bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of Medical Needle Characteristics on the Resistance to Puncture of Protective Glove Materials
Authors: Dolez Patricia I. , Vu-Khanh Toan , Nguyen C. Thang , Guero Gbeuli , Gauvin Chantal , Lara Jaime 
Published: January 2008

Abstract
Puncture of protective clothing by medical needles is a major concern for a number of professional groups. This is particularly true since it has been shown that the protection level of protective gloves measured using the current puncture resistance standards is not relevant when dealing with medical needles. This paper proposes a step-by-step analysis of the puncture mechanism of membranes by medical needles. It investigates also the influence on the puncture force of various characteristics of medical needles, including the needle diameter, number of facets, and facet angle, for a number of materials relevant to protective gloves. It is observed that the effect of these parameters is sometimes very dependent on the type of material punctured. Tests also reveal that the variation in the measured puncture force for mass-produced three-facet medical needles can be associated with the variation of one of the needle dimensions, i.e., the outer diameter at the transition between the facets. Finally, a study of the effect of needle reuse in successive trials shows that cutting-edge wear is much more extensive with reinforced materials. This justifies the need to use needles only once for measuring the puncture resistance of protective clothing materials.
Reducing complications associated with a deeply engaged head at caesarean section: a simple instrument
Authors: Singh Mandeep , Varma Rajiv 
Published: January 2008

Key content

There has been a disproportionate increase in caesarean section performed in the second stage of labour in the last few years.
Difficult delivery of the fetal head during caesarean section carries a higher risk of complications for both mother and baby.
The National Sentinel Caesarean Section Audit Report, published by the Royal College of Obstetricians and Gynaecologists recommends a consultant presence when caesarean section is performed at full dilatation.

Learning objectives

The obstetrician needs to anticipate the possibility of difficult delivery of the fetal head during caesarean section.
Using an assistant to push the fetus can cause trauma, as the force required to push is uncontrolled.
The Foetal Disimpacting System® seems to be effective in elevating the fetal head when it is deeply engaged.

Ethical issues

There is a need for more data before the fetal disimpacting device is adopted in routine obstetric practice.
Use of this device when preparing for an emergency caesarean section, for instance in a situation of umbilical cord prolapse, may be justified.

Please cite this article as: Singh M, Varma R. Reducing complications associated with a deeply engaged head at caesarean section: a simple instrument. The Obstetrician & Gynaecologist 2008;10:38–41.
The ethics of preimplantation genetic diagnosis
Authors: El‐Toukhy Tarek , Williams Clare , Braude Peter 
Published: January 2008

Key content

Preimplantation genetic diagnosis (PGD) is an alternative to prenatal diagnosis and termination of affected pregnancies.
PGD for late‐onset and susceptibility conditions requires careful consideration on a case‐by‐case basis.
PGD for sex selection for nonmedical reasons is prohibited in the UK.
The use of PGD is expanding and its ethical implications are likely to increase.

Learning objectives

To recognise the main ethical difficulties raised by the practice of PGD.
To understand the role of regulation.
To appreciate the potential ethical implications of new developments in reproductive genetics.

Ethical issues

Is PGD more acceptable than prenatal diagnosis and termination for all disorders?
Should PGD be offered for Huntington disease on a nondisclosure basis?
Should noncarrier embryos be replaced in preference to carrier embryos in recessive conditions?
Is PGD for HLA typing a step too far?

Please cite this article as: El‐Toukhy T, Williams C, Braude P. The ethics of preimplantation genetic diagnosis. The Obstetrician & Gynaecologist 2008;10:49–54.
Fish Community Responses to Half-Log Additions in Warmwater Streams
Authors: Hrodey Peter J. , Sutton Trent M. 
Published: January 2008

