Same-sex marriage and mental health.

OBJECTIVES: It has been proposed that legislation for same-sex marriage has a positive mental health benefit. The purpose of this paper is to review and evaluate the empirical and conceptual links between same-sex marriage and mental health. CONCLUSIONS: There are substantive methodological issues in the four surveys and comparisons undertaken. Difficulties with the validity of the evidence are discussed. Conceptual difficulties in the arguments relating to victimisation as well as the psychology of marriage are highlighted. It was concluded that it is premature to make claims of causality vis-a-vis same-sex marriage legislation and mental health.

Use of structured clinical documentation to identify patients' parental concerns and their childrens' wellbeing.

Children of parents with mental illness are at high risk of adverse health and functional outcomes, but little is known about how the community mental health staff identify and document these. This file audit examines parents' case managers' recording of children's needs and safety, on relevant components of New South Wales' Mental Health Structured Clinical Documentation. The audit identified 280 parental files. Study findings indicate that parenting issues form an important load of work on community mental health teams, highlighting the need for systematic identification of parental status in mental health patients.

Mirth-triggered asthma: is laughter really the best medicine?

Mirthful emotions such as laughter and excitement are unrecognized but perhaps important triggers of asthma. Our study aimed to explore the prevalence, mechanisms, and associations of mirth-triggered asthma (MTA) in children. Our MTA prevalence questionnaire was given to 285 children who presented to the Emergency Department of Sydney Children's Hospital (SCH) with an acute episode of asthma. Our MTA profile questionnaire study was a cross-sectional study of 541 children with asthma. The parents completed a questionnaire regarding their child's asthma. In our laughter diary study, diary cards were given to the parents of 21 children with asthma. The diary required details regarding the mirthful stimulus, symptoms of asthma, and recording of peak expiratory flow (PEF) measurements. Of the selected cohort, 31.9% had mirth-triggered asthma. In the cross-sectional study, mirth-triggered asthma was more common: with increasing age (P = 0.02); in those who in the last 3 months had taken more doses of salbutamol (P = 0.005), and who had more wheeze, nocturnal symptoms, and early morning symptoms (P < 0.0005); and in those who reported exercise-induced asthma (P < 0.0005). Laughter was more commonly reported as a trigger than excitement; cough was the most prominent symptom; and symptoms mostly occurred within 2 min of the mirthful stimulus. In the laughter diary study, 59 of 130 recorded events described symptoms of asthma. Mirth while watching a film led to PEF of 73% of baseline, compared with 81% for mirth with exertional play, and 95% for mirth with nonexertional play (P = 0.01). Mirth-triggered asthma is common, and is an indicator of suboptimal asthma control.

General practice in Greece: a student's and supervisor's perspective.

OBJECTIVE: The present study reports the observations of an Australian medical student, his reflections on these observations and commentary from the Greek supervisor. SETTING: One urban General Practice at the University Hospital in Heraklion, Crete and three community health centres in rural Crete. MAIN OUTCOME MEASURES: Points of comparison were formed during the patient's consultations and clinical investigations. RESULTS: Although the level of knowledge and GP's competence in Crete and New South Wales appear to be similar and there is an impression that the patient satisfaction in Greece is comparable to that in Australia, a striking feature in Greek primary care is the communication between practitioner and patient, as well as the poor level of note keeping. In contrast, Primary Care in Greece seems to be far more involved in research. CONCLUSION: To attain a higher quality in primary care, leading to a better outcome for the people of Greece, the primary care physicians need more effective vocational training and the appropriate support from health authorities.

EDL and soleus muscles of the C57BL6J/dy2j laminin-alpha 2-deficient dystrophic mouse are not vulnerable to eccentric contractions.

Many muscular dystrophies arise as a consequence of mutations in a series of interconnected proteins associated with the sarcolemma. This group of proteins is collectively referred to as the 'dystrophin-associated complex'. We used the C57BL6J/dy(2j), dystrophia muscularis, dystrophic mouse, in which the laminin-alpha(2) component of the dystrophin-associated complex is mutated, to test the hypothesis that the disruption of this complex will destabilize the lipid bilayer, rendering it more susceptible to damage during eccentric contractions. We demonstrated that neither slow- nor fast-twitch dystrophic muscles were more susceptible to eccentric contractions when compared with controls. Only fast-twitch extensor digitorum longus (EDL) muscles (from both dystrophic and control mice) showed an irreversible loss of force with our eccentric contraction protocol, suggesting that it is the fast 11b fibres (not present in slow-twitch soleus) which are most susceptible to eccentric damage. We used the general anaesthetic halothane to increase the fluidity of the lipid bilayer to see if this would uncover any greater susceptibility of the dystrophic muscle to eccentric damage. This also did not reveal any greater fragility of fast- and slow-twitch dystrophic muscles. We did, however, demonstrate that halothane made both control and dystrophic fast- and slow-twitch muscles more susceptible to eccentric contraction damage. The C57BL6J/dy(2j) dystrophic laminopathy produced the pathophysiological and pathohistological characteristics associated with muscular dystrophy: the fast- and slow-twitch dystophic muscles produced only 55 and 53%, respectively, of the force of control muscles and 34 and 40%, respectively, of the dystrophic muscle fibres were branched. The presence of the branched fibres in the dystrophic muscles did not make them more susceptible to eccentric damage but may have contributed to the reduction in maximal force in the dystrophic muscles. We conclude that our data do not support the structural hypothesis that the dystrophin-associated complex acts as a scaffolding to support the lipid bilayer, but are consistent with channel-based hypotheses put forward to explain the dystrophic process.