Mental health nursing in emergency departments: the case for a nurse practitioner role.

Aims And Objectives: This paper aims to explore the effectiveness of the mental health nurse practitioner role in the emergency department in the context of the growing use of special units or segregated areas to manage particular kinds of mental health presentations, often complicated by substance use.

Background: In recent years, there has been a significant increase in mental health presentations to emergency departments, often complicated by substance abuse. Emergency departments have introduced a variety of mechanisms to address this growing problem.

The characteristics, management and outcomes of people identified with mental health issues in an emergency department, Melbourne, Australia.

Although the number of mental health presentations to emergency departments is increasing as a result of the integration of psychiatric services with general services, few studies have explored the characteristics of mental health patients presenting to emergency departments in Australia. This study investigated the characteristics of, and outcomes in relation to, people presenting with a mental health problem to one large metropolitan emergency department. Data were collected from the emergency department's electronic records system for adult patients aged 18-65 years old with an emergency department discharge diagnosis of a mental health disorder, including substance abuse and psychosocial crisis, for two months.

Postprandial hyperinsulinemia is universal in non-diabetic patients with nonalcoholic fatty liver disease.

Background And Aims: Despite strong associations between non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes (T2D), it is unclear which patients need oral glucose tolerance testing (OGTT). Relationships between hyperglycemia, postprandial hyperinsulinemia and NAFLD severity also need clarification.

Methods: Among 111 consecutive NAFLD patients, 35 had established T2D; 70 of the remaining 76 underwent 75G OGTT with fasting, 60 and 120 min insulin.

Study of the effect of source signal bandwidth on ratiometric wavelength measurement.

We derive an analytic equation for a ratiometric wavelength measurement system and analyze the influence of the optical source signal bandwidth. Our investigation shows that in a particular optical sensing system, the higher the bandwidth of the optical signal, the better resolution the system will achieve. Experiments based on two types of optical signals (output signal of a tunable laser and a fiber Bragg grating) were carried out, and experimental results verified both the simulation results and the theoretical analysis.

Individualisation of antiviral therapy for chronic hepatitis C.

The combination of pegylated-interferon (PEG-IFN)/ribavirin is currently the standard of care antiviral treatment for chronic hepatitis C (CHC), but optimal results require an individual approach. Key issues are to deliver doses that confer optimal antiviral efficacy against hepatitis C virus (HCV) for a time sufficient to minimise relapse. Viral monitoring during therapy guides the subsequent treatment course, particularly HCV RNA results at 4 weeks (rapid viral response [RVR]) and 12 weeks (complete early viral response [cEVR]).

Facing up to 'challenging behaviour': a model for training in staff-client interaction.

Aim: This paper draws on theory and evidence to develop a conceptual staff training model for the management of 'challenging behaviour'.

Background: Staff working with clients who are experienced as challenging commonly report negative feelings such as anxiety, anger, guilt, fear, self-blame and powerlessness, as well as dissatisfaction with their jobs. Current training programmes in challenging behaviour offer a 'smorgasbord' of content, without a clearly defined conceptual framework.

A fresh look at NASH pathogenesis. Part 1: the metabolic movers.

The strong relationship between over-nutrition, central obesity, insulin resistance/metabolic syndrome and non-alcoholic fatty liver disease (NAFLD) suggest pathogenic interactions, but key questions remain. NAFLD starts with over-nutrition, imbalance between energy input and output for which the roles of genetic predisposition and environmental factors (diet, physical activity) are being redefined. Regulation of energy balance operates at both central nervous system and peripheral sites, including adipose and liver.

Mental health content of Australian pre-registration nursing curricula: summary report and critical commentary.

Background: Concerns have been expressed about inadequate mental health content in generic pre-registration nursing curricula in Australia. These have led to claims new graduates are inadequately prepared to care for patients with mental health issues. The Mental Health Nurse Education Taskforce set up for the purpose of the project by the Australian Health Ministers' Advisory Council, carried out a national exploration of mental health content in pre-registration nursing curricula in order to develop a framework for including mental health in future pre-registration courses.

Temperature performance of a macrobending single-mode fiber-based refractometer.

We present, theoretically and experimentally, an investigation of temperature dependence of a macrobending single-mode fiber-based refractometer utilizing a ratiometric scheme. The conventional scalar approximation method is utilized for predicting the temperature dependent loss of the proposed fiber refractometer. An all-fiber ratiometric measurement system is built to allow the comparison of modeled and measured results.

Challenging behaviour: an action plan for education and training.

Nurses and other health care staff frequently encounter a range of aggressive and other 'challenging behaviours' at work from clients and colleagues. In response to staff concerns, an abundance of state and national policies are now available but it is left up to individual employers to decide how best to implement them at a local level. In this paper we offer an education and training model which is conceptually sound, practical in application, and suitable for health care staff at different levels in the organisation.

Extreme lymphoproliferative disease and fatal autoimmune thrombocytopenia in FasL and TRAIL double-deficient mice.

To delineate the relative roles of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) and Fas ligand in lymphocyte biology and lymphoproliferative disease, we generated mice defective in both molecules. B6.GT mice develop severe polyclonal lymphoproliferative disease because of accumulating CD3(+)CD4(-)CD8(-)B220(+) T cells, CD4(+) and CD8(+) T cells, and follicular B cells, and mice die prematurely from extreme lymphocytosis, thrombocytopenia, and hemorrhage.

Short-term therapy with peroxisome proliferation-activator receptor-alpha agonist Wy-14,643 protects murine fatty liver against ischemia-reperfusion injury.

