bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mentally Abnormal Homicide in Western Australia
Authors: Kraya Niazi , Pillai Krishna 
Published: March 2003

Objective: To review persons charged or convicted with homicide referred to the Western Australian Forensic Psychiatric Service. Method: Review of case note of referrals over a five-year period. Results: Data from 42 cases were collected. Offenders and victims belonged to a variety of ethnic backgrounds. There were four cases of multiple homicide. The majority of perpetrators and victims were males. A significant number had a pre-existing major psychiatric disorder, about half of who were under psychiatric care at the time of the offence. Half of the patients were diagnosed with schizophrenia or delusional disorder. A gun was used in one fifth of the cases. Conclusions: The survey highlights the importance of risk management and assertive community follow-up in those with psychosis.
Using Email with Your Patients
Authors: Hatcher Simon 
Published: March 2003

Objective: To describe the potential benefits and pitfalls in relation to the use of email with patients, with a view to fostering discussion about the impact of the technology on our discipline. Conclusions: Email is useful for supplementing information provided in face-to-face sessions and for monitoring progress. ‘Cyberclinics’ present many possibilities to augment traditional patient management. Problems include not all patients having access to the technology and issues relating to confidentiality. The therapeutic relationship is inevitably altered through its use.
Early Childhood Nurse-Delivered Cognitive Behavioural Counselling for Post-Natal Depression
Authors: Prendergast Joanna , Austin Marie-Paule 
Published: March 2003

Objective: The aims were (1) to establish whether Early Childhood Nurses (ECNs) can be trained in a modified Cognitive Behavioural Therapy (CBT) for Post-natal Depression (PND), and (2) to compare the outcome of women treated with this therapy with ‘ideal standard care’ using non-specific counselling by ECNs with no additional training. Method: Five ECNs were trained in CBT and supervised weekly. Women were screened post-natally using the Edinburgh PND Scale (EPDS) and diagnostically assessed by a research registrar. Women with DSM-IV major or minor depression (n=37) were then randomized into either ‘ideal standard care’ (n=20) or CBT (n=17) for six weekly sessions. Two stages of follow-up were undertaken: research registrar interview immediately post-treatment and a postal follow-up at six months. Results: The training package was evaluated both by ECN completed questionnaires and analysis of taped therapy sessions. These evaluations indicated that ECNs could deliver modified CBT. There was a very high rate of recovery at initial follow-up with 70-80% recovered (EPDS < 10) in both groups. Six month follow-up showed a trend towards CBT being more effective in the longer term. Conclusions: ECNs can effectively provide a modified CBT intervention in the treatment of PND. For the majority of this sample with mild-moderate depression, perceived support from their ECN (forming an integral part of both the baseline assessment interview and control condition) appeared to be as effective as modified CBT.
Psychiatry in Western Australia since Federation: An Eloquent Testimony
Authors: Skerritt Paul , Ellis Arch , Prendergast Frank , Harrold Colin , Blackmore Harry , Derham Bill 
Published: March 2003

Objective: To review aspects of the history of psychiatry in Western Australia since Federation. Method: Summary of a meeting of the WA Branch RANZCP with contributions from selected senior psychiatrists and one surgeon. Conclusion: As the population of Western Australia has moved from about 150,000 to nearly 2,000,000 in the twentieth century, psychiatry has reflected world trends and sometimes has led them.
Social Policy and Humanity: The Use of Language as a Social Defence Against Anxiety
Authors: Little John , Blackman Peter , Rouhan Janice 
Published: March 2003

Objective: People who work as social policy makers and as managers use a language that is different from people whose work is direct clinical care. The aim of this paper is to describe and explore this phenomenon in an attempt to understand that difference, why it may have developed and what we may learn from it. Conclusion: This paper has at its heart the notion that the words we use (or don't use) are part of a system in which we attempt to contain our anxieties when faced with seemingly impossible health care issues. It suggests that by doing so we may unwittingly distance ourselves from people with whom we are working and in some way alter our capacity to heal divisions between and within conceptual and clinical frameworks. “The polarising of financial imperatives on the one hand and clinical concerns on the other, is entirely dysfunctional in terms of ensuring optimal health outcome and maximum effectiveness and efficiency of use of the health dollar. The task is to bring the two disciplines of clinical care and financial management into accord. This, I believe, is the challenge of today's hospital management”. Stoelwinder 1997 1
Smoking and Schizophrenia: The Development of Collaborative Management Guidelines
Authors: Meadows Graham , Strasser Kathryn , Moeller-Saxone Kristen , Hocking Barbara , Stanton John , Kee Pat 
Published: March 2003

