bluuebunny/crossref_metadata_2025 huggingface dataset:
Annual Cycle of Zooplankton Biomass, Abundance and Species Composition in the Neritic Area of the Balearic Sea, Western Mediterranean
Authors: de Puelles MªLuz Fernández , Grás David , Hernández‐León Santiago
Published: July 2003

Abstract. Seasonal changes in zooplankton biomass, abundance and species composition were studied at a neritic station in the Balearic Sea between April 1993 and May 1994. Sampling was carried out every 10 days in a zone influenced by the main current circulating through the Mallorca channel. Three main peaks of zooplankton biomass and abundance were observed: (1) at the beginning of summer when the thermocline developed, (2) in autumn when the thermocline broke down, and (3) in early spring. The smaller zooplankton fraction (100–250 μm) comprised on average 32 % of the total biomass and 73 % of total abundance. Copepods were the predominant group (64 % of the total abundance) with Clausocalanus, Oithona and Paracalanus being the most abundant genera. Paracalanus parvus, Clausocalanus furcatus, Acartia clausi, Oithona plumifera, Temora stylifera, Centropages typicus and Oncaea mediterranea were found to be the most important species in the area. Other abundant groups were cladocerans (15 %) and meroplankton larvae (12 %), both of which were particularly numerous during the stratified period. The copepod community was characterized by the above‐cited perennial species, which were abundant during the cycle studied. However, the influence of the hydrological conditions of the Balearic Sea, such as the Atlantic water influx and the physical structure of the water column (stratification and mixing), promoted the observed variability in zooplankton as well as the appearance of characteristic species during the annual cycle.
Responses to Predation Cues and Food in Two Species of Sympatric, Tropical Sea Urchins
Authors: Vadas Robert L. , Elner Robert W.
Published: July 2003

Abstract.We examined the responses of two tropical sea urchins,Lytechinus variegatusandTripneustes ventricosus, to cues from predators, simulated predation events and food. Cues released from damaged conspecifics, heterospecifics and heteroclassics (holothurian) were used to simulate predation events in field experiments. Responses to the presence of seagrass, spiny lobster or both were tested in tanks. Findings were supplemented by natural history observations of dispersion patterns off Bermuda. In field experiments, neither species formed groupings in the presence of conspecific, heterospecific or heteroclassic cues. Flight responses were greatest in conspecific treatments; responses to heterospecific cues were intermediate to control and conspecific cues. Urchins in pre‐assembled associations remained in groups in control trials but dispersed when exposed to predation cues.Lytechinusexhibited greater sensitivity to predation cues thanTripneustes. Cues from a damaged sea cucumber invoked a response fromLytechinusbut notTripneustes. Both species employed a two phased response to cues from damaged conspecifics: initially a rapid, but ephemeral (2 min), alarm response followed by a slower (≈ 35 % lower) sustained flight phase for 6+ min, which in nature would disperse urchins downstream and away from a predator. In tank experiments,Lytechinusformed groupings only around food or food + predators. The presence of a predator reduced the aggregation response to food, suggesting thatLytechinusemployed a risk aversion strategy.Tripneustesexhibited escape or refractory behavior in both control and experimental treatments in laboratory tanks.
Size‐dependent, Spatial, and Temporal Variability of Juvenile Walleye Pollock (Theragra chalcogramma) Feeding at a Structural Front in the Southeast Bering Sea
Authors: Schabetsberger Robert , Sztatecsny Marc , Drozdowski Gabriele , Brodeur Richard D. , Swartzman Gordon L. , Wilson Matthew T. , Winter Andreas G. , Napp Jeffrey M.
Published: July 2003

Abstract. The waters surrounding the Pribilof Islands are an important nursery ground for juvenile walleye pollock (Theragra chalcogramma), an important forage fish in the pelagic food web of the productive Bering Sea shelf region. The diet of juvenile pollock was studied in two consecutive years along a transect line crossing from a well‐mixed coastal domain, through a frontal region to stratified water farther offshore. Variability in stomach fullness was high and evidence for increased feeding intensity in the front was weak. Prey diversity and prey size generally increased with increasing fish size, shifting from predominantly small copepods to larger, more evasive prey items such as euphausiids, crab megalopae and fish. The diet of the fish reflected changes in the relative abundance of copepods and euphausiids in the prey fields between years. Juvenile pollock showed increased feeding rates at dusk, and stomach fullness as well as prey condition were generally lowest just before sunrise; however, the proportion of euphausiids increased in the diet of pollock caught at night, suggesting that some food was also ingested during darkness. Juvenile pollock and their euphausiid prey both vertically migrated above the thermocline at night, although each had a different daytime depth.
Warts are not merely blemishes on the skin: A study on the morbidity associated with having viral cutaneous warts
Authors: Ciconte Antoinette , Campbell Jan , Tabrizi Sepehr , Garland Suzanne , Marks Robin
Published: July 2003

