Since the introduction of anti-depressant drugs into general use in the psychiatric field, there have been several statements to the effect that such a drug administered concurrently with electrical treatment reduces the number of shocks required to achieve a satisfactory response. This has been claimed by Sargant (1961) but without experimental support. Dunlop (1960) has published a comparison between the number of electrical treatments given with the anti-depressant drug during a particular attack, and the number of treatments without the aid of a drug in an earlier attack in the same patient: however, comparison of treatments in the same group of patients at different times is unreliable because there may be other factors to account for the differences noted. A controlled trial is necessary to ensure that all factors are constant other than the one under consideration.
Coral reef systems are in global decline. In Australia, much of this decline has been attributable to cyclic outbreaks (every ~17 years) of the coral-feeding crown-of-thorns seastar. While a native species, when in large enough densities the seastar acts like an invasive pest. Since 2012 the Australian government has invested significantly in a targeted control program using lethal injection. While this program is effective for individual reefs, it is not a complete strategy for the entire Great Barrier Reef (~2,500 reefs). In order to find a longer-term solution to the problem, in 2015, the lead author travelled to New Zealand, the United States, and Canada under a Churchill Fellowship to understand successful aquatic integrated pest management strategies and their potential application to the Great Barrier Reef. Meetings and workshops were convened with experts who specialise in risk assessment, categorisation, and management of aquatic invasive species. The experts comprised academics, applied scientists, policy makers, and a not for profit community based invasive species council. Bioinvasion management and prioritisation of management effort using risk-based frameworks were reviewed for application to the crown-of-thorns seastar. This viewpoint is novel in its approach of applying invasive species tools and perspectives to a non-invasive, native marine pest. Early detection and rapid response is key to preventing the transition of the seastar from natural densities to outbreak densities. However given the seastar is a native species already established, when in outbreak mode a multifaceted post-border management approach is essential. Private support funding models, that bridge conservation and tourism/philanthropy have proved successful in New Zealand to supplement government funded marine reserve management -this is an approach which should be explored by Australia to help manage the seastar. Dedicated support and commitment is needed to break the issue-attention cycle. On the Great Barrier Reef, a dedicated biosecurity approach should be used to maintain the seastar at natural densities, increase the time between outbreaks, protect coral cover and increase resilience of the system.
We have evaluated under laboratory validation conditions and in an extensive field trial the behaviour of an ambulatory monitoring device that is capable of recording both by the Korotkoff-sound and oscillometric methods in a single cuff deflation (TM2421: A&D Co, Tokyo, Japan). The effects of subject age and blood pressure (BP) level on the accuracy and field reliability of the two methods implemented in the device have been determined. In the validation phase, automatic BP measurements were compared with readings by two trained observers in 96 subjects, and the results compared with the AAMI criteria for automatic BP monitors. In the field trial phase, the performances of Korotkoffsound and oscillometric methods over a 24-h period of ambulatory BP monitoring were compared in 515 subjects, with analysis of the agreement between the two methods in patients where both provided satisfactory
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