bluuebunny/crossref_metadata_2025_split huggingface dataset:
Service User and Significant other Versions of the Health of the Nation Outcome Scales
Authors: Stewart Malcolm 
Published: December 2009

Objectives: The aim of this paper was to test the measurement properties of self-report (SR) and significant other (SO) versions of the Health of the Nation Outcome Scales (HoNOS). Method: SR and SO HoNOSs, with content closely paralleling the clinician HoNOS but with item 8 expanded into scales rating each difficulty separately, were developed and trialed with Early Intervention for Psychosis service users and their significant others. Results: Satisfactory agreement was found between SR, SO and clinician HoNOSs, and between the SR and SO on most additional items. Conclusions: Results suggest adequate validity of the measures. The additional items proved useful for identifying comorbidities that may have been under-recognized. Results suggest that SR and SO versions of the HoNOS can be valid and valuable for triangulating and recording the perspectives of different stakeholders in promoting recovery.
Delivering Youth-Specific Mental Health Services: The Advantages of a Collaborative, Multi-Disciplinary System
Authors: Scott Elizabeth , Naismith Sharon , Whitwell Bradley , Hamilton Blake , Chudleigh Catherine , Hickie Ian 
Published: December 2009

Objective: Evidence suggests that quality mental health care is based on well-integrated multi-disciplinary care provided by a range of mental health, substance use, and general healthcare clinicians. There is a growing focus in Australia on providing this type of mental health care to young people, particularly those in the early stages of a major disorder. The development of such services has proceeded on the basis of limited service-based data and has also been impeded by current healthcare funding structures. Methods: This report outlines the service characteristics of three models: a traditional ‘fee for service’ model, a specialized youth mental health clinic, and a new headspace multi-disciplinary site in South Western Sydney. Results: Naturalistic data from these three services collected during their developmental phase indicate that each model is associated with differential demographic, illness and service organization characteristics. Conclusions: Compared with ‘fee-for-service’ type care, specialized youth models provide greater access to a broad range of multi-disciplinary clinicians.
Surveying Perceptions of the Progress of National Mental Health Reform
Authors: Hickie Ian , Groom Grace 
Published: December 2009

Objective: To provide comment on the latest Australian government commitment to a 5 year plan under the National Mental Health Strategy. Conclusions: In the absence of a credible system of accountability for the implementation of mental health reform, the Mental Health Council of Australia, in association with the Brain and Mind Research Institute, has taken up the task of auditing. A national, government-supported system needs to be developed in order to monitor progress of genuine mental health reform in Australia.
A Preliminary Survey of Undergraduate Education on Depression in Medical Schools in the Asia Pacific Region
Authors: Lee Min-Soo 
Published: December 2009

Objective: To describe the undergraduate medical curricula pertaining to depression across the Asia Pacific region. Methods: Questions were sent to the members of the SEBoD International Advisory Board asking for details on the specifics of medical curricula regarding depression. Results: Representatives of 13 medical universities from eight Asia Pacific countries provided information. All curricula include psychiatry lectures, and most countries also conduct seminars and tutorials. Provision of clinical experience is common, but not all curricula include specific presentation of cases of depression. Within the psychiatry courses reviewed, only a small component of teaching is related specifically to depression. Conclusions: As there is growing recognition of the burden of depression, development and implementation of national curricula standards are recommended to address inadequacies in teaching of depression in undergraduate medical universities throughout the Asia Pacific region.
Australia Needs a Mental Health Commission
Authors: Rosen Alan , McGorry Patrick , Groom Grace , Hickie Ian , Gurr Roger , Hocking Barbara , Leggatt Margaret , Deveson Anne , Wilson Keith , Holmes Douglas , Miller Vivienne , Dunbar Lynne , Stanley Fiona 
Published: December 2009

Objectives: The present paper aims to: (i) describe how the Mental Health Commission in New Zealand works and has contributed to the ∗ substantial enhancement of mental health resources and services; (ii) determine whether mental health reform policies will ever be implemented properly without an independent monitor with official influence at the highest levels of government; and (iii) demonstrate how variants on this model work in other Western countries and how it can be adapted to the Federated system in Australia. Conclusions: It is recommended that the Australian National Mental Health Plan 2003–2008 should be complemented by a long-standing national mental health commission (or similarly constituted body), which is also able to report independently from and to the government, with direct access to the Prime Minister, Premiers and Australian Health Ministers. Its aims would be to monitor service effectiveness and identify gaps in service provision, training and performance of the work force, management and government. It would be informed by consumer, carer and provider experience, and by reviews of evidence-based research regarding health needs and cost-effective services. It should accurately cost such service gaps, and advise government on a strategy for implementing them. It could also promote and advise formally on enhancing community awareness, decreasing stigma and discrimination and improving workforce recruitment and retention.
‘Every Me and Every You’: Responding to the Hidden Challenge of Mental Illness in Australia
Authors: Mcgorry Patrick 
Published: December 2009