Eighty‐five people aged 2–76 years with 250 common and plantar warts were followed prospectively for 9 months. The majority (57; 67%) had one to two warts. Of the 54 subjects who had a past history of warts, 41 (75.9%) had sought treatment for them. Twenty‐four (58.5%) said that treatment had been unsuccessful; 22 (53.7%) experienced pain during their treatment; 14 (34.1%) said that treatment had been inconvenient; nine (22%) required multiple treatments; and eight (19.5%) said the treatment resulted in the development of scars. The quality‐of‐life assessment related to their current warts revealed that 81.2% were moderately to extremely embarrassed by them; 70.5% were moderately to extremely concerned about negative appraisal by others for having them; 24.7% said that it was moderately to extremely difficult to play sport because of their warts. Moderate to severe discomfort from their warts occurred in 51.7% of people and 35.4% said they had moderate to severe pain. During the 9‐month study period, 27 (31.8%) of the participants had at least one wart regress spontaneously with 49 (19.6%) of the 254 warts regressing during that time. These data confirm the impression that a wart is not merely a blemish on the skin. Warts have the potential to cause considerable morbidity at times; this should be taken into account when a patient asks for treatment.
Three‐year retrospective review of superficial radiotherapy for skin conditions in a Perth radiotherapy unit
Authors: Thom Graham A , Heywood Janelle M , Cassidy Barry , Freund Jerry M
Published: July 2003

Western Australia has only two superficial radiotherapy units, one of which is located at Fremantle Hospital, and run by the radiation oncologists of Perth Radiation Oncology Centre. A 3‐year retrospective review was undertaken of all patients who underwent treatment at this unit from 1999 to 2001. Patients were identified from the unit's log book, and data was collected from their files. For malignant skin conditions, 369 lesions were treated in 259 patients over the study period. The patients' median age was 76 years. A wide variety of conditions were treated, but the most common diagnoses were basal cell carcinoma (237 lesions) and squamous cell carcinoma (92 lesions), most commonly located in the head region. The most frequently used treatment schedule was 36 Gy in six fractions over a 3‐week period. Where radiotherapy was administered as primary treatment, the diagnoses had been biopsy‐proven in only 53% of cases. Fifty‐four patients underwent treatment of benign skin disease over the study period; most commonly keloid scars (41 patients) followed by warts (six patients). We conclude that superficial radiotherapy has a distinct role in dermatology, particularly for skin carcinomas around the nose and eyes, which cannot presently be superseded by electron beam therapy.
Compound tincture of benzoin: A common contact allergen?
Authors: Scardamaglia Laura , Nixon Rosemary , Fewings John
Published: July 2003

The results of patch testing to compound tincture of benzoin in 477 patients performed at the Contact Dermatitis Clinic at the Skin and Cancer Foundation in Melbourne during 1999 are presented. There have been fewer than 30 reported cases of contact allergy from compound tincture of benzoin, and none in the last decade. Our results showed 45 out of the 477 patients had a positive reaction to compound tincture of benzoin, which was the third most common allergen in our series. Of these 45 patients, 14 had strong positive reactions, but only two definitely recalled exposure to compound tincture of benzoin and these were clinically relevant. Twenty‐eight of these patients had cross‐reactions to similar allergens (fragrance mix, balsam of Peru, colophony and tea tree oil). Of the 14 patients with a strong positive reaction to compound tincture of benzoin, 11 had at least one other positive cross‐reaction to the above allergens. This may explain the high frequency of reaction to compound tincture of benzoin found in our study.
Three patients with orbital xanthogranuloma and non‐progressive haematological abnormalities
Authors: Tang WK , Lee KC , Chong LY
Published: July 2003

Orbital xanthogranuloma is a rare dermatological condition characterized by its bilateral and rather symmetrical subcutaneous granulomatous infiltration around the eyes. It shares morphological similarities with other xanthogranulomatous diseases such as juvenile or adult type xanthogranuloma, necrobiotic xanthogranuloma and cutaneous infiltration in Erdheim–Chester disease, and should be differentiated from them. Three elderly Chinese patients with this condition were found to have underlying haematological abnormalities: normochromic normocytic anaemia, thrombocytopenia or eosinophilia. Their skin lesions remained localized and associated haematological abnormalities stable for up to 7 years. Haematological abnormalities were also reported in previous cases and this finding is unlikely to be coincidental; however, its clinical significance remains unknown.
Rare association of xanthoma disseminatum with skeletal involvement
Authors: Khandpur Sujay , Manchanda Yashpal , Sharma Vinod K , Singh Manoj K , Tandon Nikhil
Published: July 2003

A ten‐year‐old boy presented with a 2.5‐year history of painful shoulder and hip joints, 1.5 years of yellow‐brown papules and plaques on the face, flexures and trunk, and 6 months of polyuria and polydipsia. Skin biopsy revealed histological and immunohistochemical features typical of xanthoma disseminatum. Lytic bone lesions were seen in the femur and pelvis and sclerotic changes in the humerus on X‐ray. Diabetes insipidus was also diagnosed
Erdheim–Chester disease
Authors: Opie Kimble M , Kaye Joey , Vinciullo Carl
Published: July 2003

A 38‐year‐old man presented with numerous dermal nodules, similar to xanthoma disseminatum, that were histologically consistent with his diagnosis of Erdheim–Chester disease, a non‐Langerhans cell histiocytosis. Other cutaneous manifestations of this disease include eyelid xanthelasma, pretibial dermopathy and pigmented lesions of the lips and buccal mucosa. The histological diagnosis of Erdheim–Chester disease was originally made on the patient's retroperitoneal tissue, obtained at a laparotomy for surgical treatment of a presumed phaeochromocytoma, and confirmed by the pathognomonic long bone X‐ray findings of this disease.
Wells' syndrome following thiomersal‐containing vaccinations
Authors: Koh Karen J , Warren Lachlan , Moore Lynette , James Craig , Thompson Geoffrey N
Published: July 2003

