bluuebunny/crossref_metadata_2025_split huggingface dataset:
What is the Psychiatrist's Role in Drugs and Alcohol?
Authors: Pols René G. , Sellman Douglas , Jurd Steven , Baigent Michael , Waddy Nanette , Sacks Tobie , Tucker Peter , Fowler John , White Allan 
Published: November 2007

Objective: This article describes a consensus view of the role of psychiatrists in respect of alcohol and other drug (AOD) problems, in response to the view expressed by Wodak [1]. Method: The data were selected on the basis of the knowledge and experience of the authors. Results: Psychiatrists have made major contributions in the primary, secondary and tertiary prevention of AOD problems over many years in Australia and New Zealand. In recent years there has been an explosion of new knowledge in the AOD area and a shift from mental health to primary and public health care for these patients. Substance use disorders (SUD) are highly prevalent in all areas of psychiatric practice, requiring treatment in their own right as well as complicating the treatment of coexisting psychiatric illness. Conclusion: It is argued that psychiatrists have important roles in harm reduction, prevention and policy development; brief and early intervention in SUD in liaison and child psychiatry; and systematic treatment for those with dependence and other psychiatric comorbidity. A research and collaborative approach to AOD services and patients should be encouraged, rather than engaging in divisive debate over ‘ownership’ of this area of clinical practice.
Mandatory Reporting of Child Abuse: Is it in the Best Interests of the Child?
Authors: Budai Pamela 
Published: November 2007

Objective: To set out correctly the law on mandatory reporting of child abuse in each Australian jurisdiction and New Zealand to argue that all patients should be forewarned of the limits of confidentiality in respect of this and to discuss the question of whether mandatory reporting is in the best interests of the child. Method: Discussion of statutes mandating reporting of child abuse, duty of confidentiality, the experience of mandatory reporting and failure to comply, forewarning of limits of confidentiality, arguments for and against mandatory reporting, and alternatives. Results: Not all mental health providers comply with the law, for reasons both altruistic and non-altruistic. Although ethical codes for Australian mental health providers do not require forewarning, ethical practice would seem to do so. Conclusions: Mandatory reporting statutes now in force are not necessarily in the best interests of the child. An important clinical implication of the law is that consideration should be given to forewarning patients.
The Dangers of Dextropropoxyphene
Authors: Dore Glenys Marie 
Published: November 2007

Objective: Dextropropoxyphene is a commonly used analgesic despite its high toxicity in overdose and potential for abuse and dependence. This case report highlights these dangers. Clinical picture: The case of a female who was addicted to dextropropoxyphene as an alternative to other opioids is described. Its use in high doses with other psychotropic agents resulted in adverse health effects. Treatment: The patient was treated with methadone and psychosocial interventions. Outcome: The patient reduced her drug use and experienced improved physical health and psychosocial functioning. Conclusions: Caution is needed when prescribing dextropropoxyphene because of its adverse effects compared with equally efficacious analgesics.
Consultation-Liaison Psychiatry in an Obstetric Service
Authors: Dunsis Astrid , Smith Graeme C. 
Published: November 2007

Objective: The aim of this paper is to provide an overview of the work of a consultation-liaison (C-L) psychiatry service to an obstetric inpatient unit in a university affiliated teaching hospital, with the aid of a comprehensive clinical database. Method: The MICRO-CARES clinical database system was used for prospective recording of data on all obstetric inpatients referred to the C-L psychiatry service and the hospital clinical database was used to compare referred inpatients with all obstetric inpatients. Results: Ninety patients were referred in 3 years, a referral rate of 1.2% of obstetric admissions. There was no bias in referral on age, but there were significantly more unmarried patients in the referred group (p<0.001). Referred patients had a significantly prolonged length of stay: a mean of 9 days for referred patients, with 6 days for all obstetric patients (p<0.001). The most frequent reasons for referral were: coping problems, depression, anxiety/fear and past history of major psychiatric illness. The most common DSM-III-R psychiatric diagnoses were: Personality Disorders (19%), Mood Disorders (17%), Schizophrenic Disorders (15%) and Adjustment Disorders (13%). At least one confirmed diagnosis was made in 77% of patients, but 42% of diagnoses remained differential. There were significantly more patients with diseases of the nervous system, endocrine and circulatory disorders in the referred group (p<0.001). Recommendations of psychosocial interventions predominated over psychopharmacological interventions, and concordance with these was 97% and 98%, respectively. Issues in the relationship of obstetrics and psychiatric C-L services are discussed and future directions indicated. Conclusions: The referral rate was low compared with other specialty units. This is probably due to factors inherent in obstetric practice. A wide spectrum of psychiatric disorders was referred, including a higher than expected number of women with postpartum psychotic disorders, the majority of whom were managed successfully in the obstetric ward. There is a need for increased liaison with obstetric and community services and for collaborative research, with a particular emphasis on the prevention of psychiatric morbidity associated with pregnancy.
Depressive Symptoms in Patients with HIV Infection
Authors: Judd Fiona K. , Mijch Anne M. 
Published: November 2007

