bluuebunny/crossref_metadata_2025_split huggingface dataset:
The “Maga Barndi” Mental Health Service for Aboriginal People in Western Australia
Authors: Laugharne Jonathan , Glennen Michael , Austin June 
Published: March 2003

Objective: This paper describes the implementation of the “Maga Barndi” pilot project while highlighting certain issues relevant to delivering psychiatric services to Aboriginal people. Method: The process of developing and implementing the project is described with an emphasis on those aspects which seem to enhance accessibility and acceptability to the Aboriginal community. Results: Over the 2-year period of the project, a caseload of 61 Aboriginal patients was established within Geraldton. A further 22 Aboriginal patients were managed at a variety of regional centres and another 52 at the Regional Prison. This represented a marked increase in service utilisation by local Aboriginal people. Psychiatric admissions for Aboriginal patients to the local hospital were reduced by 58% in the year following service commencement. Location of the project within an Aboriginal-controlled health centre with access to Aboriginal health workers and a flexible assertive community management approach were key factors in facilitating patient access to the service. Conclusions: The project succeeded in its objective of pioneering a culturally sensitive psychiatric service for Aboriginal people in Geraldton and the Midwest. Lessons learnt during the development of the project may be useful to other services seeking to improve their accessibility and acceptability to Aboriginal people.
South Metro's Men's Respite: An Innovative Service for Violent Men
Authors: Pennebaker Duane , Olesen Terry 
Published: March 2003

Objectives: The study describes the evaluation of an integrated men's domestic violence respite centre, the South Metro Men's Respite (SMMR), in Western Australia. In addition to recognising the novel approach of SMMR to client services, assessments of mental illness in clients presenting to the service were made and compared with available norms. Furthermore, the types of services provided by the SMMR were assessed against other Australian domestic violence programs for men. Conclusions: The results suggested that even with stringent assessment criteria, a large number of the SMMR's presenting clients displayed symptoms of depression, anxiety, paranoia, and psychoticism at levels that indicated a need for treatment. The SMMR sample had levels of anxiety higher than that of the adult male psychiatric inpatients and outpatients, which would imply the suitability of the Assertive Community-based Treatment (ACT) component of the service. The SMMR's innovative approach aimed to meet service gaps in providing for men who are perpetrators of domestic violence. The service comparison review established that while seven other programs within Australia had provisions for child custody/parenting, spousal independence, addiction, personal responsibility, alternatives to violence, gender roles, and communication content, the ability to provide assertive outreach to the men was shared by only two other programs in Australia.
Concordance between Patients and Their Case Managers Using the Health of the Nation Outcome Scales
Authors: Trauer Tom , Callaly Tom 
Published: March 2003

Objective: Outcome assessment benefits from multiple perspectives, but these may differ. We aimed to compare patient and clinician ratings on respective versions of a well-known outcome assessment scale. Method: Case managers and their patients rated the patient's mental health problems using the clinician and self-rating forms of the Health of the Nation Outcome Scales (HoNOS). Results: One third of patients approached returned their self-rating form; non-return was associated with involuntary legal status. Patient ratings were significantly higher (worse) than case manager ratings on four of the twelve HoNOS items, and significantly lower on one. Overall, agreement levels were slight to moderate, but particularly low for the depressed mood item. Case managers tended to overestimate the actual degree of similarity between their own ratings and those of their patients. Conclusions: The findings support the proposition that patient and clinician perceptions of the patient’ problems represent two different sets of information.
Decision-Making in Community Treatment Orders: A Comparison of Clinicians and Mental Health Review Board Members
Authors: Jaworowski Sol , Guneva Rumiana 
Published: March 2003

Objective: The aim of this paper is to determine the level of consistency in decision-making between mental health clinicians and members of the Mental Health Review Board regarding Community Treatment Order (CTO) discharge. Method: Vignettes were composed by the first author and shown to 50 senior clinicians and 50 members of the Victorian Mental Health Review Board who were asked to indicate whether or not they would discharge the described patients from their current CTO and to justify their decision. Participants were also asked to comment on the usefulness of clinical guidelines which the first author developed to assist decision-making in this area. Results: In the main, there was concordance between the ratings of clinicians and VMHRB members. The guidelines were perceived to be useful. Conclusions: The agreement between clinicians and MHRB members suggests that the Mental Health Act in this area is clinically meaningful and able to be applied reliably.
What, With What, and to Whom: The Limits of Psychiatry
Authors: Ratcliff Eric 
Published: March 2003