A 3½‐year‐old boy presented on three occasions with painful, itchy, oedematous plaques on his limbs. On two occasions he had received hepatitis B vaccination 11–13 days previously, and on the third occasion received triple antigen (DTP) vaccination 10 days earlier. Skin biopsy revealed a prominent infiltrate of eosinophils involving the entire thickness of the dermis. In addition there were prominent ‘flame figures’ consisting of eosinophilic necrotic collagen surrounded by granular basophilic debris. The clinical and histological pictures were consistent with Wells' syndrome. The eruption settled on the second and third occasions with 0.1% mometasone furoate cream. Subsequent patch testing showed 2+ reaction to preservative thiomersal at 96 hours. This is the first description of Wells' syndrome with typical clinical and histopathological features associated with thiomersal in two different vaccines.
Hand, foot and mouth disease in an immunocompromised adult treated with aciclovir
Authors: Faulkner Catherine F , Godbolt Amanda M , DeAmbrosis Brian , Triscott Joe
Published: July 2003

A 27‐year‐old man, immunosuppressed from recent chemotherapy for metastatic Ewing's sarcoma, presented with a 1‐week history of a painful, pruritic, papulovesicular eruption on the hands and feet. A diagnosis of hand, foot and mouth disease was made based on histology, detection of Enterovirus ribonucleic acid by polymerase chain reaction on a swab from a vesicle, and a four‐fold increase in Enterovirus antibody levels. At no stage however, were there lesions in the mouth. Another unusual feature in this case was a prolonged course, presumably as a result of immunosuppression. After 3½ weeks he was commenced on oral aciclovir 200 mg five times daily, with subsequent resolution of all lesions within 5 days. There may be a role for systemic aciclovir in some patients with hand, foot and mouth disease.
Truncal lesions do not exclude a diagnosis of Gianotti–Crosti syndrome
Authors: Chuh Antonio AT
Published: July 2003

A boy aged 2 years and 10 months had a pruritic eruption and low‐grade fever for 1 week. Examination revealed discrete erythematous papules and papulovesicles on his buttocks and extensor surfaces of four limbs. Several papules were also present on his back. No lymphadenopathy and no hepatosplenomegaly were noted. Investigations failed to identify a single viral aetiology. Topical calamine lotion and a sedating oral antihistamine to be taken at night were prescribed. The truncal lesions subsided in 3 weeks. Complete remission of all lesions was seen after 6 weeks. Although most patients with Gianotti–Crosti syndrome only have the typical acrally distributed eruption, additional truncal lesions, if few in number, do not exclude the diagnosis.
Two cases of eosinophilic pustular folliculitis associated with parasitic infestations
Authors: Opie Kimble M , Heenan Peter J , Delaney Thomas A , Rohr James B
Published: July 2003

Two patients presented with papular eruptions that could not be diagnosed clinically. Biopsies of these lesions showed eosinophilic pustular folliculitis (EPF). Both cases were subsequently found to have infestations: one as a result of cutaneous larva migrans was successfully treated with ivermectin and the other caused by scabies mites was successfully treated with topical pyrethrin. The two cases of EPF presented emphasize the need for careful clinicopathological correlation to determine the cause.
Occupational contact dermatitis to hydrangea
Authors: Rademaker Marius
Published: July 2003

Two female commercial hydrangea growers, from separate nurseries, presented with similar hand and facial dermatitis. Both had a hand dermatitis affecting particularly the first three fingers and backs of both hands and complained of a recurrent facial dermatitis affecting the forehead, around both the eyes and bridge of nose. They related their dermatitis to their work. Patch tests confirmed allergy to all components of hydrangeas including petal, leaf and stem. Avoidance resulted in resolution of their dermatoses. Allergy to hydrangeas has been reported previously although infrequently.
Protracted superficial Wegener's granulomatosis
Authors: Sinovich Vania , Snow John
Published: July 2003

A 27‐year‐old woman presented with a right infra‐auricular noduloulcerative lesion progressing to a peri‐auricular pyoderma gangrenosum‐like ulcer with destruction of her right earlobe over an 8‐month period. Similar nodules appeared on the right malar and left infra‐auricular regions. The cutaneous manifestations were associated with nasal congestion, rhinorrhoea and serosanguineous nasal crusting. Skin biopsy demonstrated suppurative granulomatous inflammation. Investigation of both renal and pulmonary function showed no abnormality. Serological testing revealed a positive cytoplasmic pattern antineutrophil cytoplasmic antibody with high proteinase‐3 specificity, which in conjunction with the clinical findings is consistent with a diagnosis of protracted superficial Wegener's granulomatosis. Initial treatment with prednisone 1 mg/kg/day and azathioprine 100 mg/day resulted in complete resolution of her lesions. Reduction of the corticosteroid dose below 0.3 mg/kg/day led to recrudescence of cutaneous and upper respiratory tract symptoms, at which stage methotrexate was substituted for azathioprine with rapid induction of remission and further prednisone withdrawal. Thirty‐two months after the initial diagnosis the patient remains well with no other organ involvement.
Role of modern radiotherapy in treating skin cancer
Authors: Veness Michael , Richards Shawn
Published: July 2003

