bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relevance of measuring diastolic time intervals in the ductus venosus during the early stages of twin–twin transfusion syndrome
Authors: Bensouda B. , Fouron J.‐C. , Raboisson M.‐J. , Lamoureux J. , Lachance C. , Leduc L. 
Published: November 2007

AbstractObjectiveTo determine if the discrete myocardial diastolic dysfunction documented previously in the recipient twin during the early stages of twin–twin transfusion syndrome (TTTS) has any repercussion on flow velocities through the ductus venosus (DV) and to investigate if this could allow early differentiation between TTTS and selective intrauterine growth restriction (IUGR).MethodsTwo groups of monochorionic twin pregnancies with growth discordance between twins were reviewed retrospectively. Group I was composed of fetuses in Stages I and II of TTTS; laser or amnioreduction was not performed in any instance. Group II twin pairs each included one fetus with IUGR due to placental circulatory insufficiency. Intertwin differences (smaller minus larger fetus) were analyzed for myocardial performance index of the right ventricle (MPI‐RV) and for time variables in the DV.ResultsThere were 38 pairs of monochorionic twins (24 TTTS and 14 IUGR) in this study. In the TTTS group, the donors had a significantly lower MPI‐RV (0.419 ± 0.18 vs. 0.596 ± 0.17, F(1, 19df) = 24.017, P < 0.001), a significantly longer total ventricular filling time (150.9 ± 25.6 ms vs. 124.0 ± 22.6 ms; F(1, 21df) = 19.631, P < 0.001) and a significantly longer early filling time (118.9 ± 22.9 ms vs. 92.6 ± 18.9 ms, F(1, 21df) = 28.419, P < 0.001) than had the recipient. None of these three differences was present in the IUGR group. Probability studies revealed that cut‐off values of 12.75 for intertwin differences in total filling time and 8.5 for intertwin differences in early filling time had sensitivities of 71% and 92%, respectively. The false‐positive rates were 23% and 15%, respectively, for the early diagnosis of TTTS.ConclusionIn monochorionic twin pregnancies, shortening of the ventricular filling time in the recipient twin indicates diastolic myocardial dysfunction occurring early in the pathophysiology of TTTS. This early interwin difference in myocardial function is not found in pregnancies with IUGR in one twin due to placental circulatory insufficiency, allowing early differentiation between TTTS and selective IUGR. Copyright © 2007 ISUOG. Published by John Wiley & Sons, Ltd.
Stage I twin–twin transfusion syndrome: rates of progression and regression in relation to outcome
Authors: O'Donoghue K. , Cartwright E. , Galea P. , Fisk N. M. 
Published: November 2007

AbstractObjectivesTwin–twin transfusion syndrome (TTTS) results in high rates of perinatal mortality and neurological morbidity. Fetoscopic laser ablation of placental anastomoses is now established as the treatment of choice for advanced disease. However, there remains controversy about its use in early‐stage TTTS, in which laser‐related fetal losses need to be balanced against relatively favorable outcomes with more conservative approaches. We investigated rates of progression and regression in Stage I TTTS and determined factors influencing the course of the disease.MethodsWe undertook a retrospective observational study of all TTTS cases referred to our tertiary referral fetal medicine service from 2000 to 2006. In patients presenting with Stage I TTTS, the following variables were evaluated for their ability to predict the course and progression of the disease: gestational age (GA) at presentation, amniotic fluid index, recipient and donor deepest vertical pool, presence of artery–artery anastomoses, small‐sized bladder compared to normal donor bladder and fetal size discordance. Study end‐points were disease regression or progression, and neonatal survival at 28 days.ResultsAmong 132 consecutive cases of TTTS, 46 women presented with Stage I disease. In the majority (69.6%), disease remained stable (28.3%) or regressed (41.3%). Of cases that progressed, 79% did so within 2 weeks and 93% progressed to at least Stage III. No factor was significantly linked with progression or regression, although there was a trend towards the absence of an artery–artery anastomosis (P = 0.10) and the presence of a small rather than normal donor bladder (P = 0.10) influencing progression, and later GA at presentation (P = 0.07) influencing regression. At least one infant survived in 83% of cases and there was double survival in 59%. Perinatal outcome was significantly better in cases that regressed (the rates of at least one survivor and double survival being 89% and 89%, respectively) or remained Stage I (77% and 61%, respectively), compared with those cases that progressed (79% and 14%, respectively). Treatment with amnioreduction at first presentation did not influence progression or regression.ConclusionsThis study demonstrates that a high percentage of Stage I TTTS cases regress or remain early stage. Identification of factors predicting progression would facilitate the selection of patients for definitive therapy, while avoiding treatment‐related morbidities in mild or transient disease. Copyright © 2007 ISUOG. Published by John Wiley & Sons, Ltd.
Solar‐powered ZigBee‐based wireless motion surveillance: a prototype development and experimental results
Authors: Alexander Andell Anees , Taylor Raymond , Vairavanathan Vinujanan , Fu Yao , Hossain Ekram , Noghanian Sima 
Published: November 2007