Objective: Smoking is generally on the decline, but more people with disorders such as schizophrenia smoke than is the rule for the general population. Collectively, health professionals in primary or specialist care settings probably do not do as much as they could to help these people cut down or give up, and the issues involved are more complex than they might at first appear. Assisting change in smoking patterns optimally will require collaboration between staff providing smoking-specific interventions such as group-based programs, and medical practitioners who can appropriately support transitions in smoking behaviour. Doctors providing this support should be aware of considerations specific to this group of patients including some relevant pharmacological interactions. This paper describes a project, which involved collaboration between provision of a group-based intervention and medical care including care within a GP shared-care program. A set of guidelines developed for doctors' use within this study has been adapted for wider use. Conclusions: Our experience with these guidelines, which are summarised in this paper, suggests they should be helpful for a range of clinicians working with people with schizophrenia who also smoke. The RACGP and the RANZCP have endorsed the guidelines, which are available from an internet website.
Managing Services that Manage People with a Coexisting Mental Health and Substance use Disorders
Authors: Welch Mark , Mooney Julie 
Published: March 2003

Objective: The Mental Health and Alcohol and Drug Services (MHADS) initiated the present study as a cross-service investigation into current practice and future developments in the provision of services to clients with dual disorders. Method: A two-part study was conducted over a six-month period to determine: 1) The fidelity to the principles of care outlined in The Service Delivery Guidelines for The Management of People with a Coexisting Mental Health and Substance Use Disorder (2000) (The Service Delivery Guidelines), and 2) The barriers to following the guidelines. Results: A number of barriers to the full implementation of the guidelines were uncovered, principally in the areas of system issues, training and education, clinical issues, and policies and procedures. Conclusions: Comorbidity of mental health and substance use disorders is receiving more attention in health services as awareness of the prevalence of these problems increases and the poor outcomes from current service delivery models are more widely acknowledged. However, it is apparent that there is almost as much ‘comorbidity’ in the services that provide the care as in the population itself.
Advanced Training in Adult Psychiatry
Authors: Hughes David , Burke David , Hickie Ian , Wilson Andrrewn , Tobin margaret 
Published: March 2003

Objectives: To discuss the current and future challenges facing Adult Psychiatry, explore innovative Advanced Training in Adult Psychiatry as a solution to some of these challenges, and promote discussion among interested parties as a precursor to developing a bi-national program of Advanced Training in Adult Psychiatry. Conclusions: Adult Psychiatry is an exciting and rewarding subspecialty with a sound and substantial academic and research base.
Mercenaries or Martyrs? How to Fight the Battle in the Provinces
Authors: Hosford Ian 
Published: March 2003

Objectives: To highlight the issues in maintaining adequate numbers of psychiatrists in “provincial” areas of New Zealand and look at alternative approaches to resolve the shortage of psychiatrists in these areas. Conclusions: The current strategy in addressing this issue is not working. An alternative approach would be to offer different incentives to psychiatrists to settle in provincial areas. These incentives could be monetary or the opportunity to obtain full registration to work as a specialist in New Zealand. The College needs to drive any changes in strategy.
The Development of Consensus Guidelines for the Treatment of Young People with First Episode Psychosis
Authors: Moss Beverley , O'Connor Nick 
Published: March 2003