Radiotherapy is an important modality in the treatment of non‐melanoma skin cancers. While the majority of patients will be adequately treated without the need for radiotherapy, there are factors that may favour a recommendation for radiotherapy. The established roles of modern radiotherapy include the definitive, adjuvant and palliative settings. It is important that clinicians treating skin cancers have an understanding and awareness of these roles. The aim of this article is to present an overview of radiotherapy in the current Australian setting.
Early Intervention in Psychosis: An Overdue Reform
Authors: McGorry Patrick D. , Yung Alison R.
Published: July 2003

Objective: To discuss the rationale for early intervention in psychotic disorders and to explore why the widespread implementation of early intervention services has stalled.

Method: Four central questions are explored regarding early intervention in psychosis: (i) what is the rationale for early intervention services in psychosis and is it justified? (ii) what are the obstacles to the implementation of early intervention services throughout Australia? (iii) how could some of these obstacles be overcome? and (iv) what else needs to occur?

Results: Early intervention in psychosis aims to improve recognition and access, promote recovery from the initial psychotic episode, minimize secondary morbidity and reduce collateral damage. It may also prevent some brain dysfunction and damage, which may otherwise occur later in the illness. Despite the now growing body of evidence supporting the idea of early intervention, obstacles remain to its widespread adoption in policy and implementation, principally related to chronic under-funding of the public mental health system. Among the solutions proposed is the need to develop services with a youth focus, able to cater for young people with both psychotic and non-psychotic psychiatric disorders. These services should be well integrated with primary care and other youth orientated agencies.

Conclusions: We are hopeful that strong investment in early intervention and better services for young people will be among the highest priorities of the Third National Mental Health Plan. This is not only where the greatest public health burden lies, but also where costeffectiveness of intervention is likely to be maximal.
Early and Late Neurodevelopmental Disturbances in Schizophrenia and Their Functional Consequences
Authors: Pantelis Christos , Pantelis Christos , Yücel Murat , Wood Stephen J. , McGorry Patrick D. , Velakoulis Dennis
Published: July 2003

Objective: The evidence from structural imaging studies supports the notion that schizophrenia arises from an early abnormality in brain development. In this paper we review the timing of structural changes in schizophrenia and argue that schizophrenia is a neurodevelopmental disorder with limited progressive brain changes occurring during the evolution and early phase of psychosis.

Method: The available cross-sectional and longitudinal studies are reviewed, along with data from our own research.

Results: The current literature, including our own data, suggests that structural brain changes are apparent premorbidly, consistent with a neurodevelopmental lesion. These are prominent in frontal and cingulate regions, and appear related to premorbid neuropsychological deficits in executive function. However, there appear to be additional brain changes over the transition to illness and beyond.

Conclusions: We propose first, that an early neurodevelopmental insult interacts with either normal or abnormal postpubertal brain maturation to produce further (late neurodevelopmental) brain structural and functional changes; and second, that the effect of such neurodevelopmental lesions will have different consequences for functions that normally develop early in life, such as memory, compared with functions developing later, such as executive functions. A model is presented suggesting that the structural and functional abnormalities in schizophrenia can be understood as a consequence of the neurodevelopmental stage at which brain changes occur.
A Canadian Programme for Early Intervention in Non-Affective Psychotic Disorders
Authors: Malla Ashok , Malla Ashok , Norman Ross , McLean Terry , Scholten Derek , Townsend Laurel
Published: July 2003

Objectives: To provide a brief overview of the development of clinical services and research for early intervention in psychotic disorders in Canada; to describe components of a comprehensive clinical/research programme for nonaffective psychotic disorders; and to present a summary of results of clinical and social outcomes achieved.

Method: This is a descriptive paper providing some details of how clinical services are being developed in Canada and concentrating on one particular early intervention programme, Prevention and Early intervention Programme for Psychoses (PEPP) London, Ontario, which is using a historical control design to evaluate the impact of an assertive approach to community case detection. Components of a phase-specific treatment programme and early case detection are described followed by results based on clinical and psychosocial data collected according to a defined protocol.

Results: One year outcome for patients treated in PEPP shows use of low dose, predominantly novel antipsychotics and high (81.5%) retention and remission (75%) rates. Highly significant improvements were also reported for self-rated quality of life and cognition. Duration of untreated psychosis (DUP) and premorbid adjustment were associated with improvement in positive and negative symptoms, respectively. Systemic changes to improve access to the service resulted in substantial increases in number of cases treated and a < 50% decline in DUP.

Conclusions: Phase-specific treatment approach and case identification strategies to reduce delay in treatment are likely to substantially improve outcome in nonaffective psychotic disorders compared with what has been reported with traditional approaches.
A Statewide Evaluation System for Early Psychosis
Authors: Preston Neil J. , Preston Neil J. , Stirling Maree L. , Perera Kanthi , Bell Richard J. , Harrison Tracey J. , Whitworth Lisa , Castle David J.
Published: July 2003

Objective: We describe a system of outcome evaluation for early psychosis programmes and present preliminary data. The Early Psychosis Outcome Evaluation System (EPOES) was designed for use in a naturalistic, prospective study of a cohort of early-episode psychosis patients. We describe patients in terms of symptoms, substance use, social functioning and family burden, and examine the effectiveness of treatment programmes.

