bluuebunny/crossref_metadata_2025_split huggingface dataset:
Grief and Courage in a River Town: A Pilot Project in the Aboriginal Community of Kempsey, New South Wales
Authors: Cleworth Sally , Smith Wayne , Sealey Robyn 
Published: December 2009

Objective: To describe a pilot project implemented in Kempsey, NSW, whereby a psychiatry registrar worked in a community-controlled Aboriginal medical service, Durri Aboriginal Corporation Medical Service, which provides mental health services for Aboriginal people. Conclusions: The Aboriginal Mental Health Workers and psychiatry registrar jointly managed a significant number of Aboriginal people, often with assistance from the local mental health service at Kempsey. The registrar gained insight into the local Aboriginal community and more culturally appropriate clinical methods, as well as some cultural factors that can influence the presentation and management of mental illnesses. The Aboriginal Mental Health Workers increased their clinical knowledge and confidence through working with the registrar.
Do Clinical Pathways Really Improve Clinical Performance in Mental Health Settings?
Authors: Brett Emmerson , Aaron Frost , Lisa Fawcett , Emma Ballantyne , Warren Ward , Stan Catts 
Published: December 2009

Objective: Royal Brisbane and Women's Hospital (RBWH) Mental Health developed and trialled two clinical pathways on psychosis and depression between 2001 and 2003 with the aim of improving a range of clinical and financial parameters. There was a strong commitment from senior management, appropriate resources were allocated and there was adequate staff support. Following a 6-month trial, the pathways were reworked extensively and combined into an acute inpatient pathway. From October 2003 to 2004, we trialled the acute inpatient clinical pathway, and monitored clinical and financial parameters. Conclusion: Over this 12-month period, the acute inpatient clinical pathway failed to demonstrate improvement on a range of clinical and financial parameters and its use was ceased. This trial lends support to the view that the complexity, individuality and variability of mental disorders means that clinical pathways are not beneficial in mental health settings.
Parenting and Mental Illness: A Pilot Group Programme for Parents
Authors: Ruth Phelan , Lana Lee , Deb Howe , Garry Walter 
Published: December 2009

Objective: To describe a pilot group programme for parents with a mental illness that was developed and implemented on the NSW Central Coast. Conclusions: The Parenting and Mental Illness Group Program is a 6week group programme that is followed by four weekly, individual home visits. Data from the Eyberg Child Behaviour Inventory and Parenting Scale suggest the programme produced positive outcomes in children's behaviour and parenting practices; the programme was also viewed favourably by participants. While encouraging, these findings require replication, using larger numbers and evaluation of the programme in other sites. Supported by an evidence base, programmes such as this will be important to implement if mental health services are to improve outcomes for parents with mental health problems and their children.
Using the Internet to Enhance the Treatment of Depression
Authors: Robertson Lucy , Smith Michael , Castle David , Tannenbaum Dennis 
Published: December 2009

Objective: Deficiencies in Australia's mental health systems persist despite over a decade of mental health reform. Recent developments in ehealth provide the opportunity to facilitate health reform and improve services. This paper presents preliminary findings from the implementation of a comprehensive e-health system, called RecoveryRoad, which was designed to augment the routine clinical treatment of depression. Methods: Depressed patients (n = 144) were referred to RecoveryRoad from a public hospital and public and private clinics in Perth, Western Australia. Online features included secure e-consultations, progress monitoring questionnaires, psychoeducation and evidence-based therapy. Treating clinicians had online access to patients’ progress monitoring outcomes and e-consultations. There were two types of adherence reminders: automated email reminders and personalized case management delivered by email and telephone. Results: Adherence to the system was high (from 53% to 84%, depending on the modality of reminder), and self-reported medication adherence was over 90%. Average depression severity declined from severe to mild by the eighth session, a large effect (d = 1.0). Both clinicians and patients were generally satisfied with the programme and reported that it improved clini-cian–patient relationships. Clinicians also reported that it helped patients to better manage depression. Conclusions: Preliminary findings support the feasibility of comprehensive e-health systems in enhancing the delivery of mental health care.
Malingered Psychosis Leading to Involuntary Psychiatric Hospitalization
Authors: Waite Susan , Geddes Andy 
Published: December 2009

