bluuebunny/crossref_metadata_2025_split huggingface dataset:
Splendid Vices and Secular Virtues: Variations on Milbank's Augustine
Authors: Wetzel James 
Published: June 2004

ABSTRACTJohn Milbank's case against secular reason draws much of its authority and force from Augustine's critique of pagan virtue. Theology and Social Theory could be characterized, without too much insult to either Augustine or Milbank, as a postmodern City of God. Modern preoccupations with secular virtues, marketplace values, and sociological bottom‐lines are likened there to classically pagan preoccupations with the virtues of self‐conquest and conquest over others. Against both modern and antique “ontological violence” (where ‘to be’ is ‘to be antagonistic’), Milbank advances an Augustinian hope for the peace that is both beyond and prior to the peace of (temporarily) repressed antagonism. One aim of this essay is to consider whether virtues conceived out of such a hope are really all that different from the virtues they are taken to replace. I take a critical look at Augustine's critique of pagan virtue, Milbank's appropriation of that critique, the applicability of that critique to Plato, and the polemical value of Augustine's notion of original sin. I end up being skeptical of the notion of a peculiarly Christian way to turn antagonistically conceived virtues into love, but I am not unsympathetic to Milbank's concerns about a loveless and self‐complacent secularity.
Naves and Nukes: John Ruskin as “Augustinian” Social Theorist?
Authors: Craig David M. 
Published: June 2004

ABSTRACTJohn Milbank appropriates John Ruskin as part of his “Augustinian” tradition. Milbank's selective reading, however, omits Ruskin's fixed hierarchies as well as his acknowledgment of conflict in economic life. Neither of these ideas fits the social aesthetics of harmony and difference that Milbank claims is unique to Christian theology. While Milbank's strictly theoretical portrait of theology gains critical force from Ruskin's robust account of social practices and just exchange, Milbank lacks effective historical and institutional responses to the problems in Ruskin's corpus. This deficiency undermines Milbank's dichotomy between theology and secular reason.
Book Reviews
Authors: MIYAMURA SATOSHI , RIGBY S. H. , SAYER KAREN , LAWRENCE PETER , YARRINGTON DOUG , KOENIG DOLORES , WOOI SYN TAN , JACOBS NANCY J. , SENDER JOHN , PINCUS JONATHAN R. 
Published: June 2004

Barbara Harriss‐White, India Working: Essays on Society and Economy.Phillipp Schofield, Peasant and Community in Medieval England, 1200–1500.Nicola Verdon, Rural Women Workers in 19th Century England: Gender, Work and Wages.Jonathan R. Pincus and Jeffrey Winters (eds), Reinventing the World Bank.Julie A. Charlip, Cultivating Coffee: The Farmers of Carazo, Nicaragua, 1880–1930.Monica M. van Beusekom, Negotiating Development: African Farmers and Colonial Experts at the Office du Niger, 1920–1960.Abdul Rahman Embong, State‐led Modernization and the New Middle Class in Malaysia.David M. Anderson, Eroding the Commons: The Politics of Ecology in Baringo, Kenya 1890s–1963.Jan Breman and Gunawan Wiradi, Good Times and Bad Times in Rural Java: Case Study of Socio‐Economic Dynamics in Two Villages Towards the End of the Twentieth Century.Mario Rutten, Rural Capitalists in Asia: A Comparative Analysis on India, Indonesia and Malaysia.
Early repair of episiotomy dehiscence
Authors: UYGUR Dilek , YESILDAGLAR Nater , KIS Saime , SIPAHI Tevfik 
Published: June 2004

