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Biomedical subjects

G L Roberts

Publications and source records attributed to G L Roberts.

15 recordsLinked to original sources
PubMed2000

What can we do about domestic violence?

Domestic violence is a complex issue at both an individual and public health level. Barriers to disclosure often lie with the doctor rather than the victim. Assessment of risk and devising a safety plan are important steps for the doctor to undertake with the victim. Recommendations for joint counselling or marriage guidance for the couple are usually not appropriate. The efficacy of population screening for domestic violence has not yet been demonstrated. More limited opportunistic screening is recommended, especially in the emergency department, mental health and obstetric settings, and general practice. Health professionals can be a bridge to resources within the community, but this requires knowledge of and liaison with those services.

Adult↗
PubMed2000

Fusobacterial infections: an underestimated threat.

The involvement of fusobacteria in a wide range of human and animal infection has long been recognised. Slow-growing anaerobes, often in polymicrobial culture, they are not always identified but are present mainly in the oropharynx, from where they are bloodborne to other sites or aspirated into the lung. Fusobacterium nucleatum is commonly found in periodontal disease and produces tissue irritants such as butyric acid, proteases and cytokines. It has strong adhesive properties due to the presence of lectins, and these outer-membrane proteins mediate adhesion to epithelia and tooth surfaces, and coagglutination with other suspected pathogens. F. necrophorum may cause necrotising tonsillitis and septicaemia, leading to the spread of infection and the development of abscesses in the lung and brain--a form of Lemierre's syndrome. Calf diphtheria, foot rot and other infections in animals are well defined, with the pathogenic mechanisms involving leucotoxins, endotoxins and adhesins. A foul smell produced by butyric acid and other metabolic products is common to all fusobacterial infections. Identification using simple tests is within the scope of most laboratories.

Animals↗
PubMed1998

The impact of domestic violence on women's mental health.

This longitudinal study aimed to establish a firmer scientific basis for recognition and treatment of post-traumatic psychiatric morbidity associated with domestic violence. The study used a sample of 335 women (mean age 45.5 years) recruited from the Royal Brisbane Hospital Emergency Department. This paper reports baseline data. The outcome measures of lifetime psychiatric diagnoses (DSM-111-R classification), showed that women who reported lifetime adult intimate abuse (n = 162) received significantly more diagnoses of generalised anxiety, dysthymia, depression, phobias, current harmful alcohol consumption and psychoactive drug dependence than those who reported no abuse ever (n = 173). Of the 191 women tested for lifetime post-traumatic stress disorder, those who reported lifetime abuse (n = 115) received significantly more diagnoses than those who reported no abuse (n = 76). Crude prevalence rates of psychiatric diagnoses for women who reported double abuse as child and adult were significantly higher than for women who reported adult intimate abuse only. Adjusted rates showed that doubly abused women had significantly greater risk of current harmful alcohol consumption and lifetime drug dependence than women who reported adult abuse only. A significant independent factor for lifetime psychiatric diagnoses was reporting abuse between a woman's parents. Measurement of the population attributable risk found that one-third of the psychiatric diagnoses were attributable to domestic violence.

Adult↗
PubMed1998

How does domestic violence affect women's mental health?

In this paper we compare the mental health of women who reported domestic violence and women who reported no abuse in their lifetime. A longitudinal study was conducted with women, 16 to 74 years (n = 358), who attended the emergency department of a major public hospital in Australia. Our aim was to investigate the nature of symptoms and pattern of mental illness associated with domestic violence. The results of the baseline data reported in this paper showed that women who experienced abuse as adults suffered more ill-effects to their mental health than women who did not experience such abuse; also that women who experienced both adult and child abuse suffered more ill-effects than women who experienced abuse either as an adult or child.

Adolescent↗
PubMed1997

Impact of an education program about domestic violence on nurses and doctors in an Australian emergency department.

