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Liaison Psychiatry is primarily concerned with the detection and treatment of psychiatric disorders within the general hospitals. 1A study2 also highlighted the presence of only 45.5 core trainee posts in this speciality nationally.
Aims & objective
To survey the liaison psychiatry service recently set up as a service provision at a psychiatry unit in North Derbyshire.
We retrospectively reviewed all case notes of patients who had been assessed from January 2007 to June 2009 by the consultation-liaison service.
A total of 136 patients had been assessed since this service began in September 2007. Majority of the patients (72%) were between the ages of 31 to 65 years, while the gender was equally distributed. 51% were referred from the medical ward and most of them had been referred by core trainee. 95% of the referral was during working hours and 74% of the patients were assessed within 24 hours. Their diagnosis was variable, for e.g. 29% had depression, 19% had substance misuse problems, 8% had psychosis etc. 66% of patients were managed by medication advice, psycho-education and referral to CMHT/GP.
Liaison psychiatry was established for service provision, but it is apparent that it fulfilled both clinical and educational needs, despite the challenges. Adequate experience can be gained with a well supervised service. The overall educational value of designing and implementing a new service as a trainee cannot be overstated; it is something which is difficult to learn in classrooms.
This paper describes the system architecture of a newly constructed radio telescope – the Boolardy engineering test array, which is a prototype of the Australian square kilometre array pathfinder telescope. Phased array feed technology is used to form multiple simultaneous beams per antenna, providing astronomers with unprecedented survey speed. The test array described here is a six-antenna interferometer, fitted with prototype signal processing hardware capable of forming at least nine dual-polarisation beams simultaneously, allowing several square degrees to be imaged in a single pointed observation. The main purpose of the test array is to develop beamforming and wide-field calibration methods for use with the full telescope, but it will also be capable of limited early science demonstrations.
Milk is a source of bioactive molecules with wide-ranging functions. Among these, the immune properties have been the best characterised. In recent years, it has become apparent that besides the immunoglobulins, milk also contains a range of minor immune-related proteins that collectively form a significant first line of defence against pathogens, acting both within the mammary gland itself as well as in the digestive tract of the suckling neonate. We have used proteomics technologies to characterise the repertoire of host-defence-related milk proteins in detail, revealing more than 100 distinct gene products in milk, of which at least 15 are known host-defence-related proteins. Those having intrinsic antimicrobial activity likely function as effector proteins of the local mucosal immune defence (e.g. defensins, cathelicidins and the calgranulins). Here, we focus on the activities and biological roles of the cathelicidins and mammary serum amyloid A. The function of the immune-related milk proteins that do not have intrinsic antimicrobial activity is also discussed, notably lipopolysaccharide-binding protein, RNase4, RNase5/angiogenin and cartilage-glycoprotein 39 kDa. Evidence is shown that at least some of these facilitate recognition of microbes, resulting in the activation of innate immune signalling pathways in cells associated with the mammary and/or gut mucosal surface. Finally, the contribution of the bacteria in milk to its functionality is discussed. These investigations are elucidating how an effective first line of defence is achieved in the bovine mammary gland and how milk contributes to optimal digestive function in the suckling calf. This study will contribute to a better understanding of the health benefits of milk, as well as to the development of high-value ingredients from milk.
The Yabelo–Mega region of southern Ethiopia's Borana region holds two threatened endemic and restricted-range species, the White-tailed Swallow Hirundo megaensis (‘Vulnerable’) and Ethiopian Bush-crow Zavattariornis stresemanni (‘Endangered’). Concern about these species’ conservation status has recently increased owing to rapid alterations to their thornbush savanna habitat. This six-week field study aimed to identify the specific habitat requirements of each species, with a view to understanding how they are likely to be affected by these changes, and to provide baseline quantitative abundance data using simple and repeatable methods. White-tailed Swallows were recorded on an overall 4.7% of transects and point counts, and in all habitats (including villages and farmland) except broadleaved Combretum–Terminalia woodland. Line transects indicated that swallows avoided dense scrub and tree cover, but this was not detected during point counts. Bush-crows were recorded on an overall 16.6% of transects and point counts, and like swallows showed a strong preference for thornbush (Acacia and Commiphora) over broadleaved woodland, avoided dense scrub cover, and were particularly frequent in the vicinity of villages. During point-counts, bush-crows were more frequently encountered inside the nominally protected Yabelo Sanctuary, whereas the reverse was true for White-tailed Swallows. Recent concern about dramatic declines in bush-crow numbers revealed by roadside counts may have been exacerbated by habitat alteration along roads alone, but the species remains under threat from habitat transformation through agricultural expansion, tree felling and bush encroachment.
Fifty depressed in-patients at two psychiatric units, one in Italy the other in England, were treated with clomipramine, either orally, or intravenously and orally. A comparison of clinical response with plasma levels of clomipramine and its metabolite, desmethylclomipramine, showed clear relationships especially in the case of desmethylclomipramine. In the intravenously-treated group this was linear, in the orally-treated group it was curvilinear. Plasma levels of desmethylclomipramine and administered clomipramine correlate highly.
These findings, together with the fact that significant clinical improvement was observed in only 55 per cent of the patients, suggest that titration of the administered dose to obtain more effective plasma levels of the metabolite might improve the clinical response to the drug in some patients.
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