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Few if any studies before the AIDS epidemic suggested that male homosexuals may on average have higher levels of depression than male heterosexuals. However, several samples of homosexual and bisexual men in HIV studies suggest that depression and anxiety are high in these populations, and that this psychiatric morbidity began before the AIDS epidemic. We tested the hypothesis that high childhood gender nonconformity (CGN) is associated with depression and anxiety, and so might account for differences in these variables among samples of homosexuals. A total of 254 homosexual or bisexual male subjects were assessed for depression, anxiety, and associated symptoms using various self-report and interview measures, as well as for CGN (using the Freund Feminine Gender Identity scale, FGI). For comparison purposes only, we also evaluated the subjects for the DSM-III diagnosis of Ego-Dystonic Homosexuality. Highly gender nonconforming men (high FGI scores) were more likely to have current symptoms of anxiety and depression by self-report, and to have had a lifetime history of depression by clinical interview. This association was more often due to FGI items dealing with childhood than adulthood. When the FGI was broken into subscales by a prior factor analysis, stepwise regression suggested that the subscale measuring core gender identity nonconformity (so-called 'gender dysphoria') was more reliably associated with depression and anxiety than were the factors measuring nonconformity in the areas of masculine and feminine gender roles, or genitoerotic (sexual) roles. This subscale was also the only FGI measure correlating with Ego-Dystonic Homosexuality. AIDS (CDC stage and HIV serostatus) and age did not account for these findings. We conclude that the often-reported higher levels of depression, anxiety, and associated symptoms among homosexual and bisexual men in AIDS studies are more common in the subgroup of such men who are gender dysphoric. Theoretical and clinical implications of these data are discussed. KEY WORDS: depression; anxiety; gender nonconformity; homosexuality; gender dysphoria.

In South Carolina, like the rest of the United States, crimes committed by adolescents have escalated sharply over the past several years. Criminal justice agencies, judges, educators, religious leaders, concerned [...]

Objectives: To assess the impact of myocardial infarction on quality of life in four year survivors compared to data from "community norms", and to determine factors associated with a poor quality of life.Design: Cohort study based on the Nottingham heart attack register.Setting: Two district general hospitals serving a defined urban/rural population.Subjects: All patients admitted with acute myocardial infarction during 1992 and alive at a median of four years.Main Outcome Measures: Short form 36 (SF 36) domain and overall scores.Results: Of 900 patients with an acute myocardial infarction in 1992, there were 476 patients alive and capable of responding to a questionnaire in 1997. The response rate was 424 (89. 1%). Compared to age and sex adjusted normative data, patients aged under 65 years exhibited impairment in all eight domains, the largest differences being in physical functioning (mean difference 20 points), role physical (mean difference 23 points), and general health (mean difference 19 points). In patients over 65 years mean domain scores were similar to community norms. Multiple regression analysis revealed that impaired quality of life was closely associated with inability to return to work through ill health, a need for coronary revascularisation, the use of anxiolytics, hypnotics or inhalers, the need for two or more angina drugs, a frequency of chest pain one or more times per week, and a Rose dyspnoea score of >/= 2.Conclusions: The SF 36 provides valuable additional information for the practising clinician. Compared to community norms the greatest impact on quality of life is seen in patients of working age. Impaired quality of life was reported by patients unfit for work, those with angina and dyspnoea, patients with coexistent lung disease, and those with anxiety and sleep disturbances. Improving quality of life after myocardial infarction remains a challenge for physicians. [ABSTRACT FROM AUTHOR]

Objective: To determine whether survival from out-of-hospital cardiac arrest is influenced by the on-scene availability of different grades of ambulance personnel and other health professionals.Design: Population based, retrospective, observational study.Setting: County of Nottinghamshire with a population of one million.Subjects: All 2094 patients who had resuscitation attempted by Nottinghamshire Ambulance Service crew from 1991 to 1994; study of 1547 patients whose arrest were of cardiac aetiology.Main Outcome Measures: Survival to hospital admission and survival to hospital discharge.Results: Overall survival from out-of-hospital cardiac arrest remains poor: 221 patients (14.3%) survived to reach hospital alive and only 94 (6.1%) survived to be discharged from hospital. Multivariate logistic regression analysis showed that the chances of those resuscitated by technician crew reaching hospital alive were poor but were greater when paramedic crew were either called to assist technicians or dealt with the arrest themselves (odds ratio 6.9 (95% confidence interval 3.92 to 26.61)). Compared to technician crew, survival to hospital discharge was only significantly improved with paramedic crew (3.55 (1.62 to 7.79)) and further improved when paramedics were assisted by either a health professional (9.91 (3.12 to 26.61)) or a medical practitioner (20.88 (6.72 to 64.94)).Conclusions: Survival from out-of-hospital cardiac arrest remains poor despite attendance at the scene of the arrest by ambulance crew and other health professionals. Patients resuscitated by a paramedic from out-of-hospital cardiac arrest caused by cardiac disease were more likely to survive to hospital discharge than when resuscitation was provided by an ambulance technician. Resuscitation by a paramedic assisted by a medical practitioner offers a patient the best chances of surviving the event. [ABSTRACT FROM AUTHOR]