Objective: The aim is to describe the process adopted in Northern Sydney, Sydney, Australia for developing consensus guidelines for the treatment of young people with first episode psychosis. Method: The process included academic detailing with psychiatrists working in Northern Sydney adolescent and adult mental health services, two clinician forums, and a survey. While the guidelines were based on the Australian Clinical Guidelines for Early Psychosis and published studies, the expertise of clinicians in Northern Sydney was also sought. Results: The consensus guidelines have been endorsed for use in Northern Sydney. The guidelines cover the issues of assessment and treatment of psychosis in young people, investigations, use of parenteral medication, diagnosis, and information for clients. Conclusions: The authors make several observations about the process of guideline development. Academic detailing proved to be a more effective way than questionnaires for obtaining information from clinicians. The process of developing the guidelines seemed to be, in some ways, more important than the final product.
Thirty Years On: Psychiatric Services in the United Arab Emirates
Authors: Kraya Niazi 
Published: March 2003

Objective: To outline some aspects of the psychiatric services in the United Arab Emirates (UAE). Conclusions: In its short existence, UAE has made significant strides in all aspects and spheres of life, including the delivery of mental health services. Following brief overview of the country's history and geography, the article considers psychiatric services in UAE, workforce issues, academic psychiatry, and moves to developing a national mental health program.
A Discussion with D.M. Armstrong about the Nexus between Philosophy and Psychiatry
Authors: Bas James Le , Armstrong David , King Robert , Blomfield Jocelyn Dunphy , Phillips Neil 
Published: March 2003

Objective: To explore practical issues in the Mind-Body Problem through a discussion with philosopher D.M. Armstrong. Conclusions: Debate about the Mind-Body Problem stretches from the Ancient Greeks to the present time. Thanks to philosophers such as Armstrong and Smart, Australia has played a pivotal role in modern developments. Dialogues involving clinicians and philosophers hold the promise of opening up new fields of intersection.
Primary Care-Led Mental Health Service Reform: An Outline of the Better Outcomes in Mental Health Care Initiative
Authors: Hickie Ian , Groom Grace 
Published: March 2003

Objective: To describe the key features of the ‘Better Outcomes in Mental Health Care’ initiative (2001-2005) and to detail some of the conceptual, community, professional and epidemiological forces that shaped its content. Conclusions: The ‘Better Outcomes in Mental Health Care’ initiative represents a major development in mental health care in Australia. It recognises the central role of primary care, promotes integrated medical and psychological care, rewards treatments that occur over an episode of illness, promotes active purchasing of non-pharmacological interventions earlier in the course of illness, and attempts to better link general practitioners, non-medical mental health specialists and psychiatrists to meet population-based mental health needs. Central to its development has been a commitment by general practitioners to develop progressively better mental health skills and measure both individual consumer and system-related outcomes.
Practising Psychiatry in New Zealand's Rural Areas: Incentives, Problems and Solutions
Authors: Lau Trevor , Kumar Shailesh , Thomas David 
Published: March 2003

Objectives: To identify challenges faced by psychiatrists working in New Zealand's non-metropolitan areas and identify strategies that New Zealand psychiatrists use to overcome some of these challenges. Method: Ten psychiatrists attending the RANZCP New Zealand Branch conference in 2000 participated in a focus group. They identified positive and negative aspects of working in New Zealand's non-metropolitan areas and possible solutions to problems. Results: Ten main themes were identified. These focussed on professional challenges of practising psychiatry in rural areas. Social and economic factors did not rank highly. The solutions generated included expanding the local psychiatric workforce, modifying workload or work pattern of existing psychiatrists, utilising differing models of service delivery, and enhancing professional development. Conclusions: This is the first study that has reported on challenges of, and some solutions to, practising psychiatry in New Zealand's non-metropolitan areas. Difficulties identified and solutions generated were similar to those found in rural areas of other developed countries. It is important that a widely-accepted nomenclature (“rural”, “provincial”, “urban” psychiatry) be developed. More research is suggested into the characteristics of New Zealand's specialist psychiatry workforce and into the efficacy of any solutions implemented.
Hypotonic duodenograms of postbulbar duodenal lesions: Pictorial essay
Authors: Sumi Yukiharu , Ozaki Yutaka , Shindoh Noboru , Kyogoku Shinsuke , Katayama Hitoshi 
Published: March 2003

