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To address factors affecting genetic diversity and dispersal of ectoparasites, we compared mitochondrial DNA (mtDNA) population genetic structures of the generalist soft tick Ornithodoros capensis to the more host-specific nest flea Parapsyllus humboldti. A total of 103 ticks and 92 fleas were sampled at five distinct South African island/mainland African penguin (Spheniscus demersus) colonies. With its wide host range, O. capensis showed no evidence of significant cytochrome c oxidase subunit I (COI) mtDNA population differentiation among the five sampling sites (φst = 0.00 ± 0.004; p = 0.80), as well as a higher level of genetic diversity (π = 0.8% ± 0.06%) when compared to P. humboldti. In contrast, the flea showed significant population structure among most of the same sampling sites (φst = 0.22 ± 0.11; p ≤ 0.05) and a lower level of genetic diversity (π = 0.2% ± 0.01%). Our findings suggest that despite both parasites being mostly nest bound, O. capensis have few barriers to dispersal among island and mainland colonies. However, P. humboldti are more dependent on the African penguin for dispersal and thus have more impediments to gene flow among the same colonies. These findings broadly support the SGVH (specialist generalist variation hypothesis) and provide the first evidence for this hypothesis in parasites restricted to seabird colonies.

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STUDY QUESTION: Can a modified specific gravity technique be used to distinguish viable from nonviable embryos? SUMMARY ANSWER: Preliminary data suggests a modified specific gravity technique can be used to determine embryo viability and potential for future development. WHAT IS KNOWN ALREADY: Single embryo transfer (SET) is fast becoming the standard of practice. However, there is currently no reliable method to ensure development of the embryo transferred. STUDY DESIGN, SIZE, DURATION: A preliminary, animal-based in vitro study of specific gravity as a predictor of embryo development using a mouse model. PARTICIPANTS/MATERIALS, SETTING, METHODS: After a brief study to demonstrate embryo recovery, experiments were conducted to assess the ability of the specific gravity system (SGS) to distinguish between viable and nonviable embryos. In the first study, 1-cell mouse embryos were exposed to the SGS with or without previous exposure to an extreme heat source (60°C); measurements were repeated daily for 5 days. In the second experiment, larger pools of 1-cell embryos were either placed directly in culture or passed through the SGS and then placed in culture and monitored for 4 days. MAIN RESULTS AND THE ROLE OF CHANCE: In the first experiment, viable embryos demonstrated a predictable pattern of descent time over the first 48 h of development (similar to previous experience with the SGS), while embryos that were heat killed demonstrated significantly altered drop patterns (P < 0.001); first descending faster. In the second experiment, average descent times were different for embryos that stalled early versus those that developed to blastocyst (P < 0.001). Interestingly, more embryos dropped through the SGS developed to blastocyst than the culture control (P < 0.01). LIMITATIONS, REASONS FOR CAUTION: As this is a preliminary report of the SGS technology determining viability, a larger embryo population will be needed. Further, the current in vitro study will need to be followed by fecundity studies prior to application to a human population. WIDER IMPLICATIONS OF THE FINDINGS: If proven, the SGS would provide a noninvasive means of assessing embryos prior to transfer after assisted reproductive technologies procedures, thereby improving fecundity and allowing more reliable SET. STUDY FUNDING/COMPETING INTERESTS: The authors gratefully acknowledge the funding support of the U.S. Jersey Association, the Laura W. Bush Institute for Women's Health and a Howard Hughes Medical Institute grant through the Undergraduate Science Education Program to Texas Tech University. None of the authors have any conflict of interest regarding this work. TRIAL REGISTRATION NUMBER: none.

