Dysmorphogenesis in psychosis: Quantitative and qualitative measures involving the head and face

In this study, we examined qualitative and quantitative measures involving the head and face in a sample of patients and well controls drawn from the Brisbane Psychosis Study. Patients with psychosis (n=310) and age and sex-matched controls (n=303) were drawn from a defined catchment area. Features assessed involved hair whorls (position, number, and direction), eyes (epicanthus), supraorbital ridge, ears (low set, protrusion, hypoplasia, ear lobe attachment, asymmetry, helix width), and mouth (palate height and shape, palate ridges, furrowed and bifid tongue). Quantitative measures related to skull size (circumference, width and length) selected facial heights and depths. The impact of selected risk factors (place and season of birth, fathers' occupation at time of birth, selfreported pregnancy and birth complications, family history) were examined in the entire group, while the association between age of onset and dysmorphology was assessed within the patient group. Significant group (cases versus controls) differences included: patients had smaller skull bases, smaller facial heights, larger facial depths, lower set and protruding ears, different palate shape and fewer palate ridges. In the entire sample significant associations included: (a) those with positive family history of mental illness bad smaller head circumference, cranial length and facial heights; (b) pregnancy and birth complications was associated with smaller facial beights: (c) larger head circumference was associated with higher ranked fathers' occupations at birth. Within the patient group, age of onset was significantly lower in those with more qualitative anomalies or with larger facial heights. The group differences were not due to outliers or distinct subgroups, suggesting that the factors responsible for the differences may be subtle and widely dispersed in the patient group. The Stanley Foundation supported this project.

Clinical measures of obesity and weight loss in men

OBJECTIVES: (?) To determine the relationship between waist circumference and body weight in overweight men both before and after participation in a weight loss program; and (2) to make recommendations for the appropriate use of these measures at various stages of weight toss. DESIGN: Weight and waist circumference measures were taken in two diverse groups of men both before and 1-2y after commencing a men's 'waist loss' program. Regression analyses were used to assess the relationship between weight and waist measures. SUBJECTS: One group of 42 retired Caucasian men from New South Wales, and one group of 45 indigenous men from the Torres Strait region of Northern Australia. RESULTS: There were differences in the relationships of weight and waist circumference before the program and change in weight and change in waist circumference after weight loss. These differences were similar in both groups of men (indigenous men and retired Caucasian men), with a 1 cm waist loss being on average equivalent to about 3/4 kg, but with wide variability, suggesting inter-individual variation in fat losses from different depots. This variation suggests that neither weight nor waist alone is a sufficient measure of fat loss for men. CONCLUSIONS: Weight and waist circumference should both be used at various stages in the clinical situation to assess change in body fat in men involved in obesity reduction.

Death and readmission in the year after hospital admission with cardiovascular disease: the Hunter Area Heart and Stroke Register

Objectives: To compare outcomes one year after hospital admission for patients initially discharged with a diagnosis of acute myocardial infarction (AMI), other ischaemic heart disease (other IHD), congestive heart failure (CHF) or stroke. Design: Cohort study. Setting: Hunter Area Heart and Stroke Register, which registers all patients admitted with heart disease or stroke to any of the 22 hospitals in the Hunter Area Health Service in New South Wales. Patients: 4981 patients with AMI, other IHD, CHF or stroke admitted to hospital as an emergency between 1 July 1995 and 30 June 1997 and followed for at least one year. Main outcome measures: Death from any cause or emergency hospital readmission for cardiovascular disease. Results: In-hospital mortality varied from 1% of those with other IHD to 22% of those with stroke. Almost a third of all patients discharged alive (and 38% of those aged 70 or more) had died or been readmitted within one year. This varied from 22% of those with stroke to 49% of those with CHF. The causes of death and readmission were from a spectrum of cardiovascular disease, regardless of the cause of the original hospital admission. Conclusions: Data from this population register show the poor outcome, especially with increasing age, among patients admitted to hospital with cardiovascular disease. This should alert us to determine whether optimal secondary prevention strategies are being adopted among such patients.

Further results on the relationship between mu-invariant measures and quasi-stationary distributions for absorbing continuous-time Markov chains

This note considers continuous-time Markov chains whose state space consists of an irreducible class, C, and an absorbing state which is accessible from C. The purpose is to provide results on mu-invariant and mu-subinvariant measures where absorption occurs with probability less than one. In particular, the well-known premise that the mu-invariant measure, m, for the transition rates be finite is replaced by the more natural premise that m be finite with respect to the absorption probabilities. The relationship between mu-invariant measures and quasi-stationary distributions is discussed. (C) 2000 Elsevier Science Ltd. All rights reserved.

