Professional Literature: One View of a National Perspective

Content, citation and theme analyses of articles and editorials published during two five year periods (1963-67 and 1983-87) in the Australian Occupational Therapy Journal are presented. A comparison of the two publication periods shows that: there has been no increase in the number of journal issues per year, nor in the total number of articles published since 1963. The number of articles in the research category has substantially increased; research appears to reflect the scope of practice. However, the need for a unifying conceptual framework that identifies Australian occupational therapy remains. A broader service network is evident; emphasis on promoting the profession in the wider community and a functional orientation are indicative of the shift that has taken place in marketing occupational therapy services. Recommendations are made regarding issues that relate to areas of professional concern and publication management.     

Adulthood functioning: the joint effects of parental alcoholism, gender and childhood socio-economic stress

The popular literature has publicized the adjustment difficulties of adult children of an alcohol-dependent parent (ACOAs); however, empirical studies do not provide consistent support. We examined the impact of parental alcoholism, degree of childhood socio-economic stress and gender on three broad categories of adulthood functioning (psychopathology, socio-economic attainment and marital stability). These effects were investigated with a heterogeneous sample of 400 men and 226 women participating in studies at the University of Michigan Alcohol Research Center. Parental alcoholism and childhood socio-economic stress exerted significant independent effects on most adulthood functioning measures. Men and women differed substantially only on socio-economic attainment measures, and effects of parental alcoholism and childhood economic stress on men and women were generally similar. For marital stability, parental alcoholism and childhood socio-economic stress interacted. These results suggest that researchers who study the impact of family history for alcoholism on psychological functioning should consider other aspects of the family of origin that promote wellbeing. In addition, results of this study point to the need for more research on gender differences, protective factors that promote good adjustment and outcome measures reflecting general life adaptation.     

A Multicenter Experience with a Bipolar Tined Polyurethane Ventricular Lead

A multicenter study was undertaken to determine the failure rate of a specific polyurethane bipolar tined pacing lead, the Medtronic 4012 pacing lead. Six centers in the United States and Canada implanted 1,190 Medtronic 4012 pacing leads. The study was designed to determine the probability and clinical manifestations of lead failure. Only failures compatible with an insulation problem were included. The probability of a 4012 lead failure by Kaplan-Meier analysis was 20.9% at 6 years after implantation. Failures were manifested as sensing abnormalities, failure to capture, early battery depletion, and significant decrease in measured impedance compared with the previous impedance measurements. Of the 95 definite lead failures, 16 (16.8%) were associated with symptoms similar to those experienced before pacemaker placement. The observed failure rate is unacceptable, and strong consideration should be given to replacing the 4012 pacing lead in pacemaker-dependent patients and closely monitoring nondependent patients.     

A comparison of the diets of non-smokers and smokers

Dietary data, mostly in the form of the frequency of consumption of foods, from the 9003 respondents in the Health and Lifestyle Survey were used to compare lifetime non-smokers with light, heavy and ex-smokers, taking account of age and social class. Non-smokers, of both sexes, were significantly more likely than smokers to consume, frequently, fresh fruit in summer and winter, fruit juice, cooked and canned fruit, salads in summer and winter, breakfast cereals, cakes, biscuits, puddings, pasta, poultry, light desserts and preserves. They were also more likely to choose ‘brown’ bread, semi- or skimmed milk, low fat or polyunsaturated spread and to eat breakfast. Smokers were likely to consume chips and processed meats frequently, to drink more alcohol, more cups of tea and coffee and take sugar in these beverages. The differences from the non-smokers were more marked in the heavy smokers. Ex-smokers only differed from non-smokers in consuming more alcohol, tea and coffee, and nuts, in consuming cakes and soft drinks less frequently and in being more likely to choose skimmed or semi-skimmed milk. The results extend previous findings, and suggest that the eating patterns of non-smokers are more in line with current dietary recommendations than those of light smokers or, more particularly, heavy smokers.     

Modification of Late Potentials by Intracoronary Ethanol Infusion

Antiarrhythmic drugs have no consistent effects on the signal-averaged electrocardiogram (ECG) while successful surgical ablation of ventricular tachycardia is known to abolish late potentials. Ten patients with prior myocardial infarction had successful ablation of recurrent sustained ventricular tachycardia by selective ethanol infusion into a small coronary vessel supplying the tachycardia origin. Signal-averaged ECGs were performed before and after initially successful ablation in patients without pacemaker dependence or infra-ventricular conduction delay to assess the effects on late potentials and to determine if the signal-averaged EGG could predict ventricular tachycardia recurrence. Only four of ten patients were eligible for study and all four had late potentials prior to ethanol ablation. Late potentials were abolished in one patient who has not had an arrhythmia recurrence in 25 months. One patient with sudden death and another patient with ventricular tachycardia recurrence had persistent late potentials post procedure that were modified by a reduction in terminal voltage and lengthening of terminal low amplitude signal. The fourth patient who receives chronic amiodarone had no arrhythmia recurrence in spite of persistent but modified late potentials. Thus, the abolition of late potentials after ethanol ablation may predict freedom from arrhythmia recurrence.     

Regional cerebral blood flow during experimental phobic fear

Positron emission tomographic measurements of regional cerebral blood flow (rCBF) were used to investigate central nervous system correlates of fear and anxiety. Volunteers with symptomatic snake phobia were studied while exposed to visual phobogenic, aversive, and neutral stimuli. Anxiety ratings and the number of nonspecific electrodermal fluctuations increased as a function of phobic stimulation. Phobic, compared to neutral and aversive, stimulation elevated rCBF in the visual associative cortex. The basal ganglia were not activated more by phobic than aversive or neutral stimulation. However, cortical and thalamic rCBF were always correlated during phobic but not aversive or neutral stimulation. This indicates that the thalamus could be a relay station for phobic stimulus processing and affect.     

SIMPLE VERSUS SOPHISTICATED MODELS OF BREATH ALCOHOL EXHALATION PROFILES

For medicolegal purposes, breath alcohol content is typicallydetermined from an end-expiratory sample. Measurements obtainedby this method necessarily underestimate the alveolar breathalcohol content, and therefore underestimate the blood alcoholcontent. We suggest and analyse an improved paradigm which usesthe entire time-series of breath alcohol measurements duringexhalation, not simply the last recorded value. We present twomathematical models for the exhaling lung, and discuss the implicationsof each for more accurate and therefore more reliable breathalcohol measurement.