bluuebunny/crossref_metadata_2025_split huggingface dataset:
Revising the Code of Ethics of the Royal Australian and New Zealand College of Psychiatrists: Process and Outcome
Authors: Steinberg Ben , Bloch Sidney , Riley Geoff , Zelas Karen 
Published: March 2003

Objective: To describe the procedure adopted by the Ethics Committee of the Royal Australian and New Zealand College of Psychiatrists in revising its 1992 foundational code of ethics and to outline the substantial changes agreed upon and subsequently ratified by the College's General Council. Method: The members of the Ethics Committee reviewed their experience of revising the code by monitoring the process as we went along, examining all relevant documents that emerged over the 18 months it took, and discussing both procedure and outcome with the benefit of hindsight. Results and Conclusion: The revision process comprised two consultative stages, three face to face meetings of the committee and a presentation to General Council for its consideration. The second consultation, in which an advanced draft was circulated to various arms of the College and to pertinent community organisations, yielded a highly satisfactory response compared to the first consultation's desultory results. The most notable change is the introduction of an entirely new principle which addresses directly the power differential in the psychiatrist–patient relationship and its potential for exploitation of the patient. Sexual exploitation is explicitly and emphatically cited, in that sexual relations between psychiatrist and patient, including a former patient, are always unethical. Other forms of exploitation, such as on the grounds of age, gender, race, ethnicity, sexual orientation, creed, disability, religion and political affiliation, are carefully spelled out. One specific form of exploitation, sexual harassment, is entirely new; its scope is outlined and examples provided. The new code pays more attention than its predecessor to the role of the family and other carers in a patient's life, as well as to the fact that many features of the family are culturally specific. The final principle, covering responsibilities psychiatrists have to society overall, has been modified in several ways. All the principles and their respective annotations have been brought up to date. The new code pertains to affiliates and trainees as well as to Fellows.
An Experience of Psychiatry in Ladakh, India
Authors: Monasterio Erik 
Published: March 2003

Objectives: To describe the author's experience of mental health services available in Ladakh, a remote region of India. Method: A review of inpatient medical files was undertaken to ascertain the possible incidence of psychiatric presentations to the regions only hospital. Case descriptions are presented, as well as a summary of educational material provided. Results: Approximately 0.1% of admissions were for an apparent primary psychiatric condition. Conclusion: There is a very significant lack of services and expertise to deal with mental health problems in Ladakh.
The Mental Health of Young People in Australia: Child and Adolescent Component of the National Survey — A Commentary
Authors: Birleson Peter , Sawyer Michael , Storm Victor 
Published: March 2003

Objective: This article reports some of the main findings from the recent national survey of the mental health and well-being of children and adolescents and considers its implications. Conclusions: There is a high prevalence of mental health problems in Australian children and adolescents, and these have a significant impact on sufferers and their families. We will need to collect ongoing data about child and adolescent mental health to monitor the effectiveness of our response to these problems. ADHD is surprisingly common and greater attention needs to be given to research on ADHD in Australia. The resources devoted to child and adolescent mental health services are currently not adequate or equitable and need boosting, as do efforts to increase primary mental health care for this population. Whole population and selected prevention and early intervention approaches offer the most logical method for lowering the prevalence and burden of disorder. Community education for parents, and a boost to research and training in child and adolescent mental health is required if we are to make a difference.
Educational Aims and Objectives for Working in Multidisciplinary Teams
Authors: Burke David , Herrman Helen , Evans Mandy , Cockram Alex , Trauer Tom 
Published: March 2003

Objective: The aims of this paper are to discuss the issues surrounding multidisciplinary teamwork and to enunciate a set of educational aims and objectives for RANZCP trainees and supervisors to utilise in training rotations that involve the trainee in multidisciplinary teamwork. Conclusions: The paper identifies a number of key areas in multidiscipli-nary teamwork, including role definition, leadership, clinical responsibility and accountability, and understanding between the professions. The paper proposes that effective teamwork is supported by key factors including agreed goals, an agreed plan, effective communication styles, clear team roles, and competent leadership. The paper also presents the advantages of collaborative teamwork, including continuity of care, the ability to take a comprehensive view of the patient, the availability of a range of skills, and mutual professional support and education.
Creeping Custodialism
Authors: Patfield Martyn 
Published: March 2003