AbstractWe retrospectively reviewed the medical records of our hospital between 1 March 2001 and 1 March 2003 for patients with episitomy dehiscence. In the study period, there were 37 patients with episiotomy dehiscence. While 12 of the patients with episiotomy dehiscence were allowed to heal by secondary intention, 25 patients underwent early repair. All the episiotomies were mediolateral. Infection was the obvious cause of dehiscence in the majority (25 out of 37) of the women. The average time from recognition of dehiscence to discharge from hospital was 5.6 ± 2.8 days for the patients with early repair of episiotomy dehiscence and 5.8 ± 2.4 days in patients allowed to heal by secondary intention. Patients were seen 2 weeks after being discharged. Among the patients treated by early repair, three patients had a superficial separation of skin edges. Healing was complete in the rest of the patients with early repair of episiotomy dehiscence. We concluded that with adequate preoperative care, primarily wound cleansing and intravenous antibiotics, early repair of episiotomy dehiscence is safe and effective.
Prospective evaluation of a first trimester screening program for Down syndrome and other chromosomal abnormalities using maternal age, nuchal translucency and biochemistry in an Australian population
Authors: SCOTT Fergus , PETERS Helen , BONIFACIO Michael , MCLENNAN Andrew , BOOGERT Antheunis , KESBY Greg , ANDERSON John 
Published: June 2004

AbstractBackground:  A combination of maternal age and ultrasound assessment of the nuchal translucency (NT) has been used in the first trimester to screen for chromosomal abnormality. In the United Kingdom, the addition of NT screening was shown to be beneficial.Aims:  To report the sensitivity of combined first trimester biochemistry and ultrasound screening for Down syndrome in an Australian private practice specialising in obstetric ultrasound.Methods:  A prospective study in a private obstetric ultrasound practice. Over 22 months, 2121 patients were screened and data was analysed for sensitivity (detection) and false positive rates for all chromosome abnormalities.Results:  There were 17 chromosomal abnormalities, five of which were Down syndrome. Using maternal age alone or age and biochemistry, four of the Down syndrome cases were detected for a 29 and 19% false positive rate, respectively. Using age and NT or age, NT and biochemistry, all the Down syndrome cases were detected, for a false positive rate of 5.7 and 7.2%, respectively. The difference in detection rates for Down syndrome or other chromosomal abnormalities, using the four screening methods, did not reach statistical significance. However, the false positive rates in screening methods without ultrasound to assess the NT was significantly higher (P < 0.01).Conclusions:  A combination of maternal age, NT and maternal serum biochemistry gives a high detection rate for both trisomy 21 and other chromosomal abnormalities. Down syndrome screening using either maternal age alone or age in combination with first trimester biochemistry conferred screen positive rates significantly higher than when combined with NT.
Levonorgestrel‐releasing intrauterine system for treating menstrual disorders: A patient satisfaction questionnaire
Authors: RADESIC Bruno , SHARMA Anil 
Published: June 2004

AbstractAims:  To establish the continuation and satisfaction rates and the reasons for removal of the levonorgestrel‐releasing intrauterine system (LNG‐IUS) in Palmerston North Hospital (PNH), New Zealand.Sample and Setting:  All women (120) who had a LNG‐IUS inserted at PNH between June 1998 and June 2002 were included in the study.Methods:  A survey questionnaire regarding bleeding patterns, side‐effects and satisfaction rates relating to the device as well as reasons for premature removal, current treatment for dysfunctional uterine bleeding (DUB) and contraception was sent to all 120 women. Seventy‐eight of the 85 women who received the questionnaire (91%) responded to it. Thirty‐five women were lost to follow‐up and the overall response rate was 65%.Results:  The LNG‐IUS was prematurely removed from nine women and expulsion occurred in one case. The overall continuation rate was 87%. No women had LNG‐IUS removed as a result of hormonal side‐effects except for bleeding abnormalities. The overall satisfaction rate was 76%.Conclusion:  Levonorgestrel‐releasing intrauterine system is a well‐accepted and efficacious therapy for heavy menstrual bleeding. These satisfaction and premature removal rates compare favourably with international figures. The response rate to the questionnaire was reasonably high given the highly mobile nature of the studied population.
Is placenta accreta catching up with us?
Authors: ARMSTRONG Charles A. , HARDING Steven , MATTHEWS Tom , DICKINSON Jan E. 
Published: June 2004

