Rural-urban differences in reasons for living
- Authors: McLaren, Suzanne , Hopes, Lisa
- Date: 2002
- Type: Text , Journal article
- Relation: Australian and New Zealand Journal of Psychiatry Vol. 36, no. 5 (2002), p. 688-692
- Full Text: false
- Reviewed:
- Description: Objective: The suicide rate in Australia is cause for concern, especially the increase in attempted and completed suicides in rural and regional locations. The present study examined reasons for choosing not to commit suicide as a function of residential location. Method: The study involved 655 Victorian residents from four population-based strata; urban, regional city, regional town, and rural. Results: Results from the Reasons for Living Inventory revealed significant differences as a function of residential location. Overall, residents in rural locations reported having significantly more to live for than their urban counterparts. Further analysis of six reasons for living (child, family, moral, social, coping and death-related concerns) showed a pattern whereby residents in rural locations reported having the most to live for, followed by regional residents, and urban residents who reported having the least to live for. Conclusions: These findings are in contrast to increase of suicide rates in rural areas, and highlight the need for a greater understanding of the mechanisms underlying suicidal behaviour.
- Description: 2003000088
Cardiovascular diseases and G-protein beta 3 subunit gene (GNB3) in the era of genomewide scans
- Authors: Tomaszewski, Maciej , Charchar, Fadi , Padmanabhan, Sandosh , Zukowska-Szczechowska, Ewa , Grzeszczak, Wladyslaw , Dominiczak, Anna
- Date: 2003
- Type: Text , Journal article
- Relation: Journal of Human Hypertension Vol. 17, no. 6 (2003), p. 379-380
- Full Text: false
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Is the revised trauma score still useful?
- Authors: Gabbe, Belinda , Cameron, Peter , Finch, Caroline
- Date: 2003
- Type: Text , Journal article
- Relation: ANZ Journal of Surgery Vol. 73, no. 11 (2003), p. 944-948
- Full Text: false
- Reviewed:
- Description: The revised trauma score (RTS) has been embraced by the trauma community worldwide. Although originally developed as a triage tool, the use of the RTS has since been expanded to include the prediction of outcome following traumatic injury. Through a critical review of the literature, evidence for use of the RTS is discussed along with the limitations of this commonly used tool. In summary, the RTS is a well-established predictor of mortality in trauma populations, but there is a lack of definitive evidence supporting its use as a primary triage tool and as a predictor of outcomes other than mortality. Difficulty in collecting the components of the RTS creates issues for data validity and the use of the RTS as a research tool. Although the weighted RTS has been developed to improve the prediction capacity of the RTS, studies reporting its use are few and there is debate regarding the applicability of the published coefficients for broad use. Overall, further studies are warranted to clearly establish the usefulness of the RTS as a triage tool in the field, to further evaluate the weighted version of the RTS, and to determine the ability of the RTS to predict functional outcome and quality of life. In particular, future research is needed to address these issues in Australian trauma populations.
- Description: 2003005273
Severe chronic idiopathic neutropenia in adults : Long-term follow-up of 358 patients
- Authors: Bolyard, Audrey , Pracht, G. , Schwinzer, Beate , Zeidler, Cornelia , Bonilla, Mary Ann , Boxer, Laurence , Cham, Bonnie , Donadieu, J. , Fier, Carol , Freedman, Melvin , Kannourakis, George , Kinsey, Sally , Winkelstein, J. , Alter, Blanche , Reeves, L. , Welte, Karl , Dale, David
- Date: 2003
- Type: Text , Journal article
- Relation: Blood Vol. 102, no. 11 (Nov 2003), p. 273A-273A
- Full Text: false
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- Description: C1
Strikingly low circulating CRP concentrations in ultramarathon runners independent of markers of adiposity - How low can you go?
