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Biomedical subjects

C Tennant

Publications and source records attributed to C Tennant.

At least 37 records · Page 2Linked to original sources
PubMed1998

Infants conceived using in-vitro fertilization do not over-utilize health care resources after the neonatal period.

Health outcomes during the first year for 95 infants born following in-vitro fertilization (IVF) were compared with those of 79 naturally conceived controls whose mothers were of identical parity and similar age. Primigravid women were enrolled prospectively at 30 weeks gestation, perinatal and neonatal data were collected during pregnancy and following birth, and details of health care resource use were obtained from mothers at 4 and 12 months. Median (range) number of medical problems during the first year tended to be less for IVF infants, 4 (0-41) versus 5 (0-12) (P = 0.07), whilst total number of visits to health care workers was similar for IVF and control infants, 19 (2-47) versus 19 (1-47). IVF infants were more likely to have an excessive number of visits to Early Childhood Health Care Centres [odds ratio (OR; 95% confidence interval, CI) = 2.44 (1.11-5.56)], but less likely to have an excessive number of visits to general medical practitioners [OR = 0.45 (0.22-0.93)] and other health care workers [OR = 0.48 (0.23-0.99)]. These data provide some degree of reassurance about medium-term health outcomes for children conceived using IVF. Although they are more likely to utilize the resources of neonatal intensive care units, IVF infants do not appear to have an increased number of medical problems or to over-utilize health care resources during the remainder of their first year of life.

Adult↗
PubMed1998

Prisoner of war experience: effects on wives.

The aim of this study was to compare the wives of Australian soldiers who had been imprisoned during World War II (POWs) with a control group of non-POWs' wives and also to compare the POWs and non-POWs themselves in respect to several psychological and family life characteristics on which differences might be expected to arise from the long-term effects of imprisonment. A random sample of 145 of these veterans and their wives completed several self-administered mood and family life scales, an inventory of somatic symptoms, questions about the impact of the war on the veteran in the postwar decades, and several social background questions. The POWs themselves were more depressed and reported more somatic symptoms and a greater postwar impact of the war than the non-POWs. However, these differences were not accompanied by concomitant differences among their wives. There was some evidence of an influence of the POW's mood on his wife's mood in significant correlations between husbands' and wives' depression and anxiety scale scores in POW couples alone. Otherwise, there was very little indication that the POW experience had any long-term effect on the marriage relationship as measured by the variables included in this study.

Adaptation, Psychological↗
PubMed1998

Violence and aggression in psychiatric units.

OBJECTIVE: To help predict aggressive and violent behaviors, the frequency and types of these behaviors in acute psychiatric inpatient settings were examined, and potential interactions between staffing and patient mix and rates of the behaviors were explored. METHODS: Data on violent incidents were gathered prospectively in three adult acute psychiatric units in a general hospital and two units in a primary psychiatric hospital in Sydney, Australia. Staff recorded violent and aggressive incidents, which were ranked on an 8-level scale. They also completed weekly reports of staffing levels and patient mix. Poisson regression analysis was used to calculate relative rates, 95 percent confidence intervals, and p values. RESULTS: A total of 1,289 violent incidents were recorded over a seven-month period. Based on the scale, 58 percent of the incidents were serious. Seventy-eight percent were directed toward nursing staff. Complex relationships between staffing, patient mix, and violence were found. Relative risk increased with more nursing staff (of either sex), more nonnursing staff on planned leave, more patients known to instigate violence, a greater number of disoriented patients, more patients detained compulsorily, and more use of seclusion. The relative risk decreased with more young staff (under 30 years old), more nursing staff with unplanned absenteeism, more admissions, and more patients with substance abuse or physical illness. In total these factors accounted for 62 percent of the variance in violence. CONCLUSIONS: Violent incidents in psychiatric settings are a frequent and serious problem. Incidents appear to be underreported, and the seriousness of an incident does not guarantee it will be reported.

Adult↗
PubMed1998

Repetitively violent patients in psychiatric units.

