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The effect of a therapist's personal and professional variables on their decision to treat or refer a suicidal adolescent was studied. 242 mental health professionals were randomly exposed to one of four case descriptions of an adolescent in crisis. The cases shared a common background story, however differed in suicidal condition (high vs. low) and gender. The questionnaires employed aimed to reflect the subject's evaluation of the patient's suicidal severity, countertransference, suicidal ideation, depression, professional competence, and seniority. Subjects were asked about their willingness to treat or likeliness to refer the case. Results indicate a lower willingness to treat and higher tendency to refer highly suicidal adolescents regardless of gender. Professional factors, countertransference, and trait-like suicide ideations positively contributed to willingness to accept the patient. Mental health professionals are unwilling to accept adolescents at risk for suicide for treatment. Nevertheless, professional factors contribute to the willingness to treat such adolescents, thereby underlining the importance of improving skills and tools with regard to the treatment of suicidal behavior. Acquaintance with a similar adolescent is a positive contributor for accepting a potentially suicidal adolescent patient to therapy. [ABSTRACT FROM AUTHOR]

Abstract: The West Wishbone Ridge (WWR), east of New Zealand, has previously been interpreted as a Cretaceous plate boundary, although both the nature and timing of motion along this feature have been disputed. Here, using recently acquired seismic reflection data from the region of the intersection of the WWR with the Chatham Rise, we show that the WWR was primarily a dextral strike‐slip fault during the Late Cretaceous. The WWR first propagated along the eastern margin of the Hikurangi Plateau after the collision of the Hikurangi Plateau with the Chatham Rise, in response to the slowing of spreading at the Osbourn Trough while spreading continued unabated east of the East Wishbone Ridge, from ca. 105 Ma. Reorientation of spreading at the Osbourn Trough at this time resulted in short‐lived, oblique subduction beneath the southern extent of the WWR. Motion along the WWR likely ceased with the cessation of Osbourn Trough spreading. Using our seismic reflection data and gravity modeling across those same profiles, we locate, for the first time, the eastern boundary of the Hikurangi Plateau between 42–43°S. We also find anomalously thick oceanic crust (∼12 km thick) north of the Hikurangi Plateau. Matching tectonic fabric and fracture zone links between the East Wishbone Ridge and the De Gerlache Gravity Anomaly near Ellsworth Land on the West Antarctic margin indicates that these features were linked or parallel during the Late Cretaceous, and fed strike‐slip motion southward into the Gondwana interior, contributing to the onset of Gondwana rifting ca. 85 Ma. [ABSTRACT FROM AUTHOR]

Wide-angle reflection and refraction data recorded during the Seismic Array HiKurangi Experiment (SAHKE) are used to constrain the crustal P-wave velocity (Vp) structure along two profiles spanning the length and width of Wanganui Basin, located landwards of the southern Hikurangi subduction margin, New Zealand. These models provide high-resolution constraints on the structure and crustal thickness of the overlying Australian and subducted Pacific plates and plate interface geometry. Wide-angle reflections are modelled to show that the subducted oceanic Pacific plate crust is anomalously thick (~10 km) below southern North Island and is overlain by a ~1.5-4.0 km thick, low Vp (4.8-5.4 km s-1) layer, interpreted as a channel of sedimentary material, that persists landwards at least as far as Kapiti Island. Distinct near vertical reflections from onshore shots identify a ~4 km high mound of low-velocity sedimentary material that appears to underplate the overlying Australian plate crust and is likely to contribute to local rock uplift along the Axial ranges. The overriding Australian plate Moho beneath Wanganui Basin is imaged as deepening southwards and reaches a depth of at least 36.4 km. The Moho shape approximately mirrors the thickening of the basin sediments, suggestive of crustal downwarping. However, the observed crustal thickness variation is insufficient to explain the large negative Bouguer gravity anomaly (-160 mGal) centred over the basin. Partial serpentinization within the upper mantle with a concomitant density decrease is one possible way of reconciling this anomaly. [ABSTRACT FROM AUTHOR]

Plate tectonics successfully describes the surface of Earth as a mosaic of moving lithospheric plates. But it is not clear what happens at the base of the plates, the lithosphere-asthenosphere boundary (LAB). The LAB has been well imaged with converted teleseismic waves, whose 10-40-kilometre wavelength controls the structural resolution. Here we use explosion-generated seismic waves (of about 0.5-kilometre wavelength) to form a high-resolution image for the base of an oceanic plate that is subducting beneath North Island, New Zealand. Our 80-kilometre-wide image is based on P-wave reflections and shows an approximately 15° dipping, abrupt, seismic wave-speed transition (less than 1 kilometre thick) at a depth of about 100 kilometres. The boundary is parallel to the top of the plate and seismic attributes indicate a P-wave speed decrease of at least 8 ± 3 per cent across it. A parallel reflection event approximately 10 kilometres deeper shows that the decrease in P-wave speed is confined to a channel at the base of the plate, which we interpret as a sheared zone of ponded partial melts or volatiles. This is independent, high-resolution evidence for a low-viscosity channel at the LAB that decouples plates from mantle flow beneath, and allows plate tectonics to work. [ABSTRACT FROM AUTHOR]