Objective: To describe a patient with feigned psychosis who was admitted to an acute psychiatric unit under the Mental Health Act, and to discuss the clinical features of malingering in this treatment setting. Method: Case report. Results: A 40-year-old man with no known past psychiatric history was brought by police to the Emergency Department. He gave a history of paranoia, hallucinations and bizarre behaviour and was admitted to a secure ward. Treatment with parenteral medication was required due to hostile and aggressive behaviour. Collateral history was inconsistent with his reported symptoms and, when confronted with this information, he acknowledged fabricating his symptoms in order to obtain a disability pension. Conclusions: It is important to consider malingering as a differential diagnosis in patients who present with atypical features and have clear external incentives for their behaviour. With improved health literacy and access to health information, individuals who are marginalized in society and have limited social and occupational opportunities may malinger symptoms for obvious personal gain. Inconsistency between reported symptoms and clinical observations, as well as contradictory collateral information from multiple sources, are helpful tools in diagnosing malingering. It is important for clinicians to identify malingerers early and limit unnecessary admissions.
Increased levels of the inflammatory biomarker C‐reactive protein at baseline are associated with childhood sickle cell vasocclusive crises
Authors: Krishnan Suba , Setty Yamaja , Betal Suhita G. , Vijender Vaidyula , Rao Koneti , Dampier Carlton , Stuart Marie 
Published: December 2009

SummarySeveral lines of evidence suggest that sickle cell disease (SCD) is associated with a chronic inflammatory state. In this study of 70 children with SCD at steady state evaluated by a broad panel of biomarkers representing previously examined mechanisms of pathogenicity in SCD, high sensitivity C‐reactive protein (hs‐CRP), a marker of low‐grade, systemic inflammation, emerged as the most significant laboratory correlate of hospitalizations for pain or vaso‐occlusive (VOC) events. While markers of increased haemolytic status, endothelial activation and coagulation activation all correlated positively with VOC events by univariate analysis, baseline hs‐CRP levels provided the most significant contribution to the association in multiple regression models (22%), and, hs‐CRP, along with age, provided the best fit in negative binomial models. These data highlight the clinical relevance of the role of inflammation in paediatric VOC, providing both a rationale for future therapeutic strategies targeting inflammation in microvessel occlusive complications of SCD, and the potential clinical use of hs‐CRP as a biomarker in childhood SCD.
188Re anti‐CD66 radioimmunotherapy combined with reduced‐intensity conditioning and in‐vivo T cell depletion in elderly patients undergoing allogeneic haematopoietic cell transplantation
Authors: Lauter Anett , Strumpf Annette , Platzbecker Uwe , Schetelig Johannes , Wermke Martin , Radke Jörgen , Kiani Alexander , Wunderlich Gerd , Thiede Christian , Ehninger Gerhard , Kotzerke Jorg , Bornhäuser Martin 
Published: December 2009

SummaryThe addition of radioimmunotherapy to conventional and reduced‐intensity conditioning has been shown to be feasible and effective. Within an ongoing prospective phase II trial, 22 patients with advanced myeloid malignancies and a median age of 65 years (range 54–76) received anti‐CD66 Rhenium radioimmunotherapy followed by fludarabine (150 mg/m2), busulfan (8 mg/kg) and alemtuzumab (75 mg) before allogeneic haematopoietic stem cell transplantation from matched sibling (n = 7) and unrelated donors (n = 15). The extramedullary toxicity in the first 100 d post‐transplantation was limited and all patients engrafted with complete donor chimaerism. The incidence of non‐relapse mortality at day 100 and after 2 years was 4·5% and 23%, respectively. The probability of overall survival at 2 years was 40%. A comparison with a younger historical cohort (median age 57 years) having received the same dose of fludarabine and busulfan but neither radioimmunotherapy nor alemtuzumab showed no difference in outcome. Although the use of alemtuzumab reduced the incidence of acute graft‐versus‐host‐disease, it was associated with a relapse incidence of 40% despite the incorporation of radioimmmunotherapy. In summary, we confirmed the feasibility of combined radioimmunotherapy and reduced‐intensity conditioning in elderly patients. Further optimisation, probably involving less T cell depletion, is necessary before a randomized comparison with standard conditioning can be planned.
Alemtuzumab is safe and effective as immunosuppressive treatment for aplastic anaemia and single‐lineage marrow failure: a pilot study and a survey from the EBMT WPSAA
Authors: Risitano Antonio Maria , Selleri Carmine , Serio Bianca , Torelli Giovanni Fernando , Kulagin Alexander , Maury Sébastien , Halter Jörg , Gupta Vikas , Bacigalupo Andrea , Sociè Gerard , Tichelli André , Schrezenmeier Hubert , Marsh Judith , Passweg Jakob , Rotoli Bruno ,   on behalf of the Working Party Severe Aplastic Anaemia (WPSAA) of the European Group for Blood and Marrow Transplantation (EBMT)
Published: December 2009

