Planning hydrological restoration of coastal wetlands: Key model considerations and solutions.

The hydrological restoration of coastal wetlands is an emerging approach for mitigating and adapting to climate change and enhancing ecosystem services such as improved water quality and biodiversity. This paper synthesises current knowledge on selecting appropriate modelling approaches for hydrological restoration projects. The selection of a modelling approach is based on project-specific factors, such as costs, risks, and uncertainties, and aligns with the overall project objectives. We provide guidance on model selection, emphasising the use of simpler and less expensive modelling approaches when appropriate, and identifying situations when models may not be required for project managers to make informed decisions. This paper recognises and supports the widespread use of hydrological restoration in coastal wetlands by bridging the gap between hydrological science and restoration practices. It underscores the significance of project objectives, budget, and available data and offers decision-making frameworks, such as decision trees, to aid in matching modelling methods with specific project outcomes.

Right unilateral electroconvulsive therapy at six times seizure threshold.

OBJECTIVE: To examine the clinical practice of right unilateral electroconvulsive therapy (ECT) administered at six times seizure threshold (6 x RUL ECT). METHOD: A retrospective review of all patients who received 6 x RUL ECT between July 2000 and June 2002. RESULTS: Twenty-one patients across a range of ages and diagnostic groups received D'Elia unilateral ECT at a seizure dosage at or above 388.8 milliCoumbs (mC). In order to sustain predetermined criteria for seizure adequacy, energy was increased in 71% of patients. Final seizure lengths of 45 s electroencephalographic (EEG) activity, 28 s motor activity (cuffed) and a post-ictal suppression index (PSI) of 83% were recorded. Eighty percent of patients responded after a mean of 7.0 treatments. Cognitive side-effects were noted in 21% of patients. Fifty-two percent relapsed on average 6.3 months after the last treatment despite continuation pharmacotherapy. CONCLUSIONS: 6 x RUL ECT was found to be clinically effective, associated with cognitive side-effects and relapse. The debate over electrode placement is likely to continue.

Bifrontal electroconvulsive therapy in the elderly: a 2-year retrospective.

OBJECTIVES: We sought to examine the clinical effect of bifrontal (BF) electroconvulsive therapy (ECT) in depressed patients aged 65 years and older. METHODS: A retrospective chart review of all patients who received BF ECT for a depressive disorder between January 2000 and December 2002 was made. RESULTS: Fourteen patients, with a mean age of 73.9 years, received BF ECT. Nine had unipolar and 5 had bipolar depression. Twelve patients (86%) responded unequivocally after a mean of 8.5 treatments. Five (35%) experienced cognitive side effects. Ninety-two percent of patients were discharged on lithium (0.6 mmol/L) with 86% also receiving antidepressants or antipsychotics. Only 1 patient relapsed, the remainder remaining well at follow-up after a mean of 18.7 months. CONCLUSION: BF ECT was found to be clinically effective and associated with cognitive side effects in elderly patients who were experiencing a depressive episode of either unipolar or bipolar origin.