Objective: The aim of the paper was to assess the frequency and severity of depressive symptoms amongst HIV positive patients attending an out-patient treatment clinic. Method: One hundred HIV positive patients attending the out-patient clinic at Fairfield Hospital, Melbourne, completed the Beck Depression Inventory (BDI). Results: Forty-four patients scored 14 or more on the BDI. No significant relationship was demonstrated between BDI score and living situation, relationship status, duration of known seropositivity, current CD4 count, or Centres for Disease Control (CDC) category of illness. Significantly more patients scoring in the depressed range were unable to work because of illness. Forty patients reported suicidal ideation. Conclusions: Depressive symptoms and suicidal ideation are common amongst HIV positive patients, occurring at comparable or greater rates than those found in a variety of other medically ill populations.
Rural Psychiatric Services
Authors: Tobin Margaret J. 
Published: November 2007

Objective: The objective was to describe and evaluate a community mental health service developed during 1991–1992 in an attempt to meet the mental illness needs of an isolated rural community. The setting was the Grampians health region in Western Victoria: this region has an area of 45,000 square kilo-metres and a population of 182,000. Method: The method involved firstly describing the evolution of the service delivery model. This comprised a team of travelling psychiatrists and community psychiatric nurses which succeeded in providing a combined inpatient and outpatient service which was integrated with general practitioners. Secondly, diagnostic and case load descriptions of patients receiving service were compared for both the inpatient and outpatient settings. Results: The results were that reduced reliance on inpatient beds and increased consumer satisfaction were achieved. Conclusion: It was concluded that on initial evaluation of the service it was seen to be meeting its objective of treating the seriously mentally ill in an isolated rural community based setting.
HIV in the Mentally Ill
Authors: Checkley Gill E. , Thompson Sandra C. , Crofts Nick , Mijch Anne M. , Judd Fiona K. 
Published: November 2007

Objective: To review the published literature in relation to prevalence of HIV infection and risk behaviours for HIV among the mentally ill to assist in the development of appropriate strategies for public health policy, surveillance and clinical management of HIV and HIV risk in these groups. Method: A search of published literature was carried out using ‘Medline’, in association with following up appropriate papers cited in the References of journals identified. Results: The North American literature shows an increased risk of HIV infection in psychiatric patients receiving treatment in both inpatient or community settings. HIV infection is associated with a number of risk behaviours, particularly male homosexual sex and injecting drug use, and being the sexual partner of a person with a history of these. Impulsivity, high levels of sexual activity during acute exacerbations of psychiatric illness, poor skills at negotiating safe sex, homelessness and drug abuse are all risk behaviours common among those affected by some mental illnesses. The mentally ill also have a comparatively poorer knowledge of HIV/AIDS. There is a dearth of published Australian data addressing the question of HIV seroprevalence or risk in the mentally ill. Although there has been development and implementation of HIV risk-reduction programs overseas, the development and evaluation of any programs in Australia has not been published. Conclusions: Arguably, Australia has developed a comprehensive program of national surveillance for HIV infection and has been relatively successful in its response to the HIV epidemic, with the high rates of infection in the early to mid-1980s substantially reduced to around 600 new diagnoses per year. However, while risk behaviours which exposed those infected with the virus are recorded, underlying conditions which predispose them to these behaviours are not. Nevertheless, there is HIV infection amongst mentally ill and intellectually disabled people in Australia. Examination of the North American experience reveals opportunities to prevent a high rate of HIV infection in those with mental illness in Australia. Such a program would require adequate risk behaviour assessment, appropriate diagnostic testing and management, and development of specific educational interventions which are properly evaluated to ensure their effectiveness.
Teaching Psychiatry in an Integrated Medical Curriculum
Authors: Carr Vaughan J. , Hazell Philip L. , Williamson Michael 
Published: November 2007

Objective: Efforts to improve the psychiatric competence of the general medical workforce must include an appraisal of how psychiatry is taught in medical schools. As a contribution to this appraisal a description is given of psychiatric education in the innovative undergraduate medical curriculum at the University of Newcastle. Method: An outline of the features which characterise medical education at Newcastle is provided and the way in which the teaching of psychiatry is organised within this framework is presented. Results: The characteristics of the Newcastle undergraduate program in psychiatry include its integration with teaching in other clinical and basic science disciplines, continuity throughout the entire five years of the course, and the emphasis on skills acquisition and their assessment. Conclusions: The relative merits and disadvantages of the Newcastle approach to undergraduate psychiatry education are presented and the problem of assessing the effectiveness of this approach by outcomes measurement, particularly of integrated competencies and their application in general medical settings, is discussed.
Rooming-in: An Alternative to Involuntary Detention
Authors: Richardson Michael Ernest 
Published: November 2007

