bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Development of a Clinic to Manage Disruptive Behaviour Disorders not Responding to Conventional Psychological and Psychostimulant Treatments
Authors: Vance Alasdair LA , Costin Jan , Birleson Peter , Luk Ernest SL , Tonge Bruce J , Maruff Paul 
Published: March 2003

Objective: The development of a specialised Disruptive Behaviour Disorders clinic to assess, treat and monitor clinically referred primary school-age children with Attention Deficit Hyperactivity Disorder-combined type (ADHD-CT), oppositional defiant disorder (ODD) and conduct disorder (CD) who are not responding to conventional psychological and psychostimulant medication treatments is described. Conclusions: Systematic clinical research and ongoing evaluation of complex Disruptive Behaviour Disorder cases is achievable within a metropolitan Child and Adolescent Mental Health Service.
Views of Psychiatrists and Trainees on Drug Company Involvement in CME Activities
Authors: Sara Grant , Prior Nigel 
Published: March 2003

Objective: To report the views of Australasian Psychiatry readers about pharmaceutical industry involvement in CME activities. Method: A discussion paper and fax-back survey form in a previous issue of Australasian Psychiatry sought views on specific areas of possible risk and several different strategic approaches which may be taken. Results: 182 responses were received from a wide cross section of College Fellows. Views on our current strategy (prohibition) were highly polarised and weakly associated with gender, years since fellowship and state. There was strong support for declaration, engagement and education strategies. Conclusions: There is much concern about the issue. Declaration, engagement and education strategies should be further developed.
Obsessive–Compulsive Disorder: Treatment and Treatment Resistance
Authors: Hood Sean , Alderton Deirdre , Castle David 
Published: March 2003

Objective: To review the treatment options for obsessive–compulsive disorder (OCD), with particular reference to treatment resistance, and provide a guideline for clinicians managing these patients, drawing upon evidence from clinical trials and expert consensus. Conclusions: The behavioural technique of exposure and ritual prevention (EX/RP) and serotonergic medications have emerged as effective standard treatments of OCD, although full symptom remission is rare. Predictors of poor and partial response to these treatments may reflect substantial underlying heterogeneity in OCD. Clinicians can now begin to apply psychological and pharmacological augmenting strategies that specifically target these heterogenous subgroups in an attempt to improve response. We offer a treatment algorithm for OCD derived from this understanding.
Clinical Psychology and The Common Good
Authors: Farhall John 
Published: March 2003

Objective: From the perspective of a clinical psychologist within public mental health services, this paper aims to discuss factors that affect interdisciplinary teamwork, and to draw upon both the literature and practical experience to suggest approaches that may enhance the relationships between disciplines. Conclusions: Barriers to interdisciplinary teamwork may be intergroup phenomena, organisational impediments or interpersonal processes. Intergroup barriers may be addressed through improved mutual awareness, adoption of shared frameworks, and the valuing of intellectual pluralism. Current organisational impediments, such as poor use of psychologists and confusion over team leadership, could be addressed by re-thinking in a more rational and collaborative way issues of specialist versus generic roles, and leadership in mental health teams. Most importantly, professional isolation perpetuates ignorance and breeds mistrust. Thus, the common good is most likely to be advanced if psychologists debate overarching goals and effective strategies jointly with consumers, carers and colleagues from other disciplines.
Inquiries — High Costs, Unacceptable Side Effects and Low Effectiveness: Time for Revision
Authors: Hobbs Paul 
Published: March 2003

Objective: To review recent literature about inquiries into serious adverse incidents in mental health in order to generate discussion and change. Conclusion: Inquiries held into serious adverse incidents have a number of limitations and problems. They are liable to over determine causes and to ignore “near miss” events. There is an excessive reliance on the value of risk assessment and a poor understanding of limitations of prediction, prevention, responsibility and blame. The role of experts is discussed. Inquiries can have serious consequences for clinicians and for the provision of services. Suggestions for improvement are made. Psychiatrists are advised to be prepared, more involved and more assertive.
A New Model for Postgraduate and Continuing Education in Psychiatry
Authors: Burke David 
Published: March 2003