AbstractThis paper describes the design and implementation of a solar‐powered wireless motion sensor surveillance network. Commercially available systems with similar functionality which exist today have several disadvantages including single points of failure and requires (semi) constant personnel attention as well as an elaborate power system. These systems require a lot of time to set up, they cannot be used in remote areas where a main power supply is unavailable, and are quite costly. Therefore, there is a need to develop a system which is portable, easy to set up, and is energy efficient. The wireless motion surveillance network described in this paper is designed to be portable, economically inexpensive, and energy efficient. The network is created using the IEEE 802.15.4 ZigBee wireless standard by implementing multiple Microchip PICDEM Z nodes. Each node in the network is equipped with a Direction Sensing Infrared Motion Detector (DSIMD) and a solar power unit (SPU). The DSIMD allows for detection of humans and animals alike moving into or out of the network. The system is powered by solar energy that makes it quite adaptable for remote applications. The network is able to cover an area of radius 30 m. By developing a low‐cost system, which is portable, easy to set up, and has an unlimited power supply, this technology is made accessible to a wider range of applications. The implementation of a CMOS camera is discussed at the end which can be used to take a snapshot of the detected object. Copyright © 2007 John Wiley & Sons, Ltd.
Terbutaline versus nifedipine for prolongation of pregnancy in patients with preterm labor
Authors: Mawaldi L. , Duminy P. , Tamim H. 
Published: November 2007

AbstractObjective: To compare the effectiveness, safety, and possible adverse effects of terbutaline and nifedipine in prolonging pregnancy beyond 48 h. Methods: A randomized controlled trial was conducted with 174 pregnant women admitted with preterm labor randomized into 2 groups, which were given terbutaline (95 patients) and nifedepine (79 patients), respectively. Bivariate and multivariate analyses, using logistic regression, were used to analyze the data. Results: No statistically significant difference was found between the 2 groups in terms of prolongation of gestation to 48 h. The failure rate in terms of prolonging gestation for 24 h was found to be 12.6% for the terbutaline group and 10.1% for the nifedipine group, which was not found to be statistically significant (P value = 0.61). Side effects were significantly more common in the terbutaline group, except for maternal hypotension. Conclusion: Terbutaline and nifedipine appear to be equally effective in their tocolytic action. However, nifedipine did have the advantage of ease of administration. It also had significantly less effect on the fetal heart rate.
A Dynamic Model for Wellbeing
Authors: Campion Jonathan , Nurse Jo 
Published: November 2007

Objective: This paper presents a public health model of mental health which places wellbeing at its centre and illustrates how wellbeing is influenced by the inter-relationship between risk, protective and environmental factors. This model should encourage a more comprehensive approach to wellbeing promotion and will assist in developing appropriate mental health public health initiatives. Methods: The model considers how different social and individual risk factors impact negatively upon mental health and how these risk factors can be addressed. It explores the need for active development of protective factors in order to increase an individual's resilience to deal with stresses of life and the additional input required to promote resilience in those with existing mental health problems. This approach to wellbeing balances addressing risk factors with promoting protective factors and uses a public mental health approach to wellbeing promotion within particular settings and the wider environment, supported by both local-level and regional policy. It also suggests that considerable economic savings could be achieved by implementing such integrated management programmes.
The Interface of Mental Health and Human Rights in Indigenous Peoples: Triple Jeopardy and Triple Opportunity
Authors: Tarantola Daniel 
Published: November 2007

Objective: Insufficient understanding of the reciprocal interactions between health and human rights, mental health and human rights and the realization of all human rights by Indigenous peoples constitute a triple jeopardy in how these topics are currently being addressed and/or openly antagonized. This paper will attempt to show how a combined health and human rights approach to mental health in Indigenous peoples can transform a triple jeopardy into a triple opportunity. Methods: The vast and growing body of literature on mental health, health as a whole, and human rights as these relate to health and to Indigenous peoples will be used to frame the discussion. Results: Attention to the complex interactions of health and human rights can guide policy formulation and action by offering a method of analysis, a process of participatory decision and a framework for accountability. In addition, mental health can find its rightful place in the health and human rights discourse through efforts to help policymakers and practitioners broaden their vision of mental illness to holistically encompass aspects of physical, social, emotional and cultural wellbeing. Finally, connecting the role that rights realization plays in determining health and wellbeing will add power to the rightful claims by Indigenous peoples to the promotion and protection of all their human rights – civil, political, economic, social and cultural. Broadening the research agenda by applying systematically a health and human rights analytical framework to the understanding of social determinants of health would minimize the risk of assigning health outcome merely to behaviours, practices and lifestyles, uncovering structural determinants of holistic health entrenched in policies and governmental conduct. Conclusions: Building the evidence of the negative impact of human rights violation on health and the negative impact of ill-health on the fulfilment of other human rights can help in designing comprehensive interventions, building on the synergy between the promotion of health and the promotion of rights. A way forward is proposed for which it is essential that work be carried out across ethnic lines and professional boundaries to further advance the claim of Indigenous peoples for better health and greater enjoyment of human rights.
Challenges of Measuring the Mental Health of Indigenous Australians: Honouring Ethical Expectations and Driving Greater Accuracy
Authors: Haswell-Elkins Melissa , Sebasio Trudi , Hunter Ernest , Mar Materoa 
Published: November 2007