OBJECTIVE: To increase the knowledge of nurses and doctors in an emergency department about the topic of domestic violence; to change any negative practices and attitudes toward victims; to increase knowledge of the referral processes for psychosocial aspects of domestic violence; and to increase knowledge of community resources for domestic violence victims. METHODS: Identical knowledge, attitude, and practice surveys were conducted with nurses and doctors in an emergency department before and after an educational intervention program about domestic violence. A matched-pair analysis of those respondents who answered both pretest and posttest surveys was conducted to measure the impact of the program on nurses and doctors. RESULTS: Nurses and doctors had a reasonable knowledge of the topic of domestic violence before the education program (correct answers: nurses, 61.6%; doctors, 63.4%). However, the program had a positive impact on their knowledge (correct answers posttest: nurses, 71.5%; doctors, 72.4%), with more significant changes for nurses than for doctors. The program affected both nurses' and doctors' attitudes (of 10 positive attitudinal statements: pretest, 7.9; posttest, 8.6). On both the pretest and posttest, nurses and doctors did not subscribe to a number of the myths about domestic violence that have been described in the domestic violence literature. These findings should be treated with caution because of the low response rates to the surveys from doctors (28.0%, n = 20) and nurses (53.0%, n = 48). DISCUSSION: Further research is needed into the beliefs and practices of nurses and doctors about domestic violence. The impact of this education program highlights the necessity for introducing training programs for health professionals on domestic violence problems.

Australia↗
PubMed1997

Domestic violence in the Emergency Department: I. Two case-control studies of victims.

The object of this study was to compare the diagnoses and characteristics of self-reported domestic violence victims with a random sample of nonvictim controls who were selected from attendees at the Emergency Department (ED) of a major public hospital in Australia. Comparisons were made at index presentation and for the 5 years prior to index presentation. Subjects were drawn from two screening studies carried out 1 year apart which were conducted to assess the prevalence of domestic violence among attendees at the ED. From these groups, the medical records of all individuals who had disclosed domestic violence were examined and compared with the medical records of a random sample of nondisclosers, matched for age (+/- 10 years), sex, and type of entry into the ED (acute vs nonacute). The two case-control studies, conducted 12 months apart, showed that there were statistically significant differences between the diagnoses and characteristics of victims and nonvictims. Victims made more visits to the ED and Outpatients' Department than nonvictims; victims had more psychiatric index presentations; more victims had evidence of treatment of psychiatric conditions, both as inpatients and outpatients, in the previous 5 years than nonvictims; victims had greater rates of attempted suicide and alcohol problems than nonvictims at index presentation and for the previous 5 years. The findings indicate the need for the prevention and treatment of psychiatric conditions of domestic violence victims, including drug and alcohol problems and suicidal ideation. The findings form the basis of hypotheses for further studies to investigate the association between domestic violence and psychiatric illness.

Adult↗
PubMed1997

Domestic violence in the Emergency Department: 2. Detection by doctors and nurses.

This study was conducted in 1991 and 1992 to determine the detection rates of domestic violence victims by doctors and nurses at the Emergency Department (ED) of Royal Brisbane Hospital, a major public hospital in Australia. The objective was to determine the outcome of an education program about domestic violence conducted in 1991 for doctors and nurses in the ED. As part of two case-control studies, the self-reports of those who disclosed domestic violence on a screening questionnaire were compared with the recording of domestic violence on each individual medical record. Subjects were drawn from two screening studies carried out 1 year apart which were conducted to assess the prevalence of domestic violence among attendees at the ED. An education program about domestic violence was conducted for doctors and nurses in the ED between the two screening studies. The examination of the medical records showed that detection rates of victims of domestic violence were unchanged between the two case-control studies. Both studies found that 50.0% of those who reported the experience of domestic violence within the 24 hours prior to index presentation, on the screening questionnaire in the prevalence studies, were recorded as such in their medical records. The low detection rates indicate the requirement for doctors and nurses to receive appropriate training to identify and record the psychosocial aspects of domestic violence victims. As well as training, referral systems need to be set in place to address the psychosocial aspects of domestic violence victims.

Adult↗
PubMed1996

Prevalence study of domestic violence victims in an emergency department.