Abstract
Half-log habitat enhancement structures are commonly used for stream restoration projects to increase fish abundance and biomass. Half logs (N = 108) were added to nine headwater streams of the upper Wabash River basin, Indiana, in July 2003. Study sites (25 m in length) were sampled with backpack electrofishing once each month during July–October 2003 and April–September 2004 to document the colonization and use of half logs by fish under agriculture, forest, and fallow-field land uses. Index of biotic integrity (IBI) scores did not change significantly after half-log additions. The effects of half-log habitat enhancement structures were variable by month, stream, and in some cases, individual fish species. Species richness and biomass significantly increased in two study streams during spring and fall due to the presence of bluntnose minnow Pimephales notatus and longear sunfish Lepomis megalotis. Absolute abundance within most sites increased during periods of low flow and high temperature in late summer and early fall, when fish are most vulnerable to predation and require habitat refugia. Fish use of half logs was also dictated by the amount of instream habitat, especially where percentages of aquatic vegetation (mean = 0.0%) and large woody debris (mean = 0.67%) were low and the percentage of pool habitat was moderate (mean = 10.53%). In this study, we found that with the exception of IBI scores, significant manipulation response was variable by stream and species and was influenced by instream habitat and time of year.
Effects and Utility of Minimum Length Limits and Mortality Caps for Flathead Catfish in Discrete Reaches of a Large Prairie River
Authors: Makinster Andrew S. , Paukert Craig P. 
Published: January 2008

Abstract
Populations of flathead catfish Pylodictis olivaris in four reaches of the Kansas River, Kansas, were examined to evaluate the effects of three minimum length limits (305 (the minimum size that anglers are willing to harvest), 610, and 762 mm total length (TL)) on population size structure and number harvested over a 30-year simulation. We used electrofishing and hoopnetting to capture and tag flathead catfish throughout the Kansas River from 2005–2006. Current exploitation (u) based on tag returns was probably less than 10%, and total annual mortality A ranged from 14% to 28% across all reaches. Increased river access and promotion of this fishery may increase u in the future, so model simulations were conducted with conditional natural mortality (cm) and u ranging from 10% to 40%. Proportional stock density (PSD) and the relative stock density of preferred-length fish (RSD-P) substantially declined (by &gt;25% and &gt;15%, respectively) as u increased with the 305-mm TL limit over the 30-year simulation. The PSD showed similar trends across all reaches, indicating that use of different regulations among reaches was not necessary and that differences in growth among reaches were less influential than u and cm. No substantial differences were observed in size structure under the 610- and 762-mm TL limits among reaches, but under a 762-mm TL limit anglers would have to sacrifice about 42% of the number harvested under the current cm level. Mortality caps revealed that each reach could sustain an A of about 60% and 55% to maintain current PSD and RSD-P levels, respectively; this result suggests that quality flathead catfish size structure can be preserved. Our results show that the effects (or lack thereof) on flathead catfish and other sport fishes should be evaluated before harvest restrictions are implemented.
Paradox, Persecution and the Double Game: Psychotherapy in Anorexia Nervosa
Authors: Russell Janice , Meares Russell 
Published: January 2008

Objective: In anorexia nervosa, the interface between psychotherapy and effective physical management continues to arouse dissent. For this reason, theoretical underpinnings and their practical applications were explored. Method: A selective review of the literature was based on the authors' clinical experience in hospital treatment settings. Results: The psychosomatic paradigm, the threat to life, the reward characteristics and the developmental trajectory of anorexia nervosa necessitate a particular form of integrated psychotherapy. Conclusions: The approach is essentially that of self psychology but with an important departure which must be addressed in the therapeutic process. This is exem-plifed in the paradox of persecution by refeeding and the curious double game that evolves.
Psychosis following Acute Alteration of Thyroid Status
Authors: Irwin Rosie , Ellis Pete M. , Delahunt John 
Published: January 2008

Objective: Mania with psychotic features presenting following abrupt normalisation of thyroid function from severe Graves's disease is reported. Clinical picture: A 33-year-old man with severe, untreated Graves's disease was treated aggressively, with rapid restoration of normal serum thyroid hormone levels. Symptoms of mania and psychosis then developed. Treatment: Time limited anti psychotic medication and continuing medical treatment. Outcome: There was resolution of psychiatric symptoms. Conclusions: The association of mania and psychosis with thyroid disease is rare, but aggressive medical treatment and rapid restoration of normal serum thyroid levels may increase the risk of the emergence of such symptoms.
Erotomania Associated with Temporal Lobe Abnormalities following Radiotherapy
Authors: Wijeratne Chanaka , Hickie Ian , Schwartz Raymond 
Published: January 2008

