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This paper presents data obtained in a one-day census investigation in five European countries (Austria, Hungary, Romania, Slovakia, Slovenia). The census forms were filled in for 4191 psychiatric inpatients. Concerning legal status, 11.2% were hospitalised against their will (committed) and 21.4% were treated in a ward with locked doors. There was only a small correlation between commitment and treatment in a locked ward. More frequent than treatment of committed patients in locked wards was treatment of committed patients in open wards (Austria, Hungary) and treatment of voluntary patients in closed wards (Slovakia, Slovenia). Concerning employment, 27.7% of patients aged 18–60 held a job before admission. The vast majority of patients (84.8%) had a length of stay of less than 3 months. A comparison of these data with the results of a study performed in 1996 and using the same method shows a decrease of rates of long-stay patients. In 1996 the rates of employment were significantly higher in Romania (39.3%) and Slovakia (42.5%) compared to Austria (30.7%). These differences disappeared in 1999 due to decreasing rates of employment in Romania and Slovakia. The numbers of mental health personnel varies between types of institution (university or non-university) and countries, being highest in Austria and lowest in Romania. A considerable increase in the numbers of staff was found in Slovakia.
Clinical case studies have long been recognized as a useful adjunct to problem-based learning and continuing professional development. They emphasize the need for clinical reasoning, integrative thinking, problem-solving, communication, teamwork and self-directed learning - all desirable generic skills for health care professionals. This volume contains a selection of cases on assisted reproduction that will inform and challenge reproductive medicine practitioners at all stages in their careers. Both common and uncommon cases are included. The aim is to reinforce diagnostic skill through careful analysis of individual presenting patterns, and to guide treatment decisions. Each case consists of a clinical history, examination findings and special investigations, before a diagnosis is made. Clinical issues raised by each case are discussed and major teaching points emphasized. Selective references are provided. The book provides a useful complementary adjunct to existing textbooks of reproductive medicine, and an excellent resource for teaching and continuing professional development.
Rebecca L. Robker, The Robinson Institute Research Centre for Reproductive Health, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia,
Robert J. Norman, The Robinson Institute Research Centre for Reproductive Health, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia
Obesity has become one of the most urgent nutritional and health issues of our time. Globally, the number of obese people is at a historical high with the incidence continuing to rise. Obesity is prevalent in young women  and latest predictions indicate that in the USA and UK 40–50% of women will be obese by 2030 . A neglected complication of obesity is female infertility as well as increased risk of polycystic ovary syndrome (or PCOS), a prevalent endocrine disorder which manifests with both metabolic symptoms including insulin resistance and dyslipidemia, as well as reproductive complications such as anovulation. Entering pregnancy in an obese condition predisposes both mother and fetus to significant health problems that can complicate an already risky pregnancy.
It is increasingly evident that obesity is a self-perpetuating transgenerational disease that is transmitted from mothers to the next generation. While obesity alters body metabolism and leads to consequences in multiple aspects of the reproductive system, this chapter will summarize the available data from experimental animal models and clinical studies showing an impact on oocyte developmental potential. This rapidly accumulating evidence, particularly from animal models, demonstrates that obesity affects oocyte maturation and the earliest stages of embryo development; alterations that have lasting consequences on the metabolism and developmental programming of the progeny.
Around 80% of the world population of Northern Rockhopper Penguin Eudyptes moseleyi is found at Tristan da Cunha and Gough Island in the South Atlantic Ocean, where populations appear to be declining. However, numbers of birds at Middle Island, a small satellite island of Nightingale Island at Tristan Cunha, have not been counted since 1973 when an estimated 100,000 pairs were recorded. Updated population counts were obtained for all four islands at Tristan da Cunha (Tristan, Inaccessible, Nightingale and Middle islands) in 2009 providing a census of the whole island group and the first repeat count of Middle Island. Estimated breeding numbers at these four islands were Tristan 6,700 pairs, Inaccessible 54,000 pairs, Nightingale 25,000 pairs and 83,000 pairs at Middle Island. These counts confirm that Tristan da Cunha is a vitally important site for this ?Endangered? species holding over 65% of the global population and that breeding number have been relatively stable over the last 30 years.