Objectives: To summarise changes in education and medical education which have influenced the development of a new model for postgraduate and continuing education in psychiatry, and to describe that model. Conclusions: The NSW Institute of Psychiatry Postgraduate Course in Psychiatry has incorporated developments in problem-based learning in medical education, the modern principles of adult learning, the principles and practices of distance education, and selected advances in computerbased learning. The course is unique in postgraduate and continuing medical education, and is at the forefront of learning in psychiatry.
Social Work and The Mental Health Team
Authors: Bland Robert , Renouf Noel 
Published: March 2003

Objective: The contributions of social work to the interdisciplinary team are described, along with opportunities for, and barriers to, effective teamwork. Conclusions: Social work is concerned with the social context and consequences of mental illness on the individual, family and community. Social work serves to connect the treatment team to the broader issues of family welfare, housing, income security, and community and sense of belonging. This broader focus and the social justice framework for social work can create tension between social work and other disciplines. Both undergraduate and postgraduate education for social workers remain a challenge, given the complexity and demands of the mental health workplace.
From Good Foundations: The Role of Treatment Guidelines for Psychiatrists - An Overview of The RANZCP CPG Project
Authors: Boyce Philip , Harris Meredith , Penrose-Wall Jonine 
Published: March 2003

Objectives: To provide an overview on the role of evidence-based clinical guidelines in the context of the consultation, dissemination and implementation planning phases of the new RANZCP guidelines for psychiatrists and other specialist mental health care providers. Conclusions: Despite a vast literature on guidelines and evidence-based practice in general medicine and allied health, little is published on these themes in mental health. Anxieties about the introduction of guidelines often surface during the consultation stage of developing new guidelines and provide clues to barriers for implementation. Facilitating discussion about the pros and cons of guidelines is prudent for informing dissemination planning and is a necessary precursor to any programs intended to achieve implementation. Guidelines must reflect a fit between clinician aspirations, the evidence, and consumer expectations if they are to be adopted into routine service delivery. The six RANZCP guidelines will be foundation documents to ensure that all practitioners have access to the basic tools to guide practice. In particular, they will contain the evidence status and rationale behind recommended treatments, so that this information can be at hand or committed to memory to justify and share clinical decision making with consumers.
The Greater Murray Accessline
Authors: Wilson Andrew , Cullen Matthew 
Published: March 2003

Objective: To provide an overview of the service delivery model and operational data for a technology-enabled rural mental health triage and case management programme. Implications for other mental health services will be discussed. Method: Naturalistic descriptive data collection and analysis using the service provider's telephony and clinical information systems. Service utilisation, sociodemographic and illness variables are reported as well as consumer and provider satisfaction data obtained via survey. Results: Over 25,000 telephone contacts occurred during the eighteen-month period reported. Approximately 40% were triage calls with the remainder related to telephone-based case management. A wide variety of user groups were identified with utilisation by the indigenous population significantly higher than expected (12% of total contacts). Ninety five per cent of consumers rated the service as being satisfactory or higher. A trend was observed for reduced use of inpatient resources. Conclusions: This paper confirms international data supporting the value of technology driven, protocol-based triage and case management. Delivery of telephone-based contacts within a mental health service can be successfully achieved from a geographically remote site and may provide significant benefits for the delivery of rural mental health services.
Psychotherapy in Hollywood Cinema
Authors: Gabbard Glen 
Published: March 2003

Objective: To describe the portrayal of psychotherapy in Hollywood cinema. This may reveal popular myths and fantasies about this therapeutic modality.Conclusions: The perceived omniscience of psychiatrists is both envied and feared, and psychiatrists are continually denigrated to neutralise these feelings. Movies reflect this process by seeking to show that psychiatrists have the same human frailties as everyone else.
Do Patients Expect Psychiatrists to be Interested in Spiritual Issues?
Authors: D'Souza Russell 
Published: March 2003

