bluuebunny/crossref_metadata_2025 huggingface dataset:
Oospore viability and variation in zoospore and hyphal tip derivatives of the hybrid alder Phytophthoras
Authors: Delcán  , Brasier
Published: March 2003

Oospore viability, oospore germinability, and phenotypic variation among zoospore and hyphal tip derivatives of the standard and natural variant types of the hybrid alder Phytophthoras were investigated. Oospore viability in the standard hybrid, estimated by the tetrazolium bromide method, was low (≈ 31–36%). No germination was observed in more than 4000 oospores, although germination did occur in the Phytophthora cactorum, Phytophthora citricola and Phytophthora cambivora controls. This is consistent with the known meiotic irregularities in this hybrid. Mean oospore viabilities in the natural variants were significantly different (p < 0.001), ranging from approximately 24% in the UK variant to approximately 75% in the Dutch variant. Again, no oospore germination was observed. Zoospore and hyphal tip derivatives of the standard hybrid and of the Swedish and Dutch variants resembled the ‘parent’ isolate in phenotype. The derivatives of the German and UK variants, however, often differed from the parent type. Those of the UK variant were extremely and continuously variable in colony patterns, growth rates, temperature–growth relationships and fertility levels. Although these results do not support the view that the natural variants arise as genetic breakdown products of the standard hybrid, this possibility cannot yet be excluded. The apparent inviability of the oospores suggests that the mycelium and zoospores are mainly responsible for the survival and spread of the alder Phytophthoras in the field.
Formation and growth of stem cankers caused by Gremmeniella abietina on young Pinus contorta
Authors: Witzell
Published: March 2003

From 1990 to 1995, the formation and growth of stem cankers caused by Gremmeniella abietina on Pinus contorta var. latifolia was studied in three stands in northern Sweden. The stands were planted in 1976–80. The total number of cankers on 756 trees that were individually followed increased from 233 to 477 during the 5‐year period. With 42.0% of the cankers, the pathogen entered through or from the base of diseased branches, and 33.6% through visually undamaged bark. Most of the cankers were within 100 cm of the ground. In one of the three areas, the cankers were evenly distributed within 180 cm of the ground. The frequency of cankers facing north exceeded those facing south. The average vertical length of cankers had increased, 55.6% of cankers had increased their percentage coverage of the stem girth; 13.8% had fully girdled the stem. At two of the sites, there was a negative correlation between canker coverage of the stem circumference and tree height increment.
Suppression of ectomycorrhizal development in young Pinus thunbergii trees inoculated with Bursaphelenchus xylophilus
Authors: Ichihara  , Fukuda  , Suzuki
Published: March 2003

In order to study the changes in ectomycorrhizal development during symptom expression of pine wilt disease, root window observations were conducted concurrent with measurements of leaf water potential as well as photosynthetic and transpiration rates of 5‐year‐old Pinus thunbergii trees that were inoculated with the pinewood nematode (PWN) Bursaphelenchus xylophilus. Infected trees were compared with girdled and uninfected control trees. Ectomycorrhizas developed constantly during the experimental period in control trees but did not develop in the girdled trees. Ectomycorrhizal development ceased within 2 weeks in those trees that finally died after PWN infection. In the trees that survived PWN infection, ectomycorrhizal development ceased within 1–4 weeks of inoculation but was resumed thereafter within 3–6 weeks. Ectomycorrhizal development ceased prior to a decrease in both photosynthetic rate and leaf water potential in the inoculated trees.
Variation in virulence among isolates of Armillaria ostoyae
Authors: MORRISON D. J. , PELLOW K. W.
Published: March 2003

The virulence of Armillaria ostoyae isolates from coastal (16) and interior (33) British Columbia, elsewhere in North America (eight) and Europe (six) was assessed on 2‐year‐old Douglas‐fir seedlings in pots during a 3‐year trial. Isolates from most geographical locations infected similar proportions of seedlings, had similar average damage scores and killed a similar percentage of diseased seedlings. Isolates from the coastal region had a significantly higher probability than interior isolates that a diseased seedling received a damage score > 3 on a 1–5 scale, and coastal isolates killed a higher proportion of diseased seedlings than interior isolates. The mean damage score for isolates that had been in culture for 20–25 years was about 25% lower than that for recently collected isolates. The results indicate that the higher incidence and longer duration of mortality in the southern interior of British Columbia compared to the coast can not be attributed to greater virulence of interior isolates of A. ostoyae.
Effect of season and different fungi on phenolics in response to xylem wounding and inoculation in Eucalyptus nitens
Authors: BARRY K. M. , DAVIES N. W. , MOHAMMED C. L.
Published: March 2003

