Baited remote underwater video stations (BRUVS) were used to examine variation in assemblages of reef fishes at scales of 100s of kilometres (between 3 marine parks in New South Wales, Australia) and kilometres (between 4 sites within each park). Temporal variation over 5 yr was also examined in 1 park (Solitary Islands). BRUVS were able to sample the relative abundance and distribution of species from a wide range of trophic groups, and were particularly effective for detecting cryptic predators. Significant variability in the fish assemblages occurred between each park consistent with the latitudinal distribution of the parks. Fish assemblages also varied significantly between sites within each park. Contrary to expectations, total species richness did not follow the expected latitudinal gradient. However, observed geographical patterns in species richness of certain families such as Labridae (greater richness in the most northern park) and Monacanthidae (greater species richness in southern parks) followed expectations. Abundant schooling species, common to all 3 parks, were important contributors to variation between sites. Temporal variation over 5 yr at 1 park was relatively minor compared to the spatial variation among the 3 parks. This suggests largescale spatial separation is more important for structuring fish assemblages than time. A network of marine parks will therefore be required to represent variation in reef fish assemblages over this latitudinal scale.

BackgroundIn developing countries, pneumonia is one of the leading causes of death in children under five years of age and hence timely and accurate diagnosis is critical. In North America, pneumonia is also a common source of childhood morbidity and occasionally mortality. Clinicians traditionally have used the chest radiograph as the gold standard in the diagnosis of pneumonia, but they are becoming increasingly aware that it is not ideal. Numerous studies have shown that chest radiography findings lack precision in defining the etiology of childhood pneumonia. There is no single test that reliably distinguishes bacterial from non-bacterial causes. These factors have resulted in clinicians historically using a combination of physical signs and chest radiographs as a ‘gold standard’, though this combination of tests has been shown to be imperfect for diagnosis and assigning treatment. The objectives of this systematic review are to: 1) identify and categorize studies that have used single or multiple tests as a gold standard for assessing accuracy of other tests, and 2) given the ‘gold standard’ used, determine the accuracy of these other tests for diagnosing childhood bacterial pneumonia.Methods and FindingsSearch strategies were developed using a combination of subject headings and keywords adapted for 18 electronic bibliographic databases from inception to May 2008. Published studies were included if they: 1) included children one month to 18 years of age, 2) provided sufficient data regarding diagnostic accuracy to construct a 2×2 table, and 3) assessed the accuracy of one or more index tests as compared with other test(s) used as a ‘gold standard’. The literature search revealed 5,989 references of which 256 were screened for inclusion, resulting in 25 studies that satisfied all inclusion criteria. The studies examined a range of bacterium types and assessed the accuracy of several combinations of diagnostic tests. Eleven different gold standards were studied in the 25 included studies. Criterion validity was calculated for fourteen different index tests using eleven different gold standards. The most common gold standard utilized was blood culture tests used in six studies. Fourteen different tests were measured as index tests. PCT was the most common measured in five studies each with a different gold standard.ConclusionsWe have found that studies assessing the diagnostic accuracy of clinical, radiological, and laboratory tests for bacterial childhood pneumonia have used a heterogeneous group of gold standards, and found, at least in part because of this, that index tests have widely different accuracies. These findings highlight the need for identifying a widely accepted gold standard for diagnosis of bacterial pneumonia in children.

ABSTRACT. Objective. To determine predictive factors for the presence of focal infiltrates in children with clinically suspected pneumonia in a pediatric emergency department.Methods. Children (1-16 years) with clinically suspected pneumonia were studied prospectively. The presenting features were compared between the children with and without focal infiltrates using 2 analysis, t test, and odds ratio with 95% confidence intervals. A multivariate prediction rule was developed using logistic regression.Results. A total of 570 were studied. Risk factors (odds ratio; 95% confidence interval) for the presence of focal infiltrates included history of fever (3.1; 1.7-5.3), decreased breath sounds (1.4; 1.0 -2.0), crackles (2.0; 1.4 -2.9), retractions (2.8; 1.0 -7.6), grunting (7.3; 1.1-48.1), fever (1.5; 1.2-1.9), tachypnea (1.8; 1.3-2.5), and tachycardia (1.3; 1.0 -1.6). We then used logistic regression to develop a candidate prediction rule for the variables of fever, decreased breath sounds, crackles, and tachypnea, which had an area under the receiver operating curve of 0.668. This rule had excellent sensitivity (93.1%-98%) yet poor specificity (5.7%-19.4%).Conclusions. Multiple predictive factors for children with suspected pneumonia have been identified. Patients with focal infiltrates were more likely in our study to have a history of fever, tachypnea, increased heart rate, retractions, grunting, crackles, or decreased breath sounds. A multivariate prediction rule shows promise for the accurate prediction of pneumonia in children. However, the prospective evaluation of this multivariate prediction rule in a clinical setting is still required. Pediatrics 2004;113:e186 -e189. URL: http://www.pediatrics.org/ cgi/content/full/113/3/e186; pneumonia, chest radiographs, children, predictive factors.ABBREVIATIONS. ED, emergency department; OR, odds ratio; CI, confidence interval.T he accurate diagnosis of pneumonia in children remains an important yet difficult clinical problem. The chest radiograph remains the diagnostic test of choice in tertiary care centers. Given that the decision to pursue a diagnostic chest radiograph in the context of suspected pneumonia is largely influenced by clinical predictors of pediatric pneumonia, it is important to have these determined accurately.The clinical findings of patients with radiographic pneumonia have been described previously in both adult and pediatric populations in developed countries. 1-6 Some studies limit themselves to very young children. [7][8][9] However, the number of pediatric patients studied with radiographic pneumonia has been small. [1][2][3][4][5] In 1997, an evidence-based review of the literature dealing with pediatric pneumonia was published by a group of pediatric infectious disease specialists and a microbiologist. 10 The authors concluded that the absence of the pulmonary cluster as defined by Leventhal 1 of respiratory distress, tachypnea, rales, and decreased breath sounds accurately excluded pneumonia. This specific recommendation was based on a st...

