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Cardiovascular complications have been frequently reported in cancer patients and survivors, mainly because of various cardiotoxic cancer treatments. Despite the known cardiovascular toxic effects of these treatments, they are still clinically used because of their effectiveness as anti-cancer agents. In this review, we discuss the growing body of evidence suggesting that inhibition of the cytochrome P450 1B1 enzyme (CYP1B1) can be a promising therapeutic strategy that has the potential to prevent cancer treatment-induced cardiovascular complications without reducing their anti-cancer effects. CYP1B1 is an extrahepatic enzyme that is expressed in cardiovascular tissues and overexpressed in different types of cancers. A growing body of evidence is demonstrating a detrimental role of CYP1B1 in both cardiovascular diseases and cancer, via perturbed metabolism of endogenous compounds, production of carcinogenic metabolites, DNA adduct formation, and generation of reactive oxygen species (ROS). Several chemotherapeutic agents have been shown to induce CYP1B1 in cardiovascular and cancer cells, possibly via activating the Aryl hydrocarbon Receptor (AhR), ROS generation, and inflammatory cytokines. Induction of CYP1B1 is detrimental in many ways. First, it can induce or exacerbate cancer treatment-induced cardiovascular complications. Second, it may lead to significant chemo/radio-resistance, undermining both the safety and effectiveness of cancer treatments. Therefore, numerous preclinical studies demonstrate that inhibition of CYP1B1 protects against chemotherapy-induced cardiotoxicity and prevents chemo- and radio-resistance. Most of these studies have utilized phytochemicals to inhibit CYP1B1. Since phytochemicals have multiple targets, future studies are needed to discern the specific contribution of CYP1B1 to the cardioprotective and chemo/radio-sensitizing effects of these phytochemicals.

Background Renal cell carcinoma (RCC) is a common malignant tumor of the urinary system. The etiology of RCC is a complex interaction between environmental and multigenetic factors. Genome-wide association studies have identified new susceptibility risk loci for RCC. We examined associations of genetic variants of genes that are involved in metabolism, DNA repair and oncogenes with renal cancer risk. A total of 14 single nucleotide polymorphisms (SNPs) in 11 genes (VEGF, VHL, ATM, FAF1, LRRIQ4, RHOBTB2, OBFC1, DPF3, ALDH9A1 and EPAS1) were examined. Methods The current case–control study included 87 RCC patients and 114 controls matched for age, gender and ethnic origin. The 14 tag-SNPs were genotyped by Sequenom MassARRAY® iPLEX using blood genomic DNA. Results Genotype CG and allele G of ATM rs1800057 were significantly associated with RCC susceptibility (p = 0.043; OR = 8.47; CI = 1.00–71.76). Meanwhile, we found that genotype AA of rs67311347 polymorphism could increase the risk of RCC (p = 0.03; OR = 2.95; IC = 1.10–7.89). While, genotype TT and T allele of ALDH9A1 rs3845536 were observed to approach significance for a protective role against RCC (p = 0.007; OR = 0.26; CI = 0.09–0.70). Conclusion Our results indicate that ATM rs1800057 may have an effect on the risk of RCC, and suggest that ALDH9A1 was a protective factor against RCC in Algerian population.

Pension reform is one of the top public policy priorities in advanced industrialized countries due to population ageing and the significant weight of pension spending in governments’ budgets. As a result of these concerns European countries have engaged in varying degrees of pension reforms over the last three decades. The extant literature on pension reform focuses on structural, institutional and blame avoidance theories to explain how pension reform take place. Yet, how do different conditions combine to lead to significant pension reform outcomes? To answer this question we analyze a set of 48 pension reform cases in eight European countries since the late 1980s up until 2014 by using fuzzy set qualitative comparative analysis (fsQCA). Our main finding is that institutional, structural or blame avoidance theories cannot account by themselves for instances of significant pension reform. Rather, we find three pathways that combine structural and institutional conditions to lead to significant pension reform.