Objective: To draw attention to the increasing prominence given to issues of safety and security in psychiatric inpatient units at the expense of therapeutic considerations. Conclusion: Progressive removal of “hazards” in order to prevent self harm, often in response to coronial inquests or law suits, is leading to inpatient units becoming stark and oppressive. We risk returning to a dark era wherein our patients will fear our inpatient facilities, which will have become suicidogenic.
Psychiatry in Tasmania: From Old Cobwebs to New Brooms
Authors: Ratcliff Eric , Kirkby Kenneth 
Published: March 2003

Objectives: To highlight some major historical trends in psychiatric practice in Tasmania from the inception of the asylum culture in the 1830s to the dynamic of deinstitutionalisation since the 1960s. Source material includes asylum registers and case notes from the early colonial period, annual reports of the Mental Health Services Commission and some oral history, particularly from the first author. The introduction of community, subspecialty, university and general hospital services is briefly chronicled and the role of a generation of psychiatrists in this process is acknowledged. Conclusions: The fixity of institutional culture for more than a century and its gradual attrition over the past forty years are well illustrated in Tasmania. New challenges are emerging as the identity of mental health is diluted in the broader health and administrative sectors.
The Role of The Psychiatric Nurse
Authors: Grigg Margaret 
Published: March 2003

Objective: To provide an overview of the interdisciplinary team from the perspective of a psychiatric nurse. Conclusion: Psychiatric nursing has undergone many changes over the years, including changes to the training and registration of nurses and the scope and location of their activities. Tensions within the interdisciplinary team may emerge from a lack of understanding of the skills and abilities of the nurse. Nurses bring a breadth of skills to the interdisciplinary team, but often lack depth within individual skills. Models of interdisciplinary teamwork also need to consider the variety of practice settings that nurses work within, including residential settings and rural and remote communities.
Effective Interdisciplinary Teamwork: An Occupational Therapy Perspective
Authors: Fossey Ellie 
Published: March 2003

Objective: First, to describe the focus and scope of occupational therapy and some contributions of occupational therapy in mental health settings. Second, to identify opportunities for enhancing interdisciplinary teamwork so as to effectively address the full range of needs and issues experienced by people living with mental illness, from an occupational therapist's perspective. Conclusions: The significance of occupation for health and wellbeing needs to be better understood within the mental health field, and wider community, if interdisciplinary teams are to more effectively address the occupational and other needs of those living with mental illness. To this end, improved opportunities for dialogue through shared education and professional development, informed dialogue about balancing generic, specialist and nonprofessional roles in service delivery, as well as inclusion of consumers and carers in these dialogues, are recommended.
“Chemical Imbalance”: A Clinical Non Sequitur
Authors: Lachter Bruce 
Published: March 2003

Objective: To discuss the impact on the depressed patient of being told that he or she is suffering from a “chemical imbalance”. Conclusions: This ‘explanation’ encourages a flight from self-reflection - for both patient and psychiatrist - and is likely to perpetuate the former's suffering and the latter's ignorance.
ICD-10 as a Coding Tool in Psychiatry
Authors: Janca Aleksandar 
Published: March 2003

