Meldgaardgroth4485
The Mark Sheldon Remote Mental Health Team provides psychiatric services to 29 communities in very remote Central Australia. This study evaluated Mark Sheldon Remote Mental Health Team patient demographics, diagnoses and clinical management.
A retrospective cross-sectional review was performed for January 2020. ABT-199 cost Variables included age, sex, Indigenous status, diagnosis, legal status, medication class and route of administration.
A total of 180 patients were identified (85.6% Indigenous, 53.3% male). Schizophrenia and delusional disorders were most common (41.1%). A small proportion of patients (2.8%) were involuntary. Psychotropic medication was commonly prescribed (77.4%) with a low threshold for anti-psychotic depot use (51.5%). Oral medication rates varied according to class.
This study provided insights into the demographic and clinical profile of a unique population. The findings will help to optimise patient management in very remote Central Australia and serve as a foundation for similar evaluations and comparisons with other remote psychiatric services.
This study provided insights into the demographic and clinical profile of a unique population. The findings will help to optimise patient management in very remote Central Australia and serve as a foundation for similar evaluations and comparisons with other remote psychiatric services.
To gain an understanding of how women with gestational diabetes perceive their illness, and whether depressive/anxiety symptoms and/or psychological distress influence these illness perceptions.
A cross-sectional study was conducted with 159 pregnant women aged 18-44 attending gestational diabetes clinics. Participants completed a questionnaire, which included the Edinburgh Depression Scale (EDS), Kessler 10-item Psychological Distress Scale (K-10), Brief Illness Perception Questionnaire (BIPQ), and psychiatric/general health items. Multiple regression was used to explore the relationship between EDS (total and anxiety subscale) scores and BIPQ scores, as well as between K-10 (total and anxiety subscale) scores and BIPQ scores.
Regression analysis revealed a positive association between EDS total/anxiety subscale scores and BIPQ total score, as well as between K-10 total/anxiety subscale scores and BIPQ total score, controlling for potentially confounding variables. There was a strong positive correlation between EDS total score and K-10 total score. The most frequently expressed concern about GDM was an adverse effect on their baby's health. A poor diet was the most frequently reported perceived 'cause' of GDM.
Greater severity of depressive and anxiety symptoms, and psychological distress, is associated with more negative illness perceptions of GDM in pregnant women.
Greater severity of depressive and anxiety symptoms, and psychological distress, is associated with more negative illness perceptions of GDM in pregnant women.
To identify all past publications from
with subject matter particularly relevant for trainees. The results of such a search could then be collated into an easily accessible resource available to trainees and their supervisors.
An electronic search of the journal's back catalogue was conducted.
Eighty-seven articles published on subjects particularly relevant for trainees were discovered from within
. In particular, multiple useful resources were identified on the topics of the scholarly project and formulation skills.
has published a wealth of literature that is likely to be of significant benefit for trainees as they work their way through the Royal Australian and New Zealand College of Psychiatrists training programme.
Australasian Psychiatry has published a wealth of literature that is likely to be of significant benefit for trainees as they work their way through the Royal Australian and New Zealand College of Psychiatrists training programme.
The aims of this study were to explore the knowledge, attitudes, confidence and practices of Australian psychiatrists and psychiatry registrars with regard to smoking cessation with their patients and to promote clinical practice reflection and re-framing.
A mixed-methods questionnaire was developed. Interviews were conducted via telephone or face-to-face utilising participatory action research principles. Qualitative data were de-identified and analysed following a reflexive thematic approach.
The questionnaire was completed with 15 participants. The majority worked in the public health sector and agreed that smoking cessation could be used as a clinical tool across mental health services. However, nearly all of the participants reported being unfamiliar with the latest literature. Only one-third of participants reported having had received formal training in smoking cessation. Overwhelmingly, more training was reported as necessary and welcomed by participants.
Our study has identified gaps in psychiatrists' and psychiatry registrars' knowledge and confidence regarding the promotion, initiation and oversight of smoking cessation strategies for patients. It's important that psychiatrists lead the way in re-framing and engaging with this issue, and consider smoking cessation as a tool that can improve mental health outcomes. A review of existing Australian policies, guidelines and training is recommended.
Our study has identified gaps in psychiatrists' and psychiatry registrars' knowledge and confidence regarding the promotion, initiation and oversight of smoking cessation strategies for patients. It's important that psychiatrists lead the way in re-framing and engaging with this issue, and consider smoking cessation as a tool that can improve mental health outcomes. A review of existing Australian policies, guidelines and training is recommended.
To describe an approach to support Royal Australian and New Zealand College of Psychiatrists (RANZCP) trainees achieve success in the Modified Essay Question (MEQ) examination.
Synthesis of the opinion of the authorship encompassing a range of relevant stakeholders, supported by a qualitative content analysis of published examination feedback from the RANZCP Committee for Examinations.