AbstractBackground:  Concomitant with the increase in Caesarean birth over the past three decades there has been an apparent rise in the incidence of placenta accreta and its variants. The sequelae of an increase in the occurrence of abnormal placentation is the enhanced potential for severe maternal morbidity.Aim:  To determine the contempory demographics of placenta accreta over a 5‐year period in a tertiary level teaching hospital.Methods:  A retrospective review of all cases of placenta accreta and variants during the period of 1998–2002. Individual charts review followed case ascertainment via the hospital obstetric database.Results:  Thirty‐two women with placenta accreta (or variant) were identified. Median maternal age was 34 years, with a median parity of 2.5. Seventy‐eight percent of cases had had at least one prior Caesarean birth, and 88% of cases were associated with placenta praevia. Pre‐delivery ultrasonography was performed in all cases, providing diagnostic sensitivity of 63% and specificity of 43% with a predictive value of 76%. Hysterectomy was performed in 91% of cases with median intraoperative blood loss of 3000 mL. There were no maternal deaths in the current series.Conclusion:  A strong association between placenta accreta, placenta praevia and prior Caesarean birth has been demonstrated. As there is the potential for significant maternal morbidity the risk of placenta accreta needs to be recognised and women at risk should be considered for delivery at an institution with appropriate expertise and resources in managing this condition.
Diagnostic radiography in pregnancy: Risks and reality
Authors: LOWE Sandra A. 
Published: June 2004

AbstractBackground:  The use of X‐rays, computed tomography scanning and nuclear medicine imaging in the pregnant woman is a source of great anxiety for the patient, her family and the treating doctor.Methods:  A literature review of appropriate databases, articles and relevant institutional protocols was performed. Data was sought regarding any adverse effects of diagnostic radiation in pregnancy, fetal absorbed dose of diagnostic radiation and how the timing of exposure and form of administration might influence these effects.Results:  The estimated radiation dose for a fetus from background sources as well as medical imaging was identified. Most diagnostic radiation procedures will lead to a fetal absorbed dose of less than 1 mGy for imaging beyond the abdomen/pelvis and less than 10 mGy for direct or nuclear medicine imaging. Potential adverse outcomes related to radiation exposure during pregnancy include teratogenicity, genetic damage, intrauterine death and increased risk of malignancy. The only adverse effect statistically proven at the dose levels associated with diagnostic radiation procedures is a very small increase in childhood malignancy, with an estimated increase of one additional cancer death per 1700 10 mGy exposures. The important exception was the risk to the fetal thyroid from radioiodine exposure after 12 weeks’ gestation.Conclusion:  In practice, diagnostic radiography during pregnancy not involving direct abdominal/pelvic high dosage, is not associated with any significant adverse events. Counselling of pregnant women who require diagnostic radiographic procedures as well as those inadvertently exposed should be based on the available human data with an emphasis on the minimal impact of such procedures.
Hysterectomy for gynaecological cancer: A follow‐up study of subjective and objective outcome
Authors: MELTOMAA Seija S. , HIETANEN Sakari H. , TAALIKKA Mikko O. , HAARALA Mervi A. , KIILHOLMA Pentti J. A. , MÄKINEN Juha I. 
Published: June 2004

AbstractAims:  To evaluate morbidity and subjective outcome associated with hysterectomy either with or without pelvic or pelvic and para‐aortic lymphadenectomy for gynaecological cancer.Methods:  Ninety‐nine patients who underwent hysterectomy with lymphadenectomy (n = 38) or simple hysterectomy (n = 61) for ovarian, endometrial and cervical cancer in Turku University Hospital, Turku, Finland, were followed‐up prospectively to determine the incidence of complications during a 1‐year period after operation. Subjective outcomes were assessed using two questionnaires, 6 weeks and 1 year after operation. Hospital records of the patients were reviewed up to 6 years after operation.Results:  During their hospital stay 58% of patients in the hysterectomy with lymphadenectomy group and 56% in the simple hysterectomy group experienced some type of complication. Serious complications occurred in four patients (10.5%) in the former group and in two patients (3.3%) in the latter group. In the study population overall, the incidence of subjective complaints increased from 18% of respondents 6 weeks after operation to 55% 1 year after operation. Most patients (95 and 92%, respectively) remained satisfied with the operation at both times of evaluation.Conclusions:  More than half of the patients experienced morbidity related to surgical treatment for gynaecological cancer. The incidence of complications and subjective complaints were unaffected by the type of operation.
Maternal and neonatal outcomes in 54 triplet pregnancies managed in an Australian tertiary centre
Authors: BARKEHALL‐THOMAS Andrea , WOODWARD Louise , WALLACE Euan M. 
Published: June 2004