- Authors: Tomaszewski, Maciej , Charchar, Fadi , Przybycin, Malgorzata , Crawford, Lynne , Wallace, A. Michael. , Gosek, Katarzyna , Lowe, Gordon. D. , Zukowska-Szczechowska, Ewa , Grzeszczak, Wladyslaw , Sattar, Naveed , Dominiczak, Anna
- Date: 2003
- Type: Text , Journal article
- Relation: Arteriosclerosis Thrombosis and Vascular Biology Vol. 23, no. 9 (2003), p. 1640-1644
- Full Text: false
- Reviewed:
- Description: Objective-This study was undertaken to evaluate to what extent C-reactive protein (CRP) can be reduced by exercise by examining its circulating concentrations in male ultramarathon runners and to determine if low leptin as a robust circulating marker of fat mass could account for low CRP in such men. Methods and Results-Sixty-seven male ultramarathon runners and 63 sedentary male controls of similar age and body mass index were recruited. CRP and leptin were measured by ELISA and radioimmunoassay, respectively. Median CRP concentration in lean (body mass index <25 kg/m(2)) marathon runners was less than half control median (0.4 [0.2 to 0.9] mg/L versus 0.9 [0.5 to 2.7] mg/L, P=0.0013) and, more strikingly, in nonlean runners was approximately 26% of control median (0.4 [0.3 to 0.8] mg/L versus 1.5 [0.9 to 2.5] mg/L, P=0.0002). Circulating leptin levels were also substantially lower in lean (45% less) and nonlean (63% less, both P=0.0001) ultramarathon runners. However, interleukin-6 levels were not different. Furthermore, leptin adjustment only minimally attenuated the case-control difference in CRP, suggesting that mechanisms other than fat mass reduction contribute to low concentrations of CRP in marathon runners. Conclusions-This study suggests that circulating CRP concentrations can be markedly suppressed, independently of total adiposity or indeed fat mass, by intense regular physical exercise.
Declining melatonin levels and older people. How old is old?
- Authors: Graham, D. , McLachlan, Angus
- Date: 2004
- Type: Text , Journal article
- Relation: Neuroendocrinology Letters Vol. 25, no. 6 (2004), p. 415-418
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- Description: Objectives: The purpose of this study was to investigate whether melatonin levels in older cohorts within the 'aged' population were significantly lower than in younger 'aged' individuals and hence point to a possible confound in cross-sectional studies which group individuals over 55 in one category. Setting and design: Melatonin levels of 35 North Queensland residents over 55 years of age living in an aged-care facility, a retirement village or the general community were compared across three age groups. Methods: Subjects were ten 56-65 year olds, eighteen 66-75 year olds and seven over-75 year olds. Information was obtained on sleep, awakening, medical conditions and medications, with subsequent exclusion of those with known medical conditions and/or medications. Melatonin was collected by salivary samples at 2200 hours and concentrations were determined by immunoassay. Results: Mean melatonin levels were significantly lower (p=.03) in the 'oldest' (over 75 yrs) group compared to the 'youngest' (56-65 yrs) group. Main findings: The results of this preliminary study indicate that within the older population, melatonin levels appear to decline significantly with age. Conclusions: Future studies of melatonin and ageing may benefit from a longitudinal approach, with older subjects sampled across time. Copyright © Neuroendocrinology Letters.
- Description: C1
Developing Australia's first statewide trauma registry : What are the lessons?
- Authors: Cameron, Peter , Finch, Caroline , Gabbe, Belinda , Collins, Lisa , Smith, Karen , McNeil, John
- Date: 2004
- Type: Text , Journal article
- Relation: ANZ Journal of Surgery Vol. 74, no. 6 (2004), p. 424-428
- Full Text: false
- Reviewed:
- Description: Trauma registries, like disease registries, provide an important analysis tool to assess the management of patient care. Trauma registries are well established and relatively common in the USA and have been used to change legislation, promote trauma prevention and to evaluate trauma system effectiveness. In Australia, the first truly statewide trauma registry was established in Victoria in 2001 with an estimated capture of 1700 major trauma cases annually. The Victorian State Trauma Registry, managed by the Victorian State Trauma Outcomes Registry and Monitoring (VSTORM) group, was established in response to a ministerial review of trauma and emergency services undertaken in 1997 to advise the Victorian Government on a best practice model of trauma service provision that was responsive to the particular needs of critically ill trauma patients. This taskforce recommended the establishment of a new system of care for major trauma patients in Victoria and a statewide trauma registry to monitor this new system. The development of the Victorian state trauma registry has shown that there are certain issues that must be resolved for successful implementation of any system-wide registry. This paper describes the issues faced by VSTORM in developing, implementing and maintaining a statewide trauma registry.