Objective: The aim of this paper is to provide an overview of the structure, construction principles and coding conventions of importance for the application of the Tenth Revision of the International Classification of Diseases (ICD-10) in the coding of psychiatric diagnoses. Method: The method involved an extensive review of the various versions of ICD-10 and ICD-10-related documents, instruments and literature. Results: ICD-10 differs from its predecessors in many ways including the introduction of a novel alphanumerical coding scheme; development of the concept of a “family” of disease and health-related classifications; inclusion of diagnostic guidelines and explicit criteria for mental disorders; production of the mental disorders chapter of the classification in different versions and for different types of users; and provision for incorporation of nationally relevant coding standards which facilitates preparation of national adaptations of the classification such as the Australian Modification of ICD-10 or ICD-10-AM. Conclusions: Relatively late and slow implementation of ICD-10 into psychiatric coding practices in Australia is mainly due to a lack of organised ICD-10 educational programs and activities at the national and State levels. In view of the fact that, as one of the Member States of the World Health Organization, Australia has an obligation to report mortality and morbidity statistics at an international level using the ICD-10, the development of comprehensive ICD-10 educational and training strategies for all types of mental health professionals dealing with coding and recording of psychiatric diagnoses should be seen as a priority in this country. APAIS, ASSIA, BIOSIS, Cambridge Scientific Abstracts, CancerLIT, CINAHL, Current Contents/Clinical Medicine and Social & Behavioral Sciences, EMBASE/Excerpta Medica, Health Services Abstracts, Index Medicus, Inpharma Weekly, International Nursing Index, MEDLINE, Psychiatric Rehabilitation Journal, Psychological Abstracts, PsycINFO, PsycLIT, Reactions Weekly, Research Alert, Science Citation Index, SciSearch, Social Planning/Policy & Development Abstracts, Social Sciences Citation Index, Social SciSearch, Sociological Abstracts, Year Book of Psychiatric and Applied Mental Health
Psychiatric Care in Nursing Homes: More Must be Done
Authors: Snowdon John , Arie Tom , Chiu Edmond 
Published: March 2003

Objective: The purpose of this review is to highlight the prevalence of mental disorders in Australian nursing homes and to provoke discussion of the current inadequacy of mental health services in these facilities. Method: Comparisons were made between mental health care in Australian and United States (US) nursing homes. Relevant literature was reviewed. Results and Conclusions: In both US and Australian nursing homes, the prevalence of mental disorders is high, but there is under-recognition and under-treatment of these conditions. When adequately resourced, old age psychiatry services can have a beneficial impact on mental health care in nursing homes.
Why we should Reject Mandatory MOPS
Authors: Morstyn Ron 
Published: March 2003

Objective: To critically review General Council's decision designating participation in the MOPS program as mandatory for retention of Fellowship from 1 January 2003. Conclusions: Mandatory CME is increasingly being used overseas to pave the way for Managed Care. The RANZCP MOPS program, in both its compulsory audit and structured improvement components, explicitly and implicitly encourages Managed Care benchmarks, objectives and values. Managed Care inevitably leads to damage to the patient-therapist relationship and demoralisation of doctors. Mandatory MOPS is unproven, overly expensive, bureaucratic, unfair, intrusive and educationally counterproductive. It will give excessive control to the College over psychiatrists' practices and will lead to a number of legal problems. The decision of General Council should be reversed, the mandatory audit components of MOPS dropped and a more flexible, inexpensive and truly educationally based MOPS program developed. “If it looks like a duck, and quacks like a duck, we have at least to consider the possibility that we have a small aquatic bird of the family Anatidae on our hands.” Douglas Adams, Dirk Gently's Holistic Detective Agency 1
A Psychiatrist in Bougainville
Authors: Storm Victor 
Published: March 2003

Objective: This paper gives a brief background on the recent history of Bougainville and the consequences for health services. An outline of a series of mental health workshops is given, together with impressions gained from this experience. The role of a visiting consultant in this unusual situation is described. Conclusion: Short term consultation and education visits to regions without psychiatrists appear to play some role in support of community leaders during civic reconstruction. Ongoing support from Australia and New Zealand would further assist this process.
Seeking Refuge, Losing Hope: Parents and Children in Immigration Detention
Authors: Mares Sarah , Newman Louise , Dudley Michael , Gale Fran 
Published: March 2003