Pot‐grown and plantation‐grown Eucalyptus nitens trees (approximately 2 and 3 years old, respect‐ively) were experimentally wounded and inoculated with different fungi and in different seasons. Decay lesion development and defence zones were assessed. Two zones were described, a narrow brown decay interface (interface reaction zone, IRZ) and a diffuse zone beyond this being either pale brown or purple (reaction zone, RZ). The total phenol levels in the reaction zone were determined. Selected phenolics (pedunculagin, tellimagrandin 1, tetragalloylglucose, pentagalloylglucose and catechin) were quantified by liquid chromatography–mass spectrometry (LC–MS). A range of fungi (mainly decay‐causing) were used to inoculate wounds and the results indicated that more extensive decay lesions were generally associated with greater production of soluble phenols in response. Sterile inoculations and weakly aggressive fungi were associated with no or little xylem discoloration, whereas aggressive fungi elicited more discoloration and phenolic accumulation in advance of infection. This indicates that phenol accumulation is not a generalized response to wounding, but a variable response due to the interaction between microorganisms and sapwood. In plantation‐grown trees examined 6 months after wounding, purple reaction zones were commonly associated with large decay lesions. Seasonal differences in decay column area caused by Ganoderma applanatum were not significant 1 month after wounding and inoculation.
Virulence and double‐stranded RNA in Sphaeropsis sapinea
Authors: Adams G. C. , Wu N. ‐T. , Eisenberg B. E.
Published: March 2003

Forty wildtype isolates of Sphaeropsis sapinea were grouped into the morphotypes A and B based on previously defined differences in cultural and morphological criteria as well as restriction sites for Dde I and Bst UI endonucleases in nuclear ribosomal DNA amplicons. Thirteen of 20 type A isolates and nine of 20 type B isolates contained detectable dsRNA (55%) of different molecular weight and size. dsRNA was transmitted into conidia at a frequency of 71–100%. By selecting single conidia, dsRNA‐free subcultures were obtained from six of 22 isolates containing dsRNA. Pathogenicity tests on expanding buds of landscape trees of three species of Pinus showed highly significant statistical interactions between isolate virulence, Pinus species, and year. Pine species‐year had a profound impact on virulence. The pattern in the interactions was revealed by principal component analysis of the interaction sums of squares of the anova (Additive Main Effects and Multiplicative Interaction; AMMI). Pinus sylvestris was highly interactive in its susceptibility to S. sapinea with seasonal effects. P. nigra and P. resinosa were more stable. The interactivity analysis was used to apportion interaction to specific isolates to improve the accuracy of the estimates of virulence. Estimates of the relative virulence of isolates were predicted over five different Pinus species‐years. Isolates were ranked in virulence and interactivity using the AMMI model. This model permitted mean separation tests of the relative virulence among isolates over the combined Pinus species‐years. One isolate was identified as potentially having dsRNA‐mediated hypovirulence based on the significantly greater virulence of its isogenic, dsRNA‐free subculture, as expressed over the three Pinus species and 2 years. Type A isolates containing dsRNA ranged from stable to highly interactive and from low to high in virulence. Type B isolates containing dsRNA were similar in interactivity but virulence ranged from avirulent to moderate, seldom exceeding the mean for S. sapinea. dsRNA‐free isogenic subcultures tended not to express higher virulence than their dsRNA‐containing parent strains but often changed in interactivity. Therefore, in one year a dsRNA‐free subculture might be more virulent than its dsRNA‐containing parent. In another year the dsRNA‐free subculture might be less virulent.
Fungi associated with necrotic apical parts of Fraxinus excelsior shoots
Authors: Przybył K.
Published: March 2003

Stem necrosis was investigated in 2–3‐year‐old seedlings of European ash Fraxinus excelsior, both self‐sown and in plantations within four Forest Divisions in eastern, northern and central Poland. Fungi isolated from the apical parts of shoots showing fresh necroses were identified and the pathogenicity of some of them was determined. Some species were isolated at all four sites; the most consistent members of this group were Cladosporium cladosporioides, Cytospora ambiens, Discula sp., Fusarium lateritium, Phoma sp., Phomopsis scobina and P. controversa. Diplodia mutila was isolated at all the sites, but with variable frequency. It induced necrotic lesions following wound inoculation of stems of 2‐month‐old and 2‐year‐old seedlings of F. excelsior in growth chamber and greenhouse conditions.
Application of Fertilizers for Increased Saffron Yield
Authors: Behnia M. R. , Estilai A. , Ehdaie B.
Published: March 2003

Research was undertaken to determine the response of newly planted saffron to the application of different levels of nitrogen (0, 50 and 100 kg N · ha−1 · year−1), phosphorus (0, 25, and 50 kg P2O5 · ha−1 · year−1), and composted cow manure (0, 20, and 40 tons · ha−1 · year−1) in terms of fresh flower weight (FFW), saffron yield (SY) and leaf biomass. The experiments were conducted in Birjand, and Ghaen, Khorasan province, Iran, from 1991 to 1993. Significant differences were found between the two locations and among the years within each location for FFW and SY. Averaged over all treatments and years, mean values for FFW and SY were 644.3 and 9.1 kg · ha−1, respectively, at Birjand, and 296.0 and 3.7 kg · ha−1, respectively, at Ghaen. At Birjand, mean FFW in the three consecutive years was 229.0, 796.2, and 907.8 kg · ha−1 and mean SY was 3.4, 10.6, and 13.4 kg · ha−1. The corresponding means at Ghaen were 87.5, 225.9, and 574.7 kg · ha−1 for FFW and 1.3, 3.2, and 6.7 kg · ha−1 for SY. Simple correlation coefficients between FFW and SY were positive and highly significant. At both locations, FFW and SY increased significantly from year to year. The rate of increase, however, decreased with the age of the saffron field because of overcrowding of new corms. Different combinations of fertilizers had either a negative or nonsignificant effect on FFW and SY. The application of phosphorus fertilizer did not result in increased FFW and SY. The application of 40 tons · ha−1 of cow manure in the first year followed by no fertilizer in the second year and by 20 tons · ha−1 in the third year increased FFW and SY at Birjand. The use of 100 kg · ha−1 nitrogen only in the third year also increased FFW and SY at Birjand. At Ghaen, only the application of 50 kg · ha−1 nitrogen in the third year resulted in increased FFW and SY.
Mental health nursing and cultural diversity
Authors: Craig Alex B.
Published: March 2003

