The addition of employment support alongside psychological therapy enhances the chance of recovery for clients most at risk of poor clinical outcomes.

Background: Many people achieve positive outcomes from psychological therapies for anxiety and depression. However, not everyone benefits and some may require additional support. Previous studies have examined the demographic and clinical characteristics of people starting treatment and identified a patient profile that is associated with poor clinical outcomes.

Embryonal rhabdomyosarcoma of the auricle in a child.

We describe the diagnosis and management of a child with embryonal rhabdomyosarcoma of the auricle and emphasize both clinical and radiological findings of this rare condition. A nine-year-old boy presented for evaluation of a slowly enlarging left auricle mass. The mass was nodular, violaceous, semi-translucent, and hyperpigmented with an overlying pseudo-vesicular plaque.

Video laryngoscopy-assisted secondary tracheoesophageal puncture placement for the patient with severely limited neck extension.

Secondary tracheoesophageal puncture (TEP) placement in patients with severe limitations in neck extension is challenging. Visualization of the hypopharynx with traditional rigid endoscopy may not be possible. We report using the C-MAC (Karl Storz, Tuttlingen, Germany) video laryngoscope to successfully place a secondary TEP in patient with severe radiation fibrosis at a tertiary referral center.

Head and neck cancer.

Early detection of upper aerodigestive tract cancer improves prognosis. The primary care physician plays an important role in early detection of these cancers. Most upper aerodigestive tract cancers are squamous cell carcinomas that are linked to tobacco, alcohol, or human papillomavirus exposure.

Comparative ultrasound evaluation of human trabecular bone graft properties after treatment with different sterilization procedures.

New sterilization methods for human bone are likely to affect the mechanical properties of human cancellous grafts. These mechanical properties dictate the short- and mid-term results of the orthopedic procedure. The aim of this study was to compare the effects on bone mechanical properties, as assessed by ultrasound velocity, of different sterilization methods used under similar conditions: bleach and sublimation, humid heat, successive baths of physiological saline with osmotic detersion, and CO(2) in the supercritical phase.

Effects of gamma irradiation on mechanical properties of defatted trabecular bone allografts assessed by speed-of-sound measurement.

New sterilization methods for human bone allografts may lead to alterations in bone mechanical properties, which strongly influence short- and medium-term outcomes. In many sterilization procedures, bone allografts are subjected to gamma irradiation, usually with 25 KGy, after treatment and packaging. We used speed-of-sound (SOS) measurements to evaluate the effects of gamma irradiation on bone.

Role of Leptothrix discophora in mediating metal uptake in the filter-feeding bivalve Mytilus trossulus (edulis).

The potential for filter-feeding bivalves to accumulate metals from a wide range of food sources is an important consideration when examining trophic transfer of metals up the food chain. The objective of this study was to determine the role of Leptothrix discophora in mediating metal uptake in the filter-feeding bivalve Mytilus trossulus. The bacterium L.

Determination of the local structure of the first and second shells in ordered and disordered Ni-Mn alloys.

The coordination numbers and the interatomic distances for 50, 75 and 80 at.% Ni-Mn alloys in ordered and disordered states are presented. A new method for determining the first and second nearest neighbor coordination numbers in a binary alloy is applied.

Risk of cervical cancer associated with mild dyskaryosis.

In a survey of 1781 patients who had mild dyskaryosis in a cervical smear taken between 1965 and 1984 invasive cancer occurred in 10 women. In four cancer was diagnosed soon after presentation, and in three it developed some years after default from follow up. Invasion occurred in one patient during cytological surveillance and in a further two after referral for colposcopic supervision.

Risk of recurrence after treatment of severe intraepithelial neoplasia of the cervix. A follow-up of 896 patients.

Eight hundred and ninety-six patients were followed up cytologically for up to 21 years following treatment for a CIN III lesion of the cervix. The recurrence rate (8.8%) was lower after hysterectomy than after treatment which preserved the cervix (23%).

An assessment of the macrophage electrophoretic mobility test (MEM) in cancer diagnosis.

The results of an assessment of the macrophage electrophoretic mobility test in cancer diagnosis are described. We found that the test did not reliably distinguish between a group of 18 patients with benign disorders and a group of 25 with malignant disease.