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.

Standardising health outcome measurements in general practice.

Background: Outcome measures are gaining importance especially in areas such as divisions of general practice. The plethora of outcome measurements and the rhetoric surrounding this may make it difficult for doctors to decide the place of such measures in daily practice. An understanding of outcomes and their indicators is emerging as an essential requirement for good practice.

Central sleep apnoea and heart failure (part II).

Central sleep apnoea (CSA) in congestive heart failure is sleep state dependent and occurs typically in stages I and II of non-REM sleep. The pre-requisites are hypocapnia and some prolongation of the circulation time. It is not certain whether abnormalities in after-discharge activity in the brainstem are also important.

Central sleep apnoea and heart failure (Part I).

Central sleep apnoea (CSA) in congestive heart failure is sleep state dependent and occurs typically in stages I and II of non-REM sleep. The pre-requisites are hypocapnia and some prolongation of the circulation time. It is not certain whether abnormalities in after-discharge activity in the brainstem are also important.

Guidelines for every person.

Guidelines, it is assumed in health care circles, have worth. In the ideal health care system they may offer everything from medical certainty to legal protection. They have the potential to save practitioners from the trauma of indecision and at the same time protect them from the consequences of wrong decisions.

Tumour microembolism presenting as "primary pulmonary hypertension".

Pulmonary tumour microembolism is a rare cause of pulmonary hypertension. A case of rapidly progressive pulmonary hypertension in a patient with a past history of breast carcinoma is presented. Despite active consideration and investigation for malignancy as a cause, correct diagnosis was only made at necropsy.

Acute respiratory distress syndrome in a community hospital ICU.

Objective: To estimate the incidence of the acute respiratory distress syndrome (ARDS) in an Australian urban community, and to describe the pattern of disease and outcomes in a community hospital intensive care unit (ICU).

Setting: An eight-bed general ICU in a community hospital.

Design: Retrospective chart review.

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.

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.

Gastric tonometry: evaluating tissue oxygenation.

Critically ill patients require vigilant monitoring of tissue oxygenation, particularly oxygenation of the gut mucosa, because of the mucosa's fragile blood supply. With the advent of gastric tonometry, splanchnic tissue oxygenation can be measured in a minimally invasive and cost-effective manner. Requiring only a gastric tonometer (approximately $70) and facilities to measure arterial blood gases, this method allows early detection of covert compensated shock by determining pHi.

Use of an occupational therapy motor performance checklist by a school health service: a pilot study.

Objective: The aim of this pilot study was to assess whether the School Health Service could play a role in identifying the children in most need of community occupational therapy services.

Methodology: A two-tiered referral system, which incorporated a Motor Performance Checklist (MPC) devised by the authors, was used. This checklist consisted of 12 gross and fine motor items and was administered to 123 children in their first year of school.

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.

Locums. A guide on how to use them.

This article outlines a range of issues that should be resolved with each locum before placement in a general practice. It also provides some measures by which the service provided to the practice can be evaluated. Through a series of checklists, general practitioners can prepare their practice for locums and assess the impact of the service.

Massive macroglossia as a presenting feature of hypothyroid-associated pericardial effusion.

An 81-year-old woman presented with massive macroglossia and signs of both hypothyroidism and pericardial tamponade. Drainage of the pericardial effusion produced dramatic resolution of the macroglossia. Marked elevation of central venous pressure may result in macroglossia, possibly because of anomalous venous drainage of the tongue.

Maloprim-induced pulmonary eosinophilia.

A 47-year-old woman developed pulmonary eosinophilia from the use of maloprim as malaria prophylaxis. The diagnosis was confirmed by bronchoalveolar lavage (BAL) and transbronchial lung biopsy. Her condition improved with drug withdrawal and steroid therapy.

A method of spontaneously breathing anaesthesia in the prone position without endotracheal intubation.

A method of delivering anaesthetics to spontaneously breathing patients in the prone position was developed. The arterial blood gases of eighteen patients undergoing short-stay surgery and using this technique were analysed. The results showed the influence of premedication on arterial pH and PCO2 levels but they do not differ from accepted values for similar anaesthesia on supine patients.