Objective: While Indigenous Australians are exposed to more risk factors and experience a greater burden and complexity of mental disorder, there is as yet limited capacity to assess this at individual, community or societal levels. This paper explores factors associated with and consequences of inadequate mental health assessment processes. Method and findings: The excess burden of Indigenous mental disorders is now demonstrated but is still clearly an underestimate. This motivated a project based in northern Australia to develop effective mental health assessment tools. The initial stages of this project brought together academics and practitioners with Indigenous workers and researchers from Australia and New Zealand. This provided significant and shared insights in relation to the collection and use of Indigenous mental health data. Conclusions: Critical themes to guide researchers, services and practitioners were defined and presented in this paper along with a range of individual, social, service and economic consequences associated with systematic non-recognition and under-rating of mental disorders outlined.
Family Intervention in Indigenous Communities: Emergent Issues in Conducting Outcome Research
Authors: Turner Karen , Sanders Matthew 
Published: November 2007

Objective: Indigenous children and youth are at greater risk of emotional and behavioural problems than non-Indigenous youth, with family life stresses and parenting style identified as common risk factors. There is substantial evidence that parenting programs can improve family relationships and improve child outcomes, however little research has focused on Indigenous communities. Our team is conducting research to evaluate a culturally sensitive adaptation of a mainstream intervention, the Group Triple P – Positive Parenting Program, for Indigenous families. This paper shares some of the insights into research and clinical issues gained as non-Indigenous researchers working with urban, rural and remote Indigenous communities. Methods: The experience of the research team and feedback from practitioners and parents have been drawn on for this discussion. Conclusions: Parenting programs need to be sensitive to the political and cultural context in which parenting takes place, flexibly incorporate cultural practices and expectations, and develop an evidence base of outcomes for families in diverse communities. As research is needed to evaluate the acceptability and effectiveness of these programs, culturally sensitive research practices are also necessary and the value of program evaluation and its benefit to the community must be clear. Community acceptance of the research process and the intervention itself is vital and may be influenced by community perceptions, current priorities, and local issues. If our overall aim is to increase the skilled health and mental health workforce in Indigenous communities and their use of evidence-based interventions, ongoing collaborative relationships between research institutions and service providers will serve to further this aim.
Bridging the Triple Divide: Performance and Innovative Multimedia in the Service Of Behavioural Health Change in Remote Indigenous Settings
Authors: Hunter Ernest , Travers Helen , Gibson Julie , Campion Jonathan 
Published: November 2007

Objectives: The use of innovative information technology is now well established in health. However, while the gap in health status between Indigenous and other Australians is both significant and unchanging, there is limited application of these new approaches to addressing this national health priority. This may in part reflect the ‘digital divide’, which is another facet of Indigenous disadvantage. This paper describes an approach to address both issues in remote Indigenous settings. Results: The Health Interactive Technology Network began as a proof-of-concept study of touchscreen technology in two Indigenous health settings. It has subsequently expanded to a number of remote Indigenous communities and developed new platforms and applications to respond to emerging health issues. In creating narrative, interactive approaches to address choices in relation to health behaviours, the community development and engagement effects of the creative process have been highlighted. These findings suggest that these approaches will be suited to further expansion in the area of mental health.
Reflections of an Indigenous Counsellor: Sharing the Journey – Therapist and Person?
Authors: Pratt Greg 
Published: November 2007