Objective: To carry out a pilot study surveying the spiritual attitudes and needs of patients with a psychiatric illness at the Centre of Excellence in Remote and Rural Psychological Medicine, Broken Hill Base Hospital, NSW. Method: A questionnaire consisting of 6 questions was completed by 79 patients. Results: It was found that 79% of the patients rated spirituality as very important and 82% thought their therapists should be aware of their spiritual beliefs and needs. Sixty-nine per cent of the patients reported that patients's; spiritual needs should be considered by the therapist in treating their psychological illness and 67% said that their spirituality helped them cope with their psychological pain. Conclusion: The majority of patients said spirituality was important to them and that they wanted their therapist to take their spiritual needs into consideration in the assessment and management of their illness.
A Muslim Suicide
Authors: Sarfraz M. Aamer , Castle David 
Published: March 2003

Objective: To describe the case of a young Muslim male who completed suicide and discuss the implications in terms of his religion. Method: Case Report. Results: The patient's suicide occurred on the background of parental expectations regarding his career, criticism of his interests and lifestyle, and the development of a depressive illness. The aftermath was characterised by the family being rejected by their community because of the stigma associated with suicide in the religion. Conclusions: It is a myth that suicide is rare among Muslims. Muslim communities need to be re-educated about suicide phenomena through their leaders at home and abroad.
Pain from Many Inputs
Authors: Pridmor Saxby , Oberoi Gajiende , Samilowitz Hazel 
Published: March 2003

Objective: In keeping with the best scientific principles, modern medicine hankers after single aetiological agents. In our clinical observations, however, chronic pain is usually the result of many inputs. The objective was to review the etiological theories of pain, with a view to identifying potentially important inputs. Conclusion: Many potential inputs were identified, including, 1) CNS sensitization following injury, 2) impoverished interpersonal skills, 3) fear of pain and avoidance of movement, 4) care eliciting behaviour, 5) concurrent mental disorder, 6) protracted litigation, and 7) anger toward a wide range of individuals, including doctors and lawyers. In none of the reviewed theories was it necessary that the factor they supported be the only active one. It is probable that chronic pain is often the result of many inputs.
The Development of Clinical Guidelines for the Use of Zuclopenthixol Acetate
Authors: Barnes Caryl W. , Alderton Deidre , Castle David 
Published: March 2003

Objective: This paper illustrates the process that was undertaken in the development of guidelines for the use of Zuclopenthixol Acetate (ZA) and presents the guidelines that were developed at the end of this process. Conclusions: A number of investigations were undertaken to inform the above process, including: (i) A questionnaire sent to College Fellows and psychiatric registrars, to assess their use of ZA in the management of acute arousal in psychosis. This highlighted the lack of confidence that clinicians had in using ZA and some deficits in knowledge that confirmed the local need for such guidelines; (ii) A retrospective audit of the use of ZA in two psychiatric intensive care units over a 6 month period. This revealed significant differences between the centres in the manner in which ZA was prescribed; (iii) A review of published studies on ZA.
Depression in Young People: A National School-Based Initiative for Prevention, Early Intervention and Pathways for Care
Authors: Burns Jane , Hickie Ian 
Published: March 2003

Objective: To describe the national school-based initiative of ‘beyondblue’. Conclusions: The goals of the initiative are: to reduce levels of depressive symptoms in young people, to promote emotional well-being in adolescence and to increase the capacity of organisations to design, implement and evaluate interventions relevant to the prevention of depression. The theoretical framework underpinning the program will build on expertise and evidence-based research from both the education and health sectors while the proposed initiative will draw on the existing capacity of school systems. The program will target not only the specific needs of individual students but will combine this targeted approach with a whole-school approach that addresses the quality of the social climate in which the individual is situated. The intervention strategy in partnership with the education sector will seek to make changes in the schools' social and learning environments, introduce relevant and important life skills through the curriculum, and strengthen structures that promote links between the school, families and communities.
When You're Smiling does the Whole World Smile for You?
Authors: Gladstone Gemma , Parker Gordon 
Published: March 2003

