Abdominal Obesity and Brain Atrophy in Type 2 Diabetes Mellitus.

Aim: Type 2 diabetes mellitus (T2D) is associated with gray matter atrophy. Adiposity and physical inactivity are risk factors for T2D and brain atrophy. We studied whether the associations of T2D with total gray matter volume (GMV) and hippocampal volume (HV) are dependent on obesity and physical activity.

Type 2 diabetes mellitus and biomarkers of neurodegeneration.

Objective: Our objective was to investigate whether type 2 diabetes mellitus (T2DM) influences neurodegeneration in a manner similar to Alzheimer disease (AD), by promoting brain β-amyloid (Aβ) or tau.

Methods: We studied the cross-sectional associations of T2DM with cortical thickness, brain Aβ load, and CSF levels of Aβ and tau in a sample of people from the Alzheimer's Disease Neuroimaging Initiative with diagnoses of AD dementia, mild cognitive impairment, and normal cognition. All (n=816) received MRI, and a subsample underwent brain amyloid imaging (n=102) and CSF Aβ and tau measurements (n=415).

The Clinical and Service Outcomes of Unilateral and Bilateral ECT Electrode Placements in Australian Aged Psychiatry Services.

Objective: The aim of the study was to determine whether depressed aged inpatients treated with brief pulse unilateral electroconvulsive therapy (ECT) differed from those treated with bilateral (bitemporal or bifrontal) ECT with respect to numbers of treatments, length of hospital admission, changes in scores on depression and cognitive scales, and serious adverse effects.

Methods: An audit of routinely collected data regarding 221 acute ECT courses in 7 public aged psychiatry services in Victoria, Australia.

Results: Patients given unilateral, bifrontal, and bitemporal treatments were similar with respect to personal, clinical, and treatment characteristics.

Coronary heart disease--the benefits of exercise.

Background: Cardiovascular disease is the leading cause of death in developed nations, and there is a clear link between cardiovascular disease and physical inactivity.

Objective: This article describes the benefits of exercise for cardiac patients, details how exercise is prescribed in this group, and considers safety and contraindications to exercise in this group.

Discussion: The benefits of exercise, both aerobic and resistance training, in patients with coronary heart disease are well documented.

Is there any role for computed tomography measurements of medial temporal lobe atrophy in dementia? A review of the literature and case series from a memory clinic.

Neuroimaging in dementia has focused on documenting any burden of vascular disease or excluding any reversible intracranial pathology. We review the use of computed tomography to examine for medial temporal lobe atrophy in dementia and compare this with a case series of such measurements from our memory clinic. Measures of medial temporal lobe atrophy were used to separate patients with Alzheimer's disease from those with normal cognition, mood disorders or other forms of early dementia.

Exercise based cardiac rehabilitation in chronic heart failure.

People with chronic heart failure often present to their general practitioner with questions about their participation in cardiac rehabilitation programs. This article outlines the risks and benefits of such programs.

Incidence of non-traumatic spinal cord injury in Victoria, Australia: a population-based study and literature review.

Study Design: Data extraction from a state-wide, population-based, health-administration database of hospital admissions.

Objective: To determine the incidence of non-traumatic spinal cord injury (NTSCI).

Setting: Victoria, Australia.

Influence of age and gender on rehabilitation outcomes in nontraumatic spinal cord injury.

Study Design: Retrospective, 3-year case series.

Objective: To investigate the relationship between gender and age and a range variables in patients with nontraumatic spinal cord injury (SCI).

Setting: Tertiary medical unit specializing in rehabilitation of patients with nontraumatic SCI.

Studies of caloric vestibular stimulation: implications for the cognitive neurosciences, the clinical neurosciences and neurophilosophy.

Objective: Caloric vestibular stimulation (CVS) has traditionally been used as a tool for neurological diagnosis. More recently, however, it has been applied to a range of phenomena within the cognitive neurosciences. Here, we provide an overview of such studies and review our work using CVS to investigate the neural mechanisms of a visual phenomenon - binocular rivalry.

On the correlation/constitution distinction problem (and other hard problems) in the scientific study of consciousness.

Objective: In the past decade, much has been written about 'the hard problem' of consciousness in the philosophy of mind. However, a separate hard problem faces the scientific study of consciousness. The problem arises when distinguishing the neural correlates of consciousness (NCC) and the neural constitution of consciousness.

Non-traumatic spinal cord injury: what is the ideal setting for rehabilitation?

Objective: To survey rehabilitation physicians about management of patients with non-traumatic spinal cord injury (NTSCI).

Methods: Postal and email survey of Australian physicians treating adult inpatients in neurological rehabilitation or Spinal Injury Units (SIUs). 59/69 returned surveys met inclusion criteria.