- Description: 2003005108
Orthologues of GSTM expressed in human kidney
- Authors: Brosnan, Julia , Tomaszewski, Maciej , McBride, Martin , Charchar, Fadi , Lacka, Beata , Zukowska-Szczechowska, Ewa , Grzeszczak, Wladyslaw , Lee, Wai , Dominiczak, Anna
- Date: 2004
- Type: Text , Journal article
- Relation: Journal of Hypertension Vol. 22, no. Suppl. 1 (2004), p. S183
- Full Text: false
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Post sedation recovery of day procedure patients : Effect of Aldrete's assessment instrument on first stage recovery
- Authors: Deans, Cecil , Flynn, Jill
- Date: 2004
- Type: Text , Journal article
- Relation: The Day Surgery Australia Journal Vol. 3, no. 1 (2004), p. 7-9
- Full Text: false
- Reviewed:
- Description: C1
- Description: 2003000859
Reliable assessment of faecal loading in older adults by abdominal radiograph
- Authors: Yates, Mark , Day, K , Mullany, J , Harvey, Jack
- Date: 2004
- Type: Text , Journal article
- Relation: Australasian Journal on Ageing Vol. 23, no. 1 (2004), p. 13-18
- Full Text: false
- Reviewed:
- Description: Objective: To produce a measure of faecal loading using plain abdominal radiograph that has both face validity and reliability. This formed part of the Ballarat Constipation Study, which aimed to establish a suite of objective assessment tools for the identification of constipation in residential and extended care facilities. Methods: A 20-point loading scale (five levels of loading × four segments of colon) was evaluated using 75 plain abdominal films of patients older than 65 years that were taken for various purposes. These were randomly ordered and five radiologists, following appropriate training, rated the films. Each was blinded to the others' responses. To establish intra-rater reliability, each radiologist rated 25 of the films for a second time. Results: Reliability was assessed using Q-type correlations for raw scores and Cohen's kappa for dichotomised scores. Inter-rater correlations ranged from 0.57 confidence interval (CI) (0.38, 0.72) to 0.83 CI (0.74, 0.90). Inter-rater kappas ranged from 0.28 CI (0.06, 0.50) to 0.72 CI (0.50, 0.94). Intra-rater correlations ranged from 0.68 CI (0.38, 0.84) to 0.92 CI (0.82, 0.96) and intra-rater kappas ranged from 0.26 CI (−0.08, 0.60) to 0.90 CI (0.70, 0.99). Conclusion: This method of assessing and reporting faecal loading in older people has an acceptable level of reliability for four of the five radiologists. The scale was considered appropriate for use in the larger study, where its validity was tested.
