on attention. The processes that cue attention in the moment dynamically integrate learned regularities and immediate contextual cues. This paper reviews the extensive literature on cued attention and attentional learning in the adult literature and proposes that these fundamental processes are likely significant mechanisms of change in cognitive development. The value of this idea is illustrated using phenomena in children's novel word learning.
Domain‐Creating Constraints
Authors: Goldstone Robert L. , Landy David 
Published: August 2010

AbstractThe contributions to this special issue on cognitive development collectively propose ways in which learning involves developing constraints that shape subsequent learning. A learning system must be constrained to learn efficiently, but some of these constraints are themselves learnable. To know how something will behave, a learner must know what kind of thing it is. Although this has led previous researchers to argue for domain‐specific constraints that are tied to different kinds/domains, an exciting possibility is that kinds/domains themselves can be learned. General cognitive constraints, when combined with rich inputs, can establish domains, rather than these domains necessarily preexisting prior to learning. Knowledge is structured and richly differentiated, but its “skeleton” must not always be preestablished.Instead, the skeleton may be adapted to fit patterns of co‐occurrence, task requirements, and goals. Finally, we argue that for models of development to demonstrate genuine cognitive novelty, it will be helpful for them to move beyond highly preprocessed and symbolic encodings that limit flexibility. We consider two physical models that learn to make tone discriminations. They are mechanistic models that preserve rich spatial, perceptual, dynamic, and concrete information, allowing them to form surprising new classes of hypotheses and encodings.
Preterm appropriate for gestational age infants: size at birth explains subsequent growth
Authors: Funkquist E‐L , Tuvemo T , Jonsson B , Serenius F , Nyqvist KH 
Published: August 2010

AbstractAim:  The aim was to evaluate growth and breastfeeding up to 18 months corrected age (CA) among preterm appropriate for gestational age (AGA) infants whose mothers initiated breastfeeding during the infants’ hospital stay.Methods:  One hundred and twenty‐seven preterm AGA infants with a median birth weight of 2320 (769–3250) g and gestational age 34.29 (25.00–35.86) weeks were evaluated up to a CA of 18 months. A retrospective, descriptive and comparative design was used. Data were obtained by chart review of hospital medical records and a questionnaire completed by the mothers.Results:  The changes in standard deviation scores (SDS) during the infants’ hospital stay were −0.9 for weight, −0.3 for length and −0.5 for head circumference (HC). Infants with higher SDS at birth showed more negative changes from birth to discharge. Median increments in SDS from discharge to a CA of 2 months were as high as, or higher than, the loss from birth to discharge.Conclusion:  Preterm AGA infants with higher SDS for weight, length and HC at birth are at higher risk of inadequate growth during their hospital stay.
Independence and self‐provision in old age: how realistic are these goals?
Authors: Ranzijn Rob , Patrickson Margaret , Carson Ed , Le Sueur Eddie 
Published: August 2010

Objectives:  The aim of the present paper was to examine the relationship between perceived choices in work and retirement in middle age and financial security and confidence about the future in old age. Methods:  A qualitative study of 30 middle‐aged adults in Adelaide and Whyalla in South Australia, either presently employed, unemployed or retired, were interviewed about their work histories, the factors in their work changes, their perceived options concerning future work and retirement, and their anticipated financial security and sources of income in retirement. Results:  In general, participants with a history of continuous stable employment believed they were in a good financial situation and were confident about their future, but many of the participants had a history of precarious employment, no financial security, and expected to rely primarily on government support in their old age. Conclusion:  A substantial proportion of older adults may not be able to provide for themselves in later life without public policies which are more interventionist.
A randomised controlled trial of an exercise intervention to reduce functional decline and health service utilisation in the hospitalised elderly
Authors: Jones Catherine T , Lowe Adrian J , MacGregor Lachlan , Brand Caroline A , Tweddle Nicole , Russell David M 
Published: August 2010

Objective:  Functional decline is experienced by up to 50% of older hospitalised patients and is associated with increased institutionalisation, mortality and length of stay (LOS). We aimed to determine the effectiveness of an exercise program in reducing functional decline and health service utilisation in older inpatients. Methods:  A single‐blinded randomised controlled trial was conducted in a tertiary metropolitan hospital involving 180 acute general medical patients aged ≥ 65 years. In addition to usual physiotherapy care, the intervention group performed an exercise program for 30 minutes, twice daily, with supervision and assistance. Change in physical function was measured by the modified Barthel index (mBI). Analysis was done on an intention‐to‐treat basis. Results:  When admission mBI scores were low, there was a greater improvement in mBI scores in the intervention group compared with the control group. The intervention group had a shorter total LOS (Hazard ratio (HR) 1.46 (95%CI 1.04–2.05); P = 0.026).
Food insecurity among older Australians: prevalence, correlates and well‐being
Authors: Temple Jeromey B 
Published: August 2010

Objectives:  The purpose of this study is to examine (i) the prevalence of food insecurity among older persons, (ii) the characteristics of the food insecure and (iii) the association between food insecurity and well‐being. Methods:  The 2001 National Health Survey is used to measure the prevalence of food insecurity. Multivariate analysis is conducted using rare events logistic regression. Results:  Almost 3% of Australians aged 55 years and over, and 7% of those aged under 55 are estimated to be food insecure. Lone males and females are more likely to experience food insecurity when compared to couples. Low‐income earners and those with multiple long‐term conditions are at a heightened risk of food insecurity. The probability of food insecurity decreases with age. Persons who are food insecure perform poorly against self‐reported measures of well‐being. Conclusions:  Although the prevalence of food insecurity is low, a definite social gradient exists in those at risk.
Acid suppression in the elderly
Authors: Manoharan Thenmozhi , Dārzi?š Pēteris 
Published: August 2010