Introducción: Existe evidencia creciente sobre la validez del diagnóstico de trastorno bipolar infantil. Existen múltiples factores que contribuyen a que la enfermedad esté infradiagnosticada y se confunda con facilidad con otros trastornos con conductas de externalización patológica, como el trastorno por déficit de atención con hiperactividad. Caso clínico: Se presenta el caso clínico de un niño con sospecha de trastorno bipolar infantil con el que se ha llevado a cabo un seguimiento semanal desde los 3 hasta los 5 años, con la finalidad de observar su conducta y llevar a cabo un buen diagnóstico diferencial. Conclusiones: El diagnóstico de trastorno bipolar infantil debe ser considerado en aquellos menores con síntomas graves de hiperactividad, distraibilidad, impulsividad y alteración de la conducta, especialmente en aquellos casos en los que encontremos antecedentes familiares de trastorno bipolar, fluctuaciones anímicas llamativas, episodios de agresividad graves y alteración del sueño.

To assess the importance of prenatal ultrasound diagnosis of the fetus carrying meconium periorchitis and its predictive relevance for fetal monitoring and prognosis in the context of acute fetal intestinal disease.Three male fetuses have been diagnosed of meconium periorchitis in our Unit of Fetal Medicine in the last 5 years. Their prenatal ultrasound diagnoses were: testicular tumor (n=1); Meconium periorchitis with acute fetal intestinal perforation (n=2). Gestational age at diagnosis was 33, 34 and 35 weeks. Ultrasound signs at diagnosis were: Increased size of scrotal zone, with hyperechogenic lesions inside and permanence of peritoneum-vaginal canal; at abdominal zone, echographic signs of intestinal disease with or without meconium peritonitis were found (hyperechogenic lesions, edema of intestinal loops and ascites). All three neonates were assessed postnatally by ultrasound and therapeutic indication.Fetal ultrasound findings influenced both evolution and termination of pregnancy. The diagnosis of meconium periorchitis was confirmed postnatally in all cases: in the 1st case, delivered at term, scrotal tumoral pathology was ruled out and did not require abdominal surgery; the other 2 patients were delivered at the same week of prenatal diagnosis and an inguinal-scrotal surgery with intestinal approach because of meconium peritonitis was performed. No patient underwent orchiectomy, maintaining the teste-epididymal binomial intact.Prenatal ultrasound diagnosis of meconium periorchitis requires a strict ultrasound follow-up of the fetus as it is a specific marker of intestinal perforation, which can lead to the termination of pregnancy and avoid appearance of complicated meconium peritonitis.Evaluar la importancia del diagnóstico ecográfico prenatal del feto portador de periorquitis meconial y su relevancia predictiva del seguimiento y pronóstico fetal en el contexto de una enfermedad intestinal fetal aguda.En los últimos 5 años en la Unidad de Medicina Fetal se han diagnosticado tres fetos varones de periorquitis meconial cuyos diagnósticos ecográficos prenatales fueron: tumor testicular (n=1); y periorquitis meconial con perforación intestinal aguda fetal (n=2). La edad gestacional al diagnóstico fue de 33, 34 y 35 semanas. Los signos ecográficos al diagnóstico fueron: a nivel escrotal, aumento del tamaño, lesiones hiperecogénicas y permanencia del conducto peritoneo-vaginal; a nivel abdominal pueden existir signos ecográficos de enfermedad intestinal con o sin peritonitis meconial (lesiones hiperecogénicas, edemas de asas y ascitis). Los tres neonatos fueron evaluados postnatalmente mediante ecografía comparativa de los hallazgos prenatales e indicación terapéutica.Los hallazgos ecográficos fetales influyeron en la evolución y finalización de la gestación. El diagnóstico de periorquitis meconial fue confirmado postnatalmente en los tres casos: en el 1er caso a término, se descartó patología tumoral escrotal y no requirió cirugía abdominal; en los otros dos pacientes se indicó finalizar la gestación tras el diagnóstico prenatal y se realizó cirugía inguino-escrotal y abordaje intestinal por la peritonitis meconial.El diagnóstico ecográfico prenatal de periorquitis meconial obliga a un seguimiento ecográfico estricto del feto al ser un marcador específico de perforación intestinal, que puede conllevar la finalización de la gestación y evitar la aparición de una peritonitis meconial complicada.

