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Background: Epidemiological studies report markedly varying rates of adolescent alcohol involvement. Despite being a common adolescent behavior, a potential cause of this variation is that consumption of sips is either not measured or not distinguished from consumption of whole beverages., Methods: Participants were 1,843 grade 7 adolescents recruited across 49 Australian secondary schools (M age = 12.4, SD = 0.5). Quantity and frequency of lifetime and past 6-month consumption were assessed, distinguishing between sipping and drinking. For comparison with international population surveys, quantity was reported as any consumption, sipping only, and drinking only., Results: Combining sipping and drinking into a single category, lifetime consumption was reported by 67.3% of the present sample. Distinguishing lifetime consumption by sipping and drinking: only 7.8% of adolescents had consumed a whole beverage; the remaining 59.6% had only sipped. Consumption of whole beverages was mostly limited to 1 to 2 drinks (84.2% of drinkers). Sipping and drinking were also infrequent: 78.2% of sipping and 60.4% of drinking, occurred less than monthly. Heavy episodic consumption was uncommon (1.2% of the sample). When other population studies were inspected, a clear trend for higher drinking rates were found in those studies where sipping was counted as drinking and vice versa., Conclusions: Consumption of whole beverages appears infrequent in early adolescence, as sipping, but not drinking, was common in our sample. Comparing the present data with international population consumption measures highlights the need to more precisely measure and report adolescent consumption, particularly in relation to sipping., (Copyright © 2015 by the Research Society on Alcoholism.)

While evidence has accumulated suggesting that prevention initiatives may have a limited impact on alcohol use behaviour, reviews suggest that interventions with most potential for behavioural change are interactive and developmental in design. The School Health and Alcohol Harm Reduction Project (SHAHRP) is an example of such an intervention. Researchers are increasingly attempting to understand the differential effects of programmes in population subgroups. The present study is a secondary analysis of data from a non-randomised trial of SHAHRP, a classroom-based alcohol education intervention, involving school children (aged 13-16 years old) in the United Kingdom. Results showed that there were significant positive changes in knowledge about and attitudes towards alcohol in baseline abstainers, supervised drinkers and unsupervised drinkers. Significant positive behavioural effects in terms of amounts consumed, frequency of drinking and self-reported alcohol related harms, were observed almost exclusively among baseline unsupervised drinkers. These behavioural effects support those previously observed in Australia and suggest that the intervention is a viable health promotion tool in the UK., (Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.)

Background: Anxiety, depressive and substance use disorders account for three quarters of the disability attributed to mental disorders and frequently co-occur. While programs for the prevention and reduction of symptoms associated with (i) substance use and (ii) mental health disorders exist, research is yet to determine if a combined approach is more effective. This paper describes the study protocol of a cluster randomised controlled trial to evaluate the effectiveness of the CLIMATE Schools Combined intervention, a universal approach to preventing substance use and mental health problems among adolescents., Methods/design: Participants will consist of approximately 8400 students aged 13 to 14-years-old from 84 secondary schools in New South Wales, Western Australia and Queensland, Australia. The schools will be cluster randomised to one of four groups; (i) CLIMATE Schools Combined intervention; (ii) CLIMATE Schools - Substance Use; (iii) CLIMATE Schools - Mental Health, or (iv) Control (Health and Physical Education as usual). The primary outcomes of the trial will be the uptake and harmful use of alcohol and other drugs, mental health symptomatology and anxiety, depression and substance use knowledge. Secondary outcomes include substance use related harms, self-efficacy to resist peer pressure, general disability, and truancy. The link between personality and substance use will also be examined., Discussion: Compared to students who receive the universal CLIMATE Schools - Substance Use, or CLIMATE Schools - Mental Health or the Control condition (who received usual Health and Physical Education), we expect students who receive the CLIMATE Schools Combined intervention to show greater delays to the initiation of substance use, reductions in substance use and mental health symptoms, and increased substance use and mental health knowledge., Trial Registration: This trial is registered with the Australian and New Zealand Clinical Trials registry, ACTRN12613000723785.