ABSTRACT

The focus of this article is on ethnic cultural difference. The establishment of a bi‐cultural model of health care delivery has been a recent priority in New Zealand. Bi‐culturalism has become an important concept for Maori and Pakeha (Europeans), working in partnership in the planning and implementation of mental health services in New Zealand. Adoption of the principles of respect and recognition of the uniqueness of different cultural identities, by nurses, has meant that clients who use mental health services in New Zealand are beginning to benefit from nursing care that is culturally competent.
An exploratory investigation into the housing preferences of consumers of mental health services
Authors: Warren Razelle , Bell Pamela
Published: March 2003

In the present qualitative study, 10 mental health consumers living in the community were interviewed in relation to their housing situations. Three themes emerged from the interview data: ‘The place’, ‘Other consumers’ and ‘A normal life’. Consumers rejected congregated housing because it enables the larger community to more easily identify them as former psychiatric patients. The views of participants consistently indicate a desire to live a normal life. Results of this study highlight the need for greater consumer participation with mental health nurses and policy makers, in relation to the development of housing services.
Taking neuroleptic medications as the treatment for schizophrenia: A phenomenological study
Authors: Usher Kim
Published: March 2003

ABSTRACT:

Research in the area of neuroleptic medications has traditionally relied on quantitative methodologies which view the problem from the researcher’s perspective. This phenomenological study was undertaken to explore the experience of taking neuroleptic medications from the individual’s perspective using a research approach which has the potential to illuminate and respect participant experiences. Interviews were conducted with 10 individuals who take neuroleptic medications as their main treatment for schizophrenia. Interviews were analysed using an interpretive method which seeks to generate a deeper understanding of the phenomenon under study. The experience of taking neuroleptic medications emerged as incorporating hope for recovery, learning to live with the side‐effects, embodiment of illness, experiencing issues of control, and struggling to stay well. The results have relevance for practicing and novice mental health nurses, for teachers of undergraduate nursing and allied health students, and carer and consumer groups.
OBSTETRIC OUTCOMES IN AN ABORIGINAL COMMUNITY: A COMPARISON WITH THE SURROUNDING RURAL AREA
Authors: Powell Janelle , Dugdale A. E.
Published: March 2003

Antenatal, intranatal and postnatal features of all Aboriginal women who lived at Cherbourg Aboriginal Community and delivered during 1990, 1991 and 1992 were compared with all non‐Aboriginal women in the same rural area who delivered at Kingaroy Base Hospital during 1991. Almost all the Aboriginal women also delivered at Kingaroy. The data for 146 Aboriginal and 139 non‐Aboriginal women were taken from the hospital records. The Aboriginal women were generally younger at delivery (Aboriginal 35% younger than 20 years vs non‐Aboriginal 12%), made their first antenatal visit later (Aboriginal 49% after 20 weeks vs non‐Aboriginal 10%) and made fewer antenatal visits (Aboriginal 43% < 4 visits vs non‐Aboriginal 2% < 4 visits). They were more likely to be anaemic (Aboriginal 65% < 110 g/L vs non‐Aboriginal 13% < 110 g/L), have a sexually transmitted disease (STD; Aboriginal 13%vs non‐Aboriginal 2%) and drink alcohol (Aboriginal 54%vs non‐Aboriginal 32%). After making an allowance for repeat Caesarean sections, there was no significant difference in the proportion of abnormal deliveries, but birthweights of Aboriginal infants were lower. Postnatally, the only significant difference between the two groups was a lower incidence of jaundice in Aboriginal infants. Multifactorial analysis showed that birthweights were significantly decreased by primagravidy, alcohol intake and STD. It is likely that the effects of STD and alcohol on birthweight were due to associated lifestyle factors. When these factors were allowed for, ethnic background had no significant effect on birthweight.
DIABETIC RETINAL PHOTOGRAPHIC SCREENING: A MODEL FOR INTRODUCING AUDIT AND IMPROVING GENERAL PRACTITIONER CARE OF DIABETIC PATIENTS IN A RURAL SETTING
Authors: McKenzie Andrew , Grylls John
Published: March 2003