Scholarly attention on pension reform following the recent global financial crisis has focused primarily on cases entailing the renationalization of private pension pillars. We argue that radical pension reforms should also include instances of radical retrenchment of public pension pillars. We offer an explanation of such reforms in the aftermath of the crisis by analyzing the reforms adopted in Argentina and Greece since 2008. We demonstrate that highly indebted countries with no access to international financial markets and unsustainable pension systems can introduce radical reforms in response to short-term funding needs rather than long-term adequacy concerns. We argue that the narrow timeframe of the recent reforms raises questions about the sound footing of the new systems which may ultimately not prevent the introduction of further measures. This comparison provides insights to understand recent episodes of radical pension reforms in other countries.

No abstract

Background There is an increasing interest in the clinico-pathological correlation of mutations in progranulin ( PGRN ) and frontotemporal lobar degeneration (FTLD) complex diseases. We aim to study the PGRN expression variability in patients with different clinical features for a better understanding of its roles in FTLD disease. Methods We sequenced the PGRN gene in 72 patients suffering from FTLD (25 familial and 47 sporadic cases) and in 24 asymptomatic at-risk relatives. We also analyzed PGRN expression in blood by quantitative real-time polymerase chain reaction from 37 patients, 8 asymptomatic mutation carriers, and 10 control subjects as well as in brain tissue from 16 patients and 9 control subjects. Results Four novel mutations were associated with familial and sporadic FTLD and familial dementia associated with amyotrophic lateral sclerosis. We identified a close association between the IVS6-1G>A mutation in PGRN and corticobasal syndrome. Brain tissue was available for carriers of two of the four mutations (IVS6-1 G>A and P357HfsX3). Immunohistochemical analysis revealed ubiquitin- and TDP-43positive and τ/α-synuclein negative immunoreactive neuronal intranuclear inclusions. The relative expression of PGRN in the clinical sample was significantly lower in carriers of the IVS6-1 G>A than in control subjects. Conclusions Progranulopathies are a major cause of the main phenotypes included in the FTLD complex. According to our results, the level of expression of PGRN in blood could be a useful marker both for diagnostics of part of the spectrum of FTLD conditions and for monitoring future treatments that might boost the level of PGRN in this disorder.

Background: Between January 1993 and December 2003, 19 patients with familial prion diseases due to the D178N mutation were referred to the regional epidemiological registry for spongiform encephalopathies in the Basque Country in Spain, a small community of some 2 100 000 inhabitants. Methods: Ten further patients belonging to the same pedigrees were retrospectively ascertained through neurological or neuropathological records. In four of the patients, the diagnosis was confirmed by analysing DNA obtained from paraffin blocks. In this article, we report on the clinical, genetic, and pathological features of the 23 patients carrying the D178N mutation confirmed by genetic molecular analysis. Haplotyping studies suggest a founder effect among Basque born families, explaining in part this unusually high incidence of the D178N mutation in a small community. Only two patients (8%) lack familial antecedents. Results: We have observed a phenotypic variability even among homozygous 129MM patients. Our findings challenge the currently accepted belief that MM homozygosity in codon 129 is always related to a fatal familial insomnia (FFI) phenotype. Indeed, seven out of 17 patients with a 129MM genotype in this series presented with a Creutzfeldt-Jakob disease (CJD) clinicopathological picture. Conclusions: The considerable clinical and pathological overlapping observed among homozygous 129MM patients favours the view that FFI and CJD178 are the extremes of a spectrum rather than two discrete and separate entities. Other genetic or environmental factors apart from the polymorphism in codon 129 may play a role in determining the phenotypic expression of the D178N mutation in the PRNP gene.