Method: Four sites in Perth, Western Australia, participated. Outcome was evaluated from three sources: case manager (CM), patient (P) and family member (FM). Seven clinical outcome measures were used: the Brief Psychiatric Rating Scale (CM), Brief Symptom Inventory (P), Substance Use (CM); Social Functioning Scale (P); Global Assessment Scale (CM); Burden Assessment Scale (FM), and the General Health Questionnaire-12 (FM). Measures were collected at intake (baseline) into a specialist early psychosis service and thereafter every 6 months until discharge from the service.

Results: After the first year of data capture, 84 baseline assessments have been completed, and 23 patients have been followed up at 6 months. Clinicians and patients reported significantly less psychopathology at 6 months. Sixty per cent of patients reported marijuana use within 3 months of baseline assessment, and 30% amphetamine, ecstasy or cocaine use. Increased levels of psychopathology were recorded for substance-using patients. Family members (59%) reported psychological distress at baseline; this was reduced at 6 months. Patient social functioning and family burden did not improve measurably.

Conclusions: The EPOES is an effective system that provides feedback on the clinical status of early-episode psychosis patients. Both observed and self-rated psychopathology and family psychological distress, is improved after 6 months of intervention. Family burden and patient social functioning did not demonstrate improvement. Patient social functioning is an important area for treatment. Substance use is associated with poorer psychopathology. EPOES provides a feasible system of measuring outcome in early psychosis intervention.
Management of Early Psychosis in a Generic Adult Mental Health Service
Authors: Yung Alison R. , Organ Bridget A. , Harris Meredith G.
Published: July 2003

Objective: To evaluate current practice at a generic adult mental health service, St Vincent's Mental Health Service (SVMHS) in relation to management of patients with early psychosis. A further aim was to compare treatment of early psychosis patients within this generic service with management of a similar group in a specialized early psychosis service.

Method: A case file audit of all patients identified as having early psychosis (within the first 2 years of treatment) was undertaken using a standardized audit tool. Variables including proportion of early psychosis admitted as inpatients to the psychiatric unit, average length of stay (LOS), use of seclusion, involvement of police in admission process, mean neuroleptic dose and estimated duration of untreated psychosis (DUP) were studied. Results of this audit were then compared with published evaluative data from the Early Psychosis Prevention and Intervention Centre (EPPIC), a service specifically catering for young people with early psychosis (within the first 18 months of treatment).

Results: Data were collected on 62 of 68 patients identified as having early psychosis. Within the generic service, mean DUP was found to be about 15 months, a high proportion (81%) of patients were admitted and secluded (22% of those admitted), average length of stay was 46.5 days and use of police in the admission process was also high (40% of those admitted). This compares unfavourably with the EPPIC data of mean DUP of just over 6 months, 64.1% of patients admitted, 10.3% secluded, average LOS 12.9 days, and police involved in 3.8% of admissions.

Conclusions: We believe that practice at SVMHS in relation to early psychosis patients is fairly typical of management of these patients within generic services as a whole. These services tend to focus on the needs of the majority of their patients, those with chronic schizophrenia, rather than the small group of patients with early psychosis (who make up about 8% of current case-load at SVMHS). Failure to assertively assess and follow-up young people with early psychosis may contribute to long DUPs, which may in turn result in patients being more disturbed at time of initial treatment, thus requiring inpatient treatment and longer length of stay. Additionally, staff at generic services may not feel confident in managing early psychosis patients and may be unaware of the special needs of this patient group. These preliminary data suggest that generic services are not optimal for treatment of early psychosis patients and that treatment of early psychosis within them is not cost-effective
Prevalence and Course of Schizophrenia in a Chinese Rural Area
Authors: Ran Mao-Sheng , Xiang Meng-Ze , Li Sheng-Xian , Shan You-He , Huang Ming-Sheng , Li Si-Gan , Liu Zhong-Ren , Chen Eric Yu-Hai , Chan Cecilia Lai-Wan
Published: July 2003

Objective: To assess the characteristics and factors affecting course of schizophrenia in a Chinese rural area.

Method: An epidemiological investigation was conducted to identify all the patients with schizophrenia among 149 231 people in Xinjin County, Chengdu.

Results: The total prevalence of schizophrenia was 4.13 per 1000 population. Males had an earlier mean age of onset (29.6 years) than females (32.3 years). Duration of illness before treatment and the total duration of illness were found to be significantly associated with level of remission. The status of treatment, family economy, housing, and families' care of patients had a significant effect on the clinical course of the illness.

Conclusions: Duration of illness before treatment may be an important predictor of course in schizophrenia. Early treatment for the patients may produce higher level of improvement in prognosis. Education intervention and community-based service are urgent priorities for these patients.
Influence of Symptom Attribution on Reporting Depression and Recourse to Treatment
Authors: Parker Gordon , Parker Gordon , Parker Kay
Published: July 2003

Objective: A Bristol general practice study demonstrated the extent to which patients' attribution style influences psychological diagnostic case rates. We pursue this issue and several implications in this Australian study.