Objective:  To determine the proportion of older inpatients in whom acid suppression with proton pump inhibitors (PPI) and histamine antagonists (H2A) are clearly justified. Methods:  A retrospective review of the records of 100 inpatients aged 80 years or older discharged from a public hospital or its associated private hospital who were prescribed PPI or H2A on discharge. Evidence that acid suppression was indicated was sought via review of inpatient medical records and of hospital pharmacy records. Results:  On discharge, PPIs were prescribed for 90 patients and 10 received H2A. In 52 patients, the prescriptions were clearly justified. In 34 patients, acid suppression was possibly justified and in 14 cases, justification for acid suppression therapy could not be found. Conclusions:  Approximately a half of all acid suppression therapy in older people discharged from hospital did not have a clear indication documented and may not be justified.
Retrospective review of pemetrexed with or without platinum in malignant mesothelioma: The Australian ‘Special Access Scheme’ experience
Authors: BURGE ME , JOSHUA AM , McNEIL CM , HUI R , BOYER MJ , ABRAHAM R 
Published: August 2010

AbstractBackground:  Pemetrexed and cisplatin have recently been shown to significantly improve survival compared with cisplatin alone. However, there are only limited data reflecting teaching hospital experience outside a clinical trial. Pemetrexed has only been available in Australia on a restricted basis since 2002. We reviewed our experience of patients treated on the Australian ‘Special Access Scheme’ at three major thoracic oncology units.Methods:  Charts were reviewed for all patients enrolled on the scheme. Data was extracted on age, World Health Organization (WHO) performance status, histology, prior therapy, time from diagnosis to starting pemetrexed, chemotherapy (pemetrexed alone or with a platinum), cycle number, response rate, actuarial progression‐free and overall survival. Doses were cisplatin 75 mg/m2 or carboplatin AUC = 5 and pemetrexed 500 mg/m2 every 21 days.Results:  52 patients (32 male and 20 female) were reviewed. Median age was 58 years and 88% were WHO 0–1. Histology included 54% epithelial, 17% biphasic (epithelial and sarcomatoid) and 21% undefined. The median time from diagnosis to administration of pemetrexed was 145 days. Sixty‐five percent had minimal surgical intervention with video assisted thoracoscopy, pleurodesis and biopsy, while 19% had received prior palliative radiation. Seventy‐one percent were chemotherapy naïve, the remaining 29% having received previous platinum and/or gemcitabine regimens. Twenty‐three percent had pemetrexed alone, 35% in combination with carboplatin and 42% with cisplatin. The median number of cycles was 4 (range 1–13). The response rate was 33%. No toxicity was observed in 20% grade 3–4 toxicity in 10% (majority nausea/vomiting). The median progression‐free and overall survival times from starting pemetrexed were 184 days and 298 days, respectively.Conclusions:  Pemetrexed‐based regimens are safe and effective in a community setting in malignant mesothelioma.
Management of malignant pleural mesothelioma
Authors: NOWAK Anna K , BYDDER Sean 
Published: August 2010

AbstractMalignant mesothelioma is a highly fatal malignancy that may become more prevalent in the Asia–Pacific region over the next decades. We review clinical aspects of this disease, including presentation, diagnosis, staging and management. A small proportion of patients will be suitable for aggressive trimodality therapy (extra‐pleural pneumonectomy, chemotherapy and radiotherapy) with the aim of cure or achieving prolonged palliation. However, most patients will present with advanced disease and so are only suitable for palliation. We review palliative therapy with an emphasis on the practical aspects of chemotherapy as well as palliative procedures such as pleurodesis. The future direction of clinical research in mesothelioma is discussed.
Development and evaluation of a brief, peer‐led communication skills training program for cancer clinicians
Authors: SUTHERLAND Georgina , HEGARTY Suzanne , WHITE Victoria , COFFIN Janine , JEFFORD Michael 
Published: August 2010

AbstractAim:  To develop a brief, peer‐led communication skills training program for cancer clinicians working in the state of Victoria in response to mounting evidence of the detrimental effects of poor doctor–patient communication. The first workshop module developed by The Cancer Council Victoria for the Victorian Cancer Clinicians Communication Program (VCCCP) focused on delivering bad news to patients and their families.Methods:  The workshops consisted of four‐and‐a‐half hour interactive sessions co‐facilitated by an oncology clinician and clinical psychologist. Data on the participants' psychosocial beliefs about patient care, confidence and practice behavior were collected via self‐administered questionnaires before the workshop and 6 weeks after it. Evaluations on the structure and content of the sessions were collected immediately after the workshop.Results:  Data were collected from 11 programs involving a total of 93 cancer clinicians. The results showed a high level of participant satisfaction with the broad aims of the workshop components, in particular the performance of the facilitators and the role‐play sessions. Pre‐ and post‐workshop data showed significant improvements over time on items relating to clinician confidence. Despite little change in subjective reports of clinical behavior and beliefs about psychosocial care, most participants reported changes in the way they delivered bad news since attending the VCCCP workshops.Conclusion:  The Cancer Council Victoria responded to the needs of cancer clinicians working in the state and established a program that appears acceptable to clinicians who choose to participate.