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Biomedical subjects

J Coverdale

Publications and source records attributed to J Coverdale.

At least 19 recordsLinked to original sources
PubMed2006

In vivo tracking of macrophage activated killer cells to sites of metastatic ovarian carcinoma.

Radio-labelling of blood cells is an established technique for evaluating in vivo migration of normal cells to sites of pathology such as infection and haemorrhage. A limitation of cellular immunotherapies to induce anti-tumour responses is in part due to the uncertain ability of cellular effectors to reach their intended target. We extended the approach of cell radiolabelling to accurately examine the in vivo distribution of cellular immunotherapy with ex-vivo macrophage activated killer (MAK) cells. We describe the use of two methods of cell labelling for tracking the destination of autologous-derived macrophage activated killer (MAK) cells linked to the bi-specific antibody MDX-H210 delivered either by intravenous (i.v.) or intraperitoneal (i.p.) injection in ten patients with peritoneal relapse of epithelial ovarian carcinoma. Our results demonstrate the feasibility of generating high numbers and purity of GMP quality MAK cells, which can be radiolabelled with (18)F-FDG or (111)In-oxime. MAK cell administration produced minimal infusional toxicity and demonstrated a reproducible pattern of in vivo distribution and active in vivo tracking to sites of known tumour following 8 of 16 i.v. infusions or 4 of 6 i.p. infusions. However, the leakage of (18)F-FDG limited the ability to confidently confirm the tracking of MAK cells to tumour in all cases and improved PET labels are required. The addition of MDX-H210 bispecific antibody did not alter the distribution of cells to tumour sites, but did accelerate the clearance of i.v. administered MAK cells from the pulmonary circulation. This data demonstrates that cellular cancer immunotherapies may be successfully delivered to the sites of active tumour following either i.v. or i.p. injection in a proportion of patients with metastatic cancer. Incorporation of tracking studies in early cycles of cellular immunotherapy may allow selection of patients who demonstrate successful targeting of the immunotherapy for ongoing treatment.

Antibodies, Bispecific↗
PubMed2002

Management of violence in the workplace: a New Zealand survey.

OBJECTIVE: To estimate the rate of adverse events to staff, to survey the use of various preventative measures, and to assess any association between these factors and the reported event rate. METHOD: An anonymous postal nation-wide survey of violence reported to managers of psychiatric units in New Zealand. RESULTS: The mean rate of adverse event per 100 full time equivalent staff was 16.2 (range 0-187) for property damage, 16.3 (range 0-204) for attempted assault, 12 (range 0-194) for physical attack, 1.3 (range 0-33) for sexual harassment and 1.1 (range 0-17) for stalking. Inpatient units, the use of pocket alarms, and training in de-escalation were associated highly with an increase risk of adverse events. CONCLUSION: There is a high variation in the rate of violence. The issue of increased rate of events with certain interventions will require further research.

Adolescent↗
PubMed2001

A survey of threats and violent acts by patients against training physicians.

OBJECTIVES: The primary purpose was to determine the prevalence of various types of threats or assaults by patients against training physicians and to determine the psychological impact of the most distressing incidents. Differences between specialty of training and gender were examined. DESIGN: An anonymous mailed questionnaire. SETTING: The Medical School of the University of Auckland, New Zealand. SUBJECTS: All 160 postgraduate trainees in psychiatry, general medicine, surgery, and obstetrics and gynaecology. A response rate of 84% (n=135) was obtained. RESULTS: The majority of trainees had been verbally threatened (n=91, 67%) or physically intimidated (n=73, 54%) at some time during specialty training, while another 41% (n=55) had witnessed Health Board property being damaged in their presence and 39% (n=53) had been physically assaulted. Psychiatry trainees were significantly more likely to experience the various types of threat or violence. Females (n=20, 38%) were significantly more likely than men (n=8, 10%) to report having been sexually harassed (chi2=14, d.f.=1, P < 0.001). The overall mean on the Impact of Event Scale for those who described the most distressing incident was 8. On only one occasion was a training director directly informed about a trainee's most distressing incident and most trainees (n=95, 70%) had not had training on protecting against assault or on managing violence. CONCLUSION: These findings underscore a priority for developing programmes which effectively reduce threats and violence against trainees and which lessen the psychological sequelae of these incidents.

Adaptation, Psychological↗
PubMed2001

From source material to news story in New Zealand print media: a prospective study of the stigmatizing processes in depicting mental illness.