1 The effects of 4 week treatment periods of once-daily atenolol 100 mg, nadolol 80 mg, nadolol 160 mg and placebo on resting and exercise heart rate and blood pressure were compared in a single-blind crossover trial in fifteen patients with essential hypertension. 2 Both atenolol and nadolol, irrespective of dose, reduced resting and exercise blood pressures to the same extent. 3 Nadolol caused a greater bradycardia both at rest and during exercise than did atenolol, thereby effecting a greater reduction in double-product. 4 During progressive treadmill exercise neither atenolol nor nadolol prevented a linear increase in heart rate and blood pressure which were parallel to, but at a lower level than, that produced by placebo. 5 In each individual patient the magnitude of the hypotensive effect produced by one drug was similar to that produced by the other. 6 All the treatment periods resulted in the same linear increase in the patients' perceived exertion scores during exercise despite marked differences in haemodynamic responses evoked by the beta-adrenoceptor blockers compared with placebo. 7 Neither atenolol or nadolol produced any significant change in peak expiratory flow rate compared with placebo. [ABSTRACT FROM AUTHOR]

Focuses on the stage play "Verfremdungseffekt," written by Bertolt Brecht. Efforts of Brecht to change the apprehension of audiences of stage plays; Effect of the structural machinations used by Brecht on the emotional involvement of audiences; Discussion of drama as an apprehension and encompassment of reality.

Presents a criticism and interpretation of Samuel Beckett's first film, "Film." Replacement of use of words by visual perception as a primary device of the characters of the stage plays; Moment of self-perception in the film; Meaning of the splitting of the protagonist into object and eye in the "Film."

The alveolar bone of the marmoset is exceedingly vulnerable to the resorption induced by excessive amounts of parathyroid hormone. Inclusion of 50 ppm fluoride in the drinking water of the marmosets for five months resulted in a histologically measurable degree of protection against the bone-destroying proclivity of the hormone. [ABSTRACT FROM AUTHOR]

Radioisotopes of riboflavin, biotin, and folic acid were parenterally administered to marmosets to determine whether the salivary glands contribute to the vitamin content of saliva. Examination after injection showed that there were measurable amounts of each test vitamin in all samples of pilocarpine-stimulated saliva obtained from the test animals. [ABSTRACT FROM AUTHOR]

Background: Percutaneous transluminal coronary angioplasty (PTCA) and coronary-artery bypass grafting (CABG) are both effective intervention strategies for patients with coronary heart disease. We report comparative long-term clinical and health-service cost findings for these interventions in the first Randomised Intervention Treatment of Angina (RITA-1) trial.Methods: 1011 patients with coronary heart disease (45% single-vessel, 55% multivessel) were randomly assigned initial treatment strategies of PTCA or CABG. Information on clinical events, subsequent intervention, symptomatic status, exercise testing, and use of health-care resources is available for a median 6.5 years of follow-up. Analyses were by intention to treat.Findings: The predefined primary endpoint of death or nonfatal myocardial infarction occurred in 87 (17%) PTCA-group patients and 80 (16%) CABG-group patients (p=0.64). Similarly, there was no significant treatment difference in deaths alone (39 PTCA, 45 CABG), of which 46% were cardiac related. In both groups, the risk of cardiac death or myocardial infarction was more than five times higher in the first year than in subsequent years of follow-up. 26% of patients assigned PTCA subsequently also had CABG, and a further 19% required additional nonrandomised PTCA. Most of these reinterventions occurred within a year of randomisation, and from 3 years onwards the reintervention rate averaged 4% per year. In the CABG group the reintervention rate averaged 2% per year. The prevalence of angina was consistently higher in the PTCA group, with an absolute average 10% excess compared with the CABG group (p<0.001). Total health-service costs over 5 years showed no significant difference between initial strategies of PTCA and CABG (mean difference pounds sterling 426 [95% Cl -pounds sterling 383 to pounds sterling 1235]; p=0.30). The clinical and cost comparisons showed similar patterns for patients with single-vessel and multivessel disease.Interpretation: Initial strategies of PTCA and CABG led to similar long-term results in terms of survival and avoidance of myocardial infarction and to similar long-term health-care costs. Choice of approach, therefore, rests on weighing the more invasive nature of CABG against the greater risk of recurrent angina and reintervention over many years after PTCA. [ABSTRACT FROM AUTHOR]