Objective: To identify some general principles for use in deciding what is psychiatry and what is not. Method: An overview of matters referred to the Clinical Practice Advisory Committee of the Royal Australian and New Zealand College of Psychiatrists. Results: Three domains of psychiatric practice are identified: competence, ethics and performance. A number of quasi-paradoxical dichotomies in the nature of psychiatry have emerged: doctor-specialist, scientist-clinician, humane-commercial. These are not exhaustive. Conclusion: Some useful generalisations can be made about the limits of acceptable psychiatric practice but, within these, there is a need for further investigation of the realities of practice. A pilot study of clinicians' opinions is proposed.
What Causes More Destruction, AIDS or AID? Psychiatry in Zambia
Authors: Gleisner John 
Published: March 2003

Objective: To describe the state of mental health services in Zambia. Conclusions: Mental health services in Zambia are in a dreadful state, partly brought about by being afforded a low priority rating, in turn through a miscalculation. Richer countries may be in a position to help remedy Zambia's problems in this area.
Is there a Place for Psychoanalysis in Public Mental Health?
Authors: Curnow Rick 
Published: March 2003

Objective: To describe a programme of theoretical and clinical seminars, and to discuss the benefit of introducing a psychoanalyst's perspective to the supervisory process in psychiatric training. Conclusions: Vignettes of work from seminars provide examples that explain how the teaching that occurs is at the level of understanding of the countertransference experience, rather than at the level of psychoanalytic formulations. An application of the psychoanalytic concept of containment is found to be helpful to the trainees in understanding patients, particularly those with borderline personality disorder.
The Phenomenon of Collocation: a Local Solution to an Australian Problem
Authors: Taylor Andrea , Bernardi Elsa 
Published: March 2003

Objective: To describe the phenomenon of collocation in a metropolitan mental health service. Conclusions: Collocation is the locating of private and public mental health sectors in a joint working relationship. In the context of increasing numbers of clients referred to a public Community Mental Health Service, a restricted ability to refer clients to other practitioners, a limited number of medical officer hours available and a new purpose built premises with spare rooms, the Service investigated and implemented a model of collocation. This in effect locates private and public psychiatrists together, working from the same premises. Collocation has been a modest local initiative increasing cooperation between the public and private sector and partially increasing consumer choice and private psychiatrist availability
A Right Royal ‘Hoo-Ha’: Why we Should Not Change the College Name
Authors: Kisely Stephen 
Published: March 2003

Objective: To identify some reasons why the College should not change its name. Conclusions: A change of name is premature, irrelevant and contrary to the will of Australian voters. It ignores the experience of New Zealand, Ireland and Canada and confuses a recognition of the College's standing with ties to the monarchy. More useful reforms to the College would include the right to directly elect our President and Executive.
Radiology of the nasopharynx: Pictorial essay
Authors: Chong Vincent Fh , Fan Yoke‐Fun 
Published: March 2003

SUMMARYThe nasopharynx, located just below the central skull base, is a difficult area to evaluate clinically. Endoscopic examination provides useful information but cannot delineate submucosal disease. Benign lesions of the nasopharynx are relatively uncommon. They include Thornwaldt cyst, juvenile angiofibroma, haemangioma, haemangiopericytoma, Kimura’s disease, branchial cleft cyst, oncocytoma, amyloidoma, and non‐ossifying fibromyxoid tumours. The most common malignant lesions are carcinomas and lymphomas. Other malignant neoplasms such as adenocystic carcinomas are rarely seen. The purpose of the present pictorial review is to highlight the salient normal anatomy of the nasopharynx and the spectrum of pathological anatomy.
Acceptable levels of digital image compression in chest radiology
Authors: Smith I , Roszkowski A , Slaughter R , Sterling D 
Published: March 2003