Although there is an extensive recorded history of concerns related to alcohol exposed pregnancies and possible outcomes of fetal alcohol spectrum disorder in recent scientific literature, Australia has only recently begun to accurately or systematically diagnose and record these conditions, or to provide comprehensive, coordinated, policy-guided funding, prevention, and treatment. This article discusses some considerations that can guide policy development within the Australian context including the social context and determinates of alcohol consumption during pregnancy and the need to consider the issue as one that goes beyond the decision making of individual women. The article also identifies the contribution of research to guide evidence-based policy development, including emerging evidence of epigenetics, and systematic reviews for prevention. Other policy considerations include costs, and the possibility of the prevention paradox applying to this field, with its associated impact on costs and focus of prevention.

Objectives: This study assesses factors that contribute to alcohol consumption during pregnancy and identifies potential intervention strategies to reduce consumption., Methods: The study sample includes 142 pregnant women who attended a public hospital for prenatal health care in Perth, Western Australia. All participants returned a self-completion survey., Results: Women who discontinued drinking during pregnancy were significantly more likely to be engaged in full time home duties and had completed less formal education. Women who continued to drink were more likely to have drunk in previous pregnancies and during the preconception period. Nearly 40% of high risk women reported a negative comment in response to their drinking. One-third of women in the risky group were advised by a health professional not to drink alcohol. Women were most likely to drink in their own home or at the home of a friend., Conclusions: Participatory research with women who drink while pregnant can assist in identifying potential intervention strategies that have resonance with this group and therefore more potential for creating behaviour change. Implications. The World Health Organization recognises, and has done for over 10 years, that alcohol use during pregnancy which results in Foetal Alcohol Spectrum Disorder is the leading cause of environmental-related birth defects and mental retardation in the Western world.

The capsid gene sequences of 25 avian nephritis viruses (ANVs), collected in the UK, Germany and Belgium from the 1980s to 2008, were determined and compared with those of serotype 1 (ANV-1) and serotype 2 (ANV-2) ANV isolates. Amino acid identities as low as 51% were determined. Pairwise comparisons supported by phylogenetic analysis identified six ANVs, including ANV-1 and ANV-2, which shared<80% amino acid identities with one another, and which were selected to be representative of six groups. The ANVs were not distributed according to geographical location or year of sampling, and the detection of ANVs from five different groups in 11 samples sourced from six flocks belonging to the same UK organization within a 4-month period indicated that sequence-diverse ANVs were co-circulating. Amino acid alignments demonstrated the existence of variable regions throughout the capsid protein, nine of which were selected for detailed comparisons. With most ANVs, the variable region sequences were similar to those of one of the six representative ANVs, but some ANV capsids displayed novel variable region profiles, in which variable regions that were characteristic of more than one representative ANV were present. Phylogenetic analysis based on C-terminal sequences of approximately 260 amino acids and SimPlot analysis provided evidence that RNA recombination events located in the 1250 to 1350 nucleotide region resulted in new combinations of the N-terminal and C-terminal capsid regions. The high level of capsid sequence diversity observed in the present study has important implications for both the control and diagnosis of ANV infections.

The development of a reverse transcriptase-polymerase chain reaction (RT-PCR) test for detecting avian nephritis virus (ANV) is described. Primers, which amplified a fragment of 182 base pairs (bp), were located in the conserved 3' untranslated region (UTR) of the genome. The limit of detection of the test was estimated to be approximately 18 viral copies using a 10-fold dilution series of in vitro transcribed RNA. Positive signals were produced with representative ANV samples, some of which were not detected by previously described RT-PCR tests for detecting ANV, but other avian astroviruses including chicken astrovirus isolates and duck hepatitis virus types 2 and 3 tested negative. When applied to gut content samples from UK, German and US broiler flocks with enteritis/growth problems, ANVs were detected by RT-PCR in 82/82 (100%) samples. ANVs were also detected in 80/96 (83%) pooled gut content samples from longitudinal surveys of four broiler flocks displaying below-average performance. Whereas all samples collected on day 0 from the surveys were negative for ANV, all samples collected at days 4/5, 7, 10, 14, 21 and 28 tested positive. Sequence determinations performed with amplicons produced with 14 field samples confirmed the ANV specificity of the test, while comparative and phylogenetic analyses based on 109-nucleotide 3'-UTR sequences demonstrated that the majority of ANVs investigated were more closely related to the serotype 2 ANV (accession number AB 046864) than to the serotype 1 ANV (accession number NC 003790).