STUDY OBJECTIVE: In 1992, a study of the prevalence and predictors of domestic violence victims among individuals who presented to a major public hospital emergency department was conducted to replicate a study conducted by the authors in the same setting 12 months previously. The second study aimed to investigate more accurately the presentation of current victims of domestic violence to the ED. METHODS: In a retrospective, cross-sectional study, a screening questionnaire was administered to participants to establish the prevalence of a history and current presentation of domestic violence problems among patients who presented to the ED of a major public hospital. The study group comprised a representative sample of 670 male and 553 female adults (older than 16 years) who presented to all sections of a public hospital ED during 53 randomly selected 8-hour nursing shifts over an 8-week period in 1992. RESULTS: The results of the second prevalence study confirmed those of the first study. Of the 1,223 respondents in the study, 15.5% disclosed a history of adult domestic violence (8.5% of men, 23.9% of women). Women were at greater risk than men for abuse as adults (raw relative risk [RR], 3.27; 95% confidence interval [CI], 2.23 to 4.79; RR adjusted for age, history of child abuse, and country of birth, 4.13; CI, 2.86 to 5.95). Women were at greater risk than men for being doubly abused (as a child and as an adult)(raw RR, 2.17; CI, 1.33 to 3.53). The second prevalence study confirmed what had been indicated in the first study: that 2.0% of women who presented to the ED (11.6% of all women with a history of adult domestic violence) were current victims of domestic violence and that these women presented mainly between the hours of 5 pm and 8 am, when no social work services were available for referral of victims. CONCLUSION: These Australian studies support the findings of prevalence studies of domestic violence victims in ED in the United States. The prevalence and risk factors indicate the need for training of physicians and nurses in the ED about domestic violence and for provision of appropriate backup referral services such as after-hours social work services.

Adolescent↗
PubMed1993

Domestic violence victims in a hospital emergency department.

OBJECTIVE: To determine the prevalence and predictors of domestic violence victims among attenders at the emergency department at Royal Brisbane Hospital in 1991. DESIGN: Cross-sectional study in which randomly selected nursing shifts were used to screen attenders. RESULTS: Of all attenders at the emergency department, 14.1% disclosed a history of domestic violence. Women were more likely than men to disclose domestic violence ("raw" relative risk, 2.31; 95% confidence interval [CI], 1.83-2.91; relative risk adjusted for age and history of child abuse, 4.50; 95% CI, 3.02-6.71). The greatest risks for being an adult victim of domestic violence were being female and having experienced abuse as a child. Most of those who had experienced domestic violence within the last 24 hours (1.1% of attenders) came to the department after-hours when social work staff were unavailable for referral. CONCLUSIONS: The prevalence and risk factors have implications for the training of doctors and nurses in domestic violence problems and for the provision of adequate resources to deal with the psychosocial aspects of domestic violence.

Adolescent↗
PubMed1993

Accurate and systematic numerical recording system for the identification of various types of lip and maxillary clefts (RPL system).

Inaccuracies exist in identifying and recording various types of oral cleft. One of the major reasons for this problem is that no efficient or universally accepted recording system presently exists. The RPL system introduced in this article provides an accurate and systematic numerical recording for the identification of various types of lip and maxillary clefts. The simplicity of the system allows quick and efficient data storage and retrieval.

Alveolar Process↗
PubMed1989

Dental abnormalities associated with campomelic syndrome: case report.

Campomelic syndrome is a rare autosomal recessive disease. It is characterized by short stature with angulation and bowing of the lower limbs, hypoplasia of the facial bones, and various other skeletal anomalies. The facies are unusually flat with micrognathia, frequent cleft palate, hypertelorism, and micro-ophthalmia. Most infants with this syndrome die from severe respiratory distress within the first hours or days of life. Those who survive infancy are mentally retarded. This case report concerns the dental treatment of a 13-year-old female with campomelic syndrome.

Adolescent↗
PubMed1978

A method for calculating acetabular anteversion in children.

A method of calculating the degree of anteversion of the acetabular fossa is described. A posterior-anterior projection of the prone pelvis with a long focus film and focus object distance is used. The distance between the anterior and posterior rims of the fossa as projected on the films is measured and then divided by a distance equivalent to the diameter: this yields the sin of the anteversion angle. The angle is rapidly calculated with a pocket calculator.

Acetabulum↗