Objective: To provide, via ‘rooming-in’, a local, less coercive and less frightening alternative to involuntary detention. Rooming In is the voluntary participation of so-called ‘confidants’, who may be chosen family members or trusted friends, in the management of acute, severe psychiatric disturbance by their providing a 24 hour vigil with the patient in a single, safe hospital room. Method: There were 73 admissions to the rooming-in program at the Manning Base Hospital, Taree, New South Wales (NSW), Australia between 5 August 1986 and 21 September 1992. During the same period 78 patients were remitted from the hospital on an involuntary basis to urban detention centres: ‘scheduled’ under the NSW Mental Health Act. Demographic and diagnostic characteristics of the two populations, both of whom met identical criteria for involuntary detention, are compared in this retrospective, case report study. These two groups constituted only 6% of total psychiatric consults carried out at the hospital over the same 6 year period and those roomed-in represented only 12% of the psychiatric admissions. A quality assurance study evaluated the acceptability of the program. Results: The scheduled patients were more likely to be single, of no fixed abode and without a local family. They were more likely to have a schizophrenic disorder, compounded by polysubstance abuse, than a mood disorder. The average inpatient stay for those roomed-in was 10 days. Seventy per cent of confidants were required for 4 days or less. The rooming-in program was valued highly by nursing staff, patients and their families. Conclusion: A search of the world literature would suggest that rooming-in, as a model of care, is unique, at least in the developed world. It allows some seriously disturbed patients to be provided with a local and less restrictive general hospital alternative.
Fluoxetine and the Syndrome of Inappropriate Secretion of Antidiuretic Hormone (SIADH)
Authors: Burke David , Fanker Scott 
Published: November 2007

Objective: To report three new cases of the fluoxetine-induced syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Clinical picture: All three cases occurred in elderly psychiatric inpatients treated for depression with standard doses of fluoxetine within one month of starting the medication. All three patients were clinically symptomatic of SIADH. Treatment: In all three patients the medication was ceased and fluid restriction commenced. One patient required intravenous saline. Outcome: All three patients recovered fully within three weeks. None were rechallenged. Conclusions: The symptoms of hyponatraemia due to fluoxetine-induced SIADH may be difficult to distinguish from the symptoms of depression, unless appropriate laboratory investigations are made.
Fritz Müller’s legacy on Axel Heiberg Island, Nunavut, Canada
Authors: Adams Peter 
Published: November 2007

AbstractFritz Müller (1926–80) was the leader of the Jacobsen-McGill Arctic Research Expeditions to Axel Heiberg Island, Nunavut, Canada. He was a faculty member at McGill University, Montreal, Canada, from 1959 to 1970. Thereafter, he was Chair of Geography at Eidgenossische Techmsche Hochschule, Zürich, Switzerland. He conducted research on Axel Heiberg Island, mainly in the vicinity of Expedition Fiord, from 1959 until his death in 1980. This paper is a personal account of Müller’s work by one of his students, with a commentary on his contributions to Arctic science. The personal account focuses on the early years of the expeditions. The commentary includes discussion of glacier mass-balance records and lake-ice break-up from 1959 to the present, glacier-terminus records from 1948 to the present and other research focused on the region.
Climate variability and glacier reaction in the Austrian eastern Alps
Authors: Schöner Wolfgang , Auer Ingeborg , Böhm Reinhard 
Published: November 2007

AbstractA carefully homogenized climate dataset is used to interpret glacier behaviour in the Austrian Alps. Periods of glacier advance are generally more maritime and cooler, with reduced sunshine duration and increased precipitation sum during the ablation period. Periods of retreat are associated with a more continental, warmer climate, with increased sunshine duration and reduced precipitation sum. Three recent sub-periods of Austrian glacier behaviour are documented by direct measurement of glacier mass balance (before 1965 more negative; 1965–81 more positive; since 1982 more negative). A long-term mass-balance series in the eastern part of the Austrian Alps parameterized by snow-depth measurements indicates very clearly that periods of more negative mass balance have a higher correlation to summer air temperature and a lower correlation to winter accumulation. Periods of more positive mass balance are highly correlated to winter accumulation and only slightly correlated to summer temperature. The positive mass-balance period 1965–81 is also characterized by negative North Atlantic Oscillation index values which caused an increased meridional circulation mode, resulting in a northwesterly to northerly precipitation regime during winter.
Operational ice-model verification at the Canadian Ice Service
Authors: Carrieres Tom 
Published: November 2007