Method: A survey was undertaken of six general practices in Sydney, and involving more than 900 routine general practice patients. Subjects completed questionnaires assessing personality styles observed in those with clinical depression, attributional response (i.e. ‘psychological’, ‘somatic’ and ‘normalizing’) to three somatic cues, state depression, lifetime depression, use of antidepressant medication, and recourse to professional help.

Results: Responders attributing psychological explanations to the somatic cues had the highest state and lifetime depression rates, viewed their depression as more likely to be a ‘disorder’ and were more likely to have received treatment for depression. Those with a personality style of ‘anxious worrying’ reported increased morbidity across all depression variables, but personality did not make attributional style redundant in multivariate analyses.

Conclusions: Interpreting somatic cues in a psychological way is associated with higher rates of reported depression and increased recourse to depression treatment. Thus, a normalizing response style may make depression recognition and detection difficult. Study findings challenge the capacity of self-report measures to detect depression, especially in general practice settings.
More Deprived Areas Need Greater Resources for Mental Health
Authors: Abas Melanie , Vanderpyl Jane , Robinson Elizabeth , Crampton Peter
Published: July 2003

Objective: This study set out to investigate the relationship in New Zealand between the newly developed small area index of socio-economic deprivation, NZDep96, and measures of psychiatric bed utilisation. It aims to contribute to the debate on resource allocation and to estimate the distribution of beds required in relation to levels of deprivation.

Method: A cohort study of 872 persons admitted to the psychiatric in-patient unit within Counties Manukau, involving 1299 episodes of in-patient care between 1998 and 2000. The annual period prevalence of admission and the rate of total occupied bed days were calculated for the different deciles of deprivation, standardized for age and gender.

Results: There was a three-fold gradient in admission prevalence and in total occupied bed days between persons living in the most and least deprived areas.

Conclusions: Mental health services need to be organized and funded in ways that take account of the high use of in-patient care among those living in deprived areas. Further research is required to explore the relationship between socio-economic deprivation and use of community mental health services.
Which Antidepressants Flick the Switch?
Authors: Parker Gordon , Parker Gordon , Parker Kay
Published: July 2003

Objective: The Black Dog Institute seeks to address issues of relevance to the clinical management of those with a mood disorder. This overview considers the capacity of antidepressant drugs, and particularly the new classes, to induce manic switching in depressed patients.

Method: Relevant literature is reviewed.

Results: It is unclear whether antidepressant drugs from any of the classes induce switching in unipolar depressed patients. In bipolar depressed patients, the broad-spectrum tricyclic and monoamine oxidase inhibitor drugs present a clear risk of switching, the selective serotonin re-uptake inhibitors do not appear (at standard doses) to increase the risk, while the capacity of the dual action (serotonergic and noradrenergic) drugs to induce switching remains unestablished but may be slight.

Conclusions: As switching induced by narrow action antidepressants does not appear to present a substantive causal risk, clinicians can have confidence in prescribing certain antidepressants for managing bipolar depression, and without any necessity to first prescribe a mood stabilizer to pre-empt switching.
Confirmatory Factor Analysis of the GHQ-12: Can I See that Again?
Authors: Campbell Alistair , Walker Judith , Farrell Gerry
Published: July 2003

Objective: This paper reviews research relating to the factor analysis of the GHQ-12. We explore the question of whether there is a consistent replicable structure to the GHQ-12 using: (i) a comparative analysis of fit between identified factor models; and (ii) a confirmatory factor analysis of GHQ-12 data from our own study.

Method: The factor models proposed from the literature were reviewed. The published factor loadings were used to carry out a factor matching analysis to identify similarities between the various factor models that have been identified. In addition, 490 patients visiting their general practitioner completed the General Health Questionnaire (GHQ-12) in the first phase of a longitudinal study evaluating service delivery to rural Tasmania. Three different methods for scoring the GHQ-12 were utilized and each resultant data set was analysed using a Confirmatory Factor Analysis (CFA) to establish which of the various factor models provided the most consistent description of the data.

Result: None of the complete factor models that have been proposed have been consistently replicated across studies. Isolated factors were replicated between some studies but no single factor structure was replicated across all studies. All of the models had adequate fit to the Tasmanian data when the usual scoring was used. However, only one model had a consistently high ‘goodness of fit’ across scoring methods.

Conclusion: It was concluded that the ‘best fit’ was achieved by a model based on an early factor analytic study using an Australian sample. It was suggested that researchers wanting to extract scales from the GHQ-12 could use this model.
Suicide Prevention in First Episode Psychosis: The Development of a Randomised Controlled Trial of Cognitive Therapy for Acutely Suicidal Patients With Early Psychosis
Authors: Power P.J.R. , Bell R.J. , Mills R. , Herrman-Doig T. , Davern M. , Henry L. , Yuen H.P. , Khademy-Deljo A. , McGorry P.D.
Published: July 2003

Background: Young people with early psychosis are at particularly high risk of suicide. However, there is evidence that early intervention can reduce this risk. Despite these advances, first episode psychosis patients attending these new services still remain at risk. To address this concern, a program called LifeSPAN was established within the Early Psychosis Prevention and Intervention Centre (EPPIC). The program developed and evaluated a number of suicide prevention strategies within EPPIC and included a cognitively oriented therapy (LifeSPAN therapy) for acutely suicidal patients with psychosis. We describe the development of these interventions in this paper.