Sustained reduction in serious fall-related injuries in older people in hospital.

Objective: To determine whether the rate of falls and associated serious injuries in a hospital aged care setting can be reduced using a multistrategy prevention approach.

Design, Setting And Participants: Three-year quality improvement project comparing data at baseline (2001) and at 2-year follow-up (2003) after interventions to reduce falls. All patients admitted to the Aged Care Services wards at Caulfield General Medical Centre, Melbourne, between January 2001 and December 2003 were included.

Validation of the Cardiac Depression Scale in a cardiac rehabilitation population.

Objective: The current study was undertaken to provide further evidence supporting the reliability and validity of the Cardiac Depression Scale (CDS) in a population of cardiovascular patients.

Methods: The CDS was administered to 627 consecutive ambulatory adult cardiac patients attending an outpatient Cardiac Rehabilitation program, and a subgroup also completed the Geriatric Depression Scale--Short Form (GDS-SF).

Results: Factor analysis revealed six subscales accounting for 62% of scale variance.

How well do Australian medical schools prepare general practitioners to care for patients with mental disorders?

Objective: The purpose of the present paper was to map the mental health workloads of general practitioners (GPs) , and to determine GPs' views of the adequacy of their undergraduate training in psychiatry.

Methods: Twenty-nine GPs who had graduated since 1980 from an Australian medical school provided data on 339 consecutive adult patients with conspicuous psychological disorders. After listing their patients' problems and management plans, doctors rated the value of their undergraduate teaching in preparing them for this task.

Nontraumatic spinal cord injury rehabilitation: pressure ulcer patterns, prediction, and impact.

Objective: To investigate the characteristics, predictors, and consequences of pressure ulcers in patients with nontraumatic spinal cord injury (SCI).

Design: Retrospective, 3-year, case series.

Setting: Tertiary medical unit specializing in SCI rehabilitation.

Improving nursing recruitment and retention in a sub-acute health service.

The current worldwide shortage of nurses is well-documented. This paper describes one organisation's "back to basics" approach to nursing recruitment and the results of a vigorous recruitment program in 2001. Within 12 months, this organisation employed more than 200 new nursing staff, opened 67 beds, reduced agency use by 69% and reduced vacancies by 80%.

Nurses' perceptions of critical incidents.

Aims Of The Study: To determine: (1) the types of clinical events nurses perceived as 'critical'; and (2) whether nurses' experiences of critical incidents were associated with any demographic variables such as qualifications and current area of work.

Background: A review of the literature revealed little research has investigated in detail which clinical events nurses perceived as 'critical', apart from two North American studies. Exploratory research of Australian nurses was undertaken to confirm and contrast their understandings and views with those of other work specialties and North American findings.

Hyponatraemia and selective serotonin re-uptake inhibitors in elderly patients.

Hyponatraemia (serum sodium arbitrarily defined as less than 135 mmol/L) is an increasingly recognised adverse effect of selective serotonin re-uptake inhibitors (SSRIs). Its precise prevalence and incidence in the elderly are hard to determine because of confounding factors including other prescribed medications and medical conditions. Although hyponatraemia has been reported with all SSRIs and venlafaxine, most studies are small, retrospective, limited by confounding variables or are individual case reports.

Neurological abnormalities associated with mobile phone use.

Dysaesthesiae of the scalp after mobile phone use have been previously reported but the pathological basis of these symptoms has been unclear. We report finding a neurological abnormality in a patient after prolonged use of a mobile phone. He had permanent unilateral dysaesthesiae of the scalp, slight loss of sensation, and abnormalities on current perception threshold testing of cervical and trigeminal nerves.

Community-based recruitment strategies for a longitudinal interventional study: the VECAT experience.

This article examines different recruitment strategies for the VECAT Study, a 4-year, double-masked, placebo-controlled, randomized clinical trial of vitamin E in the prevention of cataract and age-related maculopathy. Five recruitment methods were employed: newspaper advertising, radio advertising, approaches to community groups, approaches via general practices, and an electoral roll mail-out. Participants (1204) from the community in Melbourne, Australia were recruited and enrolled within 15 months (age range: 55-80 years, mean 66 years; gender ratio: 57% female, 43% male).

Promoting continence as a health issue.

Urinary incontinence is a common condition affecting hundreds of millions of people worldwide but for which up to 70% of sufferers seek no help. Continence promotion activities must target not only the incontinence sufferers and their families but also the general community, health professionals, the industry that manufactures continence products and drugs, and the Government which is responsible for funding directly or indirectly various programmes. Continence promotion programmes must therefore be sufficiently flexible to target these groups about what incontinence is, what can be done about it, and where to get help, and most importantly to de-stigmatise this condition.