AbstractAn operational coupled ice-ocean forecast model is compared with observed ice features derived from daily ice charts and ice beacons. The model demonstrates significant skill in predicting ice drifts, total ice extent, total ice area and average compactness tendencies. Evaluation of ice-thickness forecasts is inconclusive. Model deficiencies may be caused by inconsistent specification of the initial ice and ocean state.
Modelling of historic variations and future scenarios of the mass balance of Svartisen ice cap, northern Norway
Authors: Engeset Rune Verpe , Elvehøy Hallgeir , Andreassen Liss Marie , Haakensen Nils , Kjøllmoen Bjarne , Roald Lars Andreas , Roland Erik 
Published: November 2007

AbstractIn glacier-dominated catchments, glaciers have an important effect on the water balance. It is important to understand the glacier control on inflow in order to assess historic trends and future scenarios. The mass balance of a 100 km2 glacier sub-basin of Svartisen ice cap, northern Norway, was reconstructed for 1917 to 1995. The reconstruction was carried out using three different methods, the hydrological method, the correlation between mass balance and meteorological observations and a precipitation-degree-day model. Calibration data were derived from field observations, map comparisons and correlation of observations at different glaciers. The reconstructed series showed a total loss of ∼3 × 109 m3 of water, most of which occurred between 1920 and 1950. After 1950, the net balance increased gradually and is currently near equilibrium with the present climate. Suggested climate scenarios for this region gave a loss between zero and 5 ×109 m3 of water until the year 2050.
Geotechnical centrifuge modelling of gelifluction processes: validation of a new approach to periglacial slope studies
Authors: Harris Charles , Rea Brice R. , Davies Michael C. R. 
Published: November 2007

AbstractHere we compare scaled centrifuge modelling of gelifluction processes with earlier full-scale physical modelling experiments. The objective is to assess the validity of the centrifuge technique for cryogenic slope-process investigations. Centrifuge modelling allows correct self-weight stresses to be generated within a small-scale physical model by placing it in an elevated gravitational field. This paper describes an experiment in which a scaled frozen-slope model was thawed in a gravitational field equivalent to ten gravities. After four cycles of thawing, during which soil temperatures, pore pressures, thaw settlement and downslope soil displacements were continuously monitored, a series of marker columns were excavated to reveal profiles of soil movement. Comparison of these data with those from an earlier full-scale laboratory simulation experiment indicates that thaw-related gelifluction was successfully reproduced during centrifuge modelling. It is concluded that rates of soil shear strain during gelifluction were not time-dependent? since soil displacements in the centrifuge tests were of a similar magnitude to or greater than those observed in the much longer-duration full-scale simulation. This suggests that no transition occurred in soil behaviour from a frictional plastic to a true viscous fluid during the period of high moisture contents immediately following thaw.
Runoff and drainage pattern derived from digital elevation models, Finsterwalderbreen, Svalbard
Authors: Hagen Jon Ove , Etzelmüller Bernd , Nuttall Anne-Marie 
Published: November 2007

AbstractFinsterwalderbreen (77°26’ N, 15° 15’ E) is a 35 km2 polythermal, surge-type glacier in southern Spitsbergen, Svalbard. Extensive field investigations have been carried out on the glacier, including mapping of bed topography by radio-echo soundings, mass-balance measurements and hydrological and meteorological registrations. In this paper we have used surface and bed topography and observations of summer ablation to estimate total runoff and subglacial drainage pattern by means of spatial map analysis in standard geographic information system software. The location and relative importance of the water-channel outlets from the glacier were estimated, as well as the change in drainage pattern over the period 1970–90. The results could be compared to direct observations of drainage pattern and discharge recordings. The analyses indicate that the location of the subglacial channels is dominated by the surface topography and thus that the channels are partly pressurized.
Modeling interdecadal variations of lake-ice thickness and sensitivity to climatic change in northernmost Alaska
Authors: Zhang T. , Jeffries M. O. 
Published: November 2007

AbstractA physically based finite-element heat-transfer model with phase change is used to simulate ice growth and thickness variability on shallow, thaw lakes on the North Slope of Alaska during the period 1947–97. The basic inputs to the model are air temperature and snow depth as recorded at the U.S. National Weather Service station, Barrow, Alaska. The simulated long-term mean maximum ice thickness was 1.91 ±0.21 m with a range from 1.33 m (1962) to 2.47 m (1976). Variations in the seasonal snow cover played a much greater role than air temperatures in controlling ice-thickness variability during the 50 year simulation period. The sensitivity of lake-ice growth to extremes of snow depth, air temperature and snow bulk thermal conductivity is investigated. This study shows that lake-ice thickness has varied significantly from year to year in northern Alaska. Continued variability combined with potential climate change could affect the area of ice that freezes completely to the bottom of lakes each winter, resulting in changes in water storage and availability, permafrost thermal regime and talik dynamics beneath lakes, and methane efflux and energy fluxes to the atmosphere. It is concluded that quantification and a full understanding of these potential effects will require systematic and continuous field measurements that will provide better forcing and validation fields for improved models.