SUMMARYGeneral features are described and examples are provided of the radiological manifestations of postbulbar duodenal lesions, particularly the findings on hypotonic duodenograms. Hypotonic duodenography does not always reveal the characteristic findings of postbulbar duodenal lesions, but it helps to evaluate luminal stenosis and diagnose disease entities even in lesions that show non‐specific findings. Radiologists should be familiar with the radiological findings of postbulbar duodenal lesions and know which kinds of lesions can affect the postbulbar duodenum. This is important in making a differential diagnosis and in preventing delays in diagnosis.
Effect of hip prostheses on radiotherapy dose
Authors: Carolan Martin , Dao Phuong , Fox Chris , Metcalfe Peter 
Published: March 2003

SUMMARYA small but growing proportion of patients requiring radiotherapy for prostate cancer have one or two hip prostheses which may shadow the target and affect the dose distribution. Approximately 10 such patients are treated at the Illawarra Cancer Care Centre per year. Hence a study was undertaken to examine the accuracy of various treatment methods that involve some of the treatment fields travelling through the prosthesis. A fixed‐field measurement showed a dose reduction of 52% in the shadow of the prosthesis. A Monte Carlo simulation confirmed an increase in dose on the distal surface of the prosthesis of 35%. Of more clinical relevance, however, is the dose distribution due to the overall combined field treatment. Using a power law correction benchmarked against thermoluminescent dosimeters and Gafchromic film, three different beam set‐ups for patient treatment were planned and the dose variation analysed. A four‐field brick technique gave a dose variation across the target volume of ± 15% whereas a dual arc technique gave a dose variation of only ± 5%. A four‐field oblique technique gave a dose variation of only ± 2% across the target volume but the oblique field technique included extra dose to the rectum.
Eligibility audits for the randomized neuropathic bone pain trial (TROG 96.05)
Authors: Roos Daniel E , Davis Sidney R , O’Brien Peter C , Hoskin Peter J , Spry Nigel A , Burmeister Bryan H , Turner Sandra L , Bernshaw David M 
Published: March 2003

SUMMARYIn February 1996 the Trans‐Tasman Radiation Oncology Group (TROG) initiated a two‐arm, multicentre, prospective randomized trial on radiotherapy for neuropathic pain due to bone metastases (TROG 96.05). This trial compares the response to a single 8‐Gy fraction with 20 Gy in five fractions. The accrual target is 270 patients. In order to evaluate compliance with eligibility criteria after approximately 1 year of accrual, an independent audit of the first 42 randomized patients was commissioned. This found that only one of these patients did not have genuine neuropathic pain, but that this patient and seven others (19%) had infringements of other eligibility/exclusion criteria for the trial. Accordingly it was decided to continue the full audit up to 90 patients. This detected no further patients without genuine neuropathic pain, and found only one other eligibility infringement (1/48; 2%). It is concluded that this quality assurance (QA) measure undertaken early in the trial led to significantly improved clinician awareness of, and compliance with, eligibility/exclusion criteria. It also enabled an accurate comparison of outcome data for all randomized versus all eligible patients at the time of the preplanned first interim analysis at 90 patients. In view of the excellent compliance demonstrated in the second audit, a one‐in‐five sampling is proposed for future audits from centres that have already accrued at least five consecutive eligible patients. This is consistent with TROG QA guidelines now operational.
Modified computed tomography peritoneography: Clinical utility in continuous ambulatory peritoneal dialysis patients
Authors: Hawkins Stewart P , Homer Jocelyn A , Murray Brendan B , Voss David M , Merwe Walter M van der 
Published: March 2003

SUMMARYThe purpose of the present paper is to review the indications, results, clinical correlation and implications for management of a modified CT peritoneography (CTP) technique in the evaluation of continuous ambulatory peritoneal dialysis (CAPD) patients. Forty CTP in 33 patients were reviewed by two observers blinded to clinical history or outcome. The CTP technique included 100 mL non‐ionic intraperitoneal contrast, 1 h of ambulation and prone positioning during the CT. No precontrast or delayed examinations were performed. A CAPD‐related complication was diagnosed in 33 of 40 (82%) CTP . Twenty‐nine CTP were performed for evaluation of suspected dialysate leaks. In this group there were 18 leaks, a total of seven umbilical hernias (five as isolated findings) and five normal studies. Nine of 18 (50%) leaks resolved with conservative management and six of nine patients (67%) of the remainder continued CAPD after appropriate surgery. Seven patients were evaluated for scrotal swelling (one bilateral), and there were five communicating hydroceles (all with inguinal fat herniation and all surgically confirmed) and three non‐communicating hydroceles (none of which progressed). Umbilical hernias were present in nine of 33 patients (27%). No false positive or false negative studies were identified. The CTP technique described provides accurate diagnostic information in the management of common CAPD‐related complications, particularly dialysate leak, genital swelling, abdominal wall hernias and peritoneal adhesions. Computed tomography peritoneography directs appropriate conservative or surgical management.
Haemangiopericytoma of the trigeminal nerve
Authors: Tan Irene , Soo Mark YS , Ng Thomas 
Published: March 2003