OBJECTIVE: The aim of this study was to analyse how newspaper articles that depict mental illnesses are generated from source materials. METHOD: From a prospectively collected national sample of print materials involving mental illness, 50 published items that related to the Privacy Commissioner's opinion about disclosure of a psychiatric patient's health information were identified. A copy of the Privacy Commissioner's original Case Note and three news stories about the Case Note distributed by the New Zealand Press Association constituted the database. These materials were subjected to discourse analysis. We identified themes and their transformation from the Case Note through the news stories and examined the impact of these transformations on the stigmatization of mental illness. RESULTS: Four themes were identified: human rights, vulnerability, risk of dangerousness and threat, and mental illness/psychiatric patient. The only potentially positive theme, human rights, was limited both by being fragmented in the source material, and by being utilized, in the published news stories to undermine the legitimacy of the patient's right to privacy. Use of the other themes was consistent with stereotypes about mental illness. CONCLUSIONS: Although there were no inaccuracies in the content of the news stories they were substantially more negative than the source material in their depiction of the identified patient. A potentially positive discourse (human rights) was not by itself sufficient to ensure a positive portrayal of mental illness. An understanding of the transformations is important for efforts to effectively combat the stigmatization of those with mental illness.

Bibliometrics↗
PubMed2000

How mental illness is portrayed in children's television. A prospective study.

BACKGROUND: There are no published studies concerning the depiction of mental illness in children's television programmes. AIMS: To determine whether mental illness was depicted in children's television. METHOD: Sample of one complete week of children's television (57 hours, 50 minutes; 128 series episodes: 69 cartoon animations, 12 non-cartoon animations, 47 real life) provided for children under the age of 10 years. Disclosure analysis of portrayals of mental illness through repeated viewings identified patterns in the use of linguistic, semiotic and rhetorical resources. RESULTS: Of the 128 episodes, 59 (46%) contained one or more references to mental illness, predominantly in cartoons (n = 47, 80%) compared with other episode types (chi 2 = 17.1, d.f. = 2, P < 0.05). Commonly occurring terms such as 'crazy' (n = 28), 'mad' (n = 19) and 'losing your mind' (n = 13) were employed to denote loss of control. The six consistently mentally ill characters were almost entirely devoid of admirable attributes. CONCLUSION: Young viewers are being socialized into stigmatizing conceptions of mental illness.

Attitude to Health↗
PubMed1999

Constructing mental illness as dangerous: a pilot study.

OBJECTIVE: There is a dearth of studies examining how dangerousness is constructed in media depictions of mentally ill individuals who are frequently portrayed as acting violently. The aim of the present study was to identify the contribution of diverse technical, semiotic and discursive resources utilised in portraying a character with a mental illness in a prime-time drama as dangerous. METHOD: Discourse analytic techniques, involving systematic, repeated, critical viewings, were applied to a single program drawn from a sample of prime-time television drama episodes touching on mental illness. RESULTS: Nine devices (appearance, music and sound effects, lighting, language, intercutting, jump-cutting, point of view shots, horror conventions and intertextuality) were identified as contributing to the signified dangerousness of person receiving care in the community for a mental illness. CONCLUSIONS: These techniques combine in signifying mental illness and a person suffering from it as dangerous. The findings suggest that mental health professionals working to reduce the stigma of mental illness need to have a reasonably sophisticated understanding of the practices and priorities of television production if they are to collaborate effectively with producers to create dramas that convey more human and sympathetic understandings of mental illness or to combat the negative effects of such portrayals.

Dangerous Behavior↗
PubMed1999

Mental illness depictions in prime-time drama: identifying the discursive resources.

OBJECTIVE: The aim of this study was to determine how the mentally ill are depicted in prime-time television dramas. METHOD: Fourteen television dramas that included at least one character with a mental illness, shown in prime-time during a 1-year period, were systematically viewed and analysed. RESULTS: Fifteen of the 20 mentally ill characters were depicted as physically violent toward self or others. Characters were also depicted negatively as simple or lacking in comprehension and appearing lost, unpredictable, unproductive, asocial, vulnerable, dangerous to self or others because of incompetent behaviours, untrustworthy, and social outcasts, and positively as caring or empathic. CONCLUSIONS: These data are consistent with an overwhelming negativity of depictions of the mentally ill found in other forms of media and settings, and contribute to the stigmatisation of this population.

Humans↗
PubMed1998

General practitioner attitudes toward mandatory reporting of doctor-patient sexual abuse.

AIM: To explore general practitioner attitudes toward mandatory reporting of doctor-patient sexual abuse. METHODS: Anonymous questionnaire mailed to a randomised sample of 217 New Zealand general practitioners. Attitudes toward mandatory reporting of doctor-patient sexual contact, seductive or sexually demeaning behaviour were appraised including an indication of whom the perceived appropriate reporting body should be. RESULTS: Forty-seven per cent of respondents supported the notion of mandatory reporting for doctor-patient sexual contact, 42% for sexually demeaning behaviour and 35% for seductive verbal behaviour. These respondents indicated that the most appropriate body to report to was a Doctor's Health Advisory Service. CONCLUSION: There was a lack of strong consensus on mandatory reporting of doctor-patient sexual abuse.

Adult↗
PubMed1997

Sexually transmitted disease and family planning counselling of psychiatric patients in New Zealand.