AbstractBackground:  To provide current data on maternal and neonatal outcomes in triplet pregnancies in an Australian population.Methods:  Retrospective case note review of all triplet pregnancies managed within a single Australian tertiary centre.Results:  Fifty‐four sets of triplets were managed from January 1996 to October 2002. A total of 59% resulted from the use of assisted reproductive technologies. The median gestation at delivery was 32.5 weeks (range: 21–36 weeks); 14% delivered prior to 28 weeks and 43% delivered before 32 weeks. Preterm labour and preterm rupture of membranes were the most common antenatal complications occurring in 57 and 22% of pregnancies, respectively. A total of 93% of pregnancies were delivered by Caesarean section and 37% of mothers experienced at least one post‐partum complication. A total of 96% of neonates were liveborn, with a median birthweight of 1644 g (range: 165–2888 g). The two most common neonatal complications were jaundice and hypoglycaemia in 52 and 43% of liveborn neonates, respectively. A total of 28% of neonates were below the 10th centile for gestational age and sex. A total of 8% of neonates demonstrated congenital anomalies. The perinatal mortality at a gestational age of 20–24 weeks was 100%, 22% at 25–28 weeks and zero for those babies born at 29 weeks or beyond.Conclusion:  Assisted reproductive technologies contribute significantly to the incidence of triplet pregnancies. Gestational age at delivery and perinatal mortality is comparable to published international data. Triplets born in a tertiary centre beyond 28 weeks gestation have a very favourable prognosis in the newborn period.
Cervical surveillance as an alternative to elective cervical cerclage for pregnancy management of suspected cervical incompetence
Authors: HIGGINS Shane P , KORNMAN Louise H. , BELL Robin J. , BRENNECKE Shaun P 
Published: June 2004

AbstractObjective:  The aim of the present study was to compare the outcome of pregnancies among patients with suspected cervical incompetence treated either by elective cervical cerclage or an alternative management program involving cervical surveillance.Design, Setting and Methods:  A prospective cohort study was performed in two groups of patients at risk of cervical incompetence with singleton gestations attending the Royal Women's Hospital, Melbourne, Australia, from 1996 to 2000. The first group was managed by their obstetric carers with an elective cerclage, while the second group was managed conservatively as part of a cervical surveillance program offered to patients attending the Department of Perinatal Medicine for pregnancy care. This program consists of weekly visits from 16 weeks’ gestation and involves alternating transvaginal ultrasound assessment of cervical morphometry with cervico‐vaginal bacteriology and fetal fibronectin swabs. Empiric insertion of a cerclage is undertaken when there is evidence of significant cervical shortening (cervical canal <2.5 cm in length at ≤24 weeks).Results:  A total of 135 patients were identified for the study. Ninety‐seven patients had an elective cervical cerclage inserted. Thrity‐eight patients were followed through the cervical surveillance program. Twelve (32%) of the surveillance patients had a cerclage inserted at a mean gestational age of 20.6 weeks. There were no statistically significant differences between the groups in terms of maternal demographics or risk assessment scoring. One out of 38 (2.6%) patients of the surveillance group and 18/97 (18.6%) of the elective cerclage group delivered before 30 weeks’ gestation (P = 0.034).Conclusions:  Our study suggests that by only inserting a cerclage when indicated on the basis of ultrasound assessment of cervical morphometry, the number of cerclages required can be reduced while the perinatal outcome is significantly improved.
Women with low‐grade abnormalities on Pap smear should be referred for colposcopy
Authors: FAIRMAN Amanda , TAN Jeffrey , QUINN Michael 
Published: June 2004