SUMMARYA 41‐year‐old man presented with a 4‐year history of progressive right‐sided diplopia on lateral gaze and right nasolabial paraesthesia. A CT revealed minor bone erosion of Meckel’s cave and of the right petrous apex by a uniformly enhancing lesion at the base of the skull. Magnetic resonance imaging on three occasions over 2 years showed tumour, measuring 4 cm in diameter, with features suggestive of a trigeminal neuroma. At surgery the lesion had the macroscopic appearance of a giant schwannoma. Histopathological findings were that of a meningeal haemangiopericytoma (HPC) of the trigeminal nerve. Intracranial HPC are rare and aggressive tumours of the central nervous system. They usually arise from the falx, tentorium and dural sinuses. The present case is unique as it originates from a cranial nerve.
Giant fibroadenoma of the breast in an Arab population
Authors: Hanna RM , Ashebu SD 
Published: March 2003

SUMMARYIn a retrospective study of giant breast masses over a period of 20 years (1980–2000), we encountered 18 patients with fibroadenomas. Most of them were adolescents and young adults. The bimodal age incidence seen in Caucasians was not observed. The masses ranged from 6 to 15 cm in size and in the youngest patient, they were bilateral. All 18 patients were examined by mammography and 10 of them by ultrasonography (US) as well. The right breast was involved in 12 patients and the left in six. The diagnosis was confirmed pathologically in all patients, by excision biopsy in 17 patients and by fine needle aspiration cytology and excision biopsy in one patient. The radiological findings were the same as those previously described. All patients were treated by simple enuculation. There was only one recurrence over a follow‐up period from 2 months to 3 years.
Dural sinus thrombosis presenting as unilateral lobar haematomas with mass effect: An easily misdiagnosed cause of cerebral haemorrhage
Authors: Singh T , Chakera T 
Published: March 2003

SummaryDural sinus thrombosis has protean clinical and radiological manifestations ranging from minimal effacement of sulci with no symptoms to severe haemorrhagic infarcts associated with focal deficits, coma and even death. An uncommon form of presentation is characterized by unilateral lobar haemorrhage associated with extensive oedema and parenchymal distortion. In an acute presentation, this might resemble haemorrhage into a tumour. In delayed presentations, the haematoma, being iso‐ or hypodense and showing peripheral ring‐like enhancement, can mimic aggressive tumours or infective processes. As this is an uncommon condition, misdiagnosis is common with the potential for mismanagement and adverse outcomes. We present five such consecutive cases that were initially misdiagnosed as other entities. Each of these cases on closer inspection show features observed on CT and MRI that should have suggested a diagnosis of dural venous sinus thrombosis. One of these cases progressed to not only extensively involve the superficial sinuses but also the deep veins, with a significant adverse outcome. The imaging features of this interesting variant of dural sinus thrombosis are reviewed. The haemodynamic basis for haemorrhage and anatomical basis for the lateralization of the lesions are discussed.
Aneurysms of the inferior vena cava
Authors: Sheth Rahul , Hanchate Vijay , Rathod Krantikumar , Ahmed Iftikhar , Deshmukh Hemant , Chaubal Nitin 
Published: March 2003

SummaryTwo cases of saccular aneurysms of the infrarenal inferior vena cava (IVC) associated with retrohepatic IVC obstruction are described. Ultrasonographic, computerized tomographic and inferior venacavography findings in these cases are presented.