During Cassini's approach to Saturn, the Cosmic Dust Analyser (CDA) discovered streams of tiny (less than 20 nanometers) high-velocity (approximately 100 kilometers per second) dust particles escaping from the saturnian system. A fraction of these impactors originated from the outskirts of Saturn's dense A ring. The CDA time-of-flight mass spectrometer recorded 584 mass spectra from the stream particles. The particles consist predominantly of oxygen, silicon, and iron, with some evidence of water ice, ammonium, and perhaps carbon. The stream particles primarily consist of silicate materials, and this implies that the particles are impurities from the icy ring material rather than the ice particles themselves.

We present measurements of the dust particle flux and mass distribution from the Stardust Dust Flux Monitor Instrument (DFMI) throughout the flyby of comet 81P/Wild 2. In the particle mass regime from 10(-14) to 10(-7) kilograms, the spacecraft encountered regions of intense swarms of particles, together with bursts of activity corresponding to clouds of particles only a few hundred meters across. This fine-scale structure can be explained by particle fragmentation. We estimate that 2800 +/- 500 particles of diameter 15 micrometers or larger impacted the aerogel collectors, the largest being approximately 6 x 10(-7) kilograms, which dominates the total collected mass.

This paper provides an up-to-date systematic review of the school drug education literature (to June 2001) and identifies components that have the potential for creating effective drug education programmes in schools. This paper is a summary of a 150-page review. The review adopts a well-defined search methodology, specific selection criteria, and has made a series of recommendations based on the findings of past reviews and recent primary studies that met the selection criteria. The review is inclusive of reviews and recent primary studies that involved young people in school settings that encompassed a classroom intervention, included drug-related behavioural measures and had a positive impact on students' drug-related behaviours. The review identifies several areas that should be the focus of future programmes. These include timing and programming issues, content and delivery issues, teacher training, and dissemination. There is much refinement that can occur in school drug education implementation and research. The way forward is to continue to create and test interventions that bring together all components of the development, implementation and evaluation of school drug education that are effective in creating behaviour change, and that are practical to the school setting.

The School Health and Alcohol Harm Reduction Project (SHAHRP) aimed to reduce alcohol-related harm by enhancing students' abilities to identify and deal with high-risk drinking situations and issues. The SHAHRP study involved a quasi-experimental research design, incorporating intervention and control groups and measuring change over a 32-month period. The study occurred in metropolitan, government secondary schools (13 - 17-year-olds) in Perth, Western Australia. The 14 intervention and control schools involved in the SHAHRP study represent approximately 23% of government secondary schools in the Perth metropolitan area. The sample was selected using cluster sampling, with stratification by socio-economic area, and involved over 2,300 intervention and control students from junior secondary schools. The retention rate of the study was 75.9% over 32 months. The intervention incorporated evidence-based approaches to enhance potential for behaviour change in the target population. The intervention was a classroom-based programme, with an explicit harm minimization goal, and was conducted in two phases over a 2-year period. The results were analysed by baseline context of alcohol use to assess the impact of the programme on students with varying experience with alcohol. Knowledge and attitudes were modified simultaneously after the first phase of the intervention in all baseline context of use groups. The programme had little behavioural impact on baseline supervised drinkers; however, baseline non-drinkers and unsupervised drinkers were less likely to consume alcohol in a risky manner, compared to their corresponding control groups. In line with programme goals, early unsupervised drinkers from the intervention group were also significantly less likely to experience harm associated with their own use of alcohol compared to the corresponding control group. Unsupervised drinkers experienced 18.4% less alcohol-related harm after participating in both phases of the programme and this difference was maintained (19.4% difference) 17 months after the completion of the programme. This study indicates that a school drug education programme needs to be offered in several phases, that programme components may need to be included to cater for the differing baseline context of use groups, and that early unsupervised drinkers experience less alcohol-related harm after participating in a harm reduction programme.