Objective: To show that mental illness affects everyone in society, describe some of the main obstacles to better outcomes, and build confidence that they can be overcome. Methods: A review and analysis of relevant evidence and experience combined with personal advocacy. Results: Mental illnesses are common and seriously under-treated, reform of the system of care has completely stalled, and insidious reinstitutionalization of the modernized system is occurring. A number of contributing factors and possible solutions are identified, including mental health literacy and advocacy campaigns, a focus on young people and early intervention, and functional reintegration of the treatment of mental and substance use disorders. Conclusions: A new wave of reform and major financial investment in the treatment of mental and substance use disorders is overdue. This can be best achieved by combining the evidence-based health care (EBHC) paradigm with a direct appeal to the self-interest of members of the general community. A National Institute of Mental Health and Addiction should be a key element of such reform, which must be a continuing process with substantially increased federal and State funding.
Therapy With Women With Metastatic Breast Cancer
Authors: Beacham Bronwen , Hill Christine , Mcdermott Fiona , O'Brien Mary , Turner Jane 
Published: December 2009

Objective: To describe some clinical issues encountered in individual and group therapy with women with metastatic breast cancer. Conclusions: The pressure to ‘keep positive’ poses dilemmas for patients and therapists alike, whether in individual or group therapy. The basis of skilled supportive care rests on the ability of therapists to assist patients and their families to face death rather than avoid it. Paradoxically, facing issues of death and dying leads to a greater sense of control, and empowers patients to reorder life's priorities, thus improving quality of life and relationships. In addition to the obvious need to detect and treat illness such as depression, working with women with metastatic breast cancer requires flexibility on the part of the therapist to adapt to her physical state of health, to include partners and family members where possible, and to liaise with colleagues in the treating team to facilitate communication and understanding of specific difficulties that may be encountered.
Diagnosis of Dementia With Lewy Bodies in Clinical Practice: A Literature Review
Authors: Singh Dhiren 
Published: December 2009

Objective: To review the research data about dementia with Lewy bodies (DLB) and describe those clinical features and investigations that will enhance more accurate diagnosis in day-to-day practice. Methods: A literature search using MEDLINE, Psychlit, Psychinfo and Cochrane databases was performed. Conclusions: The diagnosis of DLB is important now that treatment is available using cognitive enhancers and because of the risk to patients with DLB who are prescribed neuroleptics. The use of consensus criteria, despite their limitations, and judicious use of ancillary investigations, especially neuroimaging and neuropsychological tests, will enhance diagnostic accuracy.
Postnatal Depression: A Korean Perspective
Authors: Kim Jihyeon , Buist Anne 
Published: December 2009

Objective: To provide insight into the cultural influences on postnatal depression (PND) in women from Korean backgrounds. Conclusions: Lack of support has been seen to be a key risk factor in postnatal depression. In Korean society, little research has been done on this disorder, but it is likely that traditional support might have a protective role. Erosion of this with westernization of Korea, or isolation in Korean immigrants to Australia, is likely to be significant for new mothers from this cultural background.
Using Continuous Quality Improvement to Implement a Clinical Governance Framework in Amental Health Service
Authors: Arya Dinesh , Callaly Tom 
Published: December 2009

Objectives: To outline the principles of continuous quality improvement that can be utilized to develop a clinical governance framework in a mental health service. Conclusions: The term clinical governance is used to describe the framework through which health organizations are accountable for continuously improving the quality of their services and safeguarding high standards of care. Implementing a clinical governance framework requires clear leadership, particularly clinical leadership, the development of structures and processes to facilitate communication and the development of systems for monitoring and evaluating services. Effective implementation can be supported by the development of an open culture that promotes organizational learning from experience and supporting innovation.
Transcranial Magnetic Stimulation and Chronic Pain: Current Status
Authors: Pridmore Saxby , Oberoi Gajinder , Marcolin Marco , George Mark 
Published: December 2009

Objective: To examine evidence suggesting a potential role for transcranial magnetic stimulation (TMS) in the treatment of chronic pain. Conclusion: Chronic pain is characterized by brain changes that can reasonably be presumed to be associated with hyperalgesia, as occurs with neuropathic changes in the periphery. TMS has the ability to induce plastic changes in the cortex at the site of stimulation and at connected sites, including the spinal cord. It also has the ability to influence the experience of experimental/acute pain. In studies of TMS in chronic pain, there is some evidence that temporary relief can be achieved in a proportion of sufferers. Chronic pain is common. Current treatments are often ineffective and complicated by side-effects. Work to this point is encouraging, but systematic assessment of stimulation parameters is necessary if TMS is to achieve a role in the treatment of chronic pain. Maintenance TMS is currently provided in relapsing major depression and may be a useful model in chronic pain management.
Trainingmodels for Psychiatry in Primary Care: A New Frontier
Authors: Murrihy Rachael , Byrne Mitchell K. 
Published: December 2009