This paper describes the addition of diabetic retinal screening using retinal photography to an existing immunisation audit by a General Practitioner (GP) Network in a semi‐rural area 60‐min drive from central Wellington, New Zealand. The employment of a nurse‐facilitator who visited practices to assist the setting up of diabetic registers and the subsequent auditing of patterns of referral for retinal photography was seen as a first step in a process that would lead to audit of the care of diabetic patients by GPs in the Network. This should lead to a measurable improvement in health‐care delivery to diabetic patients in this area and is a model that could be adapted by any group of rural or semirural GPs within a defined geographical area.
THE EMERGENCY MEDICINE TRAINING NEEDS OF RURAL GENERAL PRACTITIONERS
Authors: Tolhurst Helen , McMillan Jane , McInerney Peter , Bernasconi Judy
Published: March 2003

This study aimed to identify the emergency medicine training needs of rural general practitioners (GPs) in the catchment area of the Hunter Rural Division of General Practice. The GPs were surveyed using a questionnaire in which they were asked about their confidence levels in a number of specific emergency medicine skills, and about the areas of emergency medicine that they saw as priorities for upskilling. More than a third of GPs who were responsible for on‐call work at the hospital indicated that they had low levels of confidence in a number of their emergency medicine skills, in particular skills relating to paediatric emergencies, cardiovascular emergencies, and respiratory emergencies. These emergency medicine domains were also seen as high priorities for upskilling by the majority of the respondents. The study shows that rural doctors need the opportunity to access emergency medicine training that provides upskilling not only in the management of clinical problems, but also in practical procedures.
RURAL AND REMOTE MENTAL HEALTH PLACEMENTS FOR NURSING STUDENTS*
Authors: Armitage Sue , McMaster Rose
Published: March 2003

Clinical placements can be instrumental in encouraging nursing students to consider a future career in rural Australia. Twenty nursing students from a metropolitan university were provided with the opportunity to undertake a clinical placement in mental health in a rural or remote setting. The majority of placements were between 2 and 4 weeks in length. They took place in community health centres and rehabilitation centres in New South Wales and in hospital inpatient facilities, remote areas and community health services in the Northern Territory. On return from the placement, students completed an open‐question pro forma giving their views and impressions of their experiences and contrasting this with clinical experience gained in urban settings. The content of the students’ responses was analysed and presented under the following themes: scale relating to urban and rural differences in population; geographical and health facility size; staffing matters; the environment; the students’ perception of the clients; and professional interaction. Additional material relating to remote area placements is presented. Questions are raised about the maintenance of students’ interest and the development of rural careers.
ISSUES AFFECTING AUSTRALIA’S RURAL OCCUPATIONAL THERAPY WORKFORCE
Authors: Millsteed Jeannine
Published: March 2003

ABSTRACT

The unequal distribution of health workers across Australia in favour of urban areas affects the provision of effective health services to rural and remote communities. Additional pressures on the current and future supply of occupational therapists may arise from a restructuring of the health labour force and demographic changes in the age structure of the population. Projections made on the basis of these data indicate that employment growth for occupational therapists will create a demand for 9600 therapists in 2005, or 79.9% more than the number of occupational therapists employed in 1994. Factors such as reductions in the level of immigration and the number of people of working age, and a diminishing population of school leavers to fill student places in universities will make it difficult to meet the projected demand for occupational therapists. Occupational therapy labour force planning suffers from a lack of detailed data on under‐serviced areas. Such data are critical for clarifying the magnitude of the projected discrepancy between future demand and supply needs for occupational therapists in rural and urban areas in Australia.
Health Beliefs and Perceptions of Women Presenting or Not Presenting for Mammographic Screening in a Rural Health Setting
Authors: Speedy Sandra , Hase Stewart
Published: March 2003

Breast cancer continues to be a major health concern among Australian women. Recently, free mammography screening has been offered as a joint State and Commonwealth initiative to enable early detection. This program has particular significance in rural areas where access to health‐care facilities, particularly those of a specialist nature, is limited. Attendance for screening is critical to the success of this type of program. Several lines of evidence suggest that health beliefs play a major role in compliance with recommended health behaviour. The present study investigated the role of five health beliefs: response efficacy, seriousness, concern, susceptibility and barriers to the likelihood of attending the North Coast Breast Screening Program in northern NSW. A questionnaire that measured these health beliefs was completed by 127 women who attended breast screening and 185 women who knew about the service but had not attended. Compared with those who had not undergone mammography, those presenting for screening were more health conscious, more likely to have had a mammography previously, more aware that mammography reduced the risk of developing severe breast cancer and less concerned about having a mammogram. A number of barriers to having a mammogram were also identified. The present study raises a number of concerns regarding the level of knowledge about breast self‐examination and mammography as important preventive health measures among women in a rural setting.
RURAL MENTAL HEALTH: NEITHER ROMANTICISM NOR DESPAIR
Authors: Wainer Jo , Chesters Janice
Published: March 2003