Purpose: To compare the physiological and performance adaptations between periodized and nonperiodized resistance training in women collegiate tennis athletes., Methods: Thirty women (19 +/- 1 yr) were assigned to either a periodized resistance training group (P), nonperiodized training group (NV), or a control group (C). Assessments for body composition, anaerobic power, VO2(max), speed, agility, maximal strength, jump height, tennis-service velocity, and resting serum hormonal concentrations were performed before and after 4, 6, and 9 months of resistance training performed 2-3 d.wk (-1)., Results: Nine months of resistance training resulted in significant increases in fat-free mass; anaerobic power; grip strength; jump height; one-repetition maximum (1-RM) leg press, bench press, and shoulder press; serve, forehand, and backhand ball velocities; and resting serum insulin-like growth factor-1, testosterone, and cortisol concentrations. Percent body fat and VO2(max) decreased significantly in the P and NV groups after training. During the first 6 months, periodized resistance training elicited significantly greater increases in 1-RM leg press (9 +/- 2 vs 4.5 +/- 2%), bench press (22 +/- 5 vs 11 +/- 8%), and shoulder press (24 +/- 7 vs 18 +/- 6%) than the NV group. The absolute 1-RM leg press and shoulder press values in the P group were greater than the NV group after 9 months. Periodized resistance training also resulted in significantly greater improvements in jump height (50 +/- 9 vs 37 +/- 7%) and serve (29 +/- 5 vs 16 +/- 4%), forehand (22 +/- 3 vs 17 +/- 3%), and backhand ball velocities (36 +/- 4 vs 14 +/- 4%) as compared with nonperiodized training after 9 months., Conclusions: These data demonstrated that periodization of resistance training over 9 months was superior for enhancing strength and motor performance in collegiate women tennis players.

The object of this study was to examine changes in muscular strength, power, and resting hormonal concentrations during 6 weeks of detraining (DTR) in recreationally strength-trained men. Each subject was randomly assigned to either a DTR (n = 9) or resistance training (RT; n = 7) group after being matched for strength, body size, and training experience. Muscular strength and power testing, anthropometry, and blood sampling were performed before the experimental period (T1), after 3 weeks (T2), and after the 6-week experimental period (T3). One-repetition maximum (1RM) shoulder and bench press increased in RT at T3 (p

The purpose of this study was to measure the effects of additional eccentric loading on subsequent concentric strength. Eight subjects with some experience in weight training volunteered to perform maximal attempts in the barbell bench press using detaching hooks that allowed them to lower 105% of their concentric 1 repetition maximum (RM) and raise 100%. The detaching hooks allowed attachment of extra weight to the bar and would release from the bar at the bottom of the lift, reducing the weight lifted during the concentric phase of the lift. After determining their 1RM for the bench press, the subjects attempted to increase their performance by using a heavier eccentric load with the detaching hooks. All 8 subjects who completed the study increased their 1RMs by 5 to 15 pounds. The use of additional eccentric loading significantly (p = 0.008) increased the weight that could be lifted on the subsequent concentric phase and therefore 1RM performance. This phenomenon was a result of the enhancement of stretch-shortening cycle performance by the increased eccentric load. Athletes who are interested in developing 1RM strength in the bench press may benefit from the use of additional eccentric loading.