Objective: Under policies implemented by the Australian Government, the success of community mental health care has increasingly relied upon general practitioners (GPs) assuming an enhanced role in the delivery of evidence-based psychological treatment. In undertaking this role, it is crucial that GPs significantly build upon limited training in evidence-based psychological therapies such as cognitive behaviour therapy (CBT). This pilot study investigates the potential role of CBT group supervision as a training model. Method: Two groups of GPs (n = 9) and one comparison group of psychiatric registrars (n = 4) completed eight 1.5 h sessions of CBT group supervision over an 8month period. Pre- to post-training measures were taken of GP performance (skills, knowledge and confidence) and the mental health outcomes of their patients. On the completion of group supervision, focus groups were conducted for in-depth feedback. Results: Randomization tests indicated that GPs' confidence and knowledge in using CBT had improved over the course of group supervision. Results from focus groups confirmed that GPs' CBT skills had improved. Conclusions: Findings suggest that group supervision is a promising training model for psychiatry in primary care. Cognitive behaviour therapy should be replaced, however, with a briefer therapy model, such as brief CBT, better suited to a general practice environment. Future research needs to replicate these findings on a larger scale.
Patterns of Current Comorbidity in Young Help-Seekers: Implications for Service Planning and Delivery
Authors: Godfrey Katherine , Yung Alison , Killackey Eóin , Cosgrave Elizabeth , Yuen Hok Pan , Stanford Carrie , Buckby Joe , Mcgorry Patrick 
Published: December 2009

Objective: To identify the pattern of current comorbidity in young help-seekers referred to a specialist mental health service. Method: One hundred and forty-nine participants were assessed for current psychiatric diagnoses following their referral to ORYGEN Youth Health. Results: Seventy-eight per cent of the sample rated for at least one diagnosis with almost half the sample presenting with two or more disorders. Next to comorbid depression and anxiety, comorbidity between substance use disorders and mood and anxiety disorders was the most prominent pattern of comorbidity in the sample. Conclusions: The present findings suggest that integration between mental health and substance abuse services is well overdue and must be addressed at policy, service system and clinical levels.
Challenges of Mental Health Interpreting when Working with Deaf Patients
Authors: Cornes Andy , Napier Jemina 
Published: December 2009

Objective: The aim of this present paper is to highlight some of the issues faced by therapists and sign language interpreters when working with deaf patients. Conclusions: Key issues include linguistic, interpreting and role challenges, and potential threats to the therapeutic alliance. Recommendations are made in relation to preparation strategies and training for sign language interpreters and therapists.
Is Psychiatry an Art or a Science? The Views of Psychiatrists and Trainees
Authors: Chur-Hansen Anna , Parker Damon 
Published: December 2009

Objective: It is generally considered by many practitioners that psychiatry is an art, that is, one of the humanities, as well as being a science. We systematically collected the views of practitioners and trainee psychiatrists regarding the question ‘Is psychiatry an art or a science?’ Method: Eleven supervisors and nine trainees were interviewed and their responses analysed, using a qualitative method, the modified framework approach. Results: Several themes emerged from the data: that ‘art’ and ‘science’ are different; psychiatry as a discipline is difficult to define; psychiatry demands a broader range of skills than other medical specialties; the relationship of psychology to psychiatry; supervisor cynicism to the ‘science’ of psychiatry; and the ‘art’ and ‘science’ of the assessment process. Conclusions: The tension that exists within the profession's identity as a discipline has important implications for teaching, learning, and clinical and research practices.
Current Delivery of Infantmental Health Services: Are Infant Mental Health Needs Being Met?
Authors: Macdonald Elspeth , Mohay Heather , Sorensen Debra , Alcorn Neil , Mcdermott Brett , Lee Erica ,   Members of the Mater CYMHS Infant Mental Health Steering Committee
Published: December 2009

Objective: To identify services supporting the well-being of infants and their families in an area of South Brisbane, Australia, highlight problems of accessing these services and recommend strategies to make them more readily available. Method: Semistructured interviews were conducted with staff from 18 service providers offering antenatal services, or programmes primarily focused on children under the age of 2 years and/or their families. The interview aimed to identify the precise nature of the services offered, problems encountered in providing those services, perceived gaps in services and potential strategies for improvement. Results: Services were diverse, provided by a range of different professionals, in varying locations (home, community, hospital) and with funding from various sources. The major findings were:(i) the fragmentation of services, lack of communication between them, and lack of continuity in services from one stage of family formation to another; (ii) the shortage of services working with the parents and infant together; and (iii) the difficulty ofproviding services for some at-risk populations. Conclusions: Recommendations included: (i) maintaining a range of different services networked through a centralized resource/referral centre; (ii) expandingjoint mother–infant services and providing training for such services; and (iii) supporting outreach services for difficult to engage populations.
The Response of Doctors to a Formal Complaint
Authors: Nash Louise , Curtis Bradley , Walton Merrilyn , Willcock Simon , Tennant Christopher 
Published: December 2009