Objective: Therapy in the form of counselling for Indigenous Australians is much debated. Effective engagement is the key to productive therapy. This paper notes some of the constraints of mainstream therapeutic methodologies and makes suggestions to ensure a therapeutic setting for both the person and therapist born from my experience as a counsellor working in government and community settings, with adults, young people and children, and in mental health, substance use and social/emotional wellbeing. What follows is an iteration of the importance of engagement and adopting a whole of life view to counselling. Findings: The “whole of life view to mental health” as described in the 1989 National Aboriginal Health Strategy is used as a reference from which to elaborate on various counselling principles. Five key elements are discussed in relation to engagement and therapy for Indigenous Australians. To focus on the specifics of task-oriented therapy can be detrimental to the relationship between therapist and person. The role of the person in the determination of their therapeutic goals and the mannerisms of the therapist strongly influence the counselling process and its outcomes. Indigenous Australia has long emphasized the significance of the person as a part of a wider world influenced primarily by their relationships with people (specifically family and community), culture, spirituality and the environment. Conclusion: An Indigenous Australian view of the world influences the way in which Indigenous Australians interact with the world and avail themselves to it. Effective therapy is dependent on the relationship between the therapist and the person, a relationship which must be based on respect, reciprocity, accountability, humility and an appreciation of the significance of how a holistic view of the world influences one's sense of self.
Dealing with Suicidal Thoughts in Schools: Information and Education Directed at Secondary Schools
Authors: Bridge Simon , Hanssens Leonore , Santhanam Radhika 
Published: November 2007

Objective: Current practice in Australia is to avoid discussing suicide or suicidal ideation directly with students in school suicide prevention programs. This paper examines why there is a strong argument to question this approach in the context of a continuing unacceptable rate of youth suicide in this country. Methods: A review of the literature that informs the debate was conducted. Using an action research methodology, a more direct intervention approach was taken based on the use of the ‘Toughin’ it out’ pamphlet. Results: A misrepresentation of the evidence surrounding school-based suicide intervention programs in Australia has made educators and guidance officers wary of being more direct with suicide prevention programs. The experience of several practitioners in northern Australia suggests that it is highly beneficial to engage students in discussions about suicide and how to deal with suicidal thoughts. Their impression is that this has led to a lessening of suicide attempts in high-risk situations and there has been no evidence of any adverse outcome. Conclusion: The ongoing tragedy of Indigenous adolescent suicide in Australia demands that all possible interventions should be considered. Taking a more direct approach to school suicide prevention and life-promoting programs using the brief intervention tool, the ‘Toughin’ it out’ pamphlet, appeared to be associated with a positive impact on suicide in high-risk secondary schools in northern Australia. The positive experience in northern Australia would support a similar approach being considered in school programs nationally.
Developing a Postgraduate Program in Indigenous Mental Health and Wellbeing at University of Southern Queensland
Authors: Hampton Ron , McCann William 
Published: November 2007

Objective: The aim of this paper is to explain the development of an innovative postgraduate program in Indigenous Australian Mental Health and Well-Being for non-Indigenous health and allied health practitioners. Methods: The historical background is explored, together with details of the approach to, and the management of, the new program. Results: The establishment of the new program has been achieved and the interest level in the new directions being undertaken has been gauged as very high. Conclusions: Judging by the number of enquiries, the enrolments so far achieved and the Department of Education, Science and Training granting of 20 HECS places for the new program, it is clear that the program will be viable and the future development of a Master's in Indigenous Mental Health and Well-Being assured.
Workers’ Learning Needs Regarding Mental Health in Aboriginal, Same-Sex Attracted and Culturally and Linguistically Diverse Young People
Authors: Hillin Anthony , McAlpine Rob , Montague Ros , Markham Ros 
Published: November 2007

Objective: Some groups of young people experience elevated rates of mental disorders and low rates of uptake of mental health services. Because an association between staff competence and uptake of services has been demonstrated a key objective of this paper is to identify relevant staff learning needs. Method: A learning needs analysis was undertaken of adolescent mental health workers employed in the health and education sectors in NSW, Australia, to explore their learning needs regarding Aboriginal, same-sex attracted and culturally and linguistically diverse young people. Results: Significant differences were found between learning needs in relation to location but no significant differences were found in relation to agency or experience. Participants ranked their learning needs as high and their knowledge and skills in working with depression and related disorders in these young people as low. Conclusion: This article highlights issues that may be of interest to clinicians and their managers regarding training, policy and service delivery.
Should Mental Health Issues be Addressed in Primary Care, and can it be Done? Views of Rural General Practitioners in Queensland
Authors: Sturk Heidi , Kavanagh David , Gallois Cindy , King David , Turpin Merrill , King Robert , Bartlett Helen 
Published: November 2007

Objective: The aim of this paper was to examine self-efficacy and perceived appropriateness among rural general practitioners (GPs) in regards to screening and intervention for physical, lifestyle and mental health issues. Method: Fifty GPs from 25 practices in eight rural Queensland towns completed a written survey designed for the study. Results: General practitioners rated opportunistic screening or assessment for smoking and for detection of relapse of mental disorders as the most appropriate, with even cardiovascular and diabetes risk falling behind these. Self-efficacy was highest for medical disorders for smoking assessment. It was significantly lower for alcohol, mental health issues, and addressing risks of physical disorder in people with mental disorders. Conclusions: High appropriateness ratings suggest that current strategies to boost self-efficacy of GPs in addressing mental health issues are timely.