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For several years the School of Nursing Science and the School of Psychosocial Behavioural Science, of a specific university, have been offering health care services in response to some of the health needs of a disadvantaged community as part of their students' experiential learning. However, these health care services were rendered independently by these two schools, implying that no feedback system existed to evaluate the worth and quality of these student-rendered health care services. The objectives of this research were to explore and describe the experiences of senior nursing and social work students, the experiences of health service delivery organisations concerned and the experiences of the disadvantaged community members receiving such health care services, as well as to investigate which communication models were apparent with regard to the major factors within health communication. An exploratory descriptive qualitative research design was used. Focus group discussions were held, interviews were conducted and field notes taken. Focus group discussions and interviews were transcribed and analysed by the research team to determine themes and sub-themes using the open coding technique. The results of the three groups showed similarities. The health service delivery organisations also identified a communication barrier, although the students were prepared to bridge it. The health service delivery organisations and the community felt positive towards the students and what they offered to the organisations and to the patients. A greater need for multi-disciplinary team work was recognised by al parties concerned. Recommendations focus on improved student accompaniment by lecturers; extending health care delivery to include a multi-disciplinary team approach by students; as well as improving the delivery of health care services.

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Nicotine exposure during prenatal to adolescent neurodevelopment causes morphologic changes in the CNS and persistent alterations of neurotransmission systems. Maternal smoking on the one hand and nicotine dependency and attention deficit hyperactivity disorder in the offspring on the other are significantly associated. There is even evidence that nicotine abuse during adolescence may result in deficits of the brain's attentional network. In contrast, any effects of nicotine exposure on the development of various psychiatric diseases are still unclear. The somatic consequences of smoking and the resulting economic problems are already well known, but the effects of nicotine on neurodevelopment are still underestimated. More public awareness training and medical education are required to avoid nicotine abuse in pregnant women, children, and adolescents.

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About twenty years ago, a new coronavirus, porcine respiratory coronavirus (PRCoV), was detected in swine herds. This virus is related to transmissible gastroenteritis virus (TGEV); however, it is not enteropathogenic but causes only minor respiratory symptoms. As PRCoV shares some epitopes for neutralizing antibodies with TGEV, it acts like a nature-made vaccine against TGEV resulting in a drastic reduction of TGE outbreaks in Europe. A major difference between the two porcine coronaviruses is a large deletion in the surface protein S gene of PRCoV. Because of this structural difference, TGEV but not PRCoV has a sialic acid binding activity that allows the attachment to mucins and mucin-type glycoproteins. The sialic acid binding activity may allow TGEV to overcome the mucus barrier in the gut and to get access to the intestinal epithelium for initiation of infection.

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INTRODUCTION: Diffusion-weighted (DW) MR imaging enables early identification of ischemic lesions in stroke. Stroke subtype may be related to different lesion patterns. The aim of this study was to analyze the subtype of ischemic lesions as determined by the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria by using DW MR imaging. METHODS AND RESULTS: In this study, 510 consecutive patients with ischemic stroke (95%) and transient ischemic attack (5%) aged 65 +/- 12 years were investigated by use of DW MR imaging within 48 hours of the clinical onset of symptoms. Lesions on DW imaging were classified as single, scattered, or multiple lesions in one vascular territory and multiple in more than one vascular territory. We found a significant overall association of DW imaging lesion patterns and classification with stroke subtype by using the TOAST criteria (P < .001). Single corticosubcortical lesions (P < .01) and multiple bilateral lesions in the anterior (AC) and posterior circulation (P < .001) on DW imaging were significantly associated with a cardiac embolic source. Multiple unilateral lesions in the AC were significantly associated with large-artery arteriosclerosis. Because of the 15-mm criterion for small-artery occlusion, cryptogenic stroke was significantly associated with subcortical lesions >/=15 mm. CONCLUSION: We found a strong relationship between stroke subtype and DW imaging lesion pattern. The finding of multiple bilateral lesions was significantly associated with a cardiac embolic source, which may be caused by a specific thrombus texture with a tendency for embolus dissemination.