A postal questionnaire on 'sterilization and disinfection' was sent to all 144 nurse members of the British Association of Health Services in Higher Education (BAHSHE). Forty-nine (34%) completed valid questionnaires were returned. Despite the majority of practices performing minor surgical procedures such as cervical cytology (N= 40, 82%), ear syringing (N= 44, 90%) and wound dressing (N= 49, 100%), only 11 (22%) had access to a sterile supply department (SSD), and the definitions of sterilization and disinfection were only identified by 23 (52%) and 14 (32%) of the respondents, respectively. Forty-one (84%) respondents had a benchtop sterilizer (30 had a benchtop sterilizer, 11 a vacuum sterilizer and two had both), although there was considerable confusion on their appropriate use and maintenance. Just over half had written procedures for sterilizer use, no practice changed the sterilizer water on a daily basis as recommended by the Medical Devices Agency (MDA), few kept a sterilizer logbook and even fewer had read the MDA Device Bulletin on benchtop sterilizers. The majority of respondents voiced an interest in attending a workshop on sterilization and disinfection. We conclude that despite the location of the general practices within an academic environment, the concept of infection control is clearly not understood by university health service staff. As the implications of a failure to implement proper infection control procedures are potentially serious, the need for adequate education and training of staff is of critical importance., (Copyright 2001 The Hospital Infection Society.)

There remains uncertainty as to the effect of radioactive iodine (131I) therapy on the associated ophthalmopathy (GO). Twenty newly diagnosed patients with Graves' hyperthyroidism treated with 131I (median dose, 15.5 mCi) were followed with ophthalmologic evaluations (OE) and magnetic resonance imaging (MRI) at baseline, 2, and 6 months, and with OE alone at 3 years. For MRI, the superior, inferior, and medial rectus muscle volumes and total muscle volumes (TMV) were measured. Replacement levothyroxine was initiated as low thyroxine (T4) levels were noted. At baseline, 10 patients (50%) showed evidence of mild GO by OE and/or MRI. There was a significant difference in TMV between the 20 patients with Graves' hyperthyroidism and 10 controls (mean +/- standard error [SE]; 2,652 +/- 118 vs. 2,046 +/- 96 mm3; P = 0.002) and between the 10 patients with and 10 without GO (3,006 +/- 96 vs. 2,298 +/- 61 mm3; P = 0.001). TMV correlated with the Hertel score (r = 0.56, P = 0.01). TMV showed no significant change at 2 or 6 months posttreatment. The inferior rectus volume increased slightly at 2 months posttreatment (P = 0.03) but remained stable at 6 months. Furthermore, no significant changes occurred in Hertel scores or in clinical assessments up to 3 years posttreatment and none showed worsening or new development of GO. In conclusion, our results show no significant risk for radioiodine-induced initiation or progression of mild GO.

We treated 33 patients with a variant of the standard 3 weekly CHOP regime, replacing doxorubicin with liposomal daunorubicin (DaunoXome, NeXstar Pharmaceuticals) 120 mg/m2 (COP-X). Eighteen subjects had relapsed/refractory aggressive NHL and 15 had indolent NHL/CLL. Median number of courses received was 4 (1-8). Thirty-two patients were evaluable for efficacy and 26 (81%) responded. 88% of patients with aggressive NHL responded; three (18%) patients achieved complete remission (CR), 12 (70%) achieved partial remission (PR), 1 (6%) patient had stable disease (SD) and 1 (6%) patient progressed through treatment. Median duration of response for patients with aggressive NHL was 3 months. The response rate in indolent NHL/CLL was 73%. Four (27%) patients achieved CR, 7 (46%) PR and 4 (27%) SD. At two years post treatment, 55% of the patients with indolent NHL/CLL remain progression-free, although 4 patients have proceeded to consolidation therapy. Twenty-seven out of 28 (96%) patients developed neutropenia of short duration following one or more of their treatments. Twenty-three patients developed an infection at some stage during therapy (all associated with neutropenia) and required hospitalisation. There were two toxic deaths (infection) both of which occurred in patients who were neutropenic before starting COP-X. Platelet toxicity was mild in patients with normal platelet counts at the commencement of therapy. Alopecia and mucositis were mild. No clinical evidence of myocardial failure was observed. We conclude that the substitution of DaunoXome for doxorubicin in the CHOP regimen to form COP-X provides excellent efficacy against non-Hodgkin's lymphoma. Response durations were short but comparable to those reported with other regimens. COP-X was well tolerated with some suggestion of reduced non-haematological toxicity. The regimen should be considered as an alternative to CHOP with potentially less non-haematological toxicity, particularly cardiac; further studies are required to evaluate the regimen in this context.