Objective: The aetiology of primary erotomania is usually discussed in terms of psychological disturbance in the patient. A case associated with demonstrable left temporal lobe abnormalities is described. Clinical picture: An elderly female patient presented with the delusion of being loved by a physician who had treated her previously. She had received radiotherapy to her left periorbital area in childhood. Structural and functional neuroimaging revealed medial temporal lobe damage. Treatment and outcome: She was treated with haloperidol with moderate improvement in her distress. Conclusions: This case illustrates the contribution of both cerebral injury and psychosocial factors in the eventual development of this unusual psychiatric syndrome.
Charles Bonnet Syndrome with Major Depression in a Chinese Middle-Aged Man
Authors: Fong Samson Yat-Yuk , Wing Yun-Kwok 
Published: January 2008

Objective: To describe a middle-aged patient with Charles Bonnet syndrome (CBS) suffering from concurrent major depression. Clinical picture: A 41-year-old Chinese man with retinitis pigmentosa developed complex and vivid visual hallucinations. This was followed by the onset of major depressive illness. His visual hallucinations were greatly influenced by his cultural background and changed during the course of his depression. Treatment: The patient was treated with imipramine. Outcome: The patient had a relapse of depression due to his non-compliance. He recovered after the resumption of imipramine but the visual hallucinations persisted. Conclusions: Patients suffering from CBS can have another concurrent psychiatric illness. The content and form of this patient's visual hallucinations were modified by his cultural background and depressive illness. Sensory deprivation is suggested to be the pathogenic mechanism of his visual hallucination.
Characteristics of the New Long-Stay Population in an Inner Melbourne Acute Psychiatric Hospital
Authors: Richards Josephine , Smith Deidre J. , Harvey Carol A. , Pantelis Christos 
Published: January 2008

Objective: There has been an accumulation of so-called ‘new long-stay’ (NLS) patients in psychiatric hospitals. To date, no Australian studies have characterised this patient group. We aimed to study the demography, and clinical and social functioning of the NLS population at Royal Park Hospital (RPH) together with patients' attitudes to treatment and views on future placement. Method: All 30 NLS patients at RPH were identified. Twenty-seven consenting patients were assessed using the following standardised instruments: Manchester Scale for psychopathology, Life Skills Profile (LSP), Physical Health Index and Patient Attitude Questionnaire. Information on past psychiatric history, past treatment and current treatment was collected. Insight and compliance were assessed. Results: The majority of patients were single men with a diagnosis of schizophrenia. Forty-one percent were detained in hospital involuntarily and 56% were considered dangerous to themselves or others. The patients were characterised by high levels of positive and negative symptoms. They were most impaired with respect to ‘social contact’ relative to the other subscales of the LSP. While 10 (48%) patients expressed a desire to leave hospital, only one patient considered that anyone would cohabit with them. Over two-thirds considered they had been unwell and that medication had helped. Staff rated one-third as having major problems with compliance. About two-thirds of patients had disability secondary to comorbid physical illnesses. Conclusion: Like other NLS patients studied in the United Kingdom and Ireland, this group had significant handicaps secondary to psychiatric illness, concomitant physical illness and disability and behaviour unacceptable in community settings. They were also characterised by significant social isolation. These factors may be important determinants of rehabilitation failure and need to be addressed in the process of de-institutionalisation as well as in longitudinal studies examining these and other factors predicting NLS status.
The Use of Guardianship Legislation for Anorexia Nervosa: A Report of 15 Cases
Authors: Griffiths Rosalyn A. , Beumont Pierre J.V. , Russell Janice , Touyz Stephen W. , Moore Gemma 
Published: January 2008