- Description: C1
- Description: 2003007688
- Description: 2003000881
What works for therapists conducting family meetings : Treatment integrity in family-focused grief therapy during palliative care and bereavement
- Authors: Chan, Eunice , O'Neill, Imogen , McKenzie, Maria , Love, Anthony , Kissane, David
- Date: 2004
- Type: Text , Journal article
- Relation: Journal of Pain and Symptom Management Vol. 27, no. 6 (2004), p. 502-512
- Full Text: false
- Reviewed:
- Description: The purpose of this study was to evaluate the treatment integrity of Family-focused Grief Therapy (FFGT), a preventive intervention designed for families at high risk of poor functioning during palliative care and bereavement. From the 81 families participating in a randomized controlled trial (53 assigned to therapy), 28 were randomly selected for this study of treatment fidelity using the ITGT integrity measure. A total of 109 family sessions were appraised. This represented a review of 62 % of treated families, 38 % of total therapy sessions, and 87% of the 15 participating therapists. Weighted mean percentage occurences therapist behaviors permitted trends in therapy application to be observed. Inter-rater reliability using the FFGT integrity measure was satisfactory, with 88 % overall agreement. Eighty-six percent of therapists adhered faithfully to core elements of the model. Therapist competence was evidenced by a strong therapeutic alliance (94 %), affirmation of family strengths in over 90%, and focus on agreed themes in 76 % of sessions. Therapists averaged 10 grief-related questions per session, 7 on communication-related issues during assessment, 7 on conflict late in therapy, and 4 on cohesiveness across the course of therapy. Consistent application of FFGT, with attention to its low-key themes of family communication, cohesiveness, conflict resolution, and shared grief has been demonstrated. The model is generalizable when applied by family therapists. (C) 2004 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
Epidemiology of scalds in vulnerable groups in New South Wales, Australia, 1998/1999 to 2002/2003
- Authors: Boufous, Soufiane , Finch, Caroline
- Date: 2005
- Type: Text , Journal article
- Relation: Journal of Burn Care & Research Vol. 26, no. 4 (2005), p. 320-326
- Full Text: false
- Reviewed:
- Description: In this study, the recently introduced International Classification of Disease, 10th revision, code for hot tap water scalds was used to examine the epidemiology of these cases and other scalds injuries in children younger than 5 years of age and adults aged 65 years and older. Although the trunk was the most common area in which scalds occurred, young children were more likely to sustain head and neck scalds (15%, 95% confidence interval 10.8-18.3) because of hot tap water than older people (2%, 95% confidence interval 0.2-4.4). Hospital separation rates for hot water scalds decreased significantly during the study period in both boys ([chi]2 = 15.6, df = 1, P < .001) and girls ([chi]2 = 5.6, df = 1, P < .001) who were younger than 5 years of age, which might be attributable to the introduction of new standards regulating the provision of hot tap water to various buildings. The severity of scalds cases did not seem to be correlated with the length of hospital stay, which remained unchanged in both age groups.
- Description: 2003005000
Managing panic disorder in general practice
- Authors: Austin, David , Blashki, Grant , Barton, David , Klein, Britt
- Date: 2005
- Type: Text , Journal article
- Relation: Australian Family Physician Vol. 34, no. 7 (2005), p. 563-571
- Full Text: false
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- Description: BACKGROUND: Panic disorder (PD) is common in the community and contributes to significant distress and decreased quality of life for people who suffer from it. Most people with PD will present in the first instance to their general practitioner or hospital emergency department for assistance, often with a focus on somatic symptoms and concerns. OBJECTIVE: This article aims to assist the GP to manage this group of patients by providing an outline of aetiology, approaches to assessment, and common management strategies. DISCUSSION Although GPs have an important role to play in ruling out any causal organic basis for panic symptoms, the diagnosis of PD can usually be made as a positive diagnosis on the basis of careful history taking. Thorough and empathic education is a vital step in management. The prognosis for PD can be improved by lifestyle changes, specific psychological techniques, and the judicious use of pharmacotherapy.