Objective: To summarise and review findings from a longitudinal study examining the predictive significance of authentic smiling. Conclusions: A smile captured at one point in time (i.e. in a college photograph) was modestly but significantly associated with less self-reported negative emotionality and more perceived self-competence in a sample of women followed up over several years. Smiling also had a favourable influence upon observer judgements, with subjects who smiled being judged as more likeable and approachable than non-smilers and non-authentic smilers. Authentic smiling in adults is probably a behavioural marker of various helpful or protective psychological qualities fuelled at least moderately by temperament. Variation exists in smiling behaviour like it does in any other individual difference, but the very act of smiling might even serve as a kind of self-fulfilling prophecy - so smile more, but don't fake it!
Choosing a Psychodynamic Psychotherapy Model for an Australian Public Sector Mental Health Service
Authors: Petchkovksy Leon , Morris Philip , Rushton Paul 
Published: March 2003

Objective: To choose models of psychodynamic psychotherapy that will work within the characteristics and constraints of Public Sector mental health practice without compromising nuancing and depth. Conclusions: The authors briefly describe the development of the Gold Coast Integrated Mental Health Services Psychotherapy Programme, and the processes which have informed their selection of suitable psycho-dynamic models. They recommend IPT (Interpersonal Therapy) and the Conversational Model.
The Relationship Between Obsessive-Compulsive Disorder and Psychosis
Authors: Gangdev Prakash S 
Published: March 2003

Objective: To report on patients with comorbid Obsessive-Compulsive Disorder (OCD) and a psychotic disorder, and to discuss the relationship between OCD and psychosis. Method: Case histories of seven patients seen at a rural mental health clinic in New Zealand are presented. Six of them were treated with selective serotonin uptake inhibitors (SSRIs). Results: Four patients had sexual obsessions and two reported aggressive obsessions. One patient had obsessive doubts and checking compulsions. Six patients improved with the addition of an SSRI to their ongoing neuroleptic medication. Conclusions: 1) OCD and psychosis may coexist by chance and may be unrelated. 2) An obsession may become a delusion or vice versa. 3) A reactive delusion of guilt or persecution may develop. 4) An obsession may trigger a psychotic episode or vice versa. 5) Obsessions may be misdiagnosed as delusions or hallucinations. 6) Recognition and treatment of OCD may improve the outcome of psychosis.
Early experience in the use of Levovist ultrasound contrast in the evaluation of liver masses
Authors: Plew J , Sanki J , Young N , Gruenewald S , Dwyer R , Brancatisano R 
Published: March 2003

SUMMARYThe aim of the present paper was to assess the utility of Levovist in defining the pathology of liver masses. Levovist is a new ultrasound contrast agent consisting of galactose microparticles, air bubbles and palmitic acid. Prospective studies were performed in patients referred for further evaluation of known liver masses. Levovist was peripherally injected and colour Doppler ultrasound studies were performed. Findings were correlated with clinicopathology and three other imaging modalities: biphasic spiral CT, CT arterial portography and contrast MRI. Twenty‐five patients were studied (15 male and 10 female) in the age range 25–74 years. Liver masses ranged from 0.5 to 7 cm in maximum diameter. Thirteen lesions were benign and 12 were malignant (four hepatomas (HCC) and eight metastases). Levovist enhancement occurred in 18 lesions. Of these, six were benign (four focal nodular hyperplasias (FNH) and two haemangiomas). All 12 malignant lesions demonstrated enhancement. The HCC showed a mosaic pattern of central and peripheral enhancement, and the FNH demonstrated a spoke‐wheel pattern. It was not possible to distinguish between haemangiomas and malignant lesions. Non‐enhancing lesions may well be benign, with all malignancies showing some enhancement. Characteristic enhancement patterns were found for HCC (mosaic) and FNH (spoke‐wheel). It was not possible to distinguish between metastases and benign lesions (haemangiomas) when the pattern of enhancement was peripheral.
Radiotherapy utilization in New South Wales from 1996 to 1998
Authors: Barton Michael 
Published: March 2003

