The Medical journal of Australia
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Comparative Study
Utility of auscultatory screening for detecting rheumatic heart disease in high-risk children in Australia's Northern Territory.
To evaluate the utility of auscultatory screening for detecting echocardiographically confirmed rheumatic heart disease (RHD) in high-risk children in the Northern Territory, Australia. ⋯ Sensitivity and positive predictive value of cardiac auscultation compared with echocardiography is poor, regardless of the expertise of the auscultator. Although negative predictive value is high, most cases of heart disease were missed by auscultation, suggesting that cardiac auscultation should no longer be used to screen for RHD in high-risk schoolchildren in Australia.
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The general-practice setting provides a unique opportunity to positively influence the impact of mental illness on individuals and families. Intervention can begin from the moment an individual seeks professional help. Using a family-focused approach, and supporting parents to develop practical strategies to promote resilience in their children, can aid parents' recovery and promote the optimal emotional wellbeing of their children. We suggest a family-orientated therapeutic approach relevant to the general-practice setting, with particular consideration of the value of communicating with children according to the child's stage of emotional development.
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To determine the effect of the Mental Health Positive Parenting Program (MHPPP) on parenting practices of parents reporting a mental health problem. ⋯ Our findings suggest the MHPPP can reduce the number of dysfunctional parenting strategies and parent-reported child behavioural problems. The MHPPP is a promising avenue for early intervention in this population.
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To evaluate the obstetric and neonatal outcomes of pregnant women with severe mental illness (SMI) who attended a specialist multidisciplinary antenatal clinic in Perth, Western Australia. ⋯ Women attending our specialist clinic had increased rates of obstetric and neonatal complications compared with the general population, and were exposed to a cluster of risk factors. We report encouraging trends in antenatal attendance, gestational age at birth, and birth weights. Managing pregnant women with SMI will require a comprehensive approach aimed at early detection of obstetric complications and psychosocial difficulties, as well as neonatal monitoring. Optimising prepregnancy maternal health and welfare may also be of benefit.