Objectives: This pilot study investigates the psychological impact on doctors of a complaint to the New South Wales Health Care Complaints Commission and the doctor's perception of legal risk. Method: Doctors who received a complaint were sent a set of questionnaires embracing psychological variables and their perceptions of legal risk. Results: The response rate was 60%. Thirty-eight per cent of respondents met screening criteria for psychiatric disorder. There was, however, minimal functional impairment of work, social or family life. Respondents scored highly on altruism, but at the same time were ‘tough minded’. The questionnaire to assess the doctor's perception of legal risk appeared to have acceptable construct validity but showed that doctors still misunderstand medico-legal risk. Conclusions: Psychiatric morbidity rates of our sample were comparable with other Australian medical samples. This small sample appeared to cope with the stress of a complaint better than those reported in other studies.
Immunological evaluation of personalized peptide vaccination monotherapy in patients with castration‐resistant prostate cancer
Authors: Uemura Hirotsugu , Fujimoto Kiyohide , Mine Takashi , Uejima Shigeya , De Velasco Marco A. , Hirao Yoshihiko , Komatsu Nobukazu , Yamada Akira , Itoh Kyogo 
Published: December 2009

(Cancer Sci 2010; 101: 601–608)We previously reported that personalized peptide vaccine (PPV) therapy in combination with leutenizing hormone‐releasing hormone (LH‐RH) analog and estramustine phosphate in certain cases is safe and capable of inducing both immune responses and clinical responses for metastatic castration‐resistant prostate cancer (CRPC) patients. In the present study, PPV monotherapy was given to CRPC patients. Twenty‐three patients with metastatic CRPC were treated with PPV without any additional treatment modalities, including LH‐RH analogs. Samples were analyzed for peptide‐specific cytotoxic T‐lymphocyte (CTL) precursor analysis and peptide‐reactive IgG. Toxicity and immunological and clinical responses were assessed on a three‐monthly basis. Seventeen patients were available for immunological and clinical evaluation. The vaccines were well tolerated, with grade 3 erythema at injection sites in only one patient. Augmentation of CTL or IgG responses to at least one of the peptides was observed in six of 17 (35%) and 15 of 17 (88%) patients tested, respectively. Among 57 peptides used, 9 and 36 peptides induced CTL and IgG responses, respectively. Delayed‐type hypersensitivity reaction was observed in eight of 17 patients. More than 30% prostate‐specific antigen (PSA) decline was observed in four of 17 patients. Of these, one patient achieved a complete PSA response and another patient showed a partial PSA response with profound shrinking of lymph node metastases and prostate. The overall median survival time was 24 months (range, 5–37 months). These results suggest that PPV monotherapy appears to be safe and capable of inducing peptide‐specific immune responses and clinical responses in CRPC patients. This trial was registered with University Hospital Medical Information Network (UMIN) number R000003339.
Platelets release novel thiol isomerase enzymes which are recruited to the cell surface following activation
Authors: Holbrook Lisa‐Marie , Watkins Nicholas A. , Simmonds Alan D. , Jones Chris I. , Ouwehand Willem H. , Gibbins Jonathan M. 
Published: December 2009

SummaryThe thiol isomerase enzymes protein disulphide isomerase (PDI) and endoplasmic reticulum protein 5 (ERp5) are released by resting and activated platelets. These re‐associate with the cell surface where they modulate a range of platelet responses including adhesion, secretion and aggregation. Recent studies suggest the existence of yet uncharacterised platelet thiol isomerase proteins. This study aimed to identify which other thiol isomerase enzymes are present in human platelets. Through the use of immunoblotting, flow cytometry, cell‐surface biotinylation and gene array analysis, we report the presence of five additional thiol isomerases in human and mouse platelets and megakaryocytes, namely; ERp57, ERp72, ERp44, ERp29 and TMX3. ERp72, ERp57, ERp44 and ERp29 are released by platelets and relocate to the cell surface following platelet activation. The transmembrane thiol isomerase TMX3 was also detected on the platelet surface but does not increase following activation. Extracellular PDI is also implicated in the regulation of coagulation by the modulation of tissue factor activity. ERp57 was identified within platelet‐derived microparticle fractions, suggesting that ERp57 may also be involved in the regulation of coagulation as well as platelet function. These data collectively implicate the expanding family of platelet‐surface thiol isomerases in the regulation of haemostasis.