SUMMARYThe purpose of the present study was to examine utilization rates of radiotherapy by newly diagnosed cancer patients in New South Wales (NSW) from 1996 to 1998. The 1989 report of the Australian Health Ministers’ Advisory Council (AHMAC) recommended that 50% of all newly diagnosed cancer patients should receive radiotherapy. Previous reports showed that the true rate was between 30 and 36%. In 1991 and 1995 the NSW Department of Health developed strategic plans that were intended to implement the AHMAC recommendation. An analysis was carried out of activity reports of radiation oncology departments in NSW and its component Area Health Services (AHS). All NSW patients newly diagnosed with cancer between 1996 and 1998 and treated by radiotherapy were included in the study. A total of 37% of newly diagnosed cancer patients received radiotherapy in NSW in 1998. This has increased from 30% since 1990–91. Rural AHS in 1998 had an identical average rate of 37% (range: 23–54%) when compared to urban AHS (average: 37%; range: 26–49%). Rural AHS have increased utilization from 19% in 1990–91. Area health services with a radiation oncology department had a slightly higher rate of utilization than those AHS without a radiation oncology department (39 and 36%, respectively). The rates of utilization of radiotherapy in NSW in 1998 continued to be well below the benchmark set by AHMAC and varied widely between AHS. Attention to and expansion of services should be focused on both rural and urban areas of need.
Diastrophic dysplasia with severe primary kyphosis and ‘monkey wrench’ appearance of the femora
Authors: Bieganski Tadeusz , Faflik Jakub , Kozlowski Kazimierz 
Published: March 2003

SUMMARYThe cases of two sisters with severe diastrophic dysplasia who showed some unusual radiographic features (kyphosis secondary to hypoplasia/dysplasia of the lumbar spine and a ‘monkey wrench’ appearance of the proximal femur) are reported here. Absent patellae were another feature that has not previously been reported in diastrophic dysplasia.
Pigmented villonodular synovitis: Magnetic resonance features of an unusual case of bilateral hip joint involvement
Authors: Patkar Deepak , Prasad Srinivasa , Shah Jeshil , Patankar Tufail , Kothari Suren 
Published: March 2003

SUMMARYPigmented villonodular synovitis (PVNS) is usually a mono‐articular disorder. Bilateral symmetrical affection of this disease process is exceptional. A case is reported of a patient with PVNS with bilateral, symmetrical hip joint involvement.
Dual phase 99m‐technetium Sestamibi imaging with single photon emission computed tomography in primary hyperparathyroidism: Influence on surgery
Authors: Nordin A Jalil , Larcos George , Ung Owen 
Published: March 2003

SUMMARYThe purposes of this study were to determine the positive and negative predictive values of 99m Technetium (99mTc) Sestamibi dual phase imaging with single photon emission computed tomography (SPECT) for parathyroid adenomata or hyperplasia and the effect of preoperative localization on duration of surgery. We reviewed 33 adults (14 men, 19 women; mean age 53 years) with newly diagnosed primary hyperparathyroidism who underwent neck exploration. The duration of surgery for this cohort was compared with a group of historical controls (n = 53) who underwent surgery without preoperative SPECT. At surgery, there were 21 adenomata (including one carcinoma), 10 patients with hyperplasia and two with no pathology detected. The positive predictive values (PPV) for adenomata and hyperplasia were 95% and 100%, respectively. The negative predictive values (NPV) for these entities were 67% and 22%, respectively. The mean weight of adenomata detected was 3.4 g (range 0.2–17 g). Mean duration of surgery was 112.6 min as compared with 113 min in the historical controls (P = not significant). We conclude that 99mTc Sestamibi dual phase imaging with SPECT has an excellent PPV for parathyroid adenomata and hyperplasia, but does not contribute to reduced duration of surgery in patients undergoing neck exploration for the first time. The NPV is low, suggesting that a negative result does not exclude an adenoma or hyperplasia.