Biomedical subjects

David Chant

Publications and source records attributed to David Chant.

29 records · Page 2Linked to original sources

PubMed2004

Gundhu Adolescent Wing: providing adolescent beds in a rural acute mental health unit.

OBJECTIVE: To describe the evolution, structure and outcomes of Gundhu Adolescent Wing, Toowoomba, Queensland, which comprises six dedicated beds set aside during development of a new rural acute mental health unit. METHODS: All adolescents discharged from Gundhu in its first 7 months were included in the study. Data pertaining to patient characteristics, model of service delivery, length of inpatient stay and outcome at 7 months were obtained. RESULTS: Thirty-three adolescents with mental illness living in the rural area were discharged from Gundhu in the first 7 months. For the 23 adolescents who stayed on the unit <14 days, outcome at 7 months after discharge was generally favourable. Six adolescents with length of stay of >or=30 days did less well, but made similar progress to patients in tertiary units. CONCLUSIONS: From the authors' experience, designating a small number of beds as adolescent within a rural acute mental health unit is an effective intervention for short-stay patients and is valued by adolescents and their families. Keeping the adolescent unit separate is beneficial even at the expense of foregoing access to space and facilities enjoyed by adult patients. Involving families early to provide off-ward fun, exercise and socialization with peers is important. Rural services tend to have high staff turnover. Involving rural general practitioners in follow-up plans may ensure better continuity of care after discharge.

Adolescent↗

PubMed2003

Directional and fluctuating asymmetry in finger and a-b ridge counts in psychosis: a case-control study.

BACKGROUND: Several studies have reported alterations in finger and a-b ridge counts, and their derived measures of asymmetry, in schizophrenia compared to controls. Because ridges are fully formed by the end of the second trimester, they may provide clues to disturbed early development. The aim of this study was to assess these measures in a sample of patients with psychosis and normal controls. METHODS: Individuals with psychosis (n = 240), and normal controls (n = 228) were drawn from a catchment-area case-control study. Differences in finger and a-b ridge count and Fluctuating Asymmetry were assessed in three group comparisons (non-affective psychosis versus controls; affective psychosis versus controls; non-affective psychosis versus affective psychosis). The analyses were performed separately for males and females. RESULTS: There were no significant group differences for finger nor a-b ridge counts. While there were no group difference for Directional Asymmetry, for Fluctuating Asymmetry measures men with non-affective psychosis had significantly higher fluctuating asymmetry of the index finger ridge count (a) when compared to controls (FA-correlation score, p = 0.02), and (b) when compared to affective psychosis (adjusted FA-difference score, p = 0.04). CONCLUSION: Overall, measures of finger and a-b ridge counts, and their derived measures of directional and fluctuating asymmetry were not prominent features of psychosis in this sample. While directional asymmetry in cerebral morphology is reduced in schizophrenia, this is not reflected in dermatoglyphic variables.

Affective Disorders, Psychotic↗

PubMed2003

A systematic review and meta-analysis of Northern Hemisphere season of birth studies in schizophrenia.

Based on the epidemiological finding that individuals with schizophrenia tend to be born in winter/spring when compared to the general population, we examined (1) the strength and timing of this effect in Northern Hemisphere sites, and (2) the correlation between the season of birth effect size and latitude. Studies were located via electronic data sources, published citations, and letters to authors. Inclusion criteria were that studies specify the diagnostic criteria used, that studies specify the counts of schizophrenia and general population births for each month, and that subjects and the general population be drawn from the same birth years and catchment area. We extracted data from eight studies based on 126,196 patients with schizophrenia and 86,605,807 general population births and drawn from 27 Northern Hemisphere sites. Comparing winter/spring versus summer/autumn births, we found a significant excess for winter/spring births (pooled odds ratio = 1.07; 95% confidence interval 1.05, 1.08; population attributable risk = 3.3%). There was a small but significant positive correlation between the odds ratios for the season of birth comparison and latitude (r = 0.271,p < 0.005). Furthermore, the shape of the seasonality in schizophrenia births varied by latitude band. These variations may encourage researchers to generate candidate seasonally fluctuating exposures.

Birth Rate↗

PubMed2002

Long-term trends in sunshine duration and its association with schizophrenia birth rates and age at first registration--data from Australia and the Netherlands.