SummaryAn alemtuzumab‐based experimental immunosuppressive treatment (IST) regimen was investigated in 35 patients with severe aplastic anaemia (SAA), pure red cell (PRCA) or pure white cell aplasia (PWCA). Alemtuzumab total dose was 73–103 mg s.c., followed by cyclosporine. No serious toxicity due to the regimen was observed. Adverse events were clinically irrelevant; infectious events were rare. The total response rate was 58%, 84% and 100% in SAA, PRCA and PWCA, respectively, with corresponding 6 months cumulative response probabilities of 84%, 84% and 100%. Subcutaneous alemtuzumab is a feasible and sufficiently safe IST regimen for patients suffering from immune‐mediated marrow failures.
Connectivity of lobster (Homarus americanus) populations in the coastal Gulf of Maine: part II. Coupled biophysical dynamics
Authors: INCZE LEWIS , XUE HUIJIE , WOLFF NICHOLAS , XU DANYA , WILSON CARL , STENECK ROBERT , WAHLE RICHARD , LAWTON PETER , PETTIGREW NEAL , CHEN YONG 
Published: December 2009

AbstractWe used a coupled biophysical model to investigate larval transport and connectivity patterns in the Gulf of Maine lobster (Homarus americanus) population. Biological ‘particles’ were released at over 21 000 locations every 10 days over a 4‐month hatching period, and were followed from hatching through late postlarval stage. In addition to circulation and dispersion, model calculations included spatial patterns of egg production, temporal patterns of hatching, temperature‐dependent development, vertical distribution and mortality. We ran the model for three larval production seasons using the same hatching patterns and individual‐based modeling parameters but different flow patterns in the coastal current system. Model results gave distribution and abundance patterns of competent postlarvae that closely resembled observed, alongshore patterns of lobster settlement density. We evaluated the relative contribution of all source regions to the total number of competent postlarvae in a series of medium‐size zones along the coastal shelf, many of which are used in lobster management. Connectivity depended on many factors, including patterns of egg production and transport, and the location and size of the receiving zones. Self recruitment ranged from a few percent to >90% of competent postlarvae. Although it was common for postlarvae to come from many, often distant, sources, most of the competent postlarvae in a zone originated within one to two zones in the prevailing ‘up‐stream’ direction, forming shorter connections along the coast than the energetic currents might otherwise suggest. Inshore migrations during summer hatching may contribute to these shorter patterns of connectivity. Transport in the prevailing ‘upstream’ direction was also indicated.
Demersal fish and invertebrate biomass in relation to an offshore hypoxic zone along the US West Coast
Authors: KELLER AIMEE A. , SIMON VICTOR , CHAN FRANCIS , WAKEFIELD W. W. , CLARKE M. E. , BARTH JOHN A. , KAMIKAWA DAN , FRUH ERICA L. 
Published: December 2009