New gravity data collected in the central West Coast of New Zealand's South Island have been used to investigate fault kinematics and structure and the effects of erosion. Buried glacial erosion channels are identified in the footwall of the Alpine Fault in the Wanganui, Whataroa and Fox floodplains. Using a modified technique for estimating channel offsets, these buried channels are found to have been displaced along the Alpine Fault by 383±74 m, 372±159 m and 450±121 m, respectively, since the Last Glacial Maximum. Adopting a date for the Last Glacial Maximum of 19±1 ka, these offsets correspond to strike-slip slip rates of 20±5 mm a−1, 20±9 mm a−1 and 24±8 mm a−1, respectively, which are consistent with previous estimates of slip rates along the central Alpine Fault. The gravity data are also used to delineate and model the South Westland Fault, a thrust fault system, 10–20 km northwest of and striking subparallel to the Alpine Fault. [ABSTRACT FROM AUTHOR]

About 50 million tons of lignin are produced annually in the pulping industry worldwide. A traditional example for lignin research is its use as a resin additive in wood based panels. The aim of this study was to find out why technical lignin has not so far succeeded in substituting for phenolic resins in the wood based panel industry. Interviews were carried out using a multistage expert interview approach adapted from Delphi methods. After the principal factors were identified and verified, quantitative data were taken for the valuation. Technical product properties received the highest ratings by the consulted experts, followed by security of supply, price difference and productivity, which received almost the same overall ratings. Interestingly, researchers rated security of supply much lower than the industry representatives. Depending on fulfilment of criteria identified, the experts expected that between 10 and 30% of phenolic resin can be potentially substituted within the next 10 years. [ABSTRACT FROM AUTHOR]

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Receiver function analysis reveals a 7 km step-like change in crustal thickness across the Taranaki-Ruapehu Line (TR-line) of North Island, New Zealand. The TR-line runs east-west between the active andesite volcanoes of Mt Taranaki and Ruapehu and marks the southern-most extent of subduction zone volcanism in New Zealand. North of the TR-line receiver functions show a strong and sharp P-to- S ( Ps) conversion at 25 ± 1.5 km depth, which is interpreted as a shallow Moho. At the TR-line the Moho Ps conversion deepens across a step to ∼32 km depth and weakens. Further south the Moho deepens to >35 km. Most of the 7 km step-change in crustal thickness occurs over a lateral distance of ∼8 km, yet there is little surface or topographic manifestation of the line. Given Fresnel zone considerations, the dip of the Moho offset could vary between 90° and 45°. Gravity, seismic attenuation and electrical data all show that the TR-line is not only a step in crustal thickness but also a profound lithospheric boundary as mantle properties, such as attenuation ( Q), implied density, and electrical resistivity change abruptly across the line. An east-west oriented cluster of earthquakes with hypocentral depths of 20-40 km is centred on the Moho step. We propose that the Moho step, the earthquakes and the rapid change in mantle properties across the TR boundary are causally related. Processes that could be responsible for the phenomena described here include the rapid removal of mantle lithosphere and lower crust to the north of the TR-line. [ABSTRACT FROM AUTHOR]

An 8.54 ± 0.20 km s−1 Pn speed is estimated on a line oriented ca. N5°E from the Alpine Fault beneath the Southern Alps of South Island based on a refraction experiment that uses the Fiordland earthquake of August 2003 as a source. This high Pn speed results from both strong anisotropy in the mantle lid of 7–13 per cent and a high Pn speed average of 8.3 ± 0.3 km s−1. A maximum crustal thickness of 48 ± 4 km is calculated for the southern South Island near the town of Wanaka. This represents a crustal root of about 18 km, compared to measured crustal thicknesses at the east and west coasts of the South Island. The average topography in the southern Southern Alps is of the order of ∼1000 m, which is less than half that predicted by Airy isostasy for an 18 km crustal root. As recently proposed for the central South Island ∼120 km to the north, we propose that thickened cold, and therefore more dense, mantle lithosphere exists beneath southern South Island, and that this excess of mass is an effective load that pulls down the overlying crust. The load is similar to that beneath the central Southern Alps, despite the predicted convergence across the Alpine Fault there being nearly twice that at Wanaka. Gravity modelling of crustal structure along a profile through Wanaka suggests that this mass excess has a minimum density contrast of 35 ± 5 kg m−3 between thickened mantle and asthenosphere, assuming an across-Moho density contrast of −300 kg m−3. We speculate that the reason for the enhanced thickening beneath Wanaka is that the subducted Australian Plate at the southwestern corner of the South Island acts like a backstop onto which Pacific mantle collides at ∼26 mm yr−1, ca. 3/4 the full plate speed. [ABSTRACT FROM AUTHOR]