BACKGROUND: Based on the well-described excess of schizophrenia births in winter and spring, we hypothesised that individuals with schizophrenia (a) would be more likely to be born during periods of decreased perinatal sunshine, and (b) those born during periods of less sunshine would have an earlier age of first registration. METHODS: We undertook an ecological analysis of long-term trends in perinatal sunshine duration and schizophrenia birth rates based on two mental health registers (Queensland, Australia n=6630; The Netherlands n=24,474). For each of the 480 months between 1931 and 1970, the agreement between slopes of the trends in psychosis and long-term sunshine duration series were assessed. Age at first registration was assessed by quartiles of long-term trends in perinatal sunshine duration. Males and females were assessed separately. RESULTS: Both the Dutch and Australian data showed a statistically significant association between falling long-term trends in sunshine duration around the time of birth and rising schizophrenia birth rates for males only. In both the Dutch and Australian data there were significant associations between earlier age of first registration and reduced long-term trends in sunshine duration around the time of birth for both males and females. CONCLUSIONS: A measure of long-term trends in perinatal sunshine duration was associated with two epidemiological features of schizophrenia in two separate data sets. Exposures related to sunshine duration warrant further consideration in schizophrenia research.

Adolescent↗

PubMed2002

Minor physical anomalies and quantitative measures of the head and face in patients with psychosis.

BACKGROUND: The aim of this study was to examine minor physical anomalies and quantitative measures of the head and face in patients with psychosis vs healthy controls. METHODS: Based on a comprehensive prevalence study of psychosis, we recruited 310 individuals with psychosis and 303 controls. From this sample, we matched 180 case-control pairs for age and sex. Individual minor physical anomalies and quantitative measures related to head size and facial height and depth were compared within the matched pairs. Based on all subjects, we examined the specificity of the findings by comparing craniofacial summary scores in patients with nonaffective or affective psychosis and controls. RESULTS: The odds of having a psychotic disorder were increased in those with wider skull bases (odds ratio [OR], 1.40; 95% confidence interval [CI], 1.02-1.17), smaller lower-facial heights (glabella to subnasal) (OR, 0.57; 95% CI, 0.44-0.75), protruding ears (OR, 1.72; 95% CI, 1.05-2.82), and shorter (OR, 2.29; 95% CI, 1.37-3.82) and wider (OR, 2.28; 95% CI, 1.43-3.65) palates. Compared with controls, those with psychotic disorder had skulls that were more brachycephalic. These differences were found to distinguish patients with nonaffective and affective psychoses from controls. CONCLUSIONS: Several of the features that differentiate patients from controls relate to the development of the neuro-basicranial complex and the adjacent temporal and frontal lobes. Future research should examine both the temporal lobe and the middle cranial fossa to reconcile our anthropomorphic findings and the literature showing smaller temporal lobes in patients with schizophrenia. Closer attention to the skull base may provide clues to the nature and timing of altered brain development in patients with psychosis.

Abnormalities, Multiple↗

PubMed2002

Enriched behavioral prediction equation and its impact on structured leaning and the dynamic calculus.

This theoretical note describes an expansion of the behavioral prediction equation, in line with the greater complexity encountered in models of structured learning theory (R. B. Cattell, 1996a). This presents learning theory with a vector substitute for the simpler scalar quantities by which traditional Pavlovian-Skinnerian models have hitherto been represented. Structured learning can be demonstrated by vector changes across a range of intrapersonal psychological variables (ability, personality, motivation, and state constructs). Its use with motivational dynamic trait measures (R. B. Cattell, 1985) should reveal new theoretical possibilities for scientifically monitoring change processes (dynamic calculus model: R. B. Cattell, 1996b), such as encountered within psychotherapeutic settings (R. B. Cattell, 1987). The enhanced behavioral prediction equation suggests that static conceptualizations of personality structure such as the Big Five model are less than optimal.

Forecasting↗

PubMed2002

No significant association between prenatal exposure poliovirus epidemics and psychosis.

OBJECTIVE: To examine the association between prenatal exposure to poliovirus infection and later development of schizophrenia or affective psychosis in a Southern Hemisphere psychiatric register. METHODS: We calculated rates of poliomyelitis cases per 10 000 background population and rates for schizophrenia(n = 6078) and affective psychosis (n = 3707)per 10 000 births for the period 1930-1964. Empirically weighted regression was used to measure the association between a given psychosis birth-rate and a poliomyelitis epidemic during gestation. RESULTS: There was no statistically significant association between exposure to a poliomyelitis epidemic during gestation and subsequent development of schizophrenia or affective psychosis. CONCLUSIONS: The lack of a consistent statistically significant association between poliovirus epidemics and schizophrenia suggests that either poliovirus may have a small effect which is only detectable with large data-sets and/or the effect may be modified by location. Further investigation of such inconsistencies may help elucidate candidate risk-modifying factors for schizophrenia.

Affective Disorders, Psychotic↗

PubMed2002

Factors influencing career development of Australian general practitioners.

