bluuebunny/crossref_metadata_2025_split huggingface dataset:
Staff Perceptions of Care for Deliberate Self‐Harm Patients in Rural Western Australia: A Qualitative Study
Authors: Slaven Janine , Kisely Stephen 
Published: March 2003

Abstract:  Suicide has been a major community concern in Esperance, a geographically isolated port on the south coast of Western Australia. This study to explores the views of regional health staff on barriers to the effective management of deliberate self‐harm (DSH) and ways in which those barriers could be addressed. Semi‐structured interviews were tape‐recorded, transcribed and subjected to qualitative content analysis. Interviewees included 77% of general practitioners (n = 7), 18% of nurses (n = 13) and 55% of mental health professionals (n = 5). The most important barrier was a lack of structure to treating DSH, resulting in deficiencies and inconsistencies in its management. Suggestions to improve the management of DSH included better communication between services, support for nurses in raising the issue of suicide, use of a simple risk assessment tool, the development of a nurse liaison position, and a multidisciplinary planning group. The higher rates of DSH and completed suicide in rural and remote regions compared with metropolitan areas make secondary prevention particularly important.
OBESITY, SMOKING AND HAZARDOUS DRINKING AMONG MEN ADMITTED TO THE SURGICAL WARDS OF A REGIONAL HOSPITAL
Authors: Peach Hedley G. 
Published: March 2003

ABSTRACT:The purpose of the study was to determine the prevalence of obesity, smoking and hazardous drinking, and identify opportunities for their reduction, among men admitted to the surgical wards of a regional hospital. A random sample of 80 patients were interviewed. Nineteen per cent were obese, 29% smoked and 16% drank hazardously. Forty‐seven per cent and 52% of those who were obese or smokers, respectively, had tried unsuccessfully to reduce their weight or smoking before admission, but mostly without professional support. A further 13% wanted to reduce their smoking but had not tried. Fifty‐five per cent continued to try or still wanted to reduce these factors 3 months after discharge. Obesity and smoking could be common among male surgical inpatients in regional hospitals, a significant proportion of whom may welcome professional help with improving their lifestyle, but a larger multi‐hospital study is needed to confirm this.
Rural community pharmacy: a feasible site for a health promotion and screening service for cardiovascular risk factors
Authors: Hourihan Fleur , Krass Ines , Chen Timothy 
Published: March 2003

ABSTRACT: A pharmacist‐delivered health promotion and screening service for cardiovascular risk factors in rural community pharmacy was implemented in the Upper Hunter Valley, New South Wales (NSW). We describe the development of the service and profile 204 participants at their initial screening. A standardised clinical protocol guided the pharmacist through delivery of the service. The mean age of participants was 44 years (SD ± 13). Over half (54%) had a Body Mass Index (BMI) > 25, 54% had cholesterol > 5.0 mmol L−1 and 18% a systolicBP≥ 140 mmHg and/or diastolicBP ≥ 90 mmHg. Most (80%) received lifestyle information (dietary, exercise or smoking cessation). One third required referral to a general practitioner. Provision of the service through community pharmacy increased the community's access to screening, 28% reported that they had never had their cholesterol measured. Since this new service was able to identify, educate and refer people at risk of cardiovascular disease in a rural community, we recommend a broader adoption through rural pharmacies.
Localized scotomata detected with temporal modulation perimetry in central serous chorioretinopathy
Authors: Vingrys Algis J , Pesudovs BscOptom, PhD and Konrad , BscOptom  
Published: March 2003

Aim: Flicker deficits have been reported in various maculopathies, including age‐related macular degeneration. We test whether flicker losses exist in patients with central serous chorioretinopathy (CSC) and whether the size and flicker frequency of the target is important in detecting such losses. Methods: We examined four CSC patients with temporal modulation (flicker perception) perimetry using the Medmont auto‐flicker module (Medmont Pty Ltd, Melbourne, Vic. Australia), as well as static perimetry and colour vision. One case was examined using sophisticated laboratory equipment to precisely measure their temporal contrast sensitivity function (temporal CSF or de Lange curve) using larger targets to consider the effect of target frequency and size. Two patients were followed longitudinally and tested after resolution of the maculopathy. We compared our patients with an age‐matched control group of 11 people. Results: Temporal modulation perimetry detected larger and more localized defects in all cases of active CSC compared with static perimetry. There appeared to be size and frequency tuning to the deficit, with greatest loss being found at 16 Hz with small (0.5°) targets. The losses resolved in one case where the retina recovered in 4 weeks, but remained to a lesser degree in another case who suffered a 2 year long fluctuating course before the CSC subsided. Conclusions: Temporal modulation perimetry detects a loss of flicker sensitivity in patients with CSC. Deeper and more clearly defined scotomata are found with a flickering stimulus compared with a steady state one. The greatest losses of flicker sensitivity are found with 16 Hz modulation and with small targets located directly over the lesion. The duration of the disease may be important for recovery of flicker sensitivity. Temporal modulation perimetry appears to be a valuable tool for the confirmation of functional loss due to CSC.
Subconjunctival fat prolapse*
Authors: McNab Alan A 
Published: March 2003

Purpose: Subconjunctival orbital fat prolapse has been rarely described in the literature and is frequently confused with other conjunctival tumours, such as dermolipoma. The purpose of the present study was to describe the clinical features and treatment of a series of patients with subconjunctival orbital fat prolapse. Methods: Review of clinical records. Results: Twelve patients with subconjunctival orbital fat prolapse were identified. Eight had a superotemporal prolapse and five of these were bilateral. All but one were male and most were elderly and tended to be obese. Five of these patients underwent surgical excision of the prolapsed fat for symptoms of discomfort or for cosmesis. Four atypical unilateral cases were seen in younger patients with fat prolapse occurring superonasally in three and inferiorly in one. In one case there was a history of trauma. Conclusions: Subconjunctival orbital fat prolapse typically occurs superotemporally in obese elderly males and is easily differentiated from other lesions, such as dermolipoma. The prolapsed orbital fat may be excised via the conjunctiva.
A new model of orthotopic penetrating corneal transplantation in the sheep: Graft survival, phenotypes of graft‐infiltrating cells and local cytokine production
Authors: Williams Ka , Standfield Sd , MedLabCert  , Mills Rad , Takano T , Larkin Dfp , Krishnan R , Russ Gr , Coster Dj 
Published: March 2003

Background: Orthotopic penetrating keratoplasty in the sheep was developed as an outbred preclinical model to allow correlation of the cellular infiltrate during graft rejection with local production of cytokine mRNA. Methods: Penetrating corneal autografts and allografts were performed in Merino sheep. Graft outcome was followed at the slit‐lamp. Corneal infiltrates were examined by immunoperoxidase staining on postmortem specimens. Cytokine mRNA was detected by polymerase chain reaction. Results: Corneal autografts survived indefinitely. Allografts became vascularized and underwent rejection at a median of 20 days postgraft. Both endothelial and epithelial rejection lines were observed. Immunohistochemical staining of rejecting grafts showed up‐regulation of major histocompatibility complex class I molecules on corneal graft epithelium, damaged or absent graft endothelium and a marked, predominantly mononuclear cell infiltrate. CD4‐positive T cells were observed in the graft within 2 days of the onset of rejection, followed several days later by CD8‐positive T cells. Messenger RNA transcripts for interleukin (IL)‐2, tumour necrosis factor (TNF)‐α and IL‐10 (but not for interferon (IFN)‐γ or IL‐4) were found in autografted corneas. Proportionately, more allografts than autografts contained transcripts for IL‐2 and TNF‐α, and IFN‐γ was detected in three of four allografts. Conclusions: Corneal graft rejection in the sheep is macroscopically and histologically similar to human corneal graft rejection. Allografts become infiltrated by both CD4‐ and CD8‐positive T cells and local production of pro‐inflammatory cytokines occurs during graft rejection.
Can the current oculokinetic perimetry chart be improved?
Authors: Chia W‐L A , Goldberg I 
Published: March 2003

Background/Method: Several studies have been performed to determine the effectiveness of oculokinetic perimetry (OKP) as a glaucoma screening test. In a previous study, we noted that OKP sensitivity and specificity was lower in mildly defective fields compared with moderately or severely, defective fields. In this study, we looked at visual fields with ‘glaucomatous’ defects. The visual field was divided into zones and points. The frequency of glaucomatous defects and visual sensitivity levels in these areas was recorded. The sensitivity and specificity of OKP to detect these defects were analysed. Results: Ninety‐six glaucomatous fields from 57 subjects were assessed. An OKP chart testing the 8 to 16 degrees of eccentricity, and an extended nasal region, would cover all the defective fields present in this study. The 12–16 degree eccentricity zone has the best sensitivity (75%) and specificity (65%). Points within the nasal, inferior temporal and 8–12 degree eccentricity might be less sensitive, but 11(11.5%) fields had defects only in these areas. Zonal and point sensitivities and specificities were very similar, suggesting that fewer points could be used in each zone with similar results. Many of the eyes with false‐negative OKP results had Humphrey Field Analyser visual sensitivity levels in the 10–18 dB range (i.e. associated with a mild or moderate defect). Decreasing the target stimulus might increase the detection rate of these milder defects; however, it might also increase overall false‐positive rates. Our proposed experimental chart consists of two to four test points in each quadrant within the 12–16 degree of eccentricity, five within the 8–12 degree zone and two in the nasal region, and a central 1 or 1.5 mm black target. Conclusion: Analysis of results with modifications of the testing device may permit the OKP chart to achieve its full potential.
Attitudes Towards People with a Mental Disorder: A Survey of the Australian Public and Health Professionals
Authors: Jorm Anthony F. , Korten Ailsa E. , Jacomb Patricia A. , Christensen Helen , Henderson Scott 
Published: March 2003

Objective: The aim of this paper was to compare the Australian public's attitudes towards people who have been treated for a mental disorder with the attitudes of general practitioners, psychiatrists and clinical psychologists. Method: The study involved a household survey of 2031 members of the Australian public and a postal survey of 872 general practitioners, 1128 psychiatrists and 454 clinical psychologists. Survey participants were presented with a vignette describing a person with schizophrenia or one with depression. They were asked opinions about the person's long-term outcome in various areas of life after receiving treatment. Participants were also asked whether they thought the person described would be discriminated against by others. Results: Both the public and professionals rated outcomes as poorer and discrimination as more likely for the person with schizophrenia than for the one with depression. The professionals made more negative ratings than the public, although the clinical psychologists had similar attitudes to the public about depression. Conclusions: Compared to the public, health professionals rate long-term outcomes more negatively and discrimination as more likely. It is possible that these more negative attitudes are realistic, being based on greater knowledge of mental disorders. However, professional attitudes may be biased by greater contact with patients who have chronic or recurrent disorders. Either way, health professionals need to be aware of the effects that their negative attitudes might have on patients and the public.
Amphetamine Withdrawal: I. Reliability, Validity and Factor Structure of a Measure
Authors: Srisurapanont Manit , Jarusuraisin Ngamwong , Jittiwutikan Jaroon 
Published: March 2003

Objective: The aim of this study was to create a short, reliable and valid questionnaire for the evaluation of amphetamine withdrawal, which we shall call the Amphetamine Withdrawal Questionnaire (AWQ). Method: Items of the AWQ included in this study were based on the fourth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) and a comprehensive review. A field trial for assessing the reliability, validity and factor structure was conducted in outpatients and inpatients with amphetamine withdrawal. Results: Thirty and 102 patients’ data were included in the reliability-validity tests and the factor study, respectively. Due to the very low mean score of insomnia item, this item was excluded from subsequent analyses. The AWQ internal consistency was satisfactory with a Cronbach's alpha of 0.77. For test-retest reliability, a Spearman rank order correlation coefficient of the AWQ total score was 0.79. The AWQ total score for criterion validity was moderately correlated with the other two accepted measures. Principal component analysis, eigenvalue-one test and a varimax rotation performed to elicit the factors of AWQ yielded a three-factor model of AWQ: namely hyperarousal, reversed vegetative and anxiety factors. Conclusions: The AWQ is a short, reliable and valid measure for assessing amphetamine withdrawal symptoms. Further studies with a larger number of patients should be conducted to confirm the results of this factor analysis.
A Survey of Suicide Prevention Curricula Taught in Australian Universities
Authors: Hazell Philip , Hazell Trevor , Waring Trevor , Sly Ketrina 
Published: March 2003

Objective: The aim of this study was to survey Australian universities to determine the scope of suicide prevention curricula in a range of prevocational courses. Method: Coordinators of undergraduate and postgraduate university programs for medicine, nursing, psychology, social work, theology, education, pharmacy, law and journalism were asked to complete a survey instrument to determine whether specific knowledge, attitude and skills items were included in the course content. Additional information was sought concerning the dominant method of teaching. Data were compared by discipline. An arbitrary threshold of 70% of courses within each discipline responding positively to each survey item was established as an adequate level of penetrance of that item into prevocational programs. Results: Overall, knowledge and attitudes related to suicide prevention are taught more comprehensively than are skills. Knowledge and attitude items are taught most comprehensively in medical and nursing schools, somewhat less in psychology, social work, and pharmacy, uncommonly in theology and education. Law and journalism courses currently include very little material related to suicide and suicide prevention. Skills relevant to the management of suicidal individuals and their families are taught most comprehensively in psychology, nursing and medical courses, with low penetrance into other courses. Conclusion: The greatest opportunity to increase exposure to knowledge and attitudes relevant to suicide prevention exists within education, theology, law and journalism courses. Programs directed to the development of interpersonal skills relevant to the management of suicidal individuals and their families could be introduced across the board.
The Influence of Client's Ethnicity on Psychotropic Medication Management in Community Mental Health Services
Authors: Ziguras Stephen , Lambert Tim J. R. , McKenzie Dean P. , Pennella Jo 
Published: March 2003

Objectives: The aim of this study was to investigate whether people born in non-English-speaking countries differed from clients born in Australia on quality of medication management, measured by mean neuroleptic dose, method of administration, use of atypical antipsychotics and perceived compliance with medication, and to investigate the influence of matching the client with a case manager from the same ethnic background on these measures. Method: Information about medication and perceived compliance was provided for 168 clients of five community mental health services in Melbourne. Chlorpromazine equivalent doses (CPZe) were calculated, and average dose, route of administration, percentage receiving atypical antipsychotics and perceived compliance with medication were analysed by country of birth and preferred language. Each analysis was repeated for clients matched to a case manager from the same ethno-linguistic background compared to those with ‘unmatched’ case managers. Results: While non-English-speaking background (NESB) clients generally did not receive different dose sizes, those born in Vietnam had a lower mean dose. People born in a non-English-speaking country tended to be more likely than the Australian born to receive a depot injection, although this was not quite statistically significant. Twenty-seven percent of clients received an atypical neuroleptic; age was a significant factor, with older clients less likely to receive an atypical. There was no difference in receipt of atypicals or perceived compliance by country of birth, language or gender. Matching for a case manager of the same background had no effect except for route of administration, with matched clients less likely to receive depot medication than unmatched. Conclusions: Generally, the ethnic background of clients had little influence on the quality of medication management they received from community mental health services.
Schizophrenia, Mental State, and Mother—Infant Interaction: Examining the Relationship
Authors: Snellen Martien , Mack Kerry , Trauer Tom 
Published: March 2003

Objective: The aim of this study is to examine the role that disturbance of mental state of hospitalised mothers with a postpartum schizophrenic illness plays in determining the quality of mother-infant interactions. Method: We examined the relationship between the nature and severity of symptomatology in mothers with schizophrenia and the quality of her interactions with her infant in a sample of 15 mother-infant dyads admitted to a psychiatric Mother-Baby Unit. Data were obtained at admission and discharge. Results: Mothers with florid positive symptoms and prominent negative symptoms of schizophrenia and their infants were identified as being at particular risk of displaying disturbed interactions. The adverse contribution of negative symptoms was often not evident until after the positive symptoms had resolved. Conclusions: Given that negative symptoms are often treatment resistant, optimal care of mothers with schizophrenia and their infants needs to involve ongoing therapeutic intervention which specifically addresses disturbances of mother-infant interaction. Further research is required to identify which interventions are likely to be of greatest benefit.
A Descriptive Study of First Presentation Psychosis in Old Age
Authors: Hassett Anne 
Published: March 2003

Objective: This report describes the characteristics of a sample of elderly subjects presenting with their first episode of psychosis in old age. Method: Forty-six (38 females and eight males) patients were assessed on a variety of cognitive, psychopathological and personality measures. Results: Female preponderance, social isolation and early cognitive deficits were findings of this study which have been replicated by other studies of late-onset psychosis. In contrast, hearing loss was not overly represented in this sample. Personality style differed significantly from accepted norms of adult personality traits, with lower scores for dimensional ratings of neuroticism, extraversion and openness to change. Conclusions: The descriptive findings in this study suggest that psychosocial factors require further investigation in patients presenting with late-onset psychosis. Comparison with younger first-onset psychotic subjects will be the subject of a later report.
Establishing the Efficacy and Cost Effectiveness of Community Intensive Case Management of Long-Term Mentally Ill: A Matched Control Group Study
Authors: Preston Neil Joseph , Fazio Sam 
Published: March 2003

Objective: The study attempted to identify whether chronic mentally ill persons after receiving intensive case management (ICM) could demonstrate improved inpatient service utilisation compared with a matched control group cohort. Costings were measured to observe whether the increase in providing intensive outpatient contacts would be offset by savings in reduced inpatient service utilisation. Method: Eighty ICM patients were matched on ICD-9 diagnosis, age, gender, length of illness, age at first inpatient and outpatient contact, marital status, educational level, employment status, country of birth, year of arrival to Australia and religion. Inpatient bed-days and outpatient contacts were recorded and compared 12 months prior to ICM treatment, 12 and 24 months after ICM using within/between group repeated measures analysis of variance. Results: The ICM group demonstrate significant reductions in inpatient service utilisation both within the 12- and 24-month period after receiving ICM treatment. The cost differential by 24 months of treatment was $801 475 in favour of the ICM model. The increase in costs of outpatient contacts were offset by a significant reduction in inpatient service utilisation. Conclusion: When outpatient contacts averaged one contact a week for the duration of the study period no significant reductions in inpatient service utilisation was recorded, as demonstrated by comparison with the matched control group. By increasing outpatient contacts by 3–4 contacts a week, inpatient contacts reduced by 36.8%. ICM is an efficacious and cost effective way to implement community-based services to the chronically long-term mentally ill.
Transcranial Magnetic Stimulation: Experience, Knowledge and Attitudes of Recipients
Authors: Walter Garry , Martin Janine , Kirkby Kenneth , Pridmore Saxby 
Published: March 2003

Objective: To examine the experience, knowledge and attitudes of recipients of transcranial magnetic stimulation (TMS) regarding the treatment. There have been no studies of patient views about TMS. Method: A 60-item survey was administered by telephone to persons with depressive illness who received TMS at Royal Hobart Hospital, Tasmania. Results: Forty-eight patients were interviewed. About two-thirds also had a history of treatment with electroconvulsive therapy (ECT). Experience and opinions about TMS were generally very positive. Almost three-quarters of interviewees believed TMS had been helpful. The vast majority rated TMS as more acceptable than having, or the prospect of having, ECT. The majority would have TMS again and would recommend it to others. Conclusions: The mostly favourable experiences and attitudes reported by interviewees will be reassuring to patients, their families and treating health professionals when TMS is being considered.