Objective To study the adverse effects of trimetazidine on motor functions. Design A retrospective study was carried out using electronic records to identify all patients seen between January 1990 and August 2003. Setting A neurological out-patient clinic. Participants Of the 10 258 patients who attended the clinic, 130 received trimetazidine. Treatment with this drug was discontinued in 128 patients. Of the 130 patients treated with trimetazidine, 29 also had other drugs capable of inducing parkinsonism withdrawn from their treatment. Main outcome measures Identification of an improvement in motor function after drug withdrawal. Results In 56 of the 130 patients who were treated with trimetazidine (43%), an adverse effect on motor function was detected that had been induced or aggravated by one of the withdrawn drugs. Indeed, drug-induced parkinsonism was detected in 20 of these patients. Of these, ten were being treated with trimetazidine only, while the remaining ten were simultaneously receiving other drugs potentially capable of inducing parkinsonism. Treatment with trimetazidine worsened previously diagnosed Parkinson's disease in 12 patients, and gait disorders coupled with disequilibrium was observed in 15 patients. Trimetazidine induced tremor in nine patients. Conclusion Trimetazidine can induce parkinsonism, gait disorder and tremor. These adverse effects have not been previously described for this drug.

In 1995, a surveillance system for prion diseases was set up in the Basque Country, an autonomous region in northern Spain (2.1 million inhabitants). In the period from January 1993 to December 2003, we diagnosed 21 patients with familial prion diseases prospectively and another 4 patients retrospectively. They represent 35% of all the cases referred to the epidemiological registry. Two main possible explanations for this unusual high incidence of familial prion diseases are proposed: first, comprehensive case ascertainment by public health neurologists; second, a probable cluster of the D178N mutation within families of Basque origin related to a still unconfirmed common ancestor. Further genetic and genealogical studies should resolve this issue.

Under automatic enrolment, employers are required to automatically enrol their employees into a qualifying pension scheme. The minimum total contribution rate is 8% of a band of earnings from £5,668 and £41,450 per annum, of which a minimum 3% must come from the employer. With over 80% of Defined Benefit (DB) schemes now closed to new members or future accruals the majority of employers are expected to select a Defined Contribution (DC) pension as their qualifying scheme. This report analyses what ranges of retirement incomes from a DC pension different individuals might achieve by making only the minimum required level of contributions. The report also analyses the contribution rate necessary for different individuals to have a “good chance” of achieving an adequate retirement income. This report employs outputs from the PPI Individual Model adapted to use stochastic modelling techniques, based on a model developed by the Department of Mathematics at King’s College London. Each individual modelled is run 100,000 times with different economic scenarios. This illustrates better the variability around investment returns and economic variables year on year.

Long-term indwelling central venous access devices are frequently used in pediatric patients. Their main complication is infection, that can even mean their removal. We try to identify the risk factors really involved in this complication and in their removal. We have made a retrospective review of 120 oncologic pediatric patients who received a central venous device between 2003 and 2009. We searched for epidemiologic, clinic, microbiologic and surgical risk factors. We made a comparative data analysis among: GROUP A, children who suffered device infection, GROUP B the others. Group A was divided into early infection (first month after implantation)/late infection, removed/not removed. Data were analized with statistical program SPSS. 29 suffered from leukemia, 19 from lymphoma and the main part, 72, from solid tumour. 31% experienced infection (GROUP A), being early in the 36% of them. 16% had to be withdrawn. Data analysis revealed statistical association with the age (p=0.015) and with the reception of chemiotherapic treatment the week before the surgical insertion. The rest of the studied factors did not revealed a real association, but could be guess a relationship among infection and leukemia, subclavian catheters, those patients whose deviced was introduced using a guide over a previous catheter and also transplanted. Related to early infection the only associateon founded was with the subclavian access (p=0.018). In conclusion, in our serie long-term central venous access infection was more frequent in the younger patients and also in those who had received chemotherapy the week before the catheter implantation. The tendency towards infection in leukemia, transplanted and subclavian carriers has to be studied in a prospective way with a larger number of oncologic children.