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According to a literature study and a research survey conducted in 2004; caregivers are increasingly forced to deal with people living with AIDS as health services are unable to cope with the fast-growing HIV/AIDS epidemic. Caring for an individual with AIDS-related disease is usually time-consuming; burdensome and stressful. There is also evidence of increased susceptibility to physical health problems; emotional distress and psychiatric disturbances amongst caregivers. There are a number of strategies that should be employed to ensure that caregivers are encouraged to do their work to the best of their ability; without them having to sacrifice their health; family life and own needs. One of the strategies that could help in this regard is the presentation of a group work programme. A programme was presented to 14 female caregivers from a church in a disadvantaged community. The group met for eight consecutive weeks. During the two-hour sessions various topics; including self-knowledge; self-esteem; communication;conflict handling; roles of caregivers; and relationships with the person living with AIDS; were discussed. The group members were subjected to measurement by means of the single system. According to this measurement and an evaluation questionnaire; the programme did succeed in supporting and empowering them as caregivers

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Acute hepatic porphyrias are genetic diseases, characterized by acute neurological symptoms, sometimes fatal, triggered by different factors, in particular by many anaesthetic drugs, and also by pregnancy. We report here the experience of three porphyric patients'deliveries, allowing us to consider a proposition of management in this context. After discussion between anaesthesiologist, obstetrician and porphyria specialist, two types of management of such patients can be foresee. Asymptomatic patients, or in long remission, can benefit from locoregional anesthesia techniques with bupivacaine for both labour analgesia and Caesarean section. Spinal anaesthesia is then the technique of choice, allowing using smaller quantity of local anaesthetic than epidural anaesthesia. For symptomatic patients, or in crisis, we have rather choose intravenous narcotics for labour analgesia, and general anaesthesia for Caesarean section. The hypnotic agent of choice for both induction and maintenance of such anaesthesia is then propofol.

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OBJECTIVE: The development of effective psychoeducational programs for the management of schizophrenia requires an understanding of attitudes towards and beliefs about the disorder in families of affected probands. In order to establish the need for adaptation of Western psychoeducational programs, these variables were investigated in Xhosa speaking families in South Africa. DESIGN: Xhosa speaking family members of patients with DSM-IV schizophrenia were recruited on a voluntary basis, and interviewed with a structured belief and attitudes questionnaire adapted from previous studies in the West. SETTING: The study population was drawn from both urban and rural Xhosa communities in South Africa. SUBJECTS: 100 Xhosa speaking family members participated in the study. RESULTS: Family members most often recommended treatment with psychotropic medications (88%) and traditional healers (32%), and least often recommended psychotherapy (4%) and meditation (1%). Of the respondents who recommended traditional healing methods, 92% also recommended simultaneous use of allopathic treatment. CONCLUSION: Attitudes towards and beliefs about schizophrenia in family members of patients with schizophrenia may differ substantially from those described in previous work in the West. An understanding of local attitudes and beliefs is crucial for the successful development of local psychoeducational programs.

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It has recently been suggested that muscle dysmorphia, a pathological preoccupation with muscularity, is a subtype of body dysmorphic disorder (BDD). There are, however, few studies of the phenomenology of this putative entity. Twenty-eight amateur competitive body builders in the Western Cape, South Africa, were studied using a structured diagnostic interview that incorporated demographic data, body-building activities and clinical questions focusing on muscle dysmorphia and BDD. There was a high rate of muscle dysmorphia in the sample (53.6%). Those with muscle dysmorphia were significantly more likely to have comorbid BDD based on preoccupations other than muscularity (33%). Use of the proposed diagnostic criteria for muscle dysmorphia indicated that this is a common and relevant entity. Its conceptualization as a subtype of BDD seems valid. The disorder deserves additional attention from both clinicians and researchers.