AbstractAim:  To assess cytological, colposcopic and histological outcomes in women referred to a teaching hospital dysplasia clinic with low‐grade changes on screening Pap smear.Methods:  Analysis of a computerised database.Results:  Repeating the Pap test was of little value. Fifteen percent of women with low‐grade changes on the referral smear had biopsy proven high‐grade change. There was little difference in biopsy proven high‐grade change in women referred with an ‘abnormal smear of uncertain significance’ (23%) or ‘an abnormal smear of uncertain significance‐possible high‐grade change’ (24%).Conclusions:  Given these findings and the current medico‐legal climate, immediate referral of women with low‐grade changes on routine cytology is indicated, and seems a safer option than the more conservative approach of a repeat smear in 6 or 12 months. Further study of the usefulness of separating smears of uncertain significance into high‐grade and low‐grade categories is warranted. Consumer input into recommendations for management of Pap smear abnormalities is required.
HIV and pregnancy in Australia
Authors: GILES Michelle L. , MIJCH Anne M. , GARLAND Suzanne M. , GROVER Sonia R. , HELLARD Margaret E. 
Published: June 2004

AbstractIt is estimated there are over 19 million women worldwide living with HIV infection. In Australia the total number of notified cases of HIV in women has been gradually increasing (the estimated number of women newly diagnosed with HIV infection was 78 in 2000 and 94 in 2001). Management of women in pregnancy and strategies to reduce perinatal transmission is critical, but differ significantly according to resource availability. The current review examines the best available scientific evidence and current guidelines for optimal management of HIV‐infected women contemplating pregnancy in Australia.
People who influence women's decisions and preferred sources of information about prenatal testing for birth defects
Authors: JAQUES Alice M. , BELL Robin J. , WATSON Lyndsey , HALLIDAY Jane L. 
Published: June 2004

AbstractBackground: More than half of Victorian pregnant women are undergoing prenatal testing for birth defects, although little is known about the factors that are influencing their decisions.Aims: To examine whom women perceived as influencing their decision about prenatal testing for birth defects, with whom they would have liked to talk more, and what sources of information they preferred.Methods: A total of 737 pregnant women aged 37 years and over, who either had or had not undergone prenatal testing (screening and/or diagnosis) completed a questionnaire in 18 hospitals throughout Victoria.Results: Over 90% reported that they themselves had a strong influence on their decision, and 70% reported their partner as strongly influencing their decision. Approximately 30% of women who had both screening and diagnosis and more than 20% of women who had no prenatal testing, would like to have discussed prenatal testing with women who had previously had testing. Face‐to‐face counselling with a doctor or counsellor was the preferred source of information, followed by a pamphlet as the second choice.Conclusions: Given that both tested and untested women felt so strongly that they were responsible for their own decisions about prenatal testing, it is unlikely that universal acceptance and uptake will occur, even in this group of women of advanced maternal age. A support network of women who have already had testing could supplement existing sources of support. However, there continues to be a need for face‐to‐face sessions with a doctor or counsellor in combination with printed material.
Medical professionalism and continuing professional development for medical specialists
Authors: WHITE Peter 
Published: June 2004

AbstractThe present paper briefly describes a growing trend in continuing professional development (CPD) for medical practitioners, examines some recent published contributions related to professionalism in medicine and describes the theoretical platform of a CPD framework based on medical professionalism that has been developed for use in a variety of medical specialties. The work arises from a project funded by The Commonwealth Department of Health and Ageing and conducted by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists on behalf of the Committee of Presidents of Medical Colleges. Overall, the aim of the project was to design and develop a framework that can be considered ‘best practice’ in the field of medical specialist CPD, and which could be applicable to a wide variety of medical specialties and practice environments. The project was informed by available literature in areas such as the ways in which medical practitioners learn and the effectiveness of CPD, as well as consultations with a variety of stakeholders in the health‐care field, including medical boards, medical defence organisations, health complaints organisations, specialist medical colleges and practising specialists. Overwhelmingly, the primary purpose of specialists participating in ongoing CPD was, according to the project consultations conducted, the maintenance, development and improvement of skills that enable consumers of healthcare to be confident of the level of care that they receive. Coupled with the need to recognise CPD as contributing to the wider context of professional practice, the resulting framework is underpinned by a theoretical platform based on the concept of medical professionalism. It is this theoretical platform, which articulates the nature of and responsibilities associated with the practice of specialist medicine, that enables a CPD framework to be constructed that can accommodate a wide range of specialist disciplines and practice settings, while also framing ongoing education expectations from the viewpoint of a range of stakeholders, rather than a single perspective; that of practitioners themselves.