Near vertical and wide-angle seismic data provide evidence for a gradational crust–mantle boundary in a depth range of 15–20 km beneath the Central Volcanic Region (CVR), New Zealand. This volcanic area includes the Taupo Volcanic Zone and is a direct extension of Tonga-Kermadec oceanic backarc spreading into continental lithosphere. Long-range seismic refraction data show velocities of 6 km s−1 and less within the top 15 km of the crust of the CVR. At a depth of 15 km compressional seismic velocities increase to 6.8 km s−1, and then to 7.4 ± 0.2 km s−1 at ∼20 km depth. These 7.4 km s−1 seismic wave speeds are interpreted as anomalous upper mantle as beneath this level passive seismic studies show similar Pn wave speeds that increase slowly to ∼7.8 km s−1 at about 80 km deep. We interpret rocks between 15 and 20 km to be a layer of new crust formed by underplating. The strongest reflection observed, and what might also be interpreted as a reflection Moho, is from the top of the proposed underplated layer at 15 km depth. At 20 km depth no such distinct reflection is observed. Rather, wide-angle reflection data show a continuum of low-level reflectivity between 15 and at least 35 km depth, indicating some heterogeneity and/or structure within the lower crust and upper mantle. Thus the transition from lower crust to upper mantle is broad, and a conventional reflection Moho does not exist beneath the CVR. Buoyancy force calculations based on rock uplift for the central North Island indicate that the subjacent mantle, to a depth of 80–100 km is ∼70 kg m−3 or 2 per cent less dense than normal mantle. Best estimates attribute half of this density anomaly to the effects of increased temperature with additional contributions from partial melt (∼1.2 per cent) and melt residuum. [ABSTRACT FROM AUTHOR]

Context: Patients experience the highest rate of death and recurrent ischemic events during the early period after an acute coronary syndrome, but it is not known whether early initiation of treatment with a statin can reduce the occurrence of these early events.Objective: To determine whether treatment with atorvastatin, 80 mg/d, initiated 24 to 96 hours after an acute coronary syndrome, reduces death and nonfatal ischemic events.Design and Setting: A randomized, double-blind trial conducted from May 1997 to September 1999, with follow-up through 16 weeks at 122 clinical centers in Europe, North America, South Africa, and Australasia.Patients: A total of 3086 adults aged 18 years or older with unstable angina or non-Q-wave acute myocardial infarction.Interventions: Patients were stratified by center and randomly assigned to receive treatment with atorvastatin (80 mg/d) or matching placebo between 24 and 96 hours after hospital admission.Main Outcome Measures: Primary end point event defined as death, nonfatal acute myocardial infarction, cardiac arrest with resuscitation, or recurrent symptomatic myocardial ischemia with objective evidence and requiring emergency rehospitalization.Results: A primary end point event occurred in 228 patients (14.8%) in the atorvastatin group and 269 patients (17.4%) in the placebo group (relative risk [RR], 0.84; 95% confidence interval [CI], 0.70-1.00; P =.048). There were no significant differences in risk of death, nonfatal myocardial infarction, or cardiac arrest between the atorvastatin group and the placebo group, although the atorvastatin group had a lower risk of symptomatic ischemia with objective evidence and requiring emergency rehospitalization (6.2% vs 8.4%; RR, 0.74; 95% CI, 0.57-0.95; P =.02). Likewise, there were no significant differences between the atorvastatin group and the placebo group in the incidence of secondary outcomes of coronary revascularization procedures, worsening heart failure, or worsening angina, although there were fewer strokes in the atorvastatin group than in the placebo group (12 vs 24 events; P =.045). In the atorvastatin group, mean low-density lipoprotein cholesterol level declined from 124 mg/dL (3.2 mmol/L) to 72 mg/dL (1.9 mmol/L). Abnormal liver transaminases (>3 times upper limit of normal) were more common in the atorvastatin group than in the placebo group (2.5% vs 0.6%; P<.001).Conclusion: For patients with acute coronary syndrome, lipid-lowering therapy with atorvastatin, 80 mg/d, reduces recurrent ischemic events in the first 16 weeks, mostly recurrent symptomatic ischemia requiring rehospitalization. [ABSTRACT FROM AUTHOR]