OBJECTIVE: Violent incidents in inpatient psychiatric settings were examined among a group of repeatedly violent patients to better understand the clinical and occupational health significance of repeated violence. METHODS: Data on violent incidents were collected prospectively over seven months in five psychiatric units in Sydney, Australia. Recidivist patients--those responsible for more than 20 incidents of violence or aggression--and nonrecidivist violent patients were compared in terms of the nature of the incidents, warning signs, and staff responses to violence. RESULTS: Of the 174 patients involved in violent incidents, 20 (12 percent) were recidivists. These patients accounted for 69 percent of the 752 violent incidents identified. Recidivists were significantly older than nonrecidivist patients. Compared with nonrecidivists, the men recidivists were more likely to have an organic brain syndrome, and the women recidivists were more likely to have a personality disorder. When a recidivist patient was violent, staff members' response was significantly less likely to include institutional mechanisms for dealing with violence, such as contacting occupational health and safety officers, completing injury notification forms, and notifying police. Violence occurred among recidivists despite their giving more warning signs than nonrecidivists, suggesting that recidivists' threats were not taken seriously by staff, perhaps reflecting demoralization in the face of repeated violence. CONCLUSIONS: Even though this study focused only on serious incidents and defined recidivism narrowly, it found that recidivism of violence and aggression among psychiatric patients was a serious problem. The relative lack of response by staff members to the violent acts of recidivist patients is of concern.

Aggression↗
PubMed1998

Nutrition and obesity in the chronic mentally ill.

OBJECTIVE: The aim of this study was to determine the need for nutrition intervention in a group of people living in mental health residential houses in the Northern Sydney Area. METHOD: A nutrition assessment was conducted by the researcher using a face-to-face interview with mental health residents and a survey on medical background completed by case managers. RESULTS: The prevalence of overweight and obesity was significantly greater than that reported for the general population. Respondents also had a significantly higher prevalence of abdominal obesity than the general population. No respondent met the minimum core food group requirements as outlined in the 12345+ Food and Nutrition Plan. CONCLUSIONS: The needs assessment has shown that nutrition promotion is required in this group. The task ahead is to motivate the group to change their food and nutrition behaviours, where many barriers to a healthy lifestyle exist.

Adolescent↗
PubMed1998

Lunar cycles and violent behaviour.

OBJECTIVE: It is commonly believed that the full moon exerts an influence on violence and aggression in psychiatric settings. The literature to date is contentious. This study used a robust methodology to examine the hypothesis that there was an increased frequency of violent and aggressive behaviour among hospitalised psychiatric clients at the time of the full moon. METHOD: Prospective data were collected in five inpatient psychiatric settings across the Northern Sydney Area Health Service. Morrison's hierarchy of violence and aggression was used to rate behaviour. Lunar phases were clearly defined and Poisson regression used to examine relationships between lunar phase and violence. Extraneous temporal variation was considered. RESULTS: No significant relationship was found between total violence and aggression or level of violence and aggression and any phase of the moon. CONCLUSION: Future research could profitably examine the implications of a belief in the lunar effect among health workers in the face of evidence that no relationship exists between violence, aggression and the lunar cycle.

Adult↗
PubMed1997

Alcohol consumption and cognitive performance in a random sample of Australian soldiers who served in the Second World War.

OBJECTIVE: To examine the association between the average daily alcohol intake of older men in 1982 and cognitive performance and brain atrophy nine years later. SUBJECTS: Random sample of 209 Australian men living in the community who were veterans of the second world war. Their mean age in 1982 was 64.3 years. MAIN OUTCOME MEASURES: 18 standard neuropsychological tests measuring a range of intellectual functions. Cortical, sylvian, and vermian atrophy on computed tomography. RESULTS: Compared with Australian men of the same age in previous studies these men had sustained a high rate of alcohol consumption into old age. However, there was no significant correlation, linear or non-linear, between alcohol consumption in 1982 and results in any of the neuropsychological tests in 1991; neither was alcohol consumption associated with brain atrophy on computed tomography. CONCLUSION: No evidence was found that apparently persistent lifelong consumption of alcohol was related to the cognitive functioning of these men in old age.

Aged↗
PubMed1997

The Family Attitude Scale: reliability and validity of a new scale for measuring the emotional climate of families.

Research on outcomes from psychiatric disorders has highlighted the importance of expressed emotion (EE), but its cost-effective measurement remains a challenge. This article describes development of the Family Attitude Scale (FAS), a 30-item instrument that can be completed by any informant. Its psychometric characteristics are reported in parents of undergraduate students and in 70 families with a schizophrenic member. The total FAS had high internal consistency in all samples, and reports of angry behaviour in FAS items showed acceptable inter-rater agreement. The FAS was associated with the reported anger, anger expression and anxiety of respondents. Substantial associations between the parents' FAS and the anger and anger expression of students was also observed. Parents of schizophrenic patients had higher FAS scores than parents of students, and the FAS was higher if disorder duration was longer or patient functioning was poorer. Hostility, high criticism and low warmth on the Camberwell Family Interview (CFI) were associated with a more negative FAS. The highest FAS in the family was a good predictor of a highly critical environment on the CFI. The FAS is a reliable and valid indicator of relationship stress and expressed anger that has wide applicability.