Petrographic and isotope constraints on the origin of authigenic carbonate minerals and the associated fluid evolution in Late Permian coal measures, Bowen Basin (Queensland), Australia

Authigenic carbonate minerals are ubiquitous throughout the Late Permian coal measures of the Bowen Basin, Queensland, Australia. In the northern Bowen Basin, carbonates include the following assemblages: siderite I (delta O-18(SMOW) = +11.4 to + 17%, delta C-13(PDB) = - 5.3 to + 120), Fe-Mg calcite-ankerite-siderite II mineral association (delta O-18(SMOW) = +7.2 to + 10.20, delta C-13(PDB) = 10.9 to - 1.80 for ankerite) and a later calcite (delta O-18(SMOW) = +5.9 to + 14.60, delta C-13(PDB) = -11.4 to + 4.40). In the southern Bowen Basin, the carbonate phase consists only of calcite (delta O-18(SMOW) = +12.5 to + 14.80, delta C-13(PDB) = -19.4 to + 0.80), where it occurs extensively throughout all stratigraphic levels. Siderite I occurs in mudrocks and sandstones and predates all other carbonate minerals. This carbonate phase is interpreted to have formed as an early diagenetic mineral from meteoric waters under cold climate and reducing conditions. Fe-Mg calcite-ankerite-siderite Il occur in sandstones as replacement of volcanic rock fragments. Clay minerals (illite-smectite, chlorite and kaolinite) postdate Ca-Fe-Mg carbonates, and precipitation of the later calcite is associated with clay mineral formation. The Ca-Fe-Mg carbonates and later calcite of the northern Bowen Basin are regarded as having formed as a result of hydrothermal activity during the latest Triassic extensional tectonic event which affected this part of the basin, rather than deep burial diagenesis during the Middle to Late Triassic as previously reported. This hypothesis is based on the timing relationships of the authigenic mineral phases and the low delta O-18 values of ankerite and calcite, together with radiometric dating of illitic clays and recently published regional geological evidence. Following the precipitation of the Ca-Fe-Mg carbonates from strongly O-18-depleted meteoric-hydrothermal fluids, continuing fluid circulation and water-rock interaction resulted in dissolution of these carbonate phases as well as labile fragments of volcaniclastic rocks. Subsequently, the later calcite and day minerals precipitated from relatively evolved (O-18-enriched) fluids. The nearly uniform delta O-18 values of the southern Bowen Basin calcite have been attributed to very low water/rock ratio in the system, where the fluid isotropic composition was buffered by the delta O-18 values of rocks. (C) 2000 Elsevier Science B.V. All rights reserved.

Hormonal factors and risk of aneurysmal subarachnoid hemorrhage - An international population-based, case-control study

Background and Purpose-Subarachnoid hemorrhage (SAH) is more common in women than in men, but the role of hormonal factors in its etiology remains uncertain. The aim of this study was to examine the relationship between hormonal factors and risk of SAH in women. Methods-This was a prospective, multicenter, population-based, case-control study performed in 4 major urban centers in Australia and New Zealand. Two hundred sixty-eight female cases of first-ever aneurysmal SAH occurred during 1995-1998. Controls were 286 frequency-matched women from the general population of each center. Outcome measures included risk of SAH associated with use of oral contraceptive pills (OCPs), hormone replacement therapy (HRT), and various endogenous hormonal factors including menstrual patterns, parity, age at birth of first child, and breast-feeding practices. Results-Cases and controls did not differ with regard to menstrual and reproductive history except in age at bir th of first child, where older age was associated with reduced risk of SAH (odds ratio [OR], 0.63; 95% CI, 0.43, 0.91). Relative to never use of HRT, the adjusted OR for over use of HRT was 0.64 (95% CI, 0.41, 0.98), which did not alter significantly after further adjustment for possible confounding factors. Borderline evidence of an inverse association was detected for past use of HRT (adjusted OR, 0.59; 95% CI, 0.30, 1.13) and current use of HRT (adjusted OR, 0.67; 95% CI, 0.40, 1.13), but there was no evidence of an association for use of OCPs (adjusted OR, 0.97; 95% CI, 0.58, 1.60). Conclusions-The risks of SAH are lower in women whose first pregnancy is at an older age and women who have ever used HRT but not OCPs. The findings suggest an independent etiologic role for hormonal factors in the pathogenesis of aneurysmal SAH and provide support for a protective role fur HRT on risk of SAH in postmenopausal women.

Detecting insomnia: comparison of four self-report measures of sleep in a young adult population

The sensitivity and specificity of four self-report measures of disordered sleep - the Sleep Impairment Index (SII), the Sleep Disorders Questionnaire (SDQ), the Dysfunctional Beliefs and Attitudes About Sleep Scale (DBAS) and the Sleep-Wake Activity Inventory (SWAI) - were compared in subjects with insomnia and normal sleep. Nineteen young adult subjects met DSM-IV criteria for primary insomnia and another 19 were normal control subjects. Discriminatory characteristics of each measure were assessed using receiver operator characteristic curve analyses. Discriminatory power was maximised for each measure to produce cut-scores applicable for identification of individuals with insomnia. The DBAS, SII and SDQ psychiatric DIMS subscale were found to correlate, and discriminated well between the two groups. The SWAI nocturnal sleep subscale was not found to be an accurate discriminator. The results suggest differences in the measures in their ability to detect insomnia, and offer guidelines as to the optimal use of test scores to identify young adults suspected of insomnia.

In situ measures of spawning synchrony and fertilization success in an intertidal, free-spawning invertebrate

The rocky intertidal zone has the potential to be one of the harshest environments for free-spawning organisms, but empirical data on fertilization success are scarce. Here, I report on an intertidal, solitary ascidian, Pyura stolonifera, which was observed to spawn at low tide. At a scale likely to be most important to gametes (metres, duration of tide), approximately 30% of individuals in the population were spawning synchronously. Spawned gametes remained in a viscous matrix and this appeared to minimise their dilution. Fertilization success varied greatly among individuals (0 to 92%) and was related to the distance to the nearest neighbouring spawner. Occasional wave wash facilitated the movement of sperm between spawners. Fertilization success in some individuals was limited by the scarcity of sperm whilst the experimental addition of sperm did not increase success in others.