AbstractIn August 2007, as part of the NOAA National Marine Fisheries Service (NMFS) West Coast Groundfish Bottom Trawl Survey, we examined the biomass of demersal organisms in a known hypoxic area off the Oregon coast. Although observed each summer, the intensity of hypoxia has varied annually (2002–2007) with the greatest temporal and spatial extent noted in 2006. In 2007 we identified the geographic extent of the hypoxic zone and sampled 17 stations along two depth contours (50 and 70 m) within the area. A Sea‐Bird SBE 19plus equipped with a dissolved oxygen (DO) sensor was attached to the bottom trawl to monitor oxygen concentration during each tow. Bottom DO concentrations at all stations were hypoxic with means along the tow tracts ranging from 0.43 to 1.27 mL L−1. Total catch per unit effort (ln CPUE, kg hectare−1) and species diversity (number of species, N) were significantly and positively related to oxygen concentration along the hypoxic gradient. In addition, CPUE (natural log‐transformed) for eight fish species and five benthic invertebrate species were significantly and positively related to bottom oxygen concentration within the hypoxic region. Condition factors for five fish species, as well as Dungeness crab (Cancer magister) increased with increased bottom oxygen levels along the hypoxic gradient. Historical catch (2003–2006) within the hypoxic zone indicates that biomass was significantly lower in 2006, the year with the lowest bottom DO levels, relative to other years.
Drift and settlement of stream insects in a complex hydraulic environment
Authors: OLDMEADOW DAVID F. , LANCASTER JILL , RICE STEPHEN P. 
Published: December 2009

Summary1. The hydraulic and geomorphic characteristics of stream patches are often associated with distinctive assemblages or densities of stream invertebrates, and it is routinely presumed that these patterns reflect primarily species‐specific habitat requirements. An alternative hypothesis is that such patterns may be influenced by constraints on movement, such as the results of departure and settlement processes. We describe a manipulative experiment that examined how the hydraulic environments created by topographic bedforms influenced the drift behaviour and potential settlement sites for two species of mayfly (Baetis rhodani and Ecdyonurus torrentis). These species are common in the drift and often co‐occur in streams, but differ in their small‐scale distribution patterns, body shape and movement behaviour.2. Flume experiments were carried out to determine how the hydraulic environments conditioned by a step bedform influence the behaviour of mayflies in the drift (swimming, posturing, tumbling), and the consequences of those behaviours (drift distance and time), compared to drift over a plane bed. The ramped step in the flume mimicked step bedforms that are common in coarse‐grained, high‐gradient streams. In contrast to the plane bed, a zone of recirculating flow was created downstream of the step, above which flow was faster and more turbulent. Uniform flows are used in most flume studies of drift; our approach is novel in recreating a complex hydraulic environment characteristic of stream channels.3. Both species had some behavioural control over drift, and drift distances and times were shorter for live larvae than for dead larvae over the plane bed. The step had no impact on drift time or distance for live Baetis, but dead larvae were trapped in the flow separation eddy and drift time increased accordingly. Some Ecdyonurus also became trapped in the eddy, but live larvae drifted farther than dead larvae, and farther over the step than the plane bed.4. Whilst in the drift, larvae altered their behaviour according to the ambient hydraulic environment, but in a species‐specific manner. Over the plane bed, Baetis had occasional swimming bursts, but primarily postured (maintained a stable body orientation), whereas Ecdyonurus spent roughly equal time posturing and swimming. In the more turbulent flows generated by the step, Baetis spent proportionately more time swimming, whereas Ecdyonurus spent more time posturing and often tumbling as body orientation became unstable.5. In a high‐gradient stream, Baetis was more abundant close to steps than in plane bed patches with less complex flow, whereas the opposite pattern held for Ecdyonurus. Thus, the small‐scale distribution patterns of these species within streams correspond to their drift behaviours and ability to access various hydraulic patch types in our flume. These results are consistent with the hypothesis that constraints on movement and settlement may be important driver of distribution patterns within streams.
A cathepsin L‐like proteinase is involved in moulting and metamorphosis in Helicoverpa armigera
Authors: Wang L.‐F. , Chai L.‐Q. , He H.‐J. , Wang Q. , Wang J.‐X. , Zhao X.‐F. 
Published: December 2009