OBJECTIVE: We aimed to determine the attitudes and behaviours of mental health professionals (MHPs) including psychiatrists towards identifying and reducing their own patients' risk for sexually transmitted diseases and unwanted pregnancies. METHOD: 102 of all of the 162 mental health professionals serving predominantly chronically psychiatrically ill adult outpatients and inpatients in Waitemata district responded to an anonymous questionnaire (response rate = 63%), concerning their own attitudes and behaviours towards identifying and counselling patients on their risk for sexually transmitted diseases and unwanted pregnancies. RESULTS: Mental health professionals reported that, on average, they had counselled 14% of their own male patients and 21% of their own female patients on sexually transmitted diseases, including AIDS prevention, and that more of their own patients were at risk than were counselled. They also reported that they had counselled 5% of their own male patients and 17% of their own female patients about family planing. Forty-two per cent of mental health professionals indicated that they had insufficient knowledge about sexually transmitted diseases to educate patients, 72% indicated that when it came to risky sexual behaviours chronic psychiatric patients were much the same as other people, and 33% or more felt uncomfortable discussing topics of condom use and patients' sexual preferences. CONCLUSION: These results suggest that family planning and sexually transmitted diseases risk preventive interventions for psychiatric patients need to overcome mental health professionals' own barriers to risk prevention.

Counseling↗
PubMed1996

A national survey of physicians' behaviors regarding sexual contact with patients.

To determine the prevalence of sexual contact between physicians and patients, we mailed a survey to a nationwide, randomized sample of 1,600 physicians, including internists, family medicine physicians, obstetrician-gynecologists, and ophthalmologists. The response rate was 52% (n = 787). Of all respondents, 4.5% reported having dated a patient and 3.4% reported having had sexual (genital-genital, oral-genital, or anal-genital) contact with a patient. Physicians older than 50 years and unmarried physicians were significantly more likely to have dated patients. No differences in dating or sexual contact according to specialty or gender were found. Physicians who reported having had sexual contact with a patient were less likely to report negative consequences of the contact than physicians who had personal knowledge of sexual contact by other physicians. These results have implications for educational interventions for physicians.

Adult↗
PubMed1994

National survey on physicians' attitudes toward social and sexual contact with patients.

To determine the attitudes of physicians toward social and sexual contact with patients, we mailed a self-report survey to a nationwide randomized sample including general practitioners, internists, obstetrician-gynecologists, and ophthalmologists. The 777 physicians who responded specified whether or not behavior such as hugging, dating, and sexual contact with their own patients may be appropriate. Less than 1% of all respondents thought that sexual contact with patients was appropriate during patient consultations. Three percent of internists and obstetrician-gynecologists considered sexual contact with patients appropriate when concurrent with treatment but outside of patient consultation, as compared with 9% of general practitioners and 12% of ophthalmologists (X2 = 17.8, df = 3, P < .001). Nearly 50% of general practitioners and more than 50% of all other physicians thought that sexual contact might be appropriate after termination of treatment of a patient. These findings may facilitate professional discussion on standards for social and sexual contact with patients.

Adult↗
PubMed1992

Ethically justified guidelines for family planning interventions to prevent pregnancy in female patients with chronic mental illness.

OBJECTIVE: This article proposes ethically justified clinical guidelines for family planning interventions to prevent pregnancy in female patients. STUDY DESIGN: We reviewed literature on family planning and consequences of pregnancy in patients with chronic mental illness and related that literature to ethical principles. RESULTS: Patients with chronic mental illness are ethically unique because they have chronically and variably impaired autonomy. Existing guidelines and proposals for family planning interventions for mentally retarded patients are shown not to apply to such patients. CONCLUSION: Three sets of guidelines for three groups of patients, representing the continuum of chronically and variably impaired autonomy, are proposed: (1) a set of guidelines for patients who can achieve thresholds of autonomy, (2) a set of guidelines for patients irreversibly near thresholds of autonomy, and (3) a set of guidelines for patients irreversibly below thresholds of autonomy. These guidelines should contribute significantly to the quality of obstetric and gynecologic care for female patients with chronic mental illness.

Comprehension↗
PubMed1992

Developing family planning services for female chronic mentally ill outpatients.

The family planning needs of chronic mentally ill women outpatients, many of whom do not use contraceptives and are at high risk for unwanted pregnancies, have been rarely addressed. Taking a thorough sexual history is the first step in assessing patients' need for family planning services. Patient education, including instruction about physiological processes and contraceptive methods and assertiveness training, is the most important service component. Offering family planning services in the mental health center has many advantages, including better communication between mental health care providers and family planning specialists about patients' special needs and enhanced opportunities for integrating family planning with other programs such as parenting classes, substance abuse treatment, and services for preventing sexually transmitted diseases.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Adolescent mental health: a review of preventive interventions.

Over the past 30 years, adolescents represent the only age group in the United States whose health status has not improved significantly. In this population, major health problems that are becoming increasingly important in regard to preventive intervention include substance abuse, depression, teenage pregnancy, and AIDS. Research in adolescent mental health during the past decade has focused on both the etiology and the prevention of problem behaviors. We review the development and application of various preventive intervention approaches in the field of adolescent mental health and discuss implications for future directions.

Adolescent↗