Adolescent↗
PubMed1997

Psychosocial adjustment and the quality of the mother-child relationship at four months postpartum after conception by in vitro fertilization.

OBJECTIVE: To examine psychological adjustment to early motherhood at 4 months postpartum in mothers who conceived by IVF-ET. DESIGN: Controlled clinical study. SETTING: Healthy human volunteers in an academic research environment. PATIENT(S): Sixty-five primiparous women undergoing IVF-ET and 62 age-matched primiparous women with no history of infertility. INTERVENTION(S): Completion of questionnaires, interviews, and videotaped interaction. MAIN OUTCOME MEASURE(S): Maternal self-reports of psychosocial adjustment and behavioral ratings of quality of mother-infant interaction based on a videotaped observation scored blind to IVF-ET status. RESULT(S): Mothers who conceived by IVF-ET did not differ from control mothers on measures of anxiety, postnatal depression, marital satisfaction, or use of support services. However, they reported lower self-esteem and lower maternal self-efficacy, and they rated their infants as more temperamentally difficult. (Ratings of temperament difficulty for the infants of mothers who conceived by IVF-ET are within the normal range when compared with Australian normative data for this age group.) The videotapes revealed no group differences in maternal behaviors, but the infants of mothers who conceived by IVF-ET displayed more negative behaviors in response to an interactive stress. Group differences were accounted for largely by those mothers who underwent more than one treatment cycle and by their infants. CONCLUSION(S): Overall, the results are reassuring for parents who conceive by IVF-ET. However, specific adjustment measures reveal some minor difficulties and suggest that mothers who conceive by IVF-ET may benefit from increased support in the early postpartum months.

Adaptation, Psychological↗
PubMed1997

Psychiatric rehospitalization following hospital discharge.

The purpose of this study was twofold: to examine the patient characteristics at discharge from an acute psychiatric unit that were associated with an increased likelihood of rehospitalization within the following six months, and to examine the relationship between rehospitalization and the nature of psychiatric aftercare in a well-integrated hospital and community based psychiatric service. The study reviewed the extent of psychiatric rehospitalization following the closure of large numbers of institutional psychiatric beds. At six months after discharge 38% of the patients had been readmitted to an institution, most commonly a hospital. Despite the provision of an integrated hospital and community health service with excellent welfare support, dissatisfaction with finances independently exerted an influence on the risk of readmission. Implications for future research and treatment planning are discussed focussing on the complex integration of health and welfare services.

Adolescent↗
PubMed1997

Noncompliance in psychiatric aftercare.

The focus of the present study was to examine the extent of noncompliance in psychiatric aftercare in an integrated hospital and community mental health service. Characteristics of those patients who were noncompliant were explored in order to facilitate the prediction of treatment noncompliance at the point of discharge from hospital. A consecutive cohort of patients discharged from an acute psychiatric general hospital unit into an integrated community mental health service provided data regarding demography, disease state, attitude to treatment and actual treatment availed in aftercare. At six months follow-up 36% of the initial cohort of 128 patients had met the study criteria of noncompliance in psychiatric aftercare. A number of demographic and clinical criteria distinguished this group including the engagement in skilled employment and the presence of an anxiety rather than psychotic disorder. Noncompliant patients were less symptomatic with more disturbed behavior than those patients remaining in treatment. Noncompliant patients were significantly more likely to have a case manager of lessor experience, to have committed serious crimes and to have predicted their default from treatment at the time of discharge. Noncompliance in psychiatric aftercare persists (despite the availability of integrated hospital and community mental health services) raising te question of the goodness of fit between patient need and service provision.

Aftercare↗
PubMed1997

Anxiety during pregnancy and fetal attachment after in-vitro fertilization conception.

The aim of this study was to compare 70 couples who had conceived by in-vitro fertilization (IVF) with 63 matched controls for the prevalence of anxiety and quality of attachment to the baby during pregnancy. Results for mothers showed no group differences using a global measure of anxiety, the Spielberger State-Trait Anxiety Inventory. However, pregnancy-specific measures revealed significantly higher levels of anxiety in IVF mothers about the survival and normality of their unborn babies, about damage to their babies during childbirth and about separating from their babies after birth. When IVF mothers were differentiated according to the number of treatment cycles, more differences in anxiety level were revealed, with most increases occurring in mothers who had experienced two or more treatment cycles. IVF fathers did not differ from controls on the global anxiety measure. No data on pregnancy-specific anxiety were available for fathers. Neither IVF mothers nor IVF fathers differed from controls on measures of attachment to the baby during pregnancy. Results are discussed in the context of the need for researchers to employ differentiated and issue-specific measures to identify concerns that may be unique to IVF couples. Clinical implications regarding the need for psychological support during pregnancy are also discussed.