SUMMARYThe introduction of picture archival and communications systems (PACS) and teleradiology has prompted an examination of techniques that optimize the storage capacity and speed of digital storage and distribution networks. The general acceptance of the move to replace conventional screen‐film capture with computed radiography (CR) is an indication that clinicians within the radiology community are willing to accept images that have been ‘compressed’. The question to be answered, therefore, is what level of compression is acceptable. The purpose of the present study is to provide an assessment of the ability of a group of imaging professionals to determine whether an image has been compressed. To undertake this study a single mobile chest image, selected for the presence of some subtle pathology in the form of a number of septal lines in both costphrenic angles, was compressed to levels of 10:1, 20:1 and 30:1. These images were randomly ordered and shown to the observers for interpretation. Analysis of the responses indicates that in general it was not possible to distinguish the original image from its compressed counterparts. Furthermore, a preference appeared to be shown for images that have undergone low levels of compression. This preference can most likely be attributed to the ‘de‐noising’ effect of the compression algorithm at low levels.
Acquired immunodeficiency syndrome‐related primary cerebral lymphoma: Response to irradiation
Authors: Khoo Vs , Wilson Pc , Sexton Mj , Liew Kh 
Published: March 2003

SUMMARYAcquired immunodeficiency syndrome‐related primary cerebral lymphoma (AIDS‐PCL) is uncommon. Fourteen cases of presumed AIDS‐PCL between 1986 and 1995 were reviewed retrospectively in order to characterize the natural history, and the response to radiotherapy. The median age was 38 years (range 24–65). The median interval between seropositive diagnosis of HIV and AIDS‐PCL was 28 months (range 5–113). The median duration of symptoms was 2 weeks (range 0.2–12). At presentation, the Eastern Cooperative Oncology Group performance status (PS) was PS1 (2/14 patients), PS2 (6/14) and PS3 (6/14). The symptoms and signs were non‐specific and depended on the site and extent of cerebral involvement. There was no characteristic pattern of brain imaging in terms of size, number, location or pattern of contrast enhancement of the cerebral lesions. Nine patients received various fractionation‐dose schedules (range 8–50 Gy). Complete and partial responses were seen in 2/9 and 3/9 cases, respectively. Clinical stabilization of neurological symptoms was noted in 3/9 cases and disease progression in 1/9. The median survival times (MST) from presentation for irradiated and non‐irradiated patients were 9.3 and 2.1 weeks, respectively (range 0.9–43.1). Although patient selection introduced bias, there appears to be a modest improvement in MST for treated patients. The MST with radiotherapy alone remains poor, but radiotherapy may provide palliation. For some selected patients, a prolonged response is possible.
Clinical application of in vitro radiohypersensitivity testing
Authors: Christie David , Lavin Martin , Tan Leong 
Published: March 2003

SUMMARYThe cases of two patients who suffered severe late effects of radiotherapy are reported; each tested positive for elevated in vitro radiohypersensitivity (RHS) but negative for the ataxia–telangiectasia mutation. The first patient underwent surgery and postoperative radiotherapy for lung cancer and subsequently developed fatal myelopathy. The second patient underwent triple‐modality therapy for cervical cancer and suffered highly symptomatic pelvic fibrosis. The value of the testing was that it increased the confidence in the diagnosis of radiation effects and enabled suitable treatment to proceed. An increasing role for clinical RHS testing is anticipated.
Alternative uses for the haemostatic vascular sheath
Authors: Snow Thomas M , O’Connell Timothy B 
Published: March 2003

SUMMARYThe haemostatic vascular sheath has several non‐vascular applications in interventional radiology. It is used to preserve access to an organ (i.e. contrast can be introduced without removing catheters and guidewires). There are also advantages regarding patient comfort and safety. Three such applications are described.
Use of digitally reconstructed radiographs in radiotherapy treatment planning and verification
Authors: Yang Charles , Guiney Michael , Hughes Peter , Leung Samuel , Liew Kuen Hoe , Matar James , Quong George 
Published: March 2003