Access to stroke care units in Australian public hospitals : Facts and temporal progress
- Authors: Cadilhac, Dominique , Lalor, Erin , Pearce, Dora , Levi, Christopher , Donnan, Geoffrey
- Date: 2006
- Type: Text , Journal article
- Relation: Internal Medicine Journal Vol. 36, no. 11 (2006), p. 700-704
- Full Text: false
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- Description: Background: There is level I evidence that management of stroke patients in stroke units (SU) improves outcomes (death and institutionalization) by approximately 20%. In Australia, there is uncertainty as to the proportion of incident cases that have access to SU. Recent national and State-based policy initiatives to increase access to SU have been taken. However, objective evidence related to SU implementation progress is lacking. The aims of the study were (i) to determine the number of SU in Australian acute public hospitals in 2004, (ii) to describe hospitals according to national SU policy criteria and (iii) to compare results to the 1999 survey to track progress. Methods: The method used in the study was a cross-sectional, postal survey technique. The participants were clinical representatives considered appropriate to describe stroke care within survey hospitals. Results: The outcome of the study was presence of a SU according to an accepted definition. Response rate was 261/301 (87%). Sixty-one sites (23%) had either a SU and/or a dedicated stroke team. Fifty sites claimed to have a SU (19%). New South Wales with 23 had the most number of SU. Based on policy criteria, up to 64 sites could have a SU. In 1999, there were 35 public hospitals with a SU. Conclusion: Access to SU in Australian public hospitals remains low compared with other countries (Sweden, 70%). Implementation strategies supported by appropriate health policy to improve access are needed. © 2006 Royal Australasian College of Physicians.
Depression following acute coronary syndromes : A comparison between the Cardiac Depression Scale and the Beck Depression Inventory II
- Authors: Di Benedetto, Mirella , Lindner, Helen , Hare, David , Kent, Stephen
- Date: 2006
- Type: Text , Journal article
- Relation: Journal of Psychosomatic Research Vol. 60, no. 1 (2006), p. 13-20
- Full Text: false
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- Description: Objective: This study compared the Cardiac Depression Scale (CDS) and the Beck Depression Inventory II (BDI-II). Method: Depression was assessed in 81 participants, 2 weeks post-ACS, using the BDI-II and the Composite International Diagnostic Interview. Results: The CDS had a strong concurrent validity with the BDI-II (r=.69). Cross-validation of the BDI-II and the CDS with the structured interview demonstrated the ability of both measures to detect severe symptoms. More patients were classified as depressed using the CDS. The CDS also had a significantly higher correlation with a trait anxiety measure than the BDI-II did. Conclusion: The CDS is a more suitable scale for assessing the less severe depressive symptoms typically seen in a cardiac population.
- Description: 2003003383
Do GPs use electronic mental health resources? A qualitative study
- Authors: Austin, David , Pier, Ciaran , Mitchell, Joanna , Schattner, Peter , Wade, Victoria , Pierce, David , Klein, Britt
- Date: 2006
- Type: Text , Journal article
- Relation: Australian Family Physician Vol. 35, no. 5 (2006), p. 365-366
- Full Text: false
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- Description: BACKGROUND: The Better Outcomes in Mental Health Care (BOMHC) initiative encourages general practitioners to use electronic mental health resources (EMHRs) during consultation with patients requiring psychological assistance. However, there is little data on GPs' acceptance and use of EMHRs. METHOD: Semistructured interviews were conducted with 27 GPs to determine their attitude toward EMHRs, and their use during consultation with patients. RESULTS: Few GPs reported frequently using EMHRs in consultation. Identified barriers to use included lack of familiarity with information technology, and insufficient knowledge of available resources. Identified advantages of electronic resources included high patient acceptance, time efficiency, and improved quality of information. DISCUSSION: General practitioners recognise several advantages of utilising electronic resources for managing patients with mental illness. However, GPs are not sufficiently familiar with electronic resources to use them effectively. This could be overcome by education.
Help-seeking by rural residents for mental health problems: The importance of agrarian values
- Authors: Judd, Fiona , Jackson, Henry , Komiti, Angela , Murray, Greg , Fraser, Caitlin , Grieve, Aaron , Gomez, Rapson
- Date: 2006
- Type: Text , Journal article
- Relation: Australian and New Zealand Journal of Psychiatry Vol. 40, no. 9 (2006), p. 769-776
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- Description: Objective: To examine the role of stoicism, self-efficacy and perceived stigma in predicting help-seeking by rural residents, for mental health problems. Method: A cross-sectional community survey was conducted with a sample of 467 rural residents (58% female), who completed self-report questionnaires assessing current levels of symptomatology, disability, perceived stigma, self-efficacy, stoicism, attitudes towards and experience of seeking help for psychological problems. Results: Overall, 7.6% (n = 129) of respondents had sought help from a general practitioner and/or mental health professional for psychological problems or a mental health issue. More women than men reported having sought such help. Lifetime help-seeking for a psychological problem or mental health issue was positively associated with higher levels of distress and lower levels of stoicism and, to a lesser extent, lower levels of self-efficacy. Conclusions: Efforts to improve help-seeking by rural residents for mental health problems should focus on understanding and addressing attitudes, such as stoicism which act as barriers to help-seeking. © 2006 The Authors; Journal compilation © 2006 The Royal Australian and New Zealand College of Psychiatrists.
