Objective : An updated systematic review was carried out of research studies looking at the value and impact of library services on health outcomes for patients and time saved by health professionals. Methods : A comprehensive systematic search was undertaken of the published literature to September 2003 in  ,  ,  ,  ,  , the Cochrane Controlled Trials Register and Google. Some handsearching was carried out, reference lists were scanned and experts in the field were contacted. Twentyeight research studies of professionally led libraries for health-care staff, including clinical librarian projects, met the inclusion criterion of at least one health or 'time saved' outcome. Papers were critically appraised using internationally accepted criteria. Data were extracted and results were summarised using a narrative format as the studies were heterogeneous and precluded a statistical analysis. Results : There is evidence of impact from both traditional and clinical librarian services. The higher quality studies of traditional services measured impacts of 37-97% on general patient care, 10 -31% on diagnosis, 20 -51% on choice of tests, 27-45% on choice of therapy and 10 -19% on reduced length of stay. Four studies of clinical librarian projects suggested that professionals saved time as a result of clinical librarian input, and two of these studies showed evidence of cost-effectiveness. However, the clinical librarian studies were generally smaller, with poorer quality standards. Conclusions : Research studies suggest that professionally led library services have an impact on health outcomes for patients and may lead to time savings for health-care professionals. The available studies vary greatly in quality but the better quality studies also suggest positive impacts. Good practice can be gathered from these studies to guide the development of a pragmatic survey for library services that includes the direct effects for patients among the outcome measures.

A systematic investigation of the role of prenatal partner support in perinatal maternal depression was conducted. Separate facets of partner support were examined (i.e., received support and support adequacy) and a multidimensional model of support was applied to investigate the effects of distinct types of support (i.e., informational, physical comfort, emotional/esteem, and tangible support). Both main and stress-buffering models of partner support were tested in the context of prenatal maternal stress resulting from exposure to a natural disaster. Questionnaire data were analyzed from N=145 partnered women using growth curve analytic techniques. Results indicate that received support interacts with maternal flood stress during pregnancy to weaken the association between stress and trajectories of maternal depression from pregnancy to 30 months postpartum. Support adequacy did not interact with stress, but was associated with levels of depressive symptoms controlling for maternal stress and received support. Results demonstrate the distinct roles of various facets and types of support for a more refined explanatory model of prenatal partner support and perinatal maternal depression. Results inform both main effect and stress buffering models of partner support as they apply to the etiology of perinatal maternal depression, and highlight the importance of promoting partner support during pregnancy that matches support preferences.

Somatic symptoms (e.g., fatigue, appetite changes, and sleep disruption) are common to both pregnancy and depression. The goal of the present study was to examine the validity of somatic symptoms as indicators of depression during pregnancy. The Inventory of Depression and Anxiety Symptoms (IDAS) was administered to a cross-sectional sample of 255 pregnant women as well as 820 women from five community-based samples, who served as a control group. Confirmatory factor analysis (CFA) was used to evaluate the fit of a single-factor model of depression in pregnant and community samples. Multigroup CFA was used to test the invariance of the factor loadings of eight depression-related symptom scales. The fit for a one-factor model was adequate for both the pregnant and community samples. All eight IDAS scales were valuable indicators of depression in the community group; however, Appetite Loss and Appetite Gain were poor indicators of depression among the pregnant women. The factor loadings for Lassitude and Appetite Gain were significantly weaker amongst the pregnant women than community women. The magnitude of the factor loadings for Insomnia and Well Being were significantly greater for the pregnant group. With the exception of appetite disturbance, somatic symptoms, though a common occurrence during pregnancy, are valid indicators of depression during pregnancy. When assessing for prenatal depression, somatic symptoms should not necessarily be dismissed as normative pregnancy experiences.

Attempts to Indigenise the curriculum run the risk of implying the application of an “impoverished” version of “Aboriginal pedagogy” and the promotion of corrupted understandings of Indigenous knowledge (Nakata, 2004, p. 11). What is required, Nakata (2004, p. 14) argues, is a recognition of the complexities and tensions at cross-cultural interfaces and the need for negotiation between “Indigenous knowledge, standpoints or perspectives” and Western disciplinary knowledge systems such that meanings are reframed or reinterpreted. Attending to these cross-cultural negotiations and the pedagogical practices they imply are profoundly challenging for both Indigenous and non-Indigenous educators.This paper focuses on a project at Queensland University of Technology (QUT) which seeks to embed Indigenous perspectives in Humanities and Human Services curricula. It outlines the curriculum framework which was developed to guide the curriculum redesign in its initial phases. This is followed by a discussion of current research that has been concerned to identify material that can support the renegotiations of curricula endorsed by Nakata’s work. The research findings indicate that it is possible to identify a number of pedagogical approaches that can assist that process. Such approaches recognise various levels of engagement beyond the “intellectual”; they insist on a consistent unsettling of Western authority; they acknowledge Indigenous positions/positioning; and require critical self-reflection.