Objective: This paper investigates compulsory treatment under guardianship legislation for 15 anorexia nervosa patients admitted to four eating disorders units in New South Wales (NSW), Australia, between 1991 and 1994. Method: A retrospective follow-up was conducted. This involved an analysis of sociodemographic, clinical, eating and weight history, and Guardianship Order details obtained from medical records. This small sample was compared to a larger sample of anorexia nervosa patients admitted voluntarily to a specialised eating disorder unit in NSW. Further follow-up included a structured interview using the Morgan-Russell Assessment Outcome Schedule at least 1 year after admission for compulsory treatment. Results: For those treated involuntarily, a larger number came from metropolitan Sydney and a larger percentage were unemployed, were purgers and required specialist medical consultations. A significantly higher proportion came from higher socioeconomic groups, and the duration of stay in hospital while patients were under guardianship was significantly greater. A high degree of comorbidity was noted. There were similarities between those treated involuntarily and those treated voluntarily for the source of referral, marital status and Body Mass Index on admission and discharge. Only three patients accepted a follow-up interview using the Morgan-Russell Outcome Schedule. Two of them had made a good recovery. Conclusions: It was noted that the guardianship sample comprised a more severely ill group than anorexic patients treated voluntarily. The nature of guardianship legislation compared to mental health law was discussed and advice offered to clinicians contemplating and implementing compulsory treatment.
Aspects of Psychiatric Admissions of Migrants to Hospitals in Perth, Western Australia
Authors: Bruxner George , Burvill Peter , Fazio Sam , Febbo Sam 
Published: January 2008

Objective: Recent Australian Government initiatives have emphasised problems with service provision to the ethnic mentally ill. This study aims to address the paucity of contemporary data describing the disposition of the ethnic mentally ill in hospital settings. Method: Patterns of admissions for psychiatric disorders to all hospitals in Perth, Western Australia, for the 3 years from 1990 to 1992, of migrants and the Australian born were compared using data from the Western Australian Mental Health Information System. Results: The overall rates for European migrants showed a ‘normalisation’ towards those of the Australian-born. There were high rates for the schizophrenic spectrum disorders in Polish and Yugoslavian (old terminology) migrants. There were low admission rates for South-East Asian migrants, predominantly those from Vietnam and Malaysia. Rates for alcoholism were low in Italian and all Asian migrants. There were high rates of organic psychosis, especially in those older than 75 years, among the Italian and Dutch migrants. The relative risk of a first admission in the 3 years being an involuntary admission to a mental hospital was almost twice that of the Australian-born for migrants from Poland, Yugoslavia, Malaysia and Vietnam. Conclusions: The results imply the possibility of significant untreated and/or undiagnosed psychiatric morbidity in the South-East Asian-born. They also indicate a need for further exploration of the unexpectedly high levels of psychiatric morbidity among some ethnic elderly groups, specifically the Dutch- and Italian-born. The findings demonstrate the persistence of high rates of presentation for psychotic disorders among Eastern European-born populations, many years post migration.
Survivor Guilt and Chronic Illness
Authors: Vamos Marina 
Published: January 2008

Objective: To examine the grief reactions that may result in patients after a death occurs within a treatment setting for chronic illness, and in particular to look at the applicability of the concept of survivor guilt in these situations. Clinical picture: Two patients with endstage renal disease are described. Both presented states of pathological grief for fellow patients. Vulnerability existed in both patients in terms of previous unresolved mourning and in terms of strong feelings of comradeship with the dead patients. Both demonstrated features reminiscent of what has been termed the ‘survivor syndrome’. Treatment: The treatment involved supportive psychotherapy allowing exploration of grief and its relationship to current psychosomatic crises. Outcome: Supportive psychotherapy successfully aided the resolution in one patient and made some difference in the other. Conclusion: The impact of death within a treatment unit is emphasised. Surviving patients may have significant distress relating to such bereavement and may need appropriate intervention.
The Meaning and Function of Ritual in Psychiatric Disorder, Religion and Everyday Behaviour
Authors: Turbott John 
Published: January 2008