Misuse of prescription drugs in the elderly can be a serious problem that is difficult to manage. Prescriptions for non-narcotic central nervous system (CNS) depressants (e.g., anxiolytics and sedative-hypnotics) are commonly written, and their use is associated with severe intoxication and withdrawal effects. The presence of comorbid psychiatric conditions (e.g., depression or panic disorder), for which these agents are prescribed frequently, complicates the clinical picture. This paper, using case examples of meprobamate abuse, describes how physicians can recognize, manage, and treat a patient who is abusing a non-narcotic CNS depressant. (J Geriatr Psychiatry Neurol 1996; 9:91-96). [ABSTRACT FROM PUBLISHER]

In a group of 64 non-insulin-dependent diabetic females, a significant positive correlation between Zung self-rated depression scores and objective measurements of diabetic peripheral neuropathy was limited to those women with Zung scores greater than 50 (depressed group, n = 12). In the overall group, there was no significant linear or quadratic relationship between peripheral neuropathy and depression scores. The associations between depression, peripheral neuropathy, and diabetes are discussed. ( J Geriatr Psychiatry Neurol 1988;1:11-15). [ABSTRACT FROM PUBLISHER]

Borehole, seismic, and gravity data are used to investigate deformation of continental lithosphere at a Miocene collisional zone. Deformation is manifested in the three following principal forms: a long wavelength (>500 km) platform subsidence ascribed to mantle convection; flexural deformation on a scale of 100-200 km due to crustal thrusting at the eastern boundary of the Taranaki Basin; and a ductile thickening, evident on the deep seismic section of Taranaki Basin, that occurs on a scale of ∼10 km. Evidence for flexural deformation principally comes from the deep seismic section that shows a 150-km wavelength bending of the Moho down toward the major zone of thrusting within the Taranaki Fault Zone. Paleowater depths, however, provide evidence for an initial early Miocene regional subsidence that is too long in wavelength to be explained by flexure induced from thrust sheet loading. Instead, we propose that this broad "platform subsidence" was driven by loading from a deep source, probably subduction-induced flow in the mantle. By ∼22-19 Ma, 1-2 km of water existed over most of the area now occupied by South Taranaki Basin. By ∼19-17 Ma the water depth in the zone east of the Taranaki Basin, the Taranaki Fault Zone, had been replaced by rock due to submarine thrusting and crustal thickening. This build up of submarine topography in the Taranaki Fault Zone constitutes part of the load (25±8 MPa) that created and maintains South Taranaki Basin. Gravity data place further constraints on loading at the thrust front and point to an additional intracrustal loading, equivalent to 15±7 MPa over a 50-km-wide zone. This intracrustal load is explained as being due to thick-skinned thrusting bringing denser, lower-crustal rocks nearer to the surface in the thrust zone. The complete load on the Taranaki foreland is therefore in three parts; the submarine-topographic load, the intracrustal load, and the loading of infilling sediments. [ABSTRACT FROM AUTHOR]

This study was conducted to determine whether or not diagnosis and treatment of delirium among patients treated with the intra-aortic balloon pump (IABP) correlates with the recording of this complication on discharge records. Since prior episodes of delirium are one of the few clear risk factors for future episodes of delirium, accurate recording of delirium on the discharge summary and list of discharge diagnoses is useful to clinicians. A retrospective review of the charts of all patients (N = 198) who underwent placement of an IABP during 1988; assessment of the type and frequency of medical and neuropsychiatric complications during IABP treatment; and comparison of chart review findings with the Massachusetts General Hospital's computer-generated lists of discharge diagnoses for the same IABP-treated patients was completed. Only 12% of patients diagnosed and treated for delirium had delirium recorded as a discharge diagnosis. In contrast, 44% and 52% of patients who had been diagnosed and treated for cerebrovascular accident and pneumonia, respectively, had these diagnoses recorded among the discharge diagnoses. Receiving a discharge diagnosis of organic brain syndrome increased the likelihood that delirium was recorded as a discharge diagnosis. Delirium is underdiagnosed as a complication associated with IABP-treatment and is under-reported on the list of discharge diagnoses, even when it is diagnosed. Further study is warranted to determine if making the diagnosis of delirium during a patient's hospital course and recording it is a complication at the time of discharge is translated into a higher level of preparedness by physicians during subsequent hospitalizations. [ABSTRACT FROM AUTHOR]