The early detection of postpartum depression: midwives and nurses trial a checklist

Objective: To evaluate the use of a standard pen-and-paper test versus the use of a checklist for the early identification of women at risk of postpartum depression and to investigate the experiences of nurses in using the checklist.

Design: A prospective cohort design using repeated measures.

Setting: The booking-in prenatal clinic at a regional hospital in Victoria, Australia, and the community-based postpartum maternal and child health service.

Participants: 107 pregnant women over 20 years of age.

Main Measures: Postpartum Depression Prediction Inventory (PDPI), Postpartum Depression Screening Scale (PDSS), Edinburgh Postnatal Depression Scale (EPDS), demographic questionnaire, and data on the outcome from the midwives and nurses.

Results: The PDPI identified 45% of the women at risk of depression during pregnancy and 30% postpartum. The PDSS and EPDS both identified the same 8 women (10%), who scored highly for depression at the 8-week postpartum health visit. Nurses provided 80% of the women with anticipatory guidance on postpartum depression in the prenatal period and 46% of women at the 8-week postpartum health visit. Nurse counseling or anticipatory guidance was provided for 60% of the women in the prenatal period.

Conclusion: The PDPI was found to be a valuable checklist by many nurses involved in this research, particularly as a way of initiating open discussion with women about postpartum depression. It correlated strongly with both the PDSS and the EPDS, suggesting that it is useful as an inventory to identify women at risk of postpartum depression.

Calibration and reliability of a school food checklist: a new tool for assessing school food and beverage consumption

There is a pressing need in Australia and other countries to develop systems for monitoring secular trends in childhood obesity and related behavioural and environmental determinants. Energy from foods and beverages consumed at school is an accessible indicator of children’s eating patterns and we have developed a school food checklist (SFC) to measure this. The SFC records the number of serves and source (home, canteen, vending machine) of 20 food and beverage categories. This study aims to assess the accuracy and to calibrate the SFC by comparing it to a weighed record (WR) and to evaluate inter-recorder reliability. Participants were 910 primary school children aged 5 to 12 years from a rural township in Victoria, Australia. WR were collected from a nonrandom sub-sample of 106 and a second sub-sample (n=46) had intake measured twice using the SFC to assess inter-recorder reliability. Mean energy values were 2992 kJ ± 924 and 3008 kJ ± 952 for the SFC and WR respectively and the correlation coefficient was strong (Pearson r = 0.77). The mean difference between the WR and SFC methods was 15 kJ (95% CI, -107 kJ to 138 kJ) and the limits of agreement (+2 standard deviations) were ± 1270 kJ. The SFC overestimated the energy/serve of breads and fruit drinks and under-estimated energy/serve from fat spreads, biscuits/crackers, muesli/fruit bars and fruit. Inter-recorder reliability was good (kappa 0.51). The SFC was designed to measure energy from food and beverages in schools. It has good accuracy and reliability and the revised version should further improve accuracy of the instrument.

Description of new species of Setosabatieria and Desmolaimus (Nematoda: Monhysterida) and a checklist of New Zealand free-living marine nematode species

Two new marine nematode species are described from intertidal sediments in southern New Zealand. Setosabatieria australis sp. nov. is characterised by an amphideal fovea with 3.5 turns, 7–9 small pre-cloacal supplements, and 2–5 sub-cephalic setae per file. Setosabatieria australis sp. nov. differs from all known species of the genus in having L-shaped spicules with a hollow median region, in contrast to the typical curved shape. Desmolaimus courti sp. nov. is characterised by the presence of four long (15 µm) cephalic setae, two cuticularised rings in the buccal cavity, and a lightly cuticularised pharyngeal lumen. It differs from other species of the genus by having eight sub-cephalic setae. A total of 116 marine species are included in the checklist of New Zealand free-living nematodes, with the majority of records from the coast of Campbell and Auckland islands from the early part of the 20th century. Most records were from habitats such as seaweed or sponge, which may explain the high proportion (>50%) of cosmopolitan species recorded in New Zealand to date. Little is known about the sediment nematode fauna, particularly in deeper waters (>120 m), from where there are no records to date.

A checklist for ecological management of landscapes for conservation

The management of landscapes for biological conservation and ecologically sustainable natural resource use are crucial global issues. Research for over two decades has resulted in a large literature, yet there is little consensus on the applicability or even the existence of general principles or broad considerations that could guide landscape conservation. We assess six major themes in the ecology and conservation of landscapes. We identify 13 important issues that need to be considered in developing approaches to landscape conservation. They include recognizing the importance of landscape mosaics (including the integration of terrestrial and aquatic areas), recognizing interactions between vegetation cover and vegetation configuration, using an appropriate landscape conceptual model, maintaining the capacity to recover from disturbance and managing landscapes in an adaptive framework. These considerations are influenced by landscape context, species assemblages and management goals and do not translate directly into on-the-ground management guidelines but they should be recognized by researchers and resource managers when developing guidelines for specific cases. Two crucial overarching issues are: (i) a clearly articulated vision for landscape conservation and (ii) quantifiable objectives that offer unambiguous signposts for measuring progress.