OBJECTIVE: To evaluate factors influencing career experiences and career choices made by former general practitioner registrars and to ascertain the reasons for these career decisions. METHOD: A postal questionnaire was sent to all former registrars who completed the RACGP Training Program between 1994 and 1996. In addition 21 selected respondents were interviewed to obtain deeper insights into the comments recorded in returned questionnaires. All data were analysed for variance according to age, gender, state and locality of current general practice (i.e. whether metropolitan, rural or remote). RESULTS: Altogether, 472 of the 988 questionnaires distributed were completed and returned. Of the respondents, 62.3% were female and 36.4% male; 68% were aged 30-34 years. Most (85.4%) lived with a partner, and 53.8% had at least one child. The majority (87.9%) of respondents gained their primary medical qualification in Australia. In addition to the FRACGP, 35.6% had also gained a Diploma of Obstetrics and Gynaecology. A number of other qualifications were recorded. Three-quarters (75.6%) of participants were currently working as group GPs, two-thirds of whom were employees; 5.9% were solo GPs; 3.4% locums; and 1.3% rural hospital medical officers. About one-third (32.4%) held a second job; most of these were in subspecialty clinics or attachments. Sixty-six percent were currently in metropolitan practice, 17.6% in rural and 2.7% in remote practice. The two highest ranked career options were continued professional development (70.8%) and performance of minor procedures (67.2%). Family and domestic circumstances stood out as the most influential factor for 79.0% of GPs. The majority (75.8%) felt that vocational training had exerted a positive effect on their careers through, for example, exposure to varied practice types and good overall clinical training. CONCLUSION: While general practice experience in undergraduate education is an important factor in career choice, vocational training strongly influences preparation for, and the type of general practice undertaken. Nevertheless, family circumstances were reported as the most important consideration, although male and female work patterns differed markedly. It is concluded that these differences reflect different priorities in balancing professional and personal demands. The particular needs of the growing proportion of female practitioners have strong implications for future educational and workforce planning.

Adult↗

PubMed1992

The measurement of attitudes towards and beliefs about pain.

This study compared the psychometric properties of two scales designed to measure attitudes towards and beliefs about pain. The Survey of Pain Attitudes (Revised) SOPA(R) (Jensen and Karoly 1987) and the Pain Beliefs and Perceptions Inventory (PBPI) (Williams and Thorn 1989) were examined in terms of internal consistency, discriminant validity, factor structure, construct validity and sensitivity to age and gender effects. Results provided strong support for the SOPA(R) as a useful measurement tool for use with patients with chronic low back pain. Further work is suggested for the PBPI, as the reported factor structure was not replicated. Discussion centered around the possible reasons for this finding, with issues such as the possible orientation of different treatment facilities, the possible differences in attitudes between patients with different types of pain, and the possible influence of length of years in pain or the receipt of workers compensation payments being considered.

Adult↗

PubMedDate not supplied

Disability, employment and work performance among people with ICD-10 anxiety disorders.

OBJECTIVE: To ascertain at a population level, patterns of disability, labour force participation, employment and work performance among people with ICD-10 anxiety disorders in comparison to people without disability or long-term health conditions. METHOD: A secondary analysis was conducted of a probability sample of 42 664 individuals collected in an Australian Bureau of Statistics (ABS) national survey in 1998. Trained lay interviewers using ICD-10 computer-assisted interviews identified household residents with anxiety disorders. RESULTS: Anxiety disorders were associated with: reduced labour force participation, degraded employment trajectories and impaired work performance compared to people without disabilities or long-term health conditions. CONCLUSION: People with anxiety disorders may need more effective treatments and assistance with completing education and training, joining and rejoining the workforce, developing career pathways, remaining in the workforce and sustaining work performance. A whole-of-government approach appears needed to reduce the burden of disease and increase community labour resources. Implications for clinicians, vocational professionals and policy makers are discussed.

Adolescent↗

PubMedDate not supplied

Paradoxical association between smoking and olfactory identification in psychosis versus controls.

OBJECTIVE: Deficits in olfactory identification have been demonstrated in patients with schizophrenia. This study examined the interaction between smoking and olfactory identification in patients with psychotic disorders versus well controls. METHOD: Olfactory identification was assessed in three groups of subjects using the University of Pennsylvania Smell Identification Test (UPSIT). Sixteen patients with affective psychoses, 22 patients with nonaffective psychoses, and 21 well controls were tested. RESULTS: There was a significant interaction between diagnostic classification (patient or control) and smoking. Patients who were smokers scored higher on the UPSIT than non-smokers, while controls who were smokers scored lower than non-smokers. CONCLUSIONS: Smoking may have a 'normalising' effect on olfactory identification in some patients with psychosis. Further studies are needed to examine the relationship between psychosis, olfactory identification and the effects of nicotine.

Adult↗