Aust Fam Physician
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Modern screening tools have the potential to decrease mortality and morbidity from bowel cancer, the second commonest cause of cancer death. The evaluation of the recent National Bowel Cancer Screening Pilot Program (NBCSPP) in Australia has prompted the commonwealth government to fund the first phase of the National Bowel Cancer Screening Program in May 2006. ⋯ Inexpensive tests are available to detect bleeding from the large bowel, a stronger indicator of early bowel cancer than symptoms, and pilot projects confirm their feasibility and acceptability in Australia. A doctor's recommendation strongly influences individual participation in screening. The medical profession are more likely to support an organised screening program if they are informed on the evidence on which the screening program is based.
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Psychotic symptoms in the elderly arise in mood disorders, schizophrenia, dementia, and delirium. ⋯ Management follows logically from a thorough mental state examination, medical work up and accurate diagnosis. Depression and mania with psychotic symptoms respond best to an antidepressant and mood stabiliser respectively, usually in combination with antipsychotic medication. Severe cases require electroconvulsive therapy. Atypical antipsychotics are now the treatment of choice in late life schizophrenia. Psychotic symptoms are common in dementia but usually fade within 6-12 months. Doses of psychiatric medications should therefore be lowered every 3 months to check that continued treatment is necessary. Most cases of delirium do not require psychiatric medication.
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A recent New South Wales Supreme Court case explored some interesting and novel concepts with respect to the law and mental illness. This article outlines the case and summarises the legislation in each Australian state and territory which regulates the care and treatment of patients who have a mental illness.