AbstractHolometabolous insects undergo larval moulting and metamorphosis within their life cycle. A cDNA encoding the cathepsin L‐like proteinase Ha‐cathL has been cloned from Helicoverpa armigera. It has a sequence of 1826 bp and encodes a 550‐residue protein with a molecular mass of 63 kDa. Northern blot analysis indicated that Ha‐cathL is specifically expressed in haemocytes, with increased expression during larval moulting and metamorphosis. In vivo experimentation revealed that Ha‐cathL is up‐regulated by 20‐hydroxyecdysone. Meanwhile, in situ hybridization and immunocytochemistry revealed that Ha‐cathL mRNA is mainly expressed in granulocytes and plasmatocytes. Knock down of cathepsin L by RNA interference results in larvae death before pupation or the formation of a chimeric pupa containing a larval head and thorax, abnormal wings and the pupal abdomen. The reason for this is that the affected haemocytes cannot become granulated, and therefore cannot participate in fat body remodelling and wing development. These facts suggest that Ha‐cathL is involved in larval moulting and metamorphosis by participating in the functioning of haemocytes.
Non‐resolving periapical inflammation: a malignant deception
Authors: Saund D. , Kotecha S. , Rout J. , Dietrich T. 
Published: December 2009

AbstractAim  To report a case of oral non‐Hodgkin’s lymphoma with a delayed diagnosis.Summary  Non‐Hodgkin’s lymphoma of the oral cavity is an uncommon but important condition. Early diagnosis is complicated when the presenting signs and symptoms are similar to those of odontogenic infections. This report describes the case of a 38‐year‐old female patient who presented to her dentist complaining of pain in her upper jaw. Subsequent dental treatment, including extraction, root canal treatment and apicectomy including biopsy were carried out by the patient’s dentist and local dental hospital. Nine months elapsed before a more extensive surgical exploration established a diagnosis of lymphoma.Key learning points

To appreciate the importance of recognizing discrepancies between the clinical scenario and histopathological findings.
To appreciate subtle radiographic changes that may accompany malignant disease of the jaw bones.
To appreciate the need for early referral when a patient’s symptoms do not satisfactorily respond to conventional dental therapies.
To appreciate lymphoma should be considered in the differential diagnosis of non‐healing periapical inflammation and non‐healing socket.
How do landscape composition and configuration, organic farming and fallow strips affect the diversity of bees, wasps and their parasitoids?
Authors: Holzschuh Andrea , Steffan‐Dewenter Ingolf , Tscharntke Teja 
Published: December 2009

Summary 1. Habitat destruction and increasing land use intensity result in habitat loss, fragmentation and degradation, and subsequently in the loss of species diversity. The fact that these factors are often highly confounded makes disentangling their effects extremely difficult, if not impossible, and their relative impact on species loss is mostly speculative. 2. In a two‐year study, we analysed the relative importance of changed landscape composition (increased areas of cropped habitats), reduced habitat connectivity and reduced habitat quality on nest colonization of cavity‐nesting bees, wasps and their parasitoids. We selected 23 pairs of conventional and organic wheat fields in the centre of landscape circles (500 m radius) differing in edge densities (landscape configuration) and % non‐crop habitats (landscape composition). Standardized trap nests were established in the field centres and in neighbouring permanent fallow strips (making a total of 92 nesting sites). 3. Factors at all three scales affected nest colonization. While bees were enhanced by high proportions of non‐crop habitat in the landscape, wasps profited from high edge densities, supporting our hypothesis that wasps are enhanced by connecting corridors. Colonization of herbivore‐predating wasps was lower in field centres than in fallow strips for conventional sites, but not for organic sites, indicating a fallow‐like connectivity value of organic fields. The relative importance of habitat type and farming system varied among functional groups suggesting that their perception of crop–non‐crop boundaries or the availability of their food resources differed. 4. Local and landscape effects on parasitoids were mainly mediated by their hosts. Parasitism rates were marginally affected by local factors. A specialist parasitoid was more sensitive to high land use intensity than its host, whereas generalist parasitoids were less sensitive. 5. We conclude that the conversion of cropland into non‐crop habitat may not be a sufficiently successful strategy to enhance wasps or other species that suffer more from isolation than from habitat loss. Interestingly, habitat connectivity appeared to be enhanced by both higher edge densities and by organic field management. Thus, we conclude that high proportions of conventionally managed and large crop fields threaten pollination and biological control services at a landscape scale.