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Trials were conducted on a farm in Mpumalanga Province in South Africa to test the possibility of grading the colour of the ocular mucous membranes of sheep as an indication of the extent to which the animals are affected by Haemonchus contortus infection. The range of observed colour shades were classified into five categories, from red, through red-pink, pink and pink-white to white. Over a period of 125 days routine drenching of a flock of 388 sheep on irrigated kikuyu (Pennisetum clandestinum) pasture was terminated. During this time the animals were examined at practically weekly intervals and haematocrit determinations done for all the sheep with pale conjunctivae. Only those sheep having a haematocrit of 15% or lower were treated. Compared to a previous drenching tempo of close to every 3 weeks during the Haemonchus season on the farm, drenching was reduced by approximately 90%, as 70% of the sheep did not require salvage drenching and only 10% of the flock had to be given more than one salvage treatment. At the time of the trial the five clinical classifications were not related to predetermined haematocrit categories. However, when compared to categories that were set in later trials, 94% of the clinical estimates in the present trial were either in the correct haematocrit category, or, if not, the sheep were probably not disadvantaged by the errors. In 2.6% of cases the incorrect estimate may have placed the sheep concerned in jeopardy, as the haematocrit values were so low that salvage drenching was required, while the sheep were not regarded as anaemic. Changes in the mean haematocrit values of drenched and undrenched sheep were mirrored reciprocally by the changes in clinical colour estimates. Lactating ewes were by far the most susceptible class of sheep, as only 44.6% of them were able to manage without drenching, compared to 83% of dry, and 70.6% of pregnant ewes. Correlations between the haematocrits and clinical estimates were highly significant, although the associations were not high enough to give reasonable surety that the haematocrit values of individual animals could be predicted with confidence from their clinical classifications. Exceptionally large numbers of worms were recovered from seven of the 14 sheep that were culled because of age at the end of the trial, but these were reflected neither in their faecal worm egg counts, nor, with one exception only, in clinical signs.

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1. Despite increased understanding of the prevalence and pharmacotherapy of social phobia (or social anxiety disorder), the neurobiology of the disorder is little understood. 2. Little data exists on the effect of pharmacotherapeutic intervention on regional cerebral blood flow (rCBF) in this disorder. Patients (n=15) who met DSM-IV diagnostic criteria for social phobia were subjected to single photon emission computed tomography (SPECT) with technetium-99m hexamethylpropylene amine oxime (Tc-99m HMPAO) before and after an eight-week trial of pharmacotherapy with the selective serotonin reuptake inhibitor (SSRI) citalopram. 3. Pharmacotherapy led to significantly reduced activity in the anterior and lateral part of the left temporal cortex; the anterior, lateral and posterior part of the left mid frontal cortex; and the left cingulum. 4. Despite the small sample size, medication non-responders (n=6) had higher activity at baseline in the anterior and lateral part of the left temporal cortex and the lateral part of the left mid frontal regions compared with responders (n=9). These data from this exploratory study are consistent with work suggesting that the anxiety disorders share certain mediating neurocircuitry, although activity in other brain regions may differ. 5. Further research is necessary to determine the neurobiological underpinnings of social phobia.

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OBJECTIVES: As one of the most powerful media, television may have an important role to play in providing psycho-education in both developed and developing countries. The South African Broadcasting Corporation (SABC) recently screened a TV series that focused on the signs and symptoms of the main psychiatric disorders. The aim of this paper is to describe calls to our Mental Health Information Centre after screening of the series. DESIGN: The TV series "Improve Your Frames of Mind" was developed by an independent producer in collaboration with the Society of Psychiatrists of South Africa, and was screened by the SABC. At the end of each show, the telephone number of our Mental Health Information Centre was given to viewers. All calls to our centre were entered into a database and later analysed. SETTING: A mental Health Information Centre in South Africa. SUBJECTS: Callers to the Mental Health Information Centre. RESULTS: Almost 3,000 calls were taken by three psychiatric nurses working at the Mental Health Information Centre. Calls related to each of the major psychiatric disorders, particularly the mood and anxiety disorders. Callers expressed satisfaction with the information that they received from the Centre. CONCLUSION: A TV series on psychiatric disorders appeared successful in encouraging viewers to seek additional information. Indeed, additional telephone lines would have allowed even more calls to be fielded. Further research is necessary to determine whether it would be useful for TV to portray specific treatment interventions.