Objective: To record observations made by the authors on a series of visits between December 2001 and March 2002 to two of Australia's immigration detention centers and to consider the mental health consequences of Australia's policy of mandatory immigration detention of asylum seekers for families and children. Conclusions: Parents and children in immigration detention are often vulnerable to mental health problems before they reach Australia. Experiences in prolonged detention add to their burden of trauma, which has an impact not only on the individual adults and children, but on the family process itself. Immigration detention profoundly undermines the parental role, renders the parent impotent and leaves the child without protection or comfort in already unpredictable surroundings where basic needs for safe play and education are unmet. This potentially exposes the child to physical and emotional neglect in a degrading and hostile environment and puts children at high risk of the developmental psychopathology that follows exposure to violence and ongoing parental despair. Psychiatrists have a role in advocating for appropriate treatment of these traumatized and vulnerable parents and children.
American and Australasian Systems in Psychiatry: Crossing the Bridge
Authors: Pavuluri Mani 
Published: March 2003

Objective: To familiarize Australasian psychiatrists about differences in the psychiatric systems of the United States and Australasia. A secondary objective is to contribute towards a multi-leveled collaboration between the Australian and New Zealand College of Psychiatrists and the American College of Psychiatry and Neurology. Conclusions: There appear to be multiple differences, including in aspects of training, acquiring credentials, cross accreditation, the effect of managed care on clinical practice, volume of research, and interpersonal relations. Despite differences in the systems, it seems critical to anchor oneself to the bio-psycho-social model in order to maintain the integrity of psychiatric practice.
Best Evidence Medical Education in Psychiatry Training
Authors: McGuckin Cathy , Burke David , McGuckin Cathy 
Published: March 2003

Objectives: To examine the evidence-base in medical education and psychiatry training, in relation to: the most effective method of imparting the attitudes, skills and knowledge essential to prepare future psychiatrists for modern psychiatric practice; the most effective method of optimising trainees' motivation to learn and their enjoyment of learning; and the most effective method of fostering trainees' commitment to self-directed, life-long learning. Methods: The current available literature was reviewed by searching medical and education computer data-bases up to December 2001; a web search of evidence-based education was conducted; and the references cited in the articles obtained were scanned for papers not yielded by the database and web searches. Results: There is evidence to support the use of both the directed and the constructivist approaches to education, there is evidence to support the use of problem-based learning in medical education, and there is no evidence for adult learning theory or transformative learning theory, although elements of both appear to be incorporated into problem-based approaches. Conclusions: The emphasis in modern medical education is on a con-structivist approach, dominated by problem-based learning and built around small-group activities. Postgraduate psychiatry training could be improved significantly by adopting the evidence-based advances that have been made in education and undergraduate medical education over the past three decades.
Description of a Rural Australian Free Call Telephone Mental Health Information and Support Service
Authors: Ledek Veronica , Deane Frank P , Lambert Gordon , McKeehan Catherine 
Published: March 2003

Objective: To describe the activity of a rural-based free call 1800-Mental Health Information and Support Service (1800-MHISS) which provides a 24-hour single point of contact for people experiencing a mental health problem. Method: Routine data collected during a 15 month period concerning service utilisation, caller characteristics, service provision, triage assessment and the impact of the service on after-hours services are described. Qualitative data from a survey of emergency department and community mental health is discussed. Results: The service received an average of 1117 calls per month. While a majority of calls were for information and support, 13% required a triage assessment and, of these, 13% resulted in an emergency response. Analysis of pre and post study data demonstrated a 43% reduction in the activation of after-hours services. Conclusions: Overall, the study suggests the 1800-MHISS provides a safe and efficient response to psychiatric emergencies and is valued by Emergency Department and community mental health staff.
Doctor to the Dictator: The Career of Theodor Morell, Personal Physician to Adolf Hitler
Authors: Kaplan Robert 
Published: March 2003

Objective: To examine the life and career of Theodor Morell, personal physician to Adolf Hitler. Conclusions: For nine years, Dr Theodor Morell had almost exclusive access to Hitler. Hitler, an illness phobic, lied about his medical history, refused to be examined except in the most superficial fashion and tended to accept or reject treatment according to his whim. Morell used a range of complementary treatments, intravenous glucose, amphetamines and opioid injections. While Morell's methods were suspect, it is doubtful he did his patient much harm. Dismissed by the disillusioned Dictator, he was captured by the Allies but never prosecuted, dying in 1948.
Spontaneous rupture of the renal pelvis
Authors: Ashebu Sd , Elshebiny Yh , Dahniya Mh 
Published: March 2003