This paper explores the relationship between rural places and mental health. It begins with a definition of mental health and an outline of the data that have led to the current concern with promoting positive mental health. We then consider aspects of rural life and place that contribute to positive mental health or increase the likelihood of mental health problems. Issues identified include environment, place, gender identity, violence and dispossession and the influence of the effects of structural changes in rural communities. The paper concludes with a discussion of some of the determinants of resilience in rural places, including social connectedness, valuing diversity and economic participation.
MEDICAL SPECIALISTS SERVICING THE NEW ENGLAND HEALTH AREA OF NEW SOUTH WALES
Authors: Alexander Christian , Fraser John
Published: March 2003

ABSTRACT: There is increasing emphasis on research, policy and program activity to recruit and retain rural general practitioners in Australia. In contrast, until recently, there has been less attention paid to specific policies and programs relating to rural medical specialists. The New England Area Health Service experiences a shortage of general practitioners and specialists. This study surveyed this region's specialist workforce in 1998 and aimed to identify recruitment and retention issues affecting specialist rural workforce planning in north‐west New South Wales. All 91 medical specialists practising in this rural area were surveyed. Seventy‐one completed survey forms were received, representing a response rate of 78%. Positive features of rural specialist practice included the rural lifestyle, professional autonomy and available medical infrastructure. Negative features included professional isolation, long working hours, lack of locum relief and inadequate remuneration. Almost all surveyed specialists believe that there is a shortage of specialists servicing the New England Health Area. The major deficits in specialty areas identified relate to: dermatology; ear, nose and throat; obstetrics and gynaecology; orthopaedics; paediatrics; and urology. Recruiting and retaining medical specialists would be facilitated by improvements in the following areas: specialist resources and facilities, specialist locum scheme, remuneration and professional support. Effective strategies need to take account of local circumstances and be based on discussions involving all local key stakeholders.
Staff Perceptions of Care for Deliberate Self‐Harm Patients in Rural Western Australia: A Qualitative Study
Authors: Slaven Janine , Kisely Stephen
Published: March 2003

Abstract:  Suicide has been a major community concern in Esperance, a geographically isolated port on the south coast of Western Australia. This study to explores the views of regional health staff on barriers to the effective management of deliberate self‐harm (DSH) and ways in which those barriers could be addressed. Semi‐structured interviews were tape‐recorded, transcribed and subjected to qualitative content analysis. Interviewees included 77% of general practitioners (n = 7), 18% of nurses (n = 13) and 55% of mental health professionals (n = 5). The most important barrier was a lack of structure to treating DSH, resulting in deficiencies and inconsistencies in its management. Suggestions to improve the management of DSH included better communication between services, support for nurses in raising the issue of suicide, use of a simple risk assessment tool, the development of a nurse liaison position, and a multidisciplinary planning group.

 The higher rates of DSH and completed suicide in rural and remote regions compared with metropolitan areas make secondary prevention particularly important.
OBESITY, SMOKING AND HAZARDOUS DRINKING AMONG MEN ADMITTED TO THE SURGICAL WARDS OF A REGIONAL HOSPITAL
Authors: Peach Hedley G.
Published: March 2003

ABSTRACT:The purpose of the study was to determine the prevalence of obesity, smoking and hazardous drinking, and identify opportunities for their reduction, among men admitted to the surgical wards of a regional hospital. A random sample of 80 patients were interviewed. Nineteen per cent were obese, 29% smoked and 16% drank hazardously. Forty‐seven per cent and 52% of those who were obese or smokers, respectively, had tried unsuccessfully to reduce their weight or smoking before admission, but mostly without professional support. A further 13% wanted to reduce their smoking but had not tried. Fifty‐five per cent continued to try or still wanted to reduce these factors 3 months after discharge. Obesity and smoking could be common among male surgical inpatients in regional hospitals, a significant proportion of whom may welcome professional help with improving their lifestyle, but a larger multi‐hospital study is needed to confirm this.
Rural community pharmacy: a feasible site for a health promotion and screening service for cardiovascular risk factors
Authors: Hourihan Fleur , Krass Ines , Chen Timothy
Published: March 2003

A pharmacist‐delivered health promotion and screening service for cardiovascular risk factors in rural community pharmacy was implemented in the Upper Hunter Valley, New South Wales (NSW). We describe the development of the service and profile 204 participants at their initial screening. A standardised clinical protocol guided the pharmacist through delivery of the service. The mean age of participants was 44 years (SD ± 13). Over half (54%) had a Body Mass Index (BMI) > 25, 54% had cholesterol > 5.0 mmol L−1 and 18% a systolicBP≥ 140 mmHg and/or diastolicBP ≥ 90 mmHg. Most (80%) received lifestyle information (dietary, exercise or smoking cessation). One third required referral to a general practitioner. Provision of the service through community pharmacy increased the community's access to screening, 28% reported that they had never had their cholesterol measured. Since this new service was able to identify, educate and refer people at risk of cardiovascular disease in a rural community, we recommend a broader adoption through rural pharmacies.
Localized scotomata detected with temporal modulation perimetry in central serous chorioretinopathy
Authors: Vingrys Algis J , Pesudovs BscOptom, PhD and Konrad , BscOptom
Published: March 2003

Aim: Flicker deficits have been reported in various maculopathies, including age‐related macular degeneration. We test whether flicker losses exist in patients with central serous chorioretinopathy (CSC) and whether the size and flicker frequency of the target is important in detecting such losses.