SUMMARYThe authors present 3 years of experience in using digitally reconstructed radiographs (DRR) for radiotherapy planning and verification. Comparison is made with simulation film (SF), to illustrate the advantages of DRR over SF. Emphasis is placed on using the appropriate equipment and applying the correct technique. A brief discourse on the principle of CT imaging is presented to illustrate the operation of CT software and optimization of image display for axial slices and DRR. Emphasis is placed on the application of clinical knowledge to enhance the usefulness, as well as the technical quality, of the DRR. Illustrative examples are given.
Soft tissue uptake on 99mTc methylene diphosphonate bone scan imaging: Pictorial review
Authors: Kaye J , Hayward Mike 
Published: March 2003

SUMMARY 99mTechnetium methylene diphosphonate (MDP) bone isotope may accumulate in many extra‐osseous sites due to a variety of both benign and malignant conditions. This finding on a bone scan can be crucial to the diagnosis and may not be apparent in other imaging or the clinical evaluation of the patient. We present a pictorial review sampling some of the many causes of extra‐osseous 99mTc MDP accumulation.
Parotid lymph‐node metastases from cutaneous squamous‐cell carcinomas: Treatment outcome and prognostic factors following surgery and adjuvant radiotherapy
Authors: Chua Margaret S‐T , Veness Michael J , Morgan Gary , Shakespeare Thomas , Hehir Andrew , Gebski Val , Cakir Burcu , Tiver Kenneth W 
Published: March 2003

SUMMARYAustralia has the highest incidence of cutaneous squamous cell carcinoma (SCC) in the world. The majority of lesions occur in the head and neck, and regional lymph‐node metastases from cutaneous SCCs, though uncommon, reflect an aggressive manifestation. Surgery and adjuvant radiotherapy are currently considered best practice. Fifty‐two eligible patients during 1980–1997 were identified in a retrospective review of patients treated within the department of Radiation Oncology, Westmead Hospital, Sydney. Relevant data were extracted from the files, referring clinicians and the New South Wales Cancer Council. The median age at diagnosis was 63 years and the majority were men (87%). Unfavourable pathological features were present in many of the patients. Only extranodal spread (P = 0.02) was identified as an independent predictor for locoregional recurrence on multivariate analysis. The cumulative locoregional recurrence rates were 28 and 45% at 2 and 5 years, respectively. The 5‐year cause‐specific survival rate in this study was 65%. We conclude that parotid lymph‐node metastases from cutaneous SCCs of the head and neck are associated with a high rate of locoregional recurrence and cause‐specific mortality despite surgery and adjuvant radiotherapy. The role of altered fractionation after surgery as a means to further enhance locoregional control warrants further investigation.
Three‐dimensional gadolinium‐enhanced magnetic resonance angiography of pulmonary arteriovenous malformation
Authors: Puvaneswary M 
Published: March 2003

SUMMARYPulmonary arteriovenous malformations (AVMs) are rare vascular malformations of the lung. Although most patients are asymptomatic, AVMs can bleed and result in haemoptysis and haemothorax. We describes a case of pulmonary AVMs in a patient with Osler–Weber–Rendu syndrome with 3‐D contrast‐enhanced MR angiography. Magnetic resonance angiography provided accurately and non‐invasively the number and size of the feeding arteries and draining veins.
ROLE OF ANDROGENS IN MEDIATING HYPERTENSION AND RENAL INJURY
Authors: Reckelhoff Jane F , Granger Joey P 
Published: March 2003

1. Men are generally at greater risk for cardiovascular disease than are women, particularly with regard to enhanced progression of hypertension and loss of renal function. Despite these gender differences in the progression of hypertension and renal disease in humans and animals, the mechanisms responsible are unknown.2. Castration in males has been shown to slow the progression of hypertension and ameliorate the loss in renal function. When serum testosterone was measured in the developing male spontaneously hypertensive rat (SHR), the peak serum testosterone level at 12 weeks coincided with the time when differences in systolic blood pressure could be measured between intact male SHR and females or castrated male SHR. Ovariectomy does not affect blood pressure in female SHR but testosterone treatment of ovariectomized females for 5 weeks results in exacerbation of hypertension almost to the level found in intact male SHR. These data strongly suggest a role for androgens in mediating the gender differences in hypertension.3. The mechanisms by which androgens could increase blood pressure are not known. We have recently shown that, at comparable renal perfusion pressures, there is a hypertensive shift in the pressure–natriuresis relationship in male SHR compared with females or castrated male SHR. Testosterone treatment of ovariectomized female SHR also causes a rightward shift in the pressure–natriuresis relationship.4. We hypothesize that androgens increase arterial pressure by causing a hypertensive shift in the pressure–natriuresis relationship, either by having a direct effect to increase proximal tubular reabsorption or by activation of the renin–angiotensin system. We also hypothesize that the enhanced proximal tubular reabsorption leads to a tubuloglomerular feedback‐mediated afferent vasodilation, which, in combination with the increase in arterial pressure, results in glomerular hypertension and renal injury.
EFFECT OF CHRONIC K+ DEFICIENCY ON CONTRACTILE PROPERTIES OF SOLEUS MUSCLE IN RATS: EVIDENCE OF SEX DIFFERENCES
Authors: Piyachaturawat Pawinee , Muchimapura Suparporn , Sophasan Samaisukh , Jariyawat Surawat , Pholpramool Chumpol , Satayavivad Jutamaad , Endou Hitoshi 
Published: March 2003