A pilot clinical trial using dendritomas, purified hybrids from the fusion of dendritic/tumor cells combined with a low dose of IL-2, in metastatic melanoma patients was conducted in order to determine its safety and potential immunological and clinical responses. Ten metastatic melanoma patients were enrolled into this study. Dendritoma vaccines were created by fusing dendritic cells stained with green fluorescent dye with irradiated autologous tumor cells stained with red fluorescent dye and purifying the hybrids using immediate fluorescent-activated cell sorting. Initial vaccine was given subcutaneously and followed by IL-2 in serially elevated doses from 3-9 million units/m 2 for 5 days. Repeated vaccinations were administered without IL-2, at 3-month intervals for a maximum of 5 times. Immune reactions were measured by the increase of interferon-Á (IFN-Á) expressing T cells. Vaccine doses ranged from 250,000 to 1,000,000 dendritomas. There was no grade 2 or higher toxicity directly attributable to the vaccine. All patients experienced toxicity due to IL-2 administration (9-grade 2, 3-grade 3, 1-grade 4). Eight of nine evaluable patients demonstrated immunologic reactions by increased IFN-Á expressing T cells. One patient developed partial response at 12 weeks after the first vaccine. Nine months later, this patient achieved a complete response. In addition, two patients had stable disease for 9 and 4 months, respectively; one patient had a mixed response. Our findings demonstrated that dendritoma vaccines with a low dose of IL-2 can be safely administered to patients with metastatic melanoma and induce immunological and clinical responses.

Disaster exposure during pregnancy has received limited attention. This study examined the impact of the 2008 Iowa Floods on perinatal maternal depression and well-being, and the role of peritraumatic distress as a possible mechanism explaining this link. Perinatal women (N = 171) completed measures of depressive symptoms and general well-being at 5 timepoints from pregnancy to 30 months postpartum. Objectively assessed prenatal flood exposure was associated with greater depression (r = .15). Further, flood-related peritraumatic distress was uniquely associated with greater depression (r = .23), and was a key mechanism through which flood exposure led to depression. Prenatal flood exposure was also associated with general well-being (r = .18); however, a mechanism other than peritraumatic distress appears to have been responsible for the effect of flood exposure on well-being. We discuss the implications of these findings for informing etiological models and enhancing the efficacy of interventions for maternal psychopathology.

We sought to identify personal characteristics associated with receiving and perceiving social support, and characteristics of support providers who give the most support and are perceived as the most available. In samples of students ( n = 755) and community adults ( n = 430), we found that people who were younger, female, more extraverted, more conscientious, and more open received and perceived more support. Female providers and romantic partners were associated with more support whereas coworkers were associated with less. In many cases, social support mediated associations between these characteristics and recipient mood. For instance, recipients reported they experience more positive mood and less negative mood when interacting with female providers. These associations were partly explained by increased received and perceived support from female providers. Notable differences emerged between received support and perceived support, and between the student and community samples. Implications for increasing support for poorly supported individuals are discussed.

Vaccination using dendritic/tumor cell hybrids represents a novel and promising cancer immunotherapy. We have developed a technology that can instantly purify the hybrids (dendritomas) from the fusion mixture of dendritic cells (DCs) and tumor cells. Our animal studies and a phase I study of stage IV melanoma patients demonstrated that dendritoma vaccination could be conducted without major toxicity and induced tumor cell-specific immunological and clinical responses. In this pilot study, ten stage IV renal cell carcinoma patients were studied. Dendritomas were made from autologous DCs and tumor cells and administered by subcutaneous injection. After initial vaccination, three escalating doses of IL-2 (3, 6, and 9 million units each) were followed within five days. This treatment regimen was tolerated well without severe adverse events directly related to the dendritoma vaccine. Most adverse events were related to IL-2 administration or pre-existing disease. Patient-specific immune responses were evaluated by flow cytometric measurement of interferon-γ-producing T-cells before and after vaccination in response to stimulation with tumor antigens. Nine out of nine patients eligible for the analysis showed an increase of IFN-γ-expressing CD4 + T cells after vaccination(s); while five out of eight patients eligible for the analysis showed an increase of IFN-γ-expressing CD8 + T cells. Clinical responses were documented in 40% of the patients, three with stabilization of disease and one with a partial response documented by a reduction in tumor size. This pilot study demonstrated that dendritoma vaccines could be administered safely to patients with metastatic renal cell carcinoma, while producing both clinical and immunologic evidence of response.