Objective: An insight into the alcohol-related experiences of young students in Perth, Western Australia, with particular emphasis to alcohol-related harm., Method: The sample of 2,329 students (female: n = 1,089, male: n = 1,240) is a school-based group selected using cluster sampling, with stratification by socio-economic area and represents 11 to 12 year olds' experiences with alcohol and alcohol-related harm. The SHAHRP survey instrument was developed and pre-tested to measure students' knowledge, attitudes, patterns and context of use, harms associated with the students' own alcohol consumption and harms associated with other people's use of alcohol and incorporates the students' perceptions of alcohol-related harm., Results: Nearly two-thirds of all young people consumed alcohol under adult supervision; nearly 40% of all young males and 34% of all young females drink alcohol in unsupervised situations; and a fifth of young males consumed alcohol alone. Young males start drinking younger and consumed alcohol more regularly than young females, and consumed more alcohol per occasion. In the past 12 months, young males experienced more than five and young females more than three alcohol-related harms associated with their own alcohol consumption. They experienced a similar number of harms associated with other people's use of alcohol. Unsupervised drinkers were nearly seven times more likely to experience alcohol-related harm than supervised drinkers and nearly 13 times more likely to experience alcohol-related harm than non-drinkers., Conclusion and Implications: The results can help inform the development of alcohol education programs for young people.

The aim of this study was to evaluate changes in school health promotion practice related to two levels of intervention in the Western Australian School Health (WASH) Project: (1) a low-intensity intervention involving a single mail-out of WASH Project resources, and (2) a high-intensity intervention involving training, planning time and expert support. The schools involved in the study were divided into three groups. Treatment group 1 received the high-intensity intervention, treatment group 2 received the low-intensity intervention and a comparison group received no intervention. Two scales were developed to assess change, i.e. a school organizational scale (Chronbach's alpha = 0.76) and a health promotion activity scale (Chronbach's alpha = 0.79). The results indicate that a high-intensity intervention, such as the WASH Project, which provides training to a critical mass of school community members from each school, ongoing access to an expert in the field, as well as dedicated planning time, is able to increase the comprehensiveness and quality of health strategic planning by schools. Furthermore, the results suggest that a low-intensity mail-out intervention is no more successful in initiating change that providing no intervention at all.

We treated 33 patients with relapsed or refractory non-Hodgkin's lymphoma (NHL) or Hodgkin's disease (HD) with a combination of etoposide, prednisolone, ifosfamide and carboplatin (EPIC). After a median of two courses (range 1-5) complete response was achieved in 7 (22%) patients and partial response in 12 (37%) patients, an overall response rate of 59%. The regimen was well tolerated with myelosuppression being the most common toxicity. There were no toxic deaths. 25 (78%) patients were able to proceed to high dose therapy (BEAM) with peripheral blood progenitor cell transplantation either immediately post EPIC or following further salvage therapy. Most patients mobilised peripheral blood progenitor cells well and 24 out of 25 patients subsequently undergoing autologous transplantation had rapid regeneration of counts. EPIC is an effective salvage therapy in the majority of patients with relapsed or refractory lymphoma and does not appear to be toxic to stem cells. Although severe, myelosuppression is of short duration and the generally low toxicity enables patients to proceed to successful peripheral blood stem cell harvest and transplantation.