1. Alterations in skeletal muscle function of chronically K+‐depleted male and female rats were investigated in isolated soleus muscles.2. By 16 weeks K+ deficiency, plasma K+ concentrations in both male and female rats were reduced to approximately 2 mEq/L, which was accompanied by an approximate 50% reduction in muscle K+ content and a marked increase in muscle Na+ content. These changes were similar in both males and females.3. Plasma creatine phosphokinase activity progressively increased with time in K+‐depleted male rats, whereas only a slight increase was observed in female rats.4. Maximum isometric twitch tension (Pt) and tetanic tension (Po) of K+‐depleted soleus muscles from male rats was markedly suppressed; this was not seen for soleus muscles obtained from female rats.5. After exposure to insulin in low‐K+ solution, the contractile tension of soleus from the K+‐depleted male rats was suppressed to a greater extent.6. All alterations in muscle function during chronic K+ depletion were restored to normal after 2 weeks K+ repletion.7. The results suggest that there is a preponderance for male over female rats in developing alterations in skeletal muscle function during chronic K+ deficiency. The changes may be associated with abnormalities of muscle membrane permeability and cellular function.
PHARMACOLOGICAL PROFILE OF ORALLY ADMINISTERED YM087, A VASOPRESSIN ANTAGONIST, IN CONSCIOUS RATS
Authors: Tomura Yuichi , Tahara Atsuo , Tsukada Junko , Yatsu Takeyuki , Uchida Wataru , Honda Yuichi Iizumi and Kazuo 
Published: March 2003

1. YM087 is a newly synthesized non‐peptide arginine vasopressin (AVP) antagonist that shows high affinity for both V1A and V2 receptors. In the present study, the V1A and V2 receptor antagonist effects of orally administered YM087 were assessed in conscious rats.2. In conscious rats, orally administered YM087 (0.1, 0.3 and 1.0 mg/kg) did not affect basal blood pressure, but YM087 dose‐dependently inhibited 30 mU/kg, i.v., AVP‐induced pressor responses. This inhibition lasted for over 8 h following the oral administration of the highest dose of YM087 (1 mg/kg).3. In rats deprived of water and food for 16–18 h, oral administration of YM087 (0.1, 0.3, 1 and 3 mg/kg) dose‐dependently increased urine volume and reduced urine osmolality, with associated increases in urinary sodium and potassium excretion. However, these increases in electrolyte excretion were lower than those seen at comparable diuretic doses of furosemide (3, 10, 30 and 100 mg/kg, p.o.).4. Oral administration of YM087 (0.3, 1 and 3 mg/kg) produced a dose‐dependent increase in urine volume in rats allowed free access to water, with the diuretic effect peaking 2–4 h post‐dosing at all dose levels. The diuretic effect of YM087 was sustained 8–10 h after a dose of 3 mg/kg; this is in contrast with the transient diuresis seen after furosemide (100 mg/kg, p.o.) dosing.5. The present results demonstrate that YM087 is an orally active AVP antagonist with potent and long‐lasting effects. YM087 suppressed V1A receptor‐mediated pressor responses to AVP with minimal effects on basal haemodynamics and exerted a diuretic effect without increased electrolyte excretion by inhibiting V2 receptor‐mediated water reabsorption.