In approaching the MEQs, candidates are encouraged to (1) read the scenario and questions carefully, (2) answer questions broadly and with justification, (3) manage time effectively, (4) undertake deliberate practice in preparation, and (5) 'check your own pulse' (i.e. limit the detrimental impact of anxiety on performance).
Preparing for the MEQ examination through deliberate practice will help candidates become competent psychiatrists. The ability to critically think in clinical practice, a key focus of this assessment, is an essential skill all psychiatrists need to develop and maintain.
Preparing for the MEQ examination through deliberate practice will help candidates become competent psychiatrists. The ability to critically think in clinical practice, a key focus of this assessment, is an essential skill all psychiatrists need to develop and maintain.
To increase awareness of practising clinicians and researchers to the phenomenological distinctions between visual hallucinations and trauma-based, dissociative, visual re-experiencing phenomena seen in psychiatric disease.
The experience of visual hallucinations is not exclusive to psychotic disorders in psychiatry. Different forms of experiences that resemble visual hallucinations may occur in patients with a trauma background and may potentially affect diagnosis. Given the paucity of literature around the subject, it is imperative that further research aims to characterise the distinction between visual hallucinations in psychosis and visual phenomena associated with trauma.
The experience of visual hallucinations is not exclusive to psychotic disorders in psychiatry. Different forms of experiences that resemble visual hallucinations may occur in patients with a trauma background and may potentially affect diagnosis. Given the paucity of literature around the subject, it is imperative that further research aims to characterise the distinction between visual hallucinations in psychosis and visual phenomena associated with trauma.
During robotic lobectomy (RL), the surgeon can elect to use either robotic staplers or hand-held laparoscopic staplers. It is assumed that either will result in similar outcomes, while robotic staplers increase cost. We sought to compare perioperative outcomes and costs between RL cases that utilized robotic staplers versus hand-held staplers in real-world clinical practice.
Patients who underwent an elective RL between October 2015 and December 2017 were identified in the Premier Hospital Perspective Database. Propensity score matching (PSM) analysis was performed to compare perioperative outcomes, healthcare resource utilization, and costs between cases using robotic staplers and hand-held staplers during RL.
In the PSM analysis, RL cases that fully utilized robotic staplers compared to hand-held staplers were associated with significantly lower risks of developing bleeding (5.6% vs 9.8%,
= 0.03) and conversion to open surgery (0.3% vs 5.9%,
= 0.004). Additionally, in a multivariable regression
Endoscopic submucosal excavation (ESE) has been established as an effective method for removal of gastric submucosal tumors (SMTs). The aim of the present study was to explore risk factors for technical difficulties in ESE.
In this retrospective study, we collected clinical data from patients who underwent ESE for gastric SMTs. Difficult ESE was defined as a procedure time ≥90 minutes, piecemeal resection, and/or occurrence of major adverse events. Univariate and multivariate analyses were performed to explore the risk factors for a difficult ESE.
ESE was successfully performed in 96.5% (195/202) of patients from April 2011 to December 2019. The average tumor size was 17.41 mm, and
resection was achieved in 97.4% of patients (190/195). Five patients (2.56%, 5/195) had complications, including two with delayed bleeding, two with fever, and one with chest pain accompanying ST-T changes in an electrocardiogram. Twenty-four patients (11.88%, 24/202) had a difficult ESE. Logistic analysis showed that outgrowth behavior and an inexperienced surgeon were risk factors for a difficult ESE.
ESE may be safe and effective to treat patients with gastric SMTs. Outgrowth behavior and an inexperienced surgeon were risk factors for a difficult ESE.
ESE may be safe and effective to treat patients with gastric SMTs. Outgrowth behavior and an inexperienced surgeon were risk factors for a difficult ESE.
We compared the diagnostic values of mammography and magnetic resonance imaging (MRI) for evaluating breast masses.
We retrospectively analyzed mammography, MRI, and histopathological data for 377 patients with breast masses on mammography, including 73 benign and 304 malignant masses.
The sensitivities and negative predictive values (NPVs) were significantly higher for MRI compared with mammography for detecting breast cancer (98.4% vs. 89.8% and 87.8% vs. 46.6%, respectively). The specificity and positive predictive values (PPV) were similar for both techniques. Compared with mammography alone, mammography plus MRI improved the specificity (67.1% vs. 37.0%) and PPV (91.8% vs. 85.6%), but there was no significant difference in sensitivity or NPV. Compared with MRI alone, the combination significantly improved the specificity (67.1% vs. 49.3%), but the sensitivity (88.5% vs. 98.4%) and NPV (58.3% vs. 87.8%) were reduced, and the PPV was similar in both groups. There was no significant difference between mammography and MRI in terms of sensitivity or specificity among 81 patients with breast masses with calcification.