Purpose: The purpose of this study was to examine the physiological effects of a weight-loss dietary regimen with or without exercise., Methods: Thirty-five overweight men were matched and randomly placed into either a control group (C; N = 6) or one of three dietary groups; a diet-only group (D; N = 8), a diet group that performed aerobic exercise three times per week (DE; N = 11); and a diet group that performed both aerobic and strength training three times per week (DES; N = 10)., Results: After 12 wk, D, DE, and DES demonstrated a similar and significant (P < or = 0.05) reduction in body mass (-9.64, -8.99, and -9.90 kg, respectively) with fat mass comprising 69, 78, and 97% of the total loss in body mass, respectively. The diet-only group also demonstrated a significant reduction in fat-free mass. Maximum strength, as determined by 1-RM testing in the bench press and squat exercise was significantly increased for DES in both the bench press (+19.6%) and squat exercise (+32.6%). Absolute peak O2 consumption was significantly elevated in DE (+24.8%) and DES (+15.4%). There were no differences in performance during a 30-s Wingate test for the DE and DES, whereas D demonstrated a significant decline in peak and mean power output. Resting metabolic rate (RMR) (kcal x d(-1)) was not significantly different for any of the groups except for the DE group. There were no significant changes in basal concentrations of serum glucose, BUN, cortisol, testosterone, and high density lipoprotein (HDL) cholesterol for any of the groups. Serum total cholesterol and low density lipoprotein (LDL) cholesterol were significantly decreased for all dietary groups. Serum triglycerides were significantly reduced for D and DES at week 6 and remained lower at week 12 for D, while triglycerides returned to baseline values for DES., Conclusions: These data indicate that a weight-loss dietary regimen in conjunction with aerobic and resistance exercise prevents the normal decline in fat-free mass and muscular power and augments body composition, maximal strength, and maximum oxygen consumption compared with weight-loss induced by diet alone.

Purpose: The purpose of this study was to examine the effect of dynamic resistance exercise on the response patterns of adrenal medullary neurohormones in strength-trained men., Methods: Ten strength-trained men (21.7+/-0.58 yr) gave informed consent and performed two resistance exercise protocols, high force and high power, of equal total work in a randomized order separated by 1 wk. Blood samples were obtained pre-exercise (baseline), 0 (R-0), 15 (R-15), and 240 (R-240) min postexercise and under resting control conditions for each time point., Results: There were no significant differences in control concentrations for each time point and no difference in pre-exercise values between the two resistance exercise protocols for plasma lactate, epinephrine, plasma peptide F (P-F), or norepinephrine (NE). Plasma lactate significantly (P< or = 0.05) increased from baseline for both protocols; however, concentrations were higher in response to the high force protocol. Plasma epinephrine was significantly increased from baseline at R-0 and returned to baseline at R-15 for both protocols. In contrast, plasma P-F was significantly decreased at R-0 from baseline; however, at R-240 P-F had significantly increased to >80% baseline for both protocols., Conclusions: These results indicate that the adrenal medulla was activated in response to the acute stress of both types of heavy resistance exercise. Furthermore, during longer recovery periods, the adrenal medulla was also active above baseline conditions as increased concentrations of proenkephalin fragments (i.e., P-F) were detected in the circulation.

Forty-three patients with chronic myeloid leukaemia in first chronic phase were recruited to study intensive chemotherapy (idarubicin plus cytarabine; IdAC) followed by collection of peripheral blood stem cells (PBSC) in the recovery phase. PBSC autografting was performed on 32 patients. One patient died during mobilization and three died following autograft. All procedural deaths occurred in patients who received IdAc more than a year from diagnosis. Nine further patients died, eight following progression of CML. 72% of transplanted patients showed a major cytogenetic response but most cases have returned to Philadelphia-positive haemopoiesis. 62% of autografted patients remain alive (median survival from diagnosis 52 months). Four of the 11 patients who did not receive a transplant remain in chronic phase.