Methods: We examined four CSC patients with temporal modulation (flicker perception) perimetry using the Medmont auto‐flicker module (Medmont Pty Ltd, Melbourne, Vic. Australia), as well as static perimetry and colour vision. One case was examined using sophisticated laboratory equipment to precisely measure their temporal contrast sensitivity function (temporal CSF or de Lange curve) using larger targets to consider the effect of target frequency and size. Two patients were followed longitudinally and tested after resolution of the maculopathy. We compared our patients with an age‐matched control group of 11 people.

Results: Temporal modulation perimetry detected larger and more localized defects in all cases of active CSC compared with static perimetry. There appeared to be size and frequency tuning to the deficit, with greatest loss being found at 16 Hz with small (0.5°) targets. The losses resolved in one case where the retina recovered in 4 weeks, but remained to a lesser degree in another case who suffered a 2 year long fluctuating course before the CSC subsided.

Conclusions: Temporal modulation perimetry detects a loss of flicker sensitivity in patients with CSC. Deeper and more clearly defined scotomata are found with a flickering stimulus compared with a steady state one. The greatest losses of flicker sensitivity are found with 16 Hz modulation and with small targets located directly over the lesion. The duration of the disease may be important for recovery of flicker sensitivity. Temporal modulation perimetry appears to be a valuable tool for the confirmation of functional loss due to CSC.
Subconjunctival fat prolapse*
Authors: McNab Alan A
Published: March 2003

Purpose: Subconjunctival orbital fat prolapse has been rarely described in the literature and is frequently confused with other conjunctival tumours, such as dermolipoma. The purpose of the present study was to describe the clinical features and treatment of a series of patients with subconjunctival orbital fat prolapse.

Methods: Review of clinical records.

Results: Twelve patients with subconjunctival orbital fat prolapse were identified. Eight had a superotemporal prolapse and five of these were bilateral. All but one were male and most were elderly and tended to be obese. Five of these patients underwent surgical excision of the prolapsed fat for symptoms of discomfort or for cosmesis. Four atypical unilateral cases were seen in younger patients with fat prolapse occurring superonasally in three and inferiorly in one. In one case there was a history of trauma.

Conclusions: Subconjunctival orbital fat prolapse typically occurs superotemporally in obese elderly males and is easily differentiated from other lesions, such as dermolipoma. The prolapsed orbital fat may be excised via the conjunctiva.
A new model of orthotopic penetrating corneal transplantation in the sheep: Graft survival, phenotypes of graft‐infiltrating cells and local cytokine production
Authors: Williams Ka , Standfield Sd , MedLabCert  , Mills Rad , Takano T , Larkin Dfp , Krishnan R , Russ Gr , Coster Dj
Published: March 2003

Background: Orthotopic penetrating keratoplasty in the sheep was developed as an outbred preclinical model to allow correlation of the cellular infiltrate during graft rejection with local production of cytokine mRNA.

Methods: Penetrating corneal autografts and allografts were performed in Merino sheep. Graft outcome was followed at the slit‐lamp. Corneal infiltrates were examined by immunoperoxidase staining on postmortem specimens. Cytokine mRNA was detected by polymerase chain reaction.

Results: Corneal autografts survived indefinitely. Allografts became vascularized and underwent rejection at a median of 20 days postgraft. Both endothelial and epithelial rejection lines were observed. Immunohistochemical staining of rejecting grafts showed up‐regulation of major histocompatibility complex class I molecules on corneal graft epithelium, damaged or absent graft endothelium and a marked, predominantly mononuclear cell infiltrate. CD4‐positive T cells were observed in the graft within 2 days of the onset of rejection, followed several days later by CD8‐positive T cells. Messenger RNA transcripts for interleukin (IL)‐2, tumour necrosis factor (TNF)‐α and IL‐10 (but not for interferon (IFN)‐γ or IL‐4) were found in autografted corneas. Proportionately, more allografts than autografts contained transcripts for IL‐2 and TNF‐α, and IFN‐γ was detected in three of four allografts.

Conclusions: Corneal graft rejection in the sheep is macroscopically and histologically similar to human corneal graft rejection. Allografts become infiltrated by both CD4‐ and CD8‐positive T cells and local production of pro‐inflammatory cytokines occurs during graft rejection.
Can the current oculokinetic perimetry chart be improved?
Authors: Chia W‐L A , Goldberg I
Published: March 2003

Background/Method: Several studies have been performed to determine the effectiveness of oculokinetic perimetry (OKP) as a glaucoma screening test. In a previous study, we noted that OKP sensitivity and specificity was lower in mildly defective fields compared with moderately or severely, defective fields. In this study, we looked at visual fields with ‘glaucomatous’ defects. The visual field was divided into zones and points. The frequency of glaucomatous defects and visual sensitivity levels in these areas was recorded. The sensitivity and specificity of OKP to detect these defects were analysed.

