Large granular lymphocytosis in a cynomolgus macaque (Macaca fascicularis) with a subclinical Trypanosoma cruzi infection.

A 5.25-year-old cynomolgus macaque (Macaca fascicularis) was found to have a marked leukocytosis due to a lymphocytosis on routine quarantine laboratory data prior to inclusion in a preclinical research study. The majority of lymphocytes were characterized as intermediate to large with round to convoluted nuclei, coarse to clumped chromatin, rare prominent nucleoli, and moderate amounts of lightly basophilic cytoplasm that frequently contained small magenta granules and/or clear vacuoles. The animal had tested negative for several viruses and other etiologic agents found in nonhuman primates 1 week prior to shipment to the research facility. However, further evaluation of the blood smear revealed rare hemoflagellates, and later testing using real-time PCR and ELISA was confirmatory for Trypanosoma cruzi (T cruzi). Trypanosoma cruzi is a zoonotic pathogen responsible for Chagas disease in people and can have negative consequences on study results when positive animals are inadvertently used for preclinical research. This case report describes a marked large granular lymphocytosis in an otherwise healthy macaque as the only indication of infection with T cruzi in an animal believed to be negative for the infection. Additionally, it highlights the diagnostic limitations of screening tests to rule out diseases in animals intended to be used in preclinical studies.

Effectiveness of nurse home visiting for families in rural South Australia.

AIM: To evaluate the effectiveness of a 2-year post-natal home-visiting programme delivered by nurses to socially disadvantaged mothers in rural regions of South Australia. METHODS: The intervention group consisted of 225 mothers who lived in rural regions and enrolled in the programme between 2010 and 2012. The comparison group consisted of 239 mothers who lived in rural areas between 2008 and 2009 when the programme was not yet available. All participants were eligible for enrolment in the home-visiting programme. Participants in both groups were assessed at baseline (mean child age = 15.2 weeks, SD = 2.4), prior to programme enrolment, and again when children were aged 9, 18 and 24 months. Outcomes were evaluated using the Parent Stress Index, Kessler Psychological Distress Scale, Ages and Stages Questionnaire, Child Behaviour Checklist, and MacArthur Communicative Developmental Inventory. RESULTS: During the follow-up period, there was little difference in the pattern of scores across the two groups. Mixed models adjusting for baseline differences between the groups did not identify any significant Group × Time interactions. This suggests that the linear trajectories of scores on outcomes did not differ significantly between the two groups. CONCLUSIONS: Findings suggest that the home-visiting programme did not have a measurable effect on maternal or child outcomes. However, the programme was relatively early in its rollout, and the greater challenges of recruitment, training and support, along with rural nurses' broader responsibilities for delivering other maternal and child health services, may explain why effects seen in the metropolitan area were not evident in rural regions.

School-based prevention of depression: a randomised controlled study of the beyondblue schools research initiative.

BACKGROUND: Depressive disorders are experienced by 3-5% of the adolescent population at any point of time. They adversely affect adolescent development in a range of areas and greatly increase risk for suicide. The present study investigated the effectiveness of a universal intervention designed to reduce depressive symptoms among students commencing high school. METHODS: Twenty-five pairs of secondary schools matched on socio-economic status were randomly assigned to either an intervention or a comparison group (n = 5,634 Year 8 students). The intervention extended over a 3-year period and utilised a comprehensive classroom curriculum programme, enhancements to the school climate, improvements in care pathways, and community forums. A range of measures completed by students, average age at baseline = 13.1 years (SD = .5), and teachers was used to assess changes in depressive symptoms, risk and protective factors relevant to depression, and the quality of the school environment. RESULTS: Changes in the level of depressive symptoms and in the levels of risk and protective factors experienced by students in the two groups did not differ significantly over the 3 years of the study. Furthermore, statistically significant differences in the ratings of school climate across this time period were found only for staff-rated assessments. CONCLUSIONS: Despite using an extensive, structured programme, based on best evidence to increase protective factors and reduce risk factors at the individual and school levels, the intervention did not reduce levels of depressive symptoms among participating adolescents. The results draw attention to the difficulties faced when implementing large-scale, school-based, universal preventive interventions. These include the need to develop methods to effectively train teachers across large geographical regions to deliver new interventions with fidelity, the difficulty of engaging young adolescents with prevention programmes, and the long period of time required to implement policy and practice changes at 'whole-school' levels.

Life events, coping and depressive symptoms among young adolescents: a one-year prospective study.

BACKGROUND: To investigate prospectively over one year, the extent to which greater exposure to negative life events, greater use of more negative coping strategies, and less use of positive coping strategies and an optimistic thinking style, predicts the onset of depressive symptoms among adolescents. METHODS: A prospective longitudinal study of 5,634 adolescents (Mean Age=13.1, SD=0.5) enrolled in Year 8 at secondary school. Standard questionnaires were used to assess depressive symptoms and the predictor variables. RESULTS: Over a one-year period, there was an independent and statistically significant relationship between transition to a CES-D score above the recommended cut-off score and i) greater exposure to negative life events and use of negative coping strategies, and ii) less use of positive coping strategies and an optimistic thinking style. Among males who experienced a higher number of negative life events, the impact on depressive symptoms was greater among those who made more use of negative coping strategies. LIMITATIONS: Self-report questionnaires completed by adolescents were employed to evaluate all the variables in the study. Only two assessment points were available. Ten percent of adolescents did not complete the follow-up assessment. CONCLUSIONS: Particularly among females, early adolescence is marked by increased susceptibility to depressive symptoms. Helping young adolescents to adopt more positive coping strategies and optimistic thinking styles may reduce their risk for the onset of depressive symptoms. This may be particularly important for young males who experience high levels of adverse life events and utilise negative coping strategies.