Lithium for schizophrenia revisited: A systematic review and meta-analysis of randomized controlled trials

Background: Clinicians frequently use lithium to augment antipsychotic medication in schizophrenia. Therefore, we undertook a systematic review and meta-analysis of the use of lithium in the treatment of schizophrenia. Data sources and study selection: Randomized controlled trials examining lithium (as a sole or an adjunctive compound) in participants with schizophrenia or related disorders were searched in the register of the Cochrane Schizophrenia Group. No language restrictions were applied. The Boolean phrase [lithium* or lithicarb or eskalith or lithobid or lithane or cibalith-s or quilonum or hypnorex] was used to locate articles. The search strategy initially identified 90 references. The authors of the included studies were contacted to obtain original patient data. The data were combined in a meta-analysis. The main outcome parameters were the number of patients with a clinically significant response and the number of patients leaving the studies early. Results: The meta-analysis includes 20 studies (N = 611). The evidence shows that lithium as a sole agent is ineffective in the treatment of schizophrenia. Eleven trials examined the augmentation of antipsychotics with lithium. More patients who received lithium augmentation than those who received antipsychotics alone were classified as responders. However, the superiority was not consistent across different response thresholds, and when patients with prominent affective symptoms were excluded from the analysis, the advantage of lithium augmentation was not significant (p = .07). Significantly more patients taking lithium left the trials early, suggesting a lower acceptability of lithium augmentation compared with that of taking antipsychotics alone. Conclusion: Despite some evidence in favor of lithium augmentation, the overall results are inconclusive. A large trial of lithium augmentation of antipsychotic medications will be required in order to detect a benefit of small effect size in patients with schizophrenia who lack affective symptoms.

'Please Mr Hay, what are my poss(abilities)?': Legitimation of ability through physical education practices

This paper provides two vignettes that draw on data from projects that interrogate how a student can be positioned by practices within physical education (PE) and directed by the PE teacher in relation to their valued or legitimated ability. Through the use of Pierre Bourdieu's conceptual tools of field, habitus and capital we investigate the complex legitimation processes that shape student poss(abilities) and that are situated in the space of the PE class. The first vignette is from the perspective of a student and draws on data from interviews, a journal, questionnaires and photos of her PE experiences in upper primary and lower secondary school. The second vignette focuses on teacher practices and his constitution of the field of a PE class highlighting the significance of teacher perspectives of 'ability' in informing assessment in senior secondary PE. Using these examples we discuss the symbolic violence that works against each student by positioning them as 'less able' or 'unable' despite their participation in a learning context. We argue that by not attending to the possible abilities of students that could have been recognized, developed and legitimated, and through the misuse of capital assignment by teachers, PE may well be counterproductive to students' ongoing engagement with the subject area and the espoused potential upon which such a subject area justifies itself.

Mud, algae or seagrass: An assessment of remote sensing techniques for mapping inter-tidal seagrass cover and composition in turbid tropical environments

Large areas of tropical sub- and inter-tidal seagrass beds occur in highly turbid environments and cannot be mapped through the water column. The purpose of this project was to determine if and how airborne and satellite imaging systems could be used to map inter-tidal seagrass properties along the wet-tropics coast in north Queensland, Australia. The work aimed to: (1) identify the minimum level of seagrass foliage cover that could be detected from airborne and satellite imagery; and (2) define the minimum detectable differences in seagrass foliage cover in exposed intertidal seagrass beds. High resolution spectral-reflectance data (2040 bands, 350 – 2500nm) were collected over 40cm diameter plots from 240 sites on Magnetic Island, Pallarenda Beach and Green Island in North Queensland at spring low tides in April 2006. The seagrass species sampled were: Thalassia hemprechii, Halophila ovalis, Halodule uninerivs; Syringodium isoetifolium, Cymodocea serrulata, and Cymodoea rotundata. Digital photos were captured for each plot and used to derive estimates of seagrass species cover, epiphytic growth, micro- and macro-algal cover, and substrate colour. Sediment samples were also collected and analysed to measure the concentration of Chlorophyll-a associated with benthic micro-algae. The field reflectance spectra were analysed in combination with their corresponding seagrass species foliage cover levels to establish the minimum foliage projective cover required for each seagrass to be significantly different from bare substrate and substrate with algal cover. This analysis was repeated with reflectance spectra resampled to the bandpass functions of Quickbird, Ikonos, SPOT 5 and Landsat 7 ETM. Preliminary results indicate that conservative minimum detectable seagrass cover levels across most the species sampled were between 30%- 35% on dark substrates. Further analysis of these results will be conducted to determine their separability and satellite images and to assess the effects epiphytes and algal cover.