Results: Ninety‐six glaucomatous fields from 57 subjects were assessed. An OKP chart testing the 8 to 16 degrees of eccentricity, and an extended nasal region, would cover all the defective fields present in this study. The 12–16 degree eccentricity zone has the best sensitivity (75%) and specificity (65%). Points within the nasal, inferior temporal and 8–12 degree eccentricity might be less sensitive, but 11(11.5%) fields had defects only in these areas. Zonal and point sensitivities and specificities were very similar, suggesting that fewer points could be used in each zone with similar results. Many of the eyes with false‐negative OKP results had Humphrey Field Analyser visual sensitivity levels in the 10–18 dB range (i.e. associated with a mild or moderate defect). Decreasing the target stimulus might increase the detection rate of these milder defects; however, it might also increase overall false‐positive rates. Our proposed experimental chart consists of two to four test points in each quadrant within the 12–16 degree of eccentricity, five within the 8–12 degree zone and two in the nasal region, and a central 1 or 1.5 mm black target.

Conclusion: Analysis of results with modifications of the testing device may permit the OKP chart to achieve its full potential.
Attitudes Towards People with a Mental Disorder: A Survey of the Australian Public and Health Professionals
Authors: Jorm Anthony F. , Korten Ailsa E. , Jacomb Patricia A. , Christensen Helen , Henderson Scott
Published: March 2003

Objective: The aim of this paper was to compare the Australian public's attitudes towards people who have been treated for a mental disorder with the attitudes of general practitioners, psychiatrists and clinical psychologists.

Method: The study involved a household survey of 2031 members of the Australian public and a postal survey of 872 general practitioners, 1128 psychiatrists and 454 clinical psychologists. Survey participants were presented with a vignette describing a person with schizophrenia or one with depression. They were asked opinions about the person's long-term outcome in various areas of life after receiving treatment. Participants were also asked whether they thought the person described would be discriminated against by others.

Results: Both the public and professionals rated outcomes as poorer and discrimination as more likely for the person with schizophrenia than for the one with depression. The professionals made more negative ratings than the public, although the clinical psychologists had similar attitudes to the public about depression.

Conclusions: Compared to the public, health professionals rate long-term outcomes more negatively and discrimination as more likely. It is possible that these more negative attitudes are realistic, being based on greater knowledge of mental disorders. However, professional attitudes may be biased by greater contact with patients who have chronic or recurrent disorders. Either way, health professionals need to be aware of the effects that their negative attitudes might have on patients and the public.
Amphetamine Withdrawal: I. Reliability, Validity and Factor Structure of a Measure
Authors: Srisurapanont Manit , Jarusuraisin Ngamwong , Jittiwutikan Jaroon
Published: March 2003

Objective: The aim of this study was to create a short, reliable and valid questionnaire for the evaluation of amphetamine withdrawal, which we shall call the Amphetamine Withdrawal Questionnaire (AWQ).

Method: Items of the AWQ included in this study were based on the fourth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) and a comprehensive review. A field trial for assessing the reliability, validity and factor structure was conducted in outpatients and inpatients with amphetamine withdrawal.

Results: Thirty and 102 patients’ data were included in the reliability-validity tests and the factor study, respectively. Due to the very low mean score of insomnia item, this item was excluded from subsequent analyses. The AWQ internal consistency was satisfactory with a Cronbach's alpha of 0.77. For test-retest reliability, a Spearman rank order correlation coefficient of the AWQ total score was 0.79. The AWQ total score for criterion validity was moderately correlated with the other two accepted measures. Principal component analysis, eigenvalue-one test and a varimax rotation performed to elicit the factors of AWQ yielded a three-factor model of AWQ: namely hyperarousal, reversed vegetative and anxiety factors.

Conclusions: The AWQ is a short, reliable and valid measure for assessing amphetamine withdrawal symptoms. Further studies with a larger number of patients should be conducted to confirm the results of this factor analysis.
A Survey of Suicide Prevention Curricula Taught in Australian Universities
Authors: Hazell Philip , Hazell Trevor , Waring Trevor , Sly Ketrina
Published: March 2003

Objective: The aim of this study was to survey Australian universities to determine the scope of suicide prevention curricula in a range of prevocational courses. Method: Coordinators of undergraduate and postgraduate university programs for medicine, nursing, psychology, social work, theology, education, pharmacy, law and journalism were asked to complete a survey instrument to determine whether specific knowledge, attitude and skills items were included in the course content. Additional information was sought concerning the dominant method of teaching. Data were compared by discipline. An arbitrary threshold of 70% of courses within each discipline responding positively to each survey item was established as an adequate level of penetrance of that item into prevocational programs.

Results: Overall, knowledge and attitudes related to suicide prevention are taught more comprehensively than are skills. Knowledge and attitude items are taught most comprehensively in medical and nursing schools, somewhat less in psychology, social work, and pharmacy, uncommonly in theology and education. Law and journalism courses currently include very little material related to suicide and suicide prevention. Skills relevant to the management of suicidal individuals and their families are taught most comprehensively in psychology, nursing and medical courses, with low penetrance into other courses.