Peritoneal drainage is one of the options for treatment in necrotizing enterocolitis (NEC). Currently its role is controversial as an alternative to laparotomy in low birthweight and mortality associated with both procedures is high (35-55%).We reviewed 30 low-weight premature (1000 g) with NEC treated surgically. We evaluate the hemodynamic, respiratory and metabolic status of the patients, as well as multi-organ involvement and the need for inotropic drugs. These data were analyzed previos to surgery and at 6 and 12 hours. We divided the sample into two groups: those who underwent peritoneal drainage (PD) input or laparotomy (LAP).In the series the average birth weight was 754 +/- 156 g and gestational age was 26.1 +/- 2.1 weeks. We carry on 10 peritoneal drainage and 20 laparotomies. The DP group before the intervention showed increased heart rate, FiO2 and acidosis (p0.05). The needs of dopamine were similar in both groups. Following the peritoneal drainage, we found breathing improvement (adequate ventilation and oxygenation, decreased FiO2) and hemodynamic improvement (blood pressure maintained, reduced heart rate, reduced requirements for dopamine) at 6 and 12 h. DP was not the definitive treatment in any of the patiens, and all survivors (80%) of this group required further laparotomy. 62% of them died. Overall mortality was 47% (70% DP and 35% LAP, p = 0.07).Peritoneal drainage allowed the stabilization of low-weight premature in critical condition. The hemodynamic and respiratory stabilization was transient and did not prevent the definitive surgical treatment, although it improved the conditions for doing so. In our series, the peritoneal drainage did not improve long-term survival, questioning its role as an alternative to surgery for NEC.

While Southern European countries have pursued a series of pension reforms since the early 1990s, these trajectories display important differences, ranging from path-breaking ones as in Italy in the early 1990s to more moderate ones as in Spain. Traditional welfare state approaches have convincingly pointed out the “distinctiveness” of the Southern European model of welfare and pensions; however they have been less successful in explaining the specific reform mechanisms and the variation in reform outcomes in this region. By combining concepts from the political economy and pension politics literature, I show that pension reform in this region follows a pattern that is less “distinctive” than what previous studies have acknowledged. Specifically, I focus on the concept of political replacement effect (i.e. the probability of a government being electorally punished for pursuing reform) and the changes in labour movement’s organizational structure to comparatively explain reforms in Spain and Italy since the 1990s. The comparative analysis of eight cases of reform (four in each country) shows that significant reforms are implemented in cases of low political replacement effect and/or when this is coupled with a labor movement that has undergone changes that have affected its organizational structure. On the contrary, in cases of high political replacement effect reform is harder to achieve, unless the labor movement has undergone significant organizational changes and it is therefore more willing to engage in negotiations with the government. The analysis shows that pension reform in Southern Europe follows a pattern that can be accounted by established concepts in the literature, yet combined in a specific way, and that is therefore less distinctive than what previous welfare state analyses have suggested.

Productivity is defined as the ratio of outputs to inputs. When applied to the public sector, productivity becomes a key performance indicator that shows how efficiently public resources are employed in providing public services. Until not too long ago productivity in the public sector was assumed to be flat as outputs were given the same price as the cost of producing them. Recent methodological approaches suggest to measure outputs directly in order to count with realistic productivity estimates. Empirical public sector productivity studies are still in its infancy. This paper proposes to contribute to this new field by analysing productivity changes in the area of tax collection. This is a key area in which, as of 2008, the central government spent over £3.3bn in administrative resources and which provided more than £450bn in revenue, involving the processing of more than 24 million different tax forms. We contend that key changes in public management approaches in the UK during the last twenty years may be related to the observed changes in tax collection productivity. Specifically, we posit that the transition from the so called New Public Management (NPM) approach to Digital Era Governance (DEG) one, which focuses on the re-centralisation of government agencies and the reliance on Information and Communication Technologies (ICT) to simplify administrative processes, must have had an impact on productivity. We test this assumption by analysing productivity trends during an eleven year period from 1997 to 2008. We find some support for our assumption, showing that the transition to DEG in the early 2000s led to a drop in productivity, which recovered its upward trend towards the mid 2000s. We also analyse how ICT and outsourcing expenditure contributed to productivity increases and we also explore how service quality levels have performed during the analysed period. We conclude by highlighting that recent productivity increases should be coupled with higher service quality levels in order to improve customer experience with this public service. Overall, this paper shows the potential to expand this analytical framework to other public services to expand our comparative knowledge of performance across the UK public sector.