A literature review of the application of the geriatric depression scale, depression anxiety stress scales and post-traumatic stress disorder checklist to community nursing cohorts

Aims and objectives. To explore through literature review the appropriateness of three common tools for use by community nurses to screen war veteran and war widow(er) clients for depression, anxiety and post-traumatic stress disorder.

Background. War veterans and, to a lesser extent, war widow(er)s, are prone to mental health challenges, especially depression, anxiety and post-traumatic stress disorder. Community nurses do not accurately identify such people with depression and related disorders although they are well positioned to do so. The use of valid and reliable self-report tools is one method of improving nurses' identification of people with actual or potential mental health difficulties for referral to a general practitioner or mental health practitioner for diagnostic assessment and treatment. The Geriatric Depression Scale, Depression Anxiety Stress Scales and Post-traumatic Stress Disorder Checklist are frequently recommended for mental health screening but the appropriateness of using the tools for screening war veteran and war widow(er) community nursing clients who are often aged and have functional impairment, is unknown.

Design. Systematic review.

Conclusions. Current literature informs that the Geriatric Depression Scale accurately predicts a diagnosis of depression in community nursing cohorts. The three Depression Anxiety Stress Scales subscales of depression, anxiety and stress are valid; however, no studies were identified that compared the performance of the Depression Anxiety Stress Scales in predicting diagnoses of depression or anxiety. The Post-traumatic Stress Disorder Checklist predicts post-traumatic stress disorder in community cohorts although no studies meeting the selection criteria included male participants.

Relevance to clinical practice. This review provides recommendations for the use of the Geriatric Depression Scale, Depression Anxiety Stress Scales and The Post-traumatic Stress Disorder Checklist based on examination of the published evidence for the application of these screening tools in samples approximated to community nursing cohorts. Findings and recommendations would guide community nurses, managers and health planners in the selection of mental health screening tools to promote holistic community nursing care.

Do-it-yourself textbook review report card (Checklist)

It is argued that teachers will encounter many changes in teaching approaches and possibly in teaching materials resulting from the development and implementation of the national curriculum. With the new national curriculum, there will be new textbooks which will be 'new' as textbooks, but not necessarily new in mathematical content or instructional approaches. Two critical questions for these textbooks (or any textbooks) are: How good are these textbooks, as textbooks? How well do these textbooks fit whatever the 'new' curriculum is? Other questions to consider are: Is the content 'new' and/or substantial? Is the material 'fair' and representative? Elements of a good textbook are discussed including that it should have good design and provide good definitions, worked examples and counter-examples.

Modeling companion diagnostics in economic evaluations of targeted oncology therapies: systematic review and methodological checklist

The successful use of a targeted therapy is intrinsically linked to the ability of a companion diagnostic to correctly identify patients most likely to benefit from treatment. The aim of this study was to review the characteristics of companion diagnostics that are of importance for inclusion in an economic evaluation. Approaches for including these characteristics in model-based economic evaluations are compared with the intent to describe best practice methods. Five databases and government agency websites were searched to identify model-based economic evaluations comparing a companion diagnostic and subsequent treatment strategy to another alternative treatment strategy with model parameters for the sensitivity and specificity of the companion diagnostic (primary synthesis). Economic evaluations that limited model parameters for the companion diagnostic to only its cost were also identified (secondary synthesis). Quality was assessed using the Quality of Health Economic Studies instrument. 30 studies were included in the review (primary synthesis n = 12; secondary synthesis n = 18). Incremental cost-effectiveness ratios may be lower when the only parameter for the companion diagnostic included in a model is the cost of testing. Incorporating the test's accuracy in addition to its cost may be a more appropriate methodological approach. Altering the prevalence of the genetic biomarker, specific population tested, type of test, test accuracy and timing/sequence of multiple tests can all impact overall model results. The impact of altering a test's threshold for positivity is unknown as it was not addressed in any of the included studies. Additional quality criteria as outlined in our methodological checklist should be considered due to the shortcomings of standard quality assessment tools in differentiating studies that incorporate important test-related characteristics and those that do not. There is a need to refine methods for incorporating the characteristics of companion diagnostics into model-based economic evaluations to ensure consistent and transparent reimbursement decisions are made.