Method: Clinical audit and surveys provided an indication of the prevalence of suicidality among first episode psychosis patients attending EPPIC. Second, staff focus groups and surveys identified gaps in service provision for suicidal young people attending the service. Third, a suicide risk monitoring system was introduced to identify those at highest risk. Finally, patients so identified were referred to and offered LifeSPAN therapy whose effectiveness was evaluated in a randomised controlled trial.

Results: Fifty-six suicidal patients with first episode psychosis were randomly assigned to standard clinical care or standard care plus LifeSPAN therapy. Forty-two patients completed the intervention. Clinical ratings and measures of suicidality and risk were assessed before, immediately after the intervention, and 6 months later. Benefits were noted in the treatment group on indirect measures of suicidality, e.g., hopelessness. The treatment group showed a greater average improvement (though not significant) on a measure of suicide ideation.

Conclusions: Early intervention in psychosis for young people reduces the risk of suicide. Augmenting early intervention with a suicide preventative therapy may further reduce this risk.
Treatment of Benzodiazepine Dependence in Methadone Maintenance Treatment Patients: A Comparison of Two Therapeutic Modalities and the Role of Psychiatric Comorbidity
Authors: Weizman Tal , Gelkopf Marc , Melamed Yuval , Adelson Miriam , Bleich Avraham
Published: July 2003

Objective: Therapeutic approaches for benzodiazepine (BZD) dependence in patients in methadone maintenance treatment (MMT) have met with limited success. Clonazepam detoxification (CDTX) and clonazepam maintenance treatment (CMT) were compared in an open, clinical naturalistic study on such patients.

Methods: Benzodiazepine dependent patients substituted their BZD of abuse for clonazepam and were then either detoxified (CDTX) or a maintenance dose was reached and maintained (CMT). Patients were considered as failing the trial if they either abused BZDs (CDTX group) or abused BZDs over the maintenance dose (CMT group). Treatment outcome was evaluated based upon self and staff reports over 1 year after beginning treatment. Axis I and II psychiatric diagnosis was assessed and methadone dosage and history of abuse was recorded.

Results: In the CDTX group, 9/33 (27.3%), were BZD-free after 2 months. In the CMT group, 26/33 (78.8%) refrained from abusing additional BZDs over the maintenance dose after 2 months. The same success rate remained over the entire year. Survival analysis showed CMT to be more successful than the CDTX. Axis I psychiatric comorbidity was found to be positively related to treatment success in the CMT group while axis II antisocial personality disorder was found to be negatively related to treatment success in that group. It had no impact in the CDTX group.

Conclusions: Maintenance strategy with clonazepam is a useful BZD treatment modality for BZD-dependent MMT patients with a long-term history of abuse and previous attempts at detoxification. Psychiatric comorbidity may have an important role in choosing the adequate treatment modality and influencing treatment outcome.
Depression in Older Chinese Migrants to Auckland
Authors: Abbott Max W. , Abbott Max W. , Wong Sai , Giles Lynne C. , Wong Sue , Young Wilson , Au Ming
Published: July 2003

Objective: This study was conducted to identify risk factors for depressive symptomatology among older Chinese migrants.

Method: One hundred and sixty-two Chinese migrants aged 55 years or older, living in the community and recruited via Chinese community organizations and general practitioners, were interviewed using a Chinese version of the Geriatric Depression Scale and measures of stressful life events, morbid conditions, self-rated health, acculturation, social support and service utilization.

Result: Twenty-six percent of participants met the criteria for depressive symptomatology. No recent migrants showed symptoms of depression. Multiple logistic regression analysis showed that lower emotional support, greater number of visits to a doctor, difficulties in accessing health services and low New Zealand cultural orientation increased the risk of showing symptoms of depression.

Conclusion: Significant numbers of older Chinese migrants appear to be depressed or at risk for depression and, while participants with depressive symptoms consulted general practitioners more than their counterparts without such symptoms, they reported greater difficulty in accessing health services. The findings point to the need for further epidemiological study of this growing sector of the population and investigation of the nature of its engagement with health services. Social support and aspects of acculturation may play a significant role in preventing depression. This also requires further investigation.
Diagnostic Concordance of ICD-10 Personality and Comorbid Disorders: A Comparison of Standard Clinical Assessment and Structured Interviews in a Clinical Setting
Authors: Egan Sarah , Nathan Paula , Lumley Margaret
Published: July 2003

Objective: The diagnosis of personality disorders is one of the most problematic areas in psychiatric diagnosis. Diagnoses are usually made by standard clinical interview, but they have poor reliability. The aim of this study was to compare the concordance in diagnosis between structured assessment tools and assessment as usual in a clinical setting.

Method: Diagnosis of 33 patients on the International Personality Disorder Examination (IPDE) and the Mini International Neuropsychiatric Interview (MINI) was compared to diagnosis made by standard assessment through clinical interview.

Results: There was poor concordance between structured measures and standard assessment by clinical interview, and poor levels of diagnostic sensitivity and specificity on standard assessment.

