Did We Forget Something? Fathering Supports and Programs in Prisons in Victoria, Australia.

This article draws from data gathered for an Australian Research Council-funded study conducted in Victoria and New South Wales between 2011 and 2015, which examined how dependent children are responded to when their primary carer is imprisoned. In particular, this article specifically addresses a gap in knowledge by examining the current state of fathering programs in prison in Victoria. To do so, the views of 39 primary carer fathers incarcerated in Victoria are analysed. We argue that there is a distinct lack of support for fathers in prison, acting as a barrier towards maintaining father-child relationships. Findings indicate that 79% of the fathers in this study were never offered any parenting support services or programs. By clearly highlighting the state of fathering programs in prisons in Victoria, this article offers suggestions as to how best to facilitate the connection between incarcerated fathers and their children.

Psychological Distress Among Older Prisoners: Associations With Health, Health Care Utilization, and the Prison Environment.

Physical and functional health issues among older prisoners may be difficult to address in an environment designed for younger inmates. This article investigates the relationships between older prisoners' health, their experiences of the prison environment and health services, and their levels of psychological distress. One hundred and seventy-three older prisoners (aged 50 years and older) from eight Australian prisons were interviewed using the Kessler Psychological Distress Scale, with additional information collected from prisoner interviews and correctional health files. Distress scores were significantly associated with measures of physical health, functional independence, and health care utilization. However, a hierarchical regression analysis determined that physical difficulties in the prison environment and issues accessing prison health care explained a significant proportion of the variation in older prisoners' distress scores.

Prison Experiences and Psychological Distress among Older Inmates.

This study investigates relationships between older prisoners' social experiences and their levels of distress. One hundred and seventy-three older prisoners (aged ≥ 50 years) from 8 Australian prisons were administered the Kessler Psychological Distress (K10) Scale, with additional information collected via individual interviews. Psychological distress scores were significantly associated with measures of self-reported safety (p < .001), prison victimization (p < .05), perceived social support from staff (p < .01) and inmates (p < .001), current employment (p < .05), and level of exercise (p < .001) among older inmates. Findings suggest that strategies for improving sense of safety, social support and level of exercise may ameliorate distress among older prisoners.

Pulmonary artery catheter-induced perforation treated with coil embolization.

The past 40 years have taught us much about the use of pulmonary artery catheters and their complications. Pulmonary artery rupture carries high morbidity and mortality, and therefore a high index of suspicion and timely management are key to the survival of patients who suffer from this rare complication. While surgical therapy has been considered the mainstay of treatment, endovascular therapy is feasible when surgery is not possible or desirable, as demonstrated in our patient. It is unknown which approach is optimal.

Short-duration oral amiodarone for prevention of atrial fibrillation post heart surgery.

BACKGROUND: Atrial fibrillation occurs in 20% to 40% of patients post cardiac surgery. Prophylactic amiodarone decreases the incidence of atrial fibrillation, especially in those not taking ß-blockers. Studies, however, vary in dosage, duration of treatment, and route of administration. Limited studies evaluating short duration use of oral amiodarone show conflicting results. We hypothesize that an order set for use of short duration, oral amiodarone started the night before surgery and continued for 4 to 6 days will decrease atrial fibrillation after heart surgery. METHODS: The Society of Thoracic Surgeons database was used to identify 471 patients who received amiodarone per order set and 151 patients that did not receive amiodarone. The amiodarone order set included amiodarone 600 mg the night before surgery and 400mg twice daily for 4 to 6 days post heart surgery. After propensity matching, 112 patients remained in each group. We compared outcomes for the 2 groups as a case-controlled, retrospective, study. RESULTS: Atrial fibrillation occurred in 43% (48 of 112) of the patients that did not receive amiodarone vs 23% (26 of 112) receiving prophylactic amiodarone (P=<.001). There was no increased incidence of hemodynamic, pulmonary, or other adverse outcomes observed between the 2 groups. CONCLUSIONS: This practical order set for, short duration, oral amiodarone, with or without adjunct ß-blocker therapy started the night before heart surgery and continued for up to six days post surgery, appears to be a safe and effective treatment for reducing the incidence of atrial fibrillation following heart surgery.

A controversy: linking atypical femoral fractures to bisphosphonate therapy.

Several cases have been reported of unusual spontaneous fractures with minimal trauma in the subtrochanteric and diaphyseal areas of the femur linked to long-term bisphosphonate use. After encountering three such patients, we conducted a review of published cases. The average age of these individuals were 68 years and approximately 25% had received concomitant glucocorticoids. Histomorphometric bone biopsy studies performed in some individuals have suggested that severe suppression of bone turnover may be the underlying cause; however, cause and effect has not been firmly established. Moreover, population studies have found this type of fracture rare and not increased in patients who have received bisphosphonate treatment. Physicians should continue to use bisphosphonate agents as a primary treatment for osteoporosis.

Urinothorax: a rare cause of pleural effusion.

There are many benign causes of pleural effusions that can be followed expectantly. This case report will detail a rare cause of pleural effusion. The evaluation of this patient led to a diagnosis of urinothorax. This case will highlight the importance of a thorough history and physical, as well as diagnostic evaluation of effusions of unknown etiology. With the increasing number of urological procedures being performed, it will likely become a more frequent finding.