Adult↗
PubMed1997

Declining prevalence of psychiatric disorder in older former prisoners of war.

The aim of this study was to examine change in the prevalence of psychiatric disorders over a decade late in the lives of ex-prisoners of war (POWs) and nonprisoner veterans of World War II. In 1982-83 we drew a random sample of POWs and non-POWs living in Sydney, Australia. They were interviewed by a psychiatrist at that time and again 9 years later. They also completed self-rating anxiety and depression scales. Anxiety disorders were the most prevalent and declined by half from 32.7% at the first interview to 16.8% 9 years later (p < .001) whereas the prevalence of depressive disorders fell by two-thirds from 26.9% to 8.7% (p < .001). In POWs the prevalence of both anxiety and depression declined more markedly than in non-POWs. Consistent changes also occurred in scores on the self-rating anxiety and depression scales. The psychological impact of these POWs' tragic wartime experience had at last begun to dim after nearly 50 years.

Aged↗
PubMed1996

Housing accommodation preferences of people with psychiatric disabilities.

OBJECTIVE: The study sought to identify the types of housing preferred by people with psychiatric disabilities seeking accommodations through a community mental health service in Sydney, Australia. METHODS: Housing options available in the mental health service's catchment area were identified, and the extent of demands on residents' behavior that was associated with each option was assessed using an established measure. Clients examined descriptions of each housing option and rank-ordered the options based on their preferences. Clients' current levels of functioning and symptoms were also assessed. RESULTS: Clients most preferred environments that ensured living alone in settings of low behavioral demand. Living in one's own home was the most preferred option, followed by living in government-subsidized housing, For-profit boarding houses were preferred over psychiatric group homes, and homelessness, long-term hospitalization, and crisis accommodations were least preferred. Shelter, privacy, food, and safety were highly valued housing attributes. Demographic characteristics, level of functioning, and severity of psychiatric symptoms did not predict accommodation preferences. CONCLUSION: Consumers' resistance to psychiatric group housing with high levels of behavioral demand is unrelated to consumer characteristics and should be considered in planning suitable accommodations for persons with psychiatric disabilities.

Activities of Daily Living↗
PubMed1994

Type A personality in Australian twins.

We examined the genetic and environmental determinants of Type A behavior in 200 pairs of same-sex twins as measured by the structured interview (SI) of Rosenman and Friedman and by the Bortner questionnaire (BARS). As noted previously, these measures are poorly correlated (r = .30). Quite different heritabilities were found for the two measures (63% for SI, 23% for BARS), and the correlation between the two was found to be largely genetic. Although the sample size meant that differences in correlation between MZ and DZ twins on the BARS were not significant in univariate analyses, they were suggestive of twin competition effects, as other twin studies have found. We conclude that further genetic analyses should concentrate on component behaviors rather than the overall Type A construct.

Adolescent↗
PubMed1994

Psychological symptom profiles in patients with chest pain.

Five-hundred and thirty-two patients with ischaemic-like chest pain referred for symptom-limited exercise thallium myocardial perfusion studies, were assessed on a range of psychosocial measures. Three groups of patients were identified on the basis of their perfusion studies: (1) normal thallium perfusion; (2) current myocardial ischaemia; and (3) past myocardial infarction (but no current ischaemia). There were no significant psychological differences between these groups on a wide range of measures which included depression, state and trait anxiety, Type A behaviour, personality, suppression of affect, locus of control, alexythymia, and hypochondriasis. Significant differences were identified, however, on measures of anger and coping style. Subjects with no current ischaemia (normal thallium perfusion and those with past myocardial infarction) had higher scores on 'immature coping' and 'anger in', than subjects with current myocardial ischaemia. These findings are discussed in the light of other published research.

Adult↗
PubMed1994

Psychosocial adjustment to infertility and its treatment: male and female responses at different stages of IVF/ET treatment.

Gender differences in psychosocial adjustment to infertility and its treatment were evaluated amongst a cross-sectional sample of 330 couples, of whom 113 were first time participants and 217 were repeat cycle couples. Whilst 30% of both husbands and wives experienced clinically elevated anxiety regardless of stage of treatment; repeat cycle women (25%) faced the further risk of developing clinically severe depressive symptoms. Significant differences in the amount of care and control received from their spouse and in the degree they suppressed their emotions were reported amongst repeat cycle couples. Any clinical implications of differences in male-female caring styles are discussed within the IVF context. Our results suggest that interventions intended not only to reduce anxiety and depressive symptoms, but also to facilitate ongoing psychosocial functioning, should be implemented for couples at different stages of IVF/ET treatment.

Adaptation, Psychological↗