Objective: Ritual is a central feature of obsessive-compulsive disorder (OCD) and is found in other psychiatric conditions. Defined in a general sense, it is seen in the everyday behaviour of animals and of humans, in secular ceremonies, and in religion. This paper examines the various types of ritual. It considers the common features and differences. Method: Material from psychiatric, biological, sociological, anthropological and religious studies literature is reviewed and discussed. Results: The term ‘ritual’ describes a wide variety of phenomena. These include the rituals of OCD and range from relatively simple animal signals to profoundly meaningful human behaviour. A common feature is stereotyped physical activity which conveys information. Some clinical, developmental, evolutionary and religioud historical evidence suggests that stereotyped motor behaviour may be the primary phenomenon. Conclusions: The study of ritual in all its manifestations provides insight into the basis of important human behaviours. Obsessive-compulsive disorder is a likely paradigm for this study. Psychiatry, with its clinical orientation and biopsychosocial perspective, is a discipline within which the study might occur.
Neuroleptic-Induced Laryngeal Dystonia Can Mimic Anaphylaxis
Authors: Ilchef Ralf 
Published: January 2008

Objective: A case report of neuroleptic-induced laryngeal dystonia mimicking acute anaphylaxis is presented with a review of the literature and discussion of common diagnostic difficulties. Clinical picture: The patient was a 24–year-old man with recently diagnosed schizophrenia who presented twice to a general hospital with difficulty speaking within 72 hours of increasing his dose of haloperidol. On both occasions, he was treated aggressively for presumed anaphylaxis with adrenaline, antihistamines and high dose corticosteroids. Treatment: The symptoms resolved with supportive medical care, withdrawal of the haloperidol and substitution of risperidone. There was no evidence of hypersensitivity on subsequent skin testing with haloperidol. Conclusion: This case illustrates one of the many clinical presentations of neuroleptic-induced dystonia. While suspected anaphylaxis needs to be vigorously treated, a history of neuroleptic use and particularly of a recent dosage increase should alert clinicians to the possibility of acute laryngeal dystonia.
Effects of Childhood Sexual Abuse in Adult Female Psychiatric Patients
Authors: Pettigrew Jill , Burcham Joyce 
Published: January 2008

Objective: The present case-control study investigated the relationship between a history of childhood sexual abuse and subsequent psychopathology.Methods: Referrals to a female psychiatrist in private practice in an urban working class area provided 73 adult female study subjects who reported having been sexually abused in childhood, and 73 randomly selected controls.Results: Subjects had earlier onset of psychiatric disorders and higher incidence of deliberate self-harm, rape in adulthood, and psychiatric hospitalisation. History of childhood sexual abuse had an effect independent of family psychiatric disorder. Although subjects and controls had a similar range of diagnoses, subjects were more likely to suffer anxiety disorders and controls more likely to suffer mood disorders. Controls were more likely to be prescribed antidepressants and subjects were more likely to receive supportive psychotherapy. Despite significantly lower initial Global Assessment of Functioning scores, subjects at completion of treatment had improved to the same scores as controls.Conclusion: The long-term effect of childhood sexual abuse is increased incidence of deliberate self-harm and is unrelated to any specific diagnosis. Despite more severe initial impairment, psychotherapy was effective for patients with a history of childhood sexual abuse.
The Bereavement Phenomenology Questionnaire: A Single Factor Only
Authors: Kissane David W. , Bloch Sidney , McKenzie Dean P. 
Published: January 2008

Objective: To review the psychometric properties and factor structure of the Bereavement Phenomenology Questionnaire (BPQ). Method: Continuous data were compared using two tailed t-tests and analysis of variance. A confirmatory factor analysis was carried out. Results: Good internal consistency (Cronbach's alpha = 0.93) with a single factor has been found. The BPQ discriminates the intensity of grief between widows and widowers, spouses and offspring, and temporally between acute and later phases of bereavement. Conclusion: Although on the BPQ items are highly correlated and only a single factor has emerged, it remains nonetheless a valid and reliable scale for the measurement of grief.