Murine typhus: a newly recognised problem in the Waikato region of New Zealand.

Aim: To characterise and investigate patients diagnosed with murine typhus in the Waikato District Health Board (DHB) region during 2006.

Method: We reviewed the hospital and general practitioner records of all patients presenting with clinical and serological evidence of murine typhus. All patients were interviewed by telephone using a semi-structured questionnaire to identify environmental risk factors for infection.

Community mental health teams (CMHTs) for people with severe mental illnesses and disordered personality.

Background: Closure of asylums and institutions for the mentally ill, coupled with government policies focusing on reducing the number of hospital beds for people with severe mental illness in favour of providing care in a variety of non-hospital settings, underpins the rationale behind care in the community. A major thrust towards community care has been the development of community mental health teams (CMHT).

Objectives: To evaluate the effects of community mental health team (CMHT) treatment for anyone with serious mental illness compared with standard non-team management.

Prosecuting psychiatric patients who assault staff: a New Zealand perspective.

Objectives: The prosecution of psychiatric inpatients for violent acts remains controversial but is increasingly considered as a management option for a minority of patients. Most of the literature so far has been based in North America. This study in a rural New Zealand psychiatric unit was undertaken to explore the rates, reasons and outcomes of referring psychiatric inpatients to the police for possible prosecution of violent acts committed while in hospital.

Psychiatrists in New Zealand: are they burning out, satisfied at work and, in any case, who cares?

Objective: To explore possible contributing or mitigating factors for burnout in New Zealand psychiatrists as well as future research directions in this area.

Method: A selective review of the literature pertaining to burnout and reports regarding New Zealand's medical workforce.

Results: Possible factors contributing to burnout in New Zealand psychiatrists include rapid changes in the country's health system, the challenge of recruiting and retaining psychiatrists, poor distribution of staff and funds and difficulties in psychiatric training.

Administrators' perspectives of the challenges in recruiting and retaining psychiatrists for New Zealand: a national study.

Objective: Administrators' perceptions of significant factors that might affect the recruitment and retention of psychiatrists for New Zealand's public mental health Services have not been previously investigated.

Methods: A postal questionnaire was sent to managers of all 21 of New Zealand's mental health Services. The questionnaire requesting information about any difficulties managers experienced in recruiting and retaining psychiatrists, factors they thought attract psychiatrists to join and stay, reasons why psychiatrists left, strategies they had tried to alleviate any psychiatrist shortages, and their relative success.

New Zealand's psychiatrist workforce: profile, recruitment and retention.

Objective: New Zealand is suspected of sharing other countries' difficulties of having inadequate numbers of practising psychiatrists and attracting psychiatrists to work outside its main urban centres, but there is no contemporary data on the socio-demographic and professional practice profile of its psychiatrists. This paper highlights some interesting trends about New Zealand's psychiatric workforce.

Method: A postal questionnaire was sent to all actively practising vocationally registered psychiatrists with a New Zealand mailing address requesting information about basic demographic data, professional training experiences, current professional status, practise intentions, why they chose to work where they do and what factors might influence them to leave for another region of New Zealand or overseas.

Can olanzapine be implicated in causing serotonin syndrome?

The present paper describes a case of serotonin syndrome (SS), which developed in a patient with bipolar affective disorder after the addition of olanzapine to her regimen of lithium and citalopram. This appears to be the first report that implicates olanzapine with SS. Clinicians should be aware of the risk of SS when adding atypical antipsychotics, such as olanzapine, to serotonergic agents.

Crowding and violence on psychiatric wards: explanatory models.

Objective: Violence is widely prevalent on acute-care psychiatric wards, and crowding has been identified as a major risk factor. This paper explores why patients may respond to crowding with violence.

Method: We carried out a literature review on Medline, using the key words "violence" and "crowding.

Ward crowding and incidents of violence on an acute psychiatric inpatient unit.

Objective: Violence in psychiatric wards is common, and it is on the rise. This study examined the relationship between ward occupancy level and staff-to-patient ratio and incidents of aggressive behavior, both physical and verbal, on an acute inpatient unit in rural New Zealand.

Methods: Logistic regression was used to analyze data collected from the ward's log of adverse incidents and the ward census over a 12-month period.

The impact of medical libraries and literature on patient care in New Zealand.

This paper reports the results of a survey of 372 physicians working in regional hospitals in New Zealand. The survey was undertaken to determine if these physicians used their local medical library and what impact the literature obtained had on patient care. The 295 respondents (80.

Vecuronium-thiopentone induction for emergency caesarean section under general anaesthesia.

Induction of general anaesthesia for emergency caesarean section has always been hazardous. Acid aspiration syndrome and adverse reactions to suxamethonium are well recognised problems, in spite of which "crash" induction using thiopentone and suxamethonium remains a common induction technique. Recent case reports suggest that the use of medium duration nondepolarising relaxants in place of suxamethonium achieves satisfactory intubating conditions in the emergency caesarean section patient.

A double blind trial of moclobemide versus amitriptyline in the treatment of depressive disorders.

The antidepressant efficacy and side-effect profile of amitriptyline were compared to those of moclobemide, a reversible monoamine oxidase inhibitor with selectivity for the type A isozyme. Forty nine patients with DSM-III major depression were randomly assigned to receive either amitriptyline or moclobemide. Thirty seven patients (amitriptyline n = 16, moclobemide n = 21) completed the six week protocol, which was conducted under double blind conditions.

High school students' attitudes towards and use of contraceptives.

A questionnaire survey was conducted in an urban coeducational secondary school in the North Island region. Of the 162 adolescents sampled in this study, 39 percent reported coital experience. Of these coitally experienced students, contraception was always used by only 42%.