Conclusion: Structured measures were more comprehensive, sensitive and specific in diagnosis than standard clinical assessment. Increased diagnostic accuracy is needed for effective understanding and treatment planning for personality disorders.
Preservation of residual renal function and factors affecting its decline in patients on peritoneal dialysis
Authors: HIDAKA Hiromi , NAKAO Toshiyuki
Published: July 2003

SUMMARY:   The decline of residual renal function (RRF) in peritoneal dialysis (PD) patients was analysed and assessed, and risk factors affecting its decline were identified. Residual glomerular filtration rate (GFR) was calculated from averaging the urea and creatinine clearance by 24‐h urine collection, and peritoneal solute removal was evaluated by creatinine clearance calculated from 24‐h effluent collection. Both GFR and peritoneal solute removal were chronologically examined in 34 PD patients from the time of initiation, and risk factors associated with rapid GFR decline were investigated. The RRF contributed to 43.1 ± 17.6% of total (peritoneal and renal) weekly creatinine clearance at 1 month after initiation of PD. Residual GFR, however, declined continuously with time (−0.19 ± 0.14 mL/min per month), and the reduction rate was high with a higher GFR, higher normalized dietary protein intake, higher urine volume and higher urine protein excretion at the initiation of PD. Other factors related to the rapid decline of GFR were: being older than 60 years of age, automated peritoneal dialysis (APD) rather than continuous ambulatory peritoneal dialysis, mean blood pressure higher than 110 mmHg, and serum human atrial natriuretic peptide level higher being than 60 pg/dL. These data suggest that while RRF plays an important role in the removal of uraemic solute in PD patients, they show a significant decrease over 2 years. The factors related to the rapid decline of GFR corresponded to older age, modality of PD (APD), higher GFR and higher amount of urine protein at initiation, higher dietary protein intake, and inadequate control of hypertension and body fluid volume.
Significance of 8‐hydroxy‐2′‐deoxyguanosine levels in patients with chronic renal failure
Authors: AKAGI Shigeru , NAGAKE Yoshio , KASAHARA Junko , SARAI Ai , KIHARA Takashi , MORIMOTO Hisanori , YANO Ai , NAKAO Kazushi , NANBA Kiyohito , ICHIKAWA Haruo , MAKINO Hirofumi
Published: July 2003

SUMMARY:   The aim of this study was to determine the significance of 8‐hydroxy‐2′‐deoxyguanosine (8‐OHdG), which is known as a marker of oxidative stress in vivo, in patients with chronic renal failure (CRF). Fifty‐one non‐dialysed CRF patients (29 men and 22 women; mean ± SD age, 57.8 ± 12.8 years) who were under dietary therapy for at least 6 months were enrolled in the study. Both serum and urinary 8‐OHdG levels were measured by using high‐sensitive enzyme‐linked immunosorbent assay (ELISA) kits. We examined the relationship between 8‐OHdG levels and clinical indices in patients with CRF. As a result, the serum 8‐OHdG level was strongly correlated with serum levels of urea nitrogen (UN; r = 0.58; P < 0.0001), creatinine (Cr; r = 0.53; P < 0.0001), and β2‐microglobulin (β2‐MG; r = 0.54; P < 0.0001). Furthermore, the serum 8‐OHdG level was inversely correlated with creatinine clearance (Ccr; r = −0.54; P < 0.0001). In contrast, urinary 8‐OHdG level was not correlated with any of the clinical parameters. This is the first report of 8‐OHdG level determination in patients with CRF. It is suggested that serum 8‐OHdG level is not sufficient as a marker of oxidative damage in patients with CRF, and it should be corrected according to the residual renal function to estimate the accurate degree of oxidative stress.
Studies on eriophyoid mites (Acari: Eriophyoidea) of Australia: A new genus and seven new species associated with tea trees, Melaleuca spp. (Myrtaceae)
Authors: Knihinicki Danuta K , Boczek Jan
Published: July 2003

Abstract One new genus and seven new species of eriophyoid mites from Australia are described and illustrated. Scutalophus mallacootensis gen. and sp. n., Calepitrimerus maddoxi sp. n., Aculus campbelli sp. n. and Phyllocoptes ballinensis sp. n. are all free‐living vagrants on Melaleuca alternifolia, an important essential oil crop in which Eriophyes melaleucae (Keifer) severely distorts the new growth. A redescription of E. melaleucae is supplemented with an illustration of the male genitalia. In addition, C. maddoxi sp. n. occurs on Melaleuca linariifolia in association with E. melaleucae. Scutalophus mallacootensis gen. and sp. n. also inhabits Melaleuca armillaris along with Eriophyes armillaris sp. n. Eriophyes quinquenerviae sp. n. forms round, pepper‐shot galls on foliage of Melaleuca quinquenervia and Eriophyes leucadendrae sp. n. builds elongated, ridge‐like galls on leaves of Melaleuca leucadendra.
Rainbow bee‐eaters (Merops ornatus) as a monitoring tool for honeybees (Apis mellifera L.; Hymenoptera: Apidae)
Authors: Bellis Glenn A , Profke Angela M
Published: July 2003

Abstract Regurgitated pellets were collected from underneath roosts of rainbow bee‐eaters in suburban Darwin, Australia, and examined for the presence of wings of honeybees. The proportion of pellets containing wings was compared prior to and after placement or removal of honeybee hives in the vicinity of four roosts. On each occasion, the addition or removal of hives was reflected in proportions of pellets containing wings. The results suggest that examination of pellets beneath bee‐eater roosts would be a useful technique for monitoring the occurrence of feral honeybees. Potential uses for this technique in eradication of unwanted bees are discussed.