SUMMARYThe object of the case report is to present a case of spontaneous rupture of the renal pelvis with no underlying pathological condition to account for the rupture, a very rare and unusual occurrence. The patient was a 46‐year‐old Korean who presented with severe left loin pain and vomiting. The diagnosis was suspected on intravenous urography and confirmed by CT. Treatment was by ureteral stenting. The patient made a complete recovery. The differential diagnosis of this condition is discussed and the literature is reviewed.
Symptomatic ossification of the posterior longitudinal ligament of the cervical spine: Pictorial essay
Authors: Soo Mys , Rajaratnam S 
Published: March 2003

SUMMARYSymptomatic ossification of the posterior longitudinal ligament (OPLL) of the cervical spine is a rare but well‐documented condition. It is the causative factor in up to 5% of cases presenting with cervical radiculopathy or myelopathy. Computed tomography is the modality of choice in showing the distinctive characteristics and extent of the disease. Magnetic resonance imaging (MRI) is sensitive in detecting cord compression and its attendant complications. Cervical OPLL commonly affects those of middle and advanced age, and the condition is noted to be particularly common in Japanese, although other racial groups are also affected. A ‘mushroom’ or ‘hill’ shape on axial CT typifies OPLL. A sharp radiolucent line separating the posterior vertebral margin from the superficial component of the ossified ligament is a characteristic feature.
Trans‐sphenoidal and sphenoethmoidal encephalocele: Report of two cases and review of the literature
Authors: Koral Korgün , Geffner Mitchell E , Curran John G 
Published: March 2003

SUMMARYBasal encephaloceles are the least common form of encephalocele. Due to the critical position of the bony defect, visual and endocrinological abnormalities are frequently associated with basal encephaloceles. There is significant confusion in the classification of basal encephaloceles, particularly among trans‐sphenoidal, sphenoethmoidal and intrasphenoidal subtypes. Two cases of basal encephaloceles are presented (one trans‐sphenoidal and one sphenoethmoidal), along with a review of the literature. The relationship between the basal encephaloceles and endocrinological abnormalities is also emphasized.
Imaging the sphenoid sinus: Pictorial essay
Authors: Chong Vfh , Fan Yf , Lau Dpc , Chee Lwj , Nguyen Tm , Sethi Ds 
Published: March 2003

SUMMARYThis paper focuses on the spectrum of sphenoid sinus lesions that may be seen radiologically and the mapping of disease extent. Imaging plays a central role in the assessment of sphenoid sinus disease. Although primary sphenoid sinus disease is uncommon, this sinus is nevertheless affected secondarily by a variety of pathological processes.
Nodular fasciitis of the breast simulating breast cancer on imaging
Authors: Dahlstrom Je , Buckingham Jm , Bell S , Jain S 
Published: March 2003

SUMMARYNodular fasciitis is a rare benign soft tissue tumour of the breast that clinically and radiologically can mimic invasive duct carcinoma. The clinical, radiological and pathological findings of nodular fasciitis of the breast in a 38‐year‐old woman, who presented with a palpable lesion in the upper inner aspect of the left breast, are described. The tumour is characterized histologically by a stellate spindle cell tumour with a focal myxoid background containing scattered inflammatory cells and microhaemorrhages. Pathological assessment of the lesion is essential in making the diagnosis.
Pneumothorax preceding pulmonary blastoma in a child
Authors: Shyamkumar NK , Athyal RP , Govindarajulu G , Narayan VP , Rangad F , Govil S , Chacko J 
Published: March 2003

SUMMARYSerial plain radiographic, ultrasound and CT findings of an unusual case of pulmonary blastoma are described with a review of the literature.