Conclusion: The greatest opportunity to increase exposure to knowledge and attitudes relevant to suicide prevention exists within education, theology, law and journalism courses. Programs directed to the development of interpersonal skills relevant to the management of suicidal individuals and their families could be introduced across the board.
The Influence of Client's Ethnicity on Psychotropic Medication Management in Community Mental Health Services
Authors: Ziguras Stephen , Lambert Tim J. R. , McKenzie Dean P. , Pennella Jo
Published: March 2003

Objectives: The aim of this study was to investigate whether people born in non-English-speaking countries differed from clients born in Australia on quality of medication management, measured by mean neuroleptic dose, method of administration, use of atypical antipsychotics and perceived compliance with medication, and to investigate the influence of matching the client with a case manager from the same ethnic background on these measures.

Method: Information about medication and perceived compliance was provided for 168 clients of five community mental health services in Melbourne. Chlorpromazine equivalent doses (CPZe) were calculated, and average dose, route of administration, percentage receiving atypical antipsychotics and perceived compliance with medication were analysed by country of birth and preferred language. Each analysis was repeated for clients matched to a case manager from the same ethno-linguistic background compared to those with ‘unmatched’ case managers.

Results: While non-English-speaking background (NESB) clients generally did not receive different dose sizes, those born in Vietnam had a lower mean dose. People born in a non-English-speaking country tended to be more likely than the Australian born to receive a depot injection, although this was not quite statistically significant. Twenty-seven percent of clients received an atypical neuroleptic; age was a significant factor, with older clients less likely to receive an atypical. There was no difference in receipt of atypicals or perceived compliance by country of birth, language or gender. Matching for a case manager of the same background had no effect except for route of administration, with matched clients less likely to receive depot medication than unmatched.

Conclusions: Generally, the ethnic background of clients had little influence on the quality of medication management they received from community mental health services.
Schizophrenia, Mental State, and Mother—Infant Interaction: Examining the Relationship
Authors: Snellen Martien , Mack Kerry , Trauer Tom
Published: March 2003

Objective: The aim of this study is to examine the role that disturbance of mental state of hospitalised mothers with a postpartum schizophrenic illness plays in determining the quality of mother-infant interactions.

Method: We examined the relationship between the nature and severity of symptomatology in mothers with schizophrenia and the quality of her interactions with her infant in a sample of 15 mother-infant dyads admitted to a psychiatric Mother-Baby Unit. Data were obtained at admission and discharge.

Results: Mothers with florid positive symptoms and prominent negative symptoms of schizophrenia and their infants were identified as being at particular risk of displaying disturbed interactions. The adverse contribution of negative symptoms was often not evident until after the positive symptoms had resolved.

Conclusions: Given that negative symptoms are often treatment resistant, optimal care of mothers with schizophrenia and their infants needs to involve ongoing therapeutic intervention which specifically addresses disturbances of mother-infant interaction. Further research is required to identify which interventions are likely to be of greatest benefit.
A Descriptive Study of First Presentation Psychosis in Old Age
Authors: Hassett Anne
Published: March 2003

Objective: This report describes the characteristics of a sample of elderly subjects presenting with their first episode of psychosis in old age.

Method: Forty-six (38 females and eight males) patients were assessed on a variety of cognitive, psychopathological and personality measures.

Results: Female preponderance, social isolation and early cognitive deficits were findings of this study which have been replicated by other studies of late-onset psychosis. In contrast, hearing loss was not overly represented in this sample. Personality style differed significantly from accepted norms of adult personality traits, with lower scores for dimensional ratings of neuroticism, extraversion and openness to change.

Conclusions: The descriptive findings in this study suggest that psychosocial factors require further investigation in patients presenting with late-onset psychosis. Comparison with younger first-onset psychotic subjects will be the subject of a later report.
Establishing the Efficacy and Cost Effectiveness of Community Intensive Case Management of Long-Term Mentally Ill: A Matched Control Group Study
Authors: Preston Neil Joseph , Fazio Sam
Published: March 2003

Objective: The study attempted to identify whether chronic mentally ill persons after receiving intensive case management (ICM) could demonstrate improved inpatient service utilisation compared with a matched control group cohort. Costings were measured to observe whether the increase in providing intensive outpatient contacts would be offset by savings in reduced inpatient service utilisation.

Method: Eighty ICM patients were matched on ICD-9 diagnosis, age, gender, length of illness, age at first inpatient and outpatient contact, marital status, educational level, employment status, country of birth, year of arrival to Australia and religion. Inpatient bed-days and outpatient contacts were recorded and compared 12 months prior to ICM treatment, 12 and 24 months after ICM using within/between group repeated measures analysis of variance.

Results: The ICM group demonstrate significant reductions in inpatient service utilisation both within the 12- and 24-month period after receiving ICM treatment. The cost differential by 24 months of treatment was $801 475 in favour of the ICM model. The increase in costs of outpatient contacts were offset by a significant reduction in inpatient service utilisation.

Conclusion: When outpatient contacts averaged one contact a week for the duration of the study period no significant reductions in inpatient service utilisation was recorded, as demonstrated by comparison with the matched control group. By increasing outpatient contacts by 3–4 contacts a week, inpatient contacts reduced by 36.8%. ICM is an efficacious and cost effective way to implement community-based services to the chronically long-term mentally ill.