Unlabelled: Steatosis increases operative morbidity/mortality from ischemia-reperfusion injury (IRI); few pharmacological approaches have been protective. Using novel genetic/dietary models of nonalcoholic steatohepatitis (NASH) and simple steatosis (SS) in Alms1 mutant (foz/foz) mice, we characterized severity of IRI in NASH versus SS and lean liver and tested our hypothesis that the lipid-lowering effects of the peroxisome proliferation-activator receptor (PPAR)-alpha agonist Wy-14,643 would be hepatoprotective. Mice were subjected to 60-minute partial hepatic IRI.

Strain sensor based on a pair of single-mode-multimode-single-mode fiber structures in a ratiometric power measurement scheme.

The strain and temperature dependencies of a step-index single-mode-multimode-single-mode (SMS) fiber structure are investigated numerically and experimentally. For intensity-based strain measurement using a single SMS fiber structure, at a selected wavelength, it is found that there is a high strain dependence, but also a temperature dependence that will induce strain measurement error. To minimize the temperature-induced strain measurement error, two SMS fiber structures are proposed and demonstrated in a ratiometric power measurement scheme; one SMS structure acts as the strain sensor, and the other SMS structure acts as the temperature monitor.

Unusual presentation of metastatic carcinoma to the eye.

Purpose: To describe four patients with an unusual presentation of metastatic carcinoma to the eye, diagnosed by histopathologic and immunohistochemical evaluation of vitrectomy material.

Methods: Retrospective case series of four patients with metastatic carcinoma to the retina/vitreous. The New York Eye and Ear Infirmary database was searched to identify patients with metastatic carcinoma to the retina or vitreous, diagnosed from 1995 to 2006.

Induction of p53 renders ATM-deficient mice refractory to hepatocarcinogenesis.

Background & Aims: p53 Mutations are very common in human hepatocellular carcinoma, and induction of hepatic p53 expression causes lysis of implanted hepatoblastoma cells in a chimeric mouse. Ataxia Telangiectasia Mutated (ATM) kinase senses DNA strand breaks and induces p53. Our aims were to establish whether ATM deficiency alters the carcinogenic response of hepatocytes to diethylnitrosamine (DEN).

Macrobending single-mode fiber-based refractometer.

A macrobending-based all-fiber refractometer sensor with a simple optical configuration is proposed and investigated both theoretically and experimentally. The proposed fiber refractometer sensor consists of a single-loop structure of bare macrobending standard single-mode fiber (SMF28) with a selected bending radius and reduced cladding diameter. The well-known scalar approximation theory is employed to theoretically predict the characteristics of the proposed fiber refractometer sensor.

Preparing nurses with enhanced mental health knowledge and skill: a major in mental health.

In Australia, since the early 1990s there has been a significant change to the way in which mental illness has been managed. Major government reforms resulted in the 'mainstreaming' of mental health care, with a significant reduction in the numbers of psychiatric hospitals. This significant policy change resulted in the demise of direct entry, specialist mental health nurse education that was the main provider of the mental health workforce.

Use of a single-multiple-single-mode fiber filter for interrogating fiber Bragg grating strain sensors with dynamic temperature compensation.

An interrogation technique for fiber Bragg grating (FBG) strain sensors with dynamic temperature compensation using a single-multiple-single-mode (SMS) fiber filter as a temperature compensating element is presented. Experimental results show that this technique offers a resolution of better than 3.4 muepsilon for strain measurements in the range from 0 to 1667 muepsilon, and the temperature induced error is as low as 34 muepsilon in the temperature range from 10 to 60 degrees C.

The liver and the waistline: Fifty years of growth.

Fifty years of the Gastroenterological Society of Australia have witnessed the changing appearance of Australians. Asian immigration has transformed the dominant urban culture from European to Eurasian, with some unique Australian attributes. Meanwhile, global conditions have altered body shape, and our sports-proud country is now fat! Thus, as in North America, Europe, China, and affluent Asia-Pacific countries, prosperity and lifestyle, cheap processed foods coupled with reduced physical activity have created an epidemic of over-nutrition resulting in overweight/obesity.

Heme oxygenase-1 protects against steatohepatitis in both cultured hepatocytes and mice.

Background & Aims: Heme oxygenase-1 (HO-1), an antioxidant defense enzyme, has been shown to protect against oxidant-induced tissue injury. We investigated the role of HO-1 in nutritional steatohepatitis in vitro and in vivo.

Methods: AML-12 hepatocytes were cultured in methionine- and choline-deficient (MCD) medium.

Roles of adipose restriction and metabolic factors in progression of steatosis to steatohepatitis in obese, diabetic mice.

Background And Aims: We previously reported that steatohepatitis develops in obese, hypercholesterolemic, diabetic foz/foz mice fed a high-fat (HF) diet for 12 months. We now report earlier onset of steatohepatitis in relation to metabolic abnormalities, and clarify the roles of dietary fat and bodily lipid partitioning on steatosis severity, liver injury and inflammatory recruitment in this novel non-alcoholic steatohepatitis (NASH) model.

Methods: Foz/foz (Alms1 mutant) and wild-type (WT) mice were fed a HF diet or chow, and metabolic characteristics and liver histology were studied at 2, 6, 12 and 24 weeks.

Differences in patient age distribution between influenza A subtypes.

Since the spring of 1977, two subtypes of influenza A virus (H3N2 and H1N1) have been seasonally infecting the human population. In this work we study the distribution of patient ages within the populations that exhibit the symptomatic disease caused by each of the different subtypes of seasonal influenza viruses. When the publicly available extensive information is pooled across multiple geographical locations and seasons, striking differences emerge between these subtypes.