A 58-year-old woman with relapsing acute Guillain-Barré syndrome separated by long asymptomatic intervals presented clinical symptoms resembling those of brain death. She remained in this situation for 15 days and recovered with amnesia for this period. The amnesia was not explained either by metabolic encephalopathy or by sedative drugs. This case stresses the importance of the precise etiologic diagnosis of severe brain disease and the isoelectric EEG in brain death.

Thalamic infarcts in paramedian artery territory are seen fairly frequently owing to certain peculiarities of the vascularization of the thalamus. However, clinical diagnosis is usually difficult because of the many varieties and peculiarities of the symptomatology.We present a review of twelve cases of bilateral paramedian infarcts of the thalamus seen in our Department of Neurology and in a private surgery. We analyze the symptoms and their relationship to the neuro-radiological findings. Finally we compare our observations with the descriptions published by other authors and seek and anatomo-functional relationship for each of the symptoms and signs observed.The usual clinical outline in our patients included disorders of consciousness, different types of oculomotor disorders and cerebellar symptoms, mainly of gait. Other less common findings were memory disorders and abnormal movements. In no case were there sensory changes and pyramidal signs were rare in the absence of significant extra-thalamic lesions.Our findings, although generally comparable to those described in the literature consulted, were somewhat different with regard to cerebellar symptoms and the absence of sensory and pyramidal signs. We also emphasize the marked differences seen between the individual patients in our series. A good knowledge of the possible clinical variants of these lesions is necessary for a correct initial diagnostic approach in the study of these patients.

Introduccion. La angiopatia amiloide inflamatoria (AAI) es una forma de presentacion infrecuente de la angiopatia amiloide cerebral recientemente reconocida y cuyo diagnostico definitivo es anatomopatologico. Objetivo. Se presenta un paciente con AAI con buena respuesta clinica, neuropsicologica y de neuroimagen al tratamiento con corticoides y en el que no se considero necesario practicar biopsia cerebral. Caso clinico. Varon de 68 anos con diagnostico de enfermedad de Alzheimer que sufrio una crisis convulsiva generalizada seguida de trastorno del lenguaje y hemiparesia derecha. La resonancia magnetica mostro una lesion de comportamiento infiltrante hemisferica izquierda y multiples microsangrados. La clinica y radiologia fueron sugestivas de AAI y se instauro tratamiento corticoideo. La neuroimagen y los tests neuropsicologicos mostraron una notable mejoria a los 30 dias del inicio del tratamiento inmunosupresor. El genotipo fue ApoE epsilon4/epsilon4. Se desestimo la realizacion de biopsia cerebral. Conclusiones. El caso descrito sugiere la posibilidad de, en casos individualizados con clinica y radiologia caracteristicas de AAI, instaurar tratamiento empirico con corticoides con diagnostico de probabilidad y realizar biopsia cerebral en caso de que no haya respuesta al tratamiento.

The scope of the suicide problem is briefly reviewed and the distinction between actuarial and clinical prediction is discussed. Three approaches to the process of clinical prediction are (1) use of multiple predictors; (2) use of objective rating scales, and (3) psychodynamic formulation of risk. These are discussed and specific suggestions are offered for incremental implementation in military medical facilities depending on availability of psychiatric resources. The major warning signs of suicidal behavior are outlined and recommendations offered for training of ward personnel.