Sustained observations allow for the tracking of change in oceanography and ecosystems, however, these are rare, particularly for the Southern Hemisphere. To address this in part, the Australian Integrated Marine Observing System (IMOS) implemented a network of nine National Reference Stations (NRS). The network builds on one long-term location, where monthly water sampling has been sustained since the 1940s and two others that commenced in the 1950s. In-situ continuously moored sensors and an enhanced monthly water sampling regime now collect more than 50 data streams. Building on sampling for temperature, salinity and nutrients, the network now observes dissolved oxygen, carbon, turbidity, currents, chlorophyll a and both phytoplankton and zooplankton. Additional parameters for studies of ocean acidification and bio-optics are collected at a sub-set of sites and all data is made freely and publically available. Our preliminary results demonstrate increased utility to observe extreme events, such as marine heat waves and coastal flooding; rare events, such as plankton blooms; and have, for the first time, allowed for consistent continental scale sampling and analysis of coastal zooplankton and phytoplankton communities. Independent water sampling allows for cross validation of the deployed sensors for quality control of data that now continuously tracks daily, seasonal and annual variation. The NRS will provide multi-decadal time series, against which more spatially replicated short-term studies can be referenced, models and remote sensing products validated, and improvements made to our understanding of how large-scale, long-term change and variability in the global ocean are affecting Australia's coastal seas and ecosystems. The NRS network provides an example of how a continental scaled observing systems can be developed to collect observations that integrate across physics, chemistry and biology.

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We used a novel mid-water baited remote underwater video (BRUV) technique to survey pelagic and mid-water fish assemblages at Lord Howe Island Marine Park, off eastern Australia (31.5°S, 159.1°E). We found differences in assemblages among regions separated on a scale of ~10s of kilometres. Of the environmental variables measured in the present study (depth, temperature, water current speed), current speed had the greatest influence on the structure of pelagic assemblages. Carcharhinus galapagensis, Seriola rivoliana and Scomber australasicus had similar distributions and were associated with low flow environments. Seriola lalandi was associated with the higher flow environments sampled during our surveys, although current speeds in the sample area were relatively slow (0.03 to 0.34 m s ). Relationships between pelagic assemblages and current speed were detected when abundances were calculated using an area-based approximation for plume dispersal, but were not detected using a linear approximation, or when current was assumed constant across all BRUV deployments. Our results demonstrate the difficulty in separating the dual effects of current speed in BRUV studies: the effect of current on bait plume size and associated estimates of fish abundance, and the role of current as an aspect of preferred pelagic fish habitat. We recommend the use of area-based approximations of plume dispersal and the inclusion of accurate estimates of current speed as a statistical covariate when interpreting mid-water BRUV data. Our results indicate that oceanographic characteristics can be important for pelagic fish habitat selection over the scale of kilometres and should be considered during marine protected area zoning.

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Theoretical models of marine protected areas (MPAs) that explore benefits to fisheries or biodiversity conservation often assume a dynamic pool of fishing effort. For instance, effort is homogenously distributed over areas from which subsets of reserves are chosen. I tested this and other model assumptions with a case study of the multiple-use Jervis Bay Marine Park. Prior to zoning of the park I conducted 166 surveys of the park's recreational fisheries, plotting the location of 16,009 anglers. I converted these plots into diagrams of fishing effort and analyzed correlates between fishing and habitat and the effect of two reserve designs-the draft and final zoning plans of the park-on the 15 fisheries observed. Fisheries were strongly correlated with particular habitats and had negatively skewed and often bimodal spatial distribution. The second mode of intensely fished habitat could be 6 SD greater than the fishery's mean allocation of effort by area. In the draft-zoning plan, sanctuary zone (no-take) area and potential subduction of fishing effort were similar. In the final plan, which was altered in response to public comment, the area of sanctuary zone increased, and the impact on fishing effort decreased. In only one case was a fishery's most intensely targeted location closed to fishing. Because of the discriminating manner with which fishers target habitats, if simple percentage targets are used for planning, sanctuary location can be adjusted to avoid existing fishing effort. According to modeled outcomes, the implication of this may be diminished reserve effectiveness. To address this, reserve area should be implicitly linked to subducted fishing effort when promoting or modeling MPAs.