- Description: C1
- Description: 2003002045
Modification of the body sensations interpretation questionnaire (BSIQ-M) : Validity and reliability
- Authors: Austin, David , Richards, Jeffrey , Klein, Britt
- Date: 2006
- Type: Text , Journal article
- Relation: Journal of Anxiety Disorders Vol. 20, no. 2 (2006), p. 237-251
- Full Text: false
- Reviewed:
- Description: The catastrophic misinterpretation model [Behav. Res. Ther. 24 (1986) 461-470] proposes that panic attacks result from misinterpretation of interoceptive stimuli as precursors to physical or psychological emergency. Inconclusive evidence for the model may be partly explained by limitations of the questionnaires developed to measure catastrophic misinterpretation. For example, the Body Sensations Interpretation Questionnaire (BSIQ) is unable to clarify whether anxiety-related interpretations of ambiguous interoceptive stimuli represent catastrophic misinterpretations or responses masking feared outcomes (e.g., heart failure). Additionally, it lacks items relating to several DSM-IV criteria for panic, thereby limiting content validity. Reliability is also potentially compromised due to experimenter-coding of participant-generated responses. A modified form of the BSIQ was developed to address these limitations and evaluated with non-anxious controls (n=34) and people with panic disorder (n=38). The revised questionnaire demonstrated good to excellent internal consistency, inter-rater reliability, and construct validity and is a useful development of the BSIQ.
Mother-infant psychotherapy and perinatal psychiatry : Current clinical practice and future directions
- Authors: Galbally, Megan , Lewis, Andrew , Snellen, Martien , Paul, Campbell , Szego, Klara , Trauer, Tom
- Date: 2006
- Type: Text , Journal article
- Relation: Australasian Psychiatry Vol. 14, no. 4 (2006), p. 384-389
- Full Text: false
- Reviewed:
- Description: Objective: To explore trends in the practice of mother-infant psychotherapy among perinatal psychiatry clinicians based in Melbourne. Methods: A cross-sectional survey with a purpose designed self-report questionnaire was used to assess the attitudes and practices of 47 perinatal and infant psychiatry clinicians in their use and understanding of mother-infant psychotherapy. Results: Seventy per cent of clinicians in this field of psychotherapy who responded to the questionnaire subscribe to a psychodynamic model, although cognitive behavioural models are also used. The interventions were mostly used in conjunction with other interventions, would be more accurately described as 'parent-infant psychotherapy', and non-psychiatrists in the area tended to be more likely to be formally trained in psychotherapy, but only 4% were formally trained in specific mother-infant psychotherapy. There was a unanimous request for further clinical training in this area. Conclusions: The emerging field of perinatal psychiatry needs to develop coherent therapeutic models and conduct outcome trials on specific interventions. Specific trainings in these models, in assessment and in diagnostic frameworks are required to enhance clinical efficacy, for research and service development purposes. © 2006 Royal Australian and New Zealand College of Psychiatrists.
- Description: C1
- Description: 2003001670
Overweight and obesity prevalence in children based on 6- or 12-month IOTF cut-points : Does interval size matter?
- Authors: Kremer, Peter , Bell, Andrew , Sanigorski, Andrea , Swinburn, Boyd
- Date: 2006
- Type: Text , Journal article
- Relation: International Journal of Obesity Vol. 30, no. 4 (2006), p. 603-605
- Full Text: false
- Reviewed:
- Description: 2003002882