Background: There are national policy drivers for mental health services to demonstrate that they are effectively meeting the psychological needs of people with long-term health conditions/medically unexplained symptoms (LTC/MUS). Aims: To evaluate the implementation of a stepped-care service delivery model within an Improving Access to Psychological Therapies (IAPT) service for patients with depression or anxiety in the context of their LTC/MUS. Method: A stepped-care model was designed and implemented. Clinical and organizational impacts were evaluated via analyses of LTC/MUS patient profiles, throughputs and outcomes. Results: The IAPT service treated N = 844 LTC and N = 172 MUS patients, with the majority (81.81%) receiving a low intensity intervention. Dropout across the service steps was low. There were few differences between LTC and MUS outcome rates regardless of step of service, but outcomes were suppressed when compared to generic IAPT patients. Conclusions: The potential contribution of IAPT stepped-care service delivery models in meeting the psychological needs of LTC/MUS patients is debated.

To date no experimental infection studies have been conducted in laboratory mice using Mus spp. bartonella strains. Therefore we designed a study to evaluate the in vivo infection characteristics of 2 Bartonella tribocorum strains from wild Mus spp. in laboratory mice with the aim of developing a mouse model that reproduces characteristics of naturally acquired bartonella infections in rodents. Groups of outbred CD1 female mice were subcutaneously inoculated with low doses of 2 mouse bartonella strains (10, 100, and 1000 bacteria/mouse). Blood was collected weekly for 27 weeks to evaluate bacteraemia kinetics in infected mice. Mouse urine collected during weeks 3–6 post-inoculation was also tested for viable bacteria to determine whether urine might serve as a source of bacterial transmission. Mice were susceptible to infection with both strains. Bacteraemias in mice lasted up to 25 weeks, sometimes with abacteraemic intervals, and achieved levels up to 107 cfu/ml of blood. Temporal lags in bacteraemia onset of up to 19 weeks in length were noted at different inoculum doses. No viable bacteria were detected in mouse urine. Bacteraemic mice displayed characteristics of infection similar to those observed in natural rodent hosts during longitudinal field studies. This mouse model of persistent bacteraemia should be suitable for a variety of experimental uses.

The hypothesis that a liver-inhabiting nematode, Capillaria hepatica, can regulate abundance of the house mouse (Mus domesticus) was tested in enclosures, in southeastern Australia. Changes in mouse abundance, and the relationship between mortality and host abundance were compared in three treatment and three control populations. Any effect of C. hepatica on mouse abundance was masked by an unknown regulating factor(s). This factor(s) caused density-dependent mortality in the control and treatment populations and, together with strong seasonal trends in parasite transmission, confounded our test of the ability of C. hepatica to regulate the abundance of house mice. The seasonal trends in transmission have important implications for the potential of this parasite as a biological control agent and for models of the interaction of C. hepatica and mouse populations. Transmission of C. hepatica apparently occurred throughout the 18 month study, further supporting its potential as a biological agent in the control of mouse plagues in this region.