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1. Symptoms of obsessive-compulsive disorder (OCD) may be acutely exacerbated by administration of certain serotonin agonists Exacerbation of OCD symptoms by sumatriptan, a 5HT1D agonist (Zohar, 1993), is consistent with pre-clinical data suggesting that the serotonin auto-receptor plays an important role in this disorder (El Mansari et al, 1995). 2. In order to investigate the functional role of the serotonin auto-receptor in OCD, the authors undertook single photon emission computed tomography in OCD patients after administration of sumatriptan and placebo. The authors hypothesized that, as in the case of m-chlorophenylpiperazine (mCPP) challenge (Hollander et al, 1995), exacerbation of OCD symptoms would be accompanied by increased cortical metabolism and thus blood flow, and more specifically by increased activity in the orbitofrontal-striatal circuit. They also expected, that as in the case of mCPP challenge (Hollander et al, 1993), exacerbation of OCD symptoms would be associated with a relatively poor response to subsequent treatment with serotonin specific reuptake inhibitors. 3. Sumatriptan (100 mg orally) and placebo were administered on separate days to 14 patients who met DSM-IV diagnostic criteria for OCD, using a randomized double-blind design. After 90 minutes, patients were injected with Tc-99m HMPAO and underwent single photon emission computed tomography (SPECT) of the brain. Activity in regions of interest was calculated, and compared using repeated measures analysis of variance. Patients were subsequently treated with a serotonin specific reuptake inhibitor (SSRI). 4. Behavioral response to sumatriptan was heterogenous, with 4 patients showing acute exacerbation, and 4 patients demonstrating a decrease in symptoms. On sumatriptan challenge, there was a significant association between symptom exacerbation and decreased activity in frontal areas. There was an association between decreased activity in an inferior frontal area with worse response to treatment, and also patients with symptom exacerbation after sumatriptan had poorer response to SSRI treatment. 5. Heterogeneity of behavioral response to sumatriptan in OCD is consistent with previous studies demonstrating conflicting and heterogenous behavioral responses to serotonergic challenges (Hollander et al, 1992), and with underlying heterogeneity in the neurobiology of this disorder. 6. It may be hypothesized that increased frontal activity in some patients with OCD is itself a compensatory mechanism. In patients with such compensatory hyperactivity, administration of a serotonin auto-receptor agonist results in decreased frontal activity and exacerbation of OCD symptoms. These patients may also be less likely to respond to treatment with a SSRI. 7. Further work combining pharmacological challenge paradigms and functional imaging techniques in OCD may be helpful in elucidating the neurobiology of this complex disorder.

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Canine acral lick dermatitis (ALD) has been suggested as an animal analogue of obsessive-compulsive disorder (OCD). A series of dogs with ALD or similar conditions were treated with citalopram, the most selective of the selective serotonin reuptake inhibitors. Six of nine (66.7%) dogs showed significant improvement. Given the apparent efficacy of citalopram in the treatment of OCD and related disorders, these data provide further evidence that ALD is a useful animal analogue of OCD.

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BACKGROUND: Despite significant advances in the understanding and treatment of psychiatric disorders in recent years, there remains a good deal of stigma and ignorance in the community. In order to increase awareness of psychiatric disorders in South Africa, we initiated a Mental Health Information Centre at the University of Stellenbosch. In this report, the first 500 calls to the centre are described. METHODS: A routine component of the service delivered by the Mental Health Information Centre is the gathering of data from callers. Data gathered from callers was collated and analysed. RESULTS: Callers from all areas of South Africa made use of the centre, asking for information about depression, obsessive-compulsive disorder and other mental health issues. Interventions included the mailing of pamphlets, referrals to general practitioners and mental health care professionals, and other forms of help. Most callers experienced significant satisfaction with the service. CONCLUSION: Psycho-education is an increasingly important component of psychiatric care. A mental health information centre may be a relatively inexpensive way of providing psycho-education to a large section of the community. Further research is necessary to determine the efficacy of such interventions.

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