OBJECTIVE: To evaluate the efficacy of high-dose intravenous gammaglobulin (IGIV) versus plasmapheresis in patients with severe Guillain-Barré syndrome (GBS) and compare the costs of both treatments. DESIGN: Retrospective review of all severely disabled GBS patients admitted between January 1 and December 31, 1990. SETTING: Neurologic unit of a tertiary-care center. PATIENTS: Six patients fulfilling the criteria for the diagnosis of GBS agreed upon by the ad hoc National Institute of Neurological and Communicative Disorders and Stroke committee. INTERVENTION: Four patients treated with plasmapheresis underwent three to six sessions of plasma exchange. Two patients received IGIV 0.4 g/kg/d administered over a five-day period. MAIN OUTCOME MEASURES: Recovery time, functional assessment (performed according to the grading scale used in the North American trial) at 30, 60, and 90 days after treatment. Cost of plasmapheresis, IGIV, and bed/day were compared. RESULTS: Clinical recovery appeared to be faster and more complete in the IGIV group than in the plasmapheresis group. No adverse reactions related to IGIV treatment appeared. The total cost was greater in the plasmapheresis group. CONCLUSIONS: These preliminary results suggest that IGIV may be more beneficial and less expensive than plasmapheresis in treatment of GBS. Definitive conclusions regarding the efficacy of IGIV in GBS will need to await the final analysis of the Ducht randomized multicenter trial comparing IGIV with plasmapheresis.

Previous research has suggested that insomnia is related positively to preoccupation with death. Introductory psychology students (N = 200) of both sexes who qualified as insomniacs were administered Implosive Therapy specifically targeted to fear of death, nonspecific Implosive Therapy, a relaxation procedure, or were assigned to a wait-control group. All three experimental treatments resulted in significant decreases in anxiety as measured by the Fear Survey Schedule II administered immediately after the experiment. The groups did not differ, however, before or after treatment on reported fear of death as measured by the Collett-Lester scale. On self-report measures collected 1 month after the experimental treatment, all groups, including the wait-control, showed a significant decrease in latency of sleep onset. Pairwise comparisons indicated that only the death implosion condition was significantly more effective than the wait-control. The finding was interpreted to mean that the death implosion produced a decrease in insomnia beyond the strong expectancy effects that resulted from all experimental treatments. The failure to observe changes in reported fear of death was attributed to Ss' anxiety-based reluctance to acknowledge openly such fear.

Administered the MMPI, Self Rating Depression Scale, and a survey of attitudes toward death to 20 males and 16 females designated as good sleepers and 24 males and 25 females designated as poor sleepers. Compared with good sleepers, poor sleepers scored in a more pathological direction on 11 of the 13 MMPI scales and on the Self Rating Depression Scale. Poor sleepers also reveal a significantly greater preoccupation with death although, paradoxically, they do not admit to fear of their own death. Results confirm previously reported personality differences between good and poor sleepers. No association was found between sex and quality of sleep.

Snake phobic Ss in groups of 10 were presented with a verbal fantasy similar to those used in individual Implosive Therapy (IT) in order to explore the adaptability of the procedure to group use. A single 25-minute implosive presentation of the same material on audio tape was effective in reducing snake phobias in about the same percentage of Ss as individual IT. It was concluded that IT can be adapted to group use, but that care should be taken to ensure an opportunity for extinction to occur through repeated presentation of the fantasy material.

The study was intended to test hypotheses concerning the differential responses of sensitizers (those subjects utilizing primarily approaching responses to anxiety) and repressers (those subjects utilizing primarily avoiding responses to anxiety) to authoritative evaluations of group performance. Four five-man groups of sensitizers and four groups of repressers were assigned to each of the following experimental conditions: failure, success and neutrality. These conditions were evaluations of group performances that had taken place in immediately preceding problem-solving, non-face-to-face activities. Before and after measures were obtained of subjects' judgments of their actual fastest and slowest times and their ideal fastest and slowest times. The major conclusