bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alcoholism and Personality
Authors: Mulder Roger T 
Published: March 2003

Objective: The search for an alcoholic personality has been pursued with varying enthusiasm throughout the 20th century. This paper reviews the methodological issues, research designs and current theories relating alcoholism and personality. Method: A selected literature search using computerised databases was ordered via the four major research design strategies: cross sectional studies, high-risk studies, longitudinal studies and genetic epidemiology studies. Results: Cross sectional studies have suggested that two broad bands of personality, impulsivity/novelty seeking and neuroticism/negative emotionality, are associated with alcoholism. Although high-risk studies have repeatedly shown that sons of male alcoholics are at increased risk of alcoholism, whether this risk is related to personality variables is unclear. Many authors believe that the presence of antisocial personality disorder is a confounder and that this may explain some of the contradictory findings. Longitudinal studies have consistently reported that antisocial behaviour and hyperactivity are related to later alcoholism. Negative emotionality seems to be less important and may largely be a consequence of the alcoholism itself. Genetic epidemiological studies suggest that personality measures play a modest but significant role in the genetic influence of alcoholism. The strongest relationships are with conduct disorder and antisocial behaviour. The postulated alcoholic subtypes (Type I, Type II or Type A/B) based on age of onset and personality style have been challenged by recent research. The most vulnerable to alcoholism may be those with both high impulsivity/high novelty seeking and high neuroticism/negative emotionality. Conclusion: Antisocial behaviour and hyperactivity are the most consistent behaviours associated with alcoholism. These behaviours are not specific for alcoholism and are associated with many other psychiatric conditions. Personality variables by themselves explain only a small proportion of the risk for alcohol dependence. There is no alcoholic personality nor are there personality measures which are specific to vulnerability to later alcohol dependence. Attempting to link alcoholism with theoretical, poorly validated models of personality is premature.
Psychiatric Morbidity and Adherence to Antiretroviral Medication in Patients With HIV/AIDS
Authors: Sternhell Peter S , Corr Melissa J 
Published: March 2003

Objective: To determine whether psychological morbidity is associated with poor compliance with antiretroviral medication in HIV-positive subjects. Method: This is a cross-sectional survey of patients attending a public HIV clinic in Sydney. Volunteers completed a survey which gathered data on substance use, psychological distress, attitudes to illness and medication, and self-reported medication adherence. Psychological morbidity was assessed using the 28 question General Health Questionnaire, GHQ-28, and adherence was assessed using a combination of direct self-report and indirect questions. Results: Forty-four per cent of subjects were identified as suffering psychological disorder on the GHQ. They reported significantly poorer adherence to antiretroviral medication than subjects not identified as ‘cases’ (odds ratio 4.5). Expressed scepticism about medication and previous use of psychotropics was also associated with poor adherence. Conclusions: Psychological morbidity is associated with poor adherence to antiretroviral medication. It is not known whether treatment of identified psychological morbidity leads to improved antiretroviral medication adherence and better medical outcome. A longitudinal study could help answer this question.
Trauma and Posttraumatic Stress Disorder in Australia: Findings in the Population Sample of the Australian National Survey of Mental Health and Wellbeing
Authors: Rosenman Stephen 
Published: March 2003

Aim: To investigate the distribution and risk factors for trauma and posttraumatic stress disorder in the Australian population sample taken for the 1997 National Survey of Mental Health and Wellbeing. Methods: The confidentialised unit record file (CURF) was prepared by the Australian Bureau of Statistics from the survey sample of 10 641 adults. It was interrogated for the lifetime experience of specific trauma and the 12-month prevalence of posttraumatic stress disorder according to DSM-IV and ICD-10. Univariate and multivariate analyses were applied to quantify risks for traumatic experience and for DSM-IV posttraumatic stress disorder. Results: Fifty-seven per cent of the population reported lifetime experience of the specified trauma. Men were more likely to experience most traumas and multiple traumas except for sexual assaults. The twelve-month prevalence of DSM-IV posttraumatic stress disorder in the overall adult population was 1.5%. It occurred in 3.8% of women and 2.0% of men who had experienced trauma. While female gender, youth, lower education and residence in poorer areas predicted posttraumatic stress disorder after trauma, multivariate analysis showed that the nature of trauma (especially sexual assault) predominated. Gender ceased to be a significant contributor to the risk of posttraumatic stress disorder when analysis controlled for type and number of trauma, and for the passage of time. Conclusion: Trauma is ubiquitous in the community and posttraumatic stress disorder is comparatively less common, persisting into the past year in 2.8% of those who have experienced lifetime trauma. The conventional models of female susceptibility to posttraumatic stress disorder are not supported in this sample. The type of trauma appears the most important determinant of progression to posttraumatic stress disorder. These community prevalence statistics complement causal understanding that comes from studies of clinical and other special populations in which posttraumatic stress disorder and selection for treatment may be confounded.
Emotional and Behavioural Problems in Childhood and Distress in Adult Life: Risk and Protective Factors
Authors: Buchanan Ann , Flouri Eirini , Ten Brinke Joann 
Published: March 2003

Objective: To assess the relationship between risk and protective factors and the continuity of psychological problems from age 7 to age 33. Methods: Data on 5591 cohort members of the National Child Development Study were used to track continuity and discontinuity between internalizing and externalizing problems at age 7, as assessed by the Rutter ‘A’ Health and Behaviour Checklist, and psychological distress at age 33, as assessed by the Malaise Inventory, controlling for risk and protective groupings present at age 7. Results: There was no association between malaise in adulthood and internalizing problems in childhood. However, people who had externalizing problems in childhood were nearly twice as likely as those without such problems to have high Malaise scores in adulthood. A grouping of risk factors (police/probation experience by family, agency referral for difficulties in school, social services involvement, domestic tension) did not predict malaise in adulthood. Also a grouping of protective factors (outings with mother, father reads to child, good creative skills, good numeric skills) predicted that women were less likely to have high Malaise scores in adult life. Conclusions: Protective factors in childhood were strongly associated with lower Malaise scores in adulthood. Research on factors associated with discontinuity of psychological problems may prove fruitful.
Psychiatrists as a Moral Community? Psychiatry Under the Nazis and its Contemporary Relevance
Authors: Dudley Michael , Gale Fran 
Published: March 2003

Objective: In Nazi-occupied Europe, substantial numbers of psychiatrists murdered their patients while many other psychiatrists were complicit with their actions. This paper addresses their motivations and actions, and with particular reference to Australia, explores issues of contemporary relevance. Methods: The events are reviewed in their historical context using mainly secondary sources. Results: The assumption that the term ‘Nazi’ denotes a closed and unrepeatable chapter is questioned. As with the Holocaust that followed, medical killing of psychiatric patients was an open secret with gradations of collective knowing. Perpetrators were impelled by pressure from peers and superiors, unquestioning obedience, racist ideology and careerism. Perpetrators and bystanders' denial was facilitated by use of deceptive language, bureaucratic and technical proficiency, and notions such as ‘a greater cause’ or ‘sacred mission’. Dissociation and numbing were common. Psychiatrists were the main medical speciality involved because Nazi race and eugenic ideology (accepted by many psychiatrists) targeted mentally ill people for sterilization and euthanasia, and because psychiatrists were state-controlled and tended to objectify patients. Few psychiatrists resisted. Implications: Nazi psychiatry raises questions about medical ethics, stigma and mental illness, scientific ‘fashions’, psychiatry's relations with government, and psychiatrists' perceived core business. Psychiatric resistance to future similar threats should be based on commemoration, broad-based education and reflection on cultural values, strong partnerships between psychiatrists and patients, and willingness to question publicly policies and attitudes that disadvantage and stigmatize groups. The principle fundamental to all these practices is an orientation to people as subjects rather than objects.
What Outcomes to Measure in Routine Mental Health Services, and How to Assess Them: A Systematic Review
Authors: Slade Mike 
Published: March 2003

Objective: Routine outcome assessment in adult mental health services involves the ongoing assessment of patient-level outcomes. Use of outcomes to inform treatment is widely recommended, but seldom implemented. The goals of this review were (i) to identify principles that have been proposed for implementing routine outcome assessment, (ii) to identify the full range of outcome domains that have been proposed for assessment, and (iii) to synthesize proposals for specific outcome domains into emergent categories. Method: A systematic review of published and unpublished research was undertaken, using electronic databases, research registers, conference proceedings, expert informants and the World Wide Web. For goal (i) studies were included that proposed principles for implementing routine outcome assessment. For goal (ii) studies were included that identified at least two patient-level outcome domains for patients using adult mental health services and made some reference to a broader literature base. Results: Six thousand four hundred publications matched initial search criteria. Seven distinct sets of principles for choosing patient-level outcomes were located, which showed a fair degree of consensus. Sixteen outcome domain proposals were identified, which were synthesized into seven emergent categories: wellbeing, cognition/emotion, behaviour, physical health, interpersonal, society and services. Conclusions: The findings from this review were used to develop a four-step method for adult mental health services wishing to implement routine outcome assessment.
Establishment of a Disaster-Related Psychological Screening Test
Authors: Huang-Chih Chou Frank , Tung-Ping Su Tom , Ou-Yang Wen-Chen , Chien I-Chia , Lu Ming-Kun , Chou Pesus 
Published: March 2003

Objective: To create a short screening scale for the detection of posttraumatic stress disorder (PTSD) and major depressive disorder (MDE) in earthquake survivors in Taiwan. Method: Trained research assistants used the Disaster-Related Psychological Screening Test (DRPST) to assess 461 residents of a village that had experienced a major earthquake. The participants were also evaluated by psychiatrists using the Mini-International Neuropsychiatric Interview (MINI). Best subset regression analysis and the receiver operating characteristics curve were used to select a subset of items and cut-off points from the DRPST. Results: A seven-symptom scale and a three-symptom analogue were selected for PTSD and MDE screening, respectively. Scores of three or more on the PTSD scale and two or more on the MDE scale were used to define a group of positive cases that provide useful information for the patient cohort and will be valuable in long-term follow-up studies of the prevalence of psychiatric diseases following a natural disaster. However, higher scores could also be used to define positive cases under limited psychiatric care resources. Conclusion: The DRPST, which was administered for phase 1 of this two-phase study, may be used for effective and rapid screening for PTSD and MDE after an earthquake, despite the usual limitations on resources following a disaster.
The Subjective Experience of Patients who Received Electroconvulsive Therapy
Authors: Frank Koopowitz Leslie , Frank Koopowitz Leslie , Chur-Hansen Anna , Reid Sally , Blashki Miriam 
Published: March 2003

Objective: Despite the vast amount of scientific literature available on electroconvulsive therapy (ECT), there is little qualitative focus upon the patients' subjective experience of this procedure. Using an exploratory descriptive methodology, this study aims to provide a more unique insight into what certain patients actually think of ECT. Method: Semistructured interviews were conducted to explore eight patients' opinions and experiences of ECT. Interviews were subjected to analysis by a five-step framework approach that identified prominent themes in relation to five broad questions and in conjunction with issues raised by the subjects themselves. Results: Eleven major themes were identified. Four of these were chosen for discussion, not only as the most prevalent themes (in terms of how frequently they were mentioned by the subjects), but also as the most striking (in regards to the intensity of emotions evoked, or their influence on their perception of ECT as a future treatment option). The four themes are fear of ECT, attribution of cognitive decline and memory loss to ECT, positive ECT experiences, and patients' suggestions. Conclusions: Using such a qualitative approach, the depth of the information obtained has revealed new perspectives on how patients perceive the experience of ECT. Fears reported by patients present an opportunity to address specific areas of the procedure that generate the most angst. These were closely associated with recommendations that many patients proposed throughout the interviews. Patients' perceptions of the cognitive effects of ECT do not necessarily correspond with those commonly reported in the literature on ECT. Positive experiences with ECT were more complex than simply its efficacy. There is a need for future research in order to explore and address patients' experiences of ECT.
AN EASY AND EFFECTIVE METHOD OF CHOLANGIOGRAPHY IN LAPAROSCOPIC CHOLECYSTECTOMY: LAPAROSCOPIC CHOLECYSTOCHOLANGIOGRAPHY
Authors: Daoud M. , Mccallum M. J. 
Published: March 2003

Background: There is ample evidence that the incidence of operative cholangiography has declined since the introduction of laparoscopic cholecystectomy. It has been suggested that one of the reasons for this decline is the technical difficulty of cystic duct catheterization. A method of cholangiography which does not require such catheterization has been developed by others. This paper examines the ease and effectiveness of operative cholangiography performed by direct puncture of the gall‐bladder. Methods: A retrospective study was made of the records of 380 consecutive patients who underwent attempted laparoscopic cholecystectomy. After exclusion of patients in whom laparoscopic cholecystectomy was abandoned in favour of open cholecystectomy and those patients in whom operative cholangiography was not attempted, the records of 325 patients were available to the study. The operation notes of each patient were studied to determine whether, in the operator’s opinion, a successful cholangiogram had been obtained. Results: There were 290 patients in whom cholangiography was attempted using direct gall‐bladder puncture (cholecystocholangiography (CCC)). There were 35 patients in whom cholangiography was attempted via cystic duct cannulation (CDC). Cholecystocholangiography was successful in 86% of those cases in which it was attempted. Cystic duct cannulation was successful in 83% of those cases in which it was attempted. Conclusion: Cholecystocholangiography is a valid alternative to cystic duct catheterization in its ability to achieve intra‐operative cholangiography in the setting of laparoscopic cholecystectomy.
RISK FACTORS FOR ANKLE FRACTURE REQUIRING OPERATIVE FIXATION
Authors: Christey G. R. , Tomlinson M. 
Published: March 2003

Background: Ankle fractures are common and expensive injuries, particularly the injuries that require operative intervention. However, epidemiological research on the causative factors is sparse. This study aims to identify the groups at risk of ankle fracture requiring operative fixation, and to suggest directions for further study.Methods: The clinical data on 336 patients with ankle fractures admitted to an urban hospital in New Zealand in 1994 were reviewed. Statistical analysis was carried out on the 252 patients with ankle fractures requiring operative fixation.Results: Those at highest risk of ankle fracture are young male rugby players and middle‐aged women who sustain injury while walking. Young males have a similar incidence of AO Type B and C fractures, while Type B fractures predominate strongly in older women.Conclusions: The groups at risk of ankle fracture requiring operative fixation, and the activities predisposing these groups to injury have been identified. More work is required to define the specific risk factors and biomechanical mechanisms that lead to these debilitating injuries.
BLOOD LIPID PROFILE IN ISCHAEMIA REPERFUSION INJURY
Authors: Sieunarine K. , Wangoo D. , Langton S. , Lawrence Brown M. M. D. , Prendergast F. J. , Goodman M. A. 
Published: March 2003

Background: Lipid components are considered to play an important role in ischaemia reperfusion injury although the mechanism of their action remains unknown. Accumulation of lipid metabolites in ischaemic tissues is a consistent observation, but exactly how these lipids are cleared from the tissues by the circulating blood during reperfusion is still open to speculation. In the present study, levels of blood lipids (fatty acids, phospholipids, triglycerides, cholesterol, lysolecithin and lysolecithin platelet activating factor (lyso PAF)) and the enzyme phospholipase A2 were determined in an experimental animal model (dogs) of ischaemic reperfusion injury. Methods: The injury was induced by 4 h of aortic clamping followed by 2 h of reperfusion (unclamping). Blood samples were collected before clamping and at predetermined time intervals (0, 15, 60 and 120 min) after the release of clamp. The lipid contents were analysed and compared with sham‐treated control dogs. Results: The results showed significantly elevated levels of triglycerides and phospholipase A2, during ischaemia and reperfusion in experimental animals indicating tissue damage in the ischaemic phase continuing into the reperfusion phase and the risk of systemic damage from these toxic substances. Total fatty acid content in the circulating blood showed decreasing trends during the same time interval, which suggested possible reduced clearance of accumulated fatty acids from the affected tissues. Serum cholesterol, phospholipids, lyso PAF and lysolecithin did not show any significant variation compared with control dogs. Conclusions: It is possible that the delayed clearance of fatty acids may be due to the presence of fatty acids binding proteins in the ischaemic tissue, which trap these fatty acids in the tissues during ischaemic reperfusion injury. The prolonged retention of the accumulated fatty acids in the tissues in association with elevated triglycerides and phospholipase A2 activity may contribute to ischaemia reperfusion injury.
WAITING TIMES FOR APPOINTMENTS WITH ORTHOPAEDIC SURGEONS IN VICTORIA: 1995–97
Authors: Feller Julian A. , Freeman Richard D. , Speck Gary R. 
Published: March 2003

Background: A number of different models have been proposed for determining surgical workforce requirements. Methods: In 1995 the Workforce Subcommittee of the Victorian Regional Branch of the Australian Orthopaedic Association commenced a prospective evaluation of waiting times for both urgent and nonurgent appointments with orthopaedic surgeons in Victoria. Results: The results for the 3 years, 1995–97, show no significant change in the waiting time for nonurgent appointments and no difference between metropolitan and rural areas. The waiting time for an urgent appointment increased from 1995 to 1997 for the state of Victoria and for metropolitan Melbourne but not for rural areas. However, the median waiting time for an urgent appointment did not change. Conclusion: Overall the waiting times were found to be satisfactory by previously reported standards.
PHAEOCHROMOCYTOMA: EXPERIENCE FROM A REFERRAL HOSPITAL IN SOUTHERN INDIA
Authors: Mathew Sajjan , Perakath Benjamin , Nair Aravindan , Seshadri M. S. , Shanthly Nylla 
Published: March 2003

Background: Phaeochromocytoma has been traditionally called the ‘Tumour of Tens’. Many investigators have reported the prevalence of extra‐adrenal phaeochromocytoma to be more than 10%. Methods: All consecutive adult patients diagnosed to have phaeochromocytoma by the departments of endocrinology and surgical endocrinology of the Christian Medical Hospital, India, over a period of 10 years from 1988 to 1998, were included in the study. Results: A total of 30 patients were diagnosed to have phaeochromocytoma. Extra‐adrenal phaeochromocytoma accounted for 26.6% of cases. Ten per cent of cases were bilateral, 6.6% were malignant and one patient had a familial tumour (multiple endocrine neoplasia IIB). The tumours were localized pre‐operatively in all patients. Multicentric extra‐adrenal tumours were not found in this series. All patients except one were explored by the anterior transperitoneal approach. Persistent hypertension was noted in 30% of patients. Conclusions: Our series shows a higher prevalence (26.6%) of extra‐adrenal tumours than the traditionally described 10%. With accurate pre‐operative localization, a transperitoneal approach may not be necessary. The laparoscopic approach needs to be evaluated in light of these findings.