We report on the case of a 34-year old man with a previously refractory high-grade non-Hodgkin's Lymphoma which regressed following dendritic cell based immunotherapy after high-dose chemotherapy. Antigen presenting cells known as dendritic cells were cultured from harvested autologous peripheral blood progenitor cells. The dendritic cells were then exposed to unfractionated tumour peptides derived from a skin biopsy section inflitrated with lymphoma. These charged dendritic cells infused into the patient together with autologous T-lymphocytes after high-dose chemotherapy with peripheral blood stem cell rescue. Although the lymphoma relapsed after the high-dose chemotherapy it regressed again following the dendritic cell infusion. The patient's T-lymphocytes demonstrated in vitro reactivity to tumour peptides whereas the lymphocytes of controls did not. We propose that the lymphoma regression occurred because of a T cell mediated response against the tumour induced by the charged dendritic cells.

The prevalence of asthma and dyspnoeic symptoms were studied in undergraduates from Ireland, north and south, entering Queen's University Belfast in the years 1972, 1978, 1983, 1986 and 1989. The records of students' compulsory entry medical examination, including responses to questions on dyspnoeic symptoms in a health screening questionnaire, were reviewed. Between 1972 and 1989, the 12-month period prevalence of asthma increased from 1.3% to 2.84% (p < 0.001). This increase was not accounted for by the changes in the sex, or socioeconomic structure of the student body. In non-asthmatics the prevalence of dyspnoea rose from 5.49% to 8.30% (p < 0.01). In students with diagnosed asthma, the proportion with dyspnoeic symptoms did not significantly increase (p = 0.167). There was a greater than two-fold increase in the prevalence of diagnosed asthma in this population between 1972 and 1989. The prevalence of asthma was higher in rural than in urban students. There was also an increased reporting of dyspnoea in non-asthmatics, the significance of which is unclear.

An EIS gathers financial and non-financial data from a variety of sources, both internal and external to an organisation, and presents them accessibly and understandably. It should facilitate the presentation of data so that it is timely and relevant to senior managers' needs. Generally, there are three categories of EIS: Front-end tools, which enhance the presentation of output from existing systems. For example, they can take the output from a general ledger system and enhance its appearance but do not change the content. Internal consolidation tools, which take data from a number of internal sources (such as the general ledger), store it in a central database, and present it to users. This is often done in report book format to which all EIS style functions may be applied. Integrators of information, which integrate data from internal and external sources. Much of the data is non-financial and a major emphasis is on the users' ability to communicate with each other. The key functions that may be included within an EIS are: Drill down. The facility to explore increasingly detailed levels of data. Trends and variances against pre-set targets, such as financial budgets. Graphics and tabular reporting. Data integrity checking. Analysis of the data, modelling and the production of forecasts using time series analysis techniques. Exception reporting through the use of some form of alert. Incorporation of text into the output.

In this article, the factors contributing to a shortage of qualified medical laboratory technologists in the US have been examined, and the Canadian perspective studied. Continued public relations programs, with special programs directed to high school, college and university students would seem to be the appropriate way to prevent similar problems from occurring and escalating in Canada.

Six hundred fifty-eight laparoscopies were performed at St. Luke's Hospital, Kansas City, Missouri, USA, between March 1, 1976 and February 28, 1977. One hundred sixty-eight (25.5%) were performed for diagnostic purposes. A review of the preoperative diagnoses and the laparoscopic findings demonstrates the value of laparoscopy as a diagnostic procedure.

Three healthy, young adults suddenly experienced the onset of slow gastric emptying. Their symptoms began in February, 1975 in association with a brief illness consistent with a viral gastroenteritis. They complained of early satiety, nausea, and vomiting when they ate solid food and they had lost 11-25 kg in body weight in 8-12 mo. On admission, their physical examinations and laboratory studies were within normal limits. Their stomachs emptied a barium mixture normally, and fiberoptic endoscopy did not detect any abnormalities. The slowed gastric emptying of food was documented with radioisotopic gastric emptying studies. The prolonged emptying rates of 2 patients were reduced 90% with metoclopramide. In association with metoclopramide therapy, the patients were able to eat more food, and they regained 8-10 kg of body weight in 4-6 mo. Their histories raise the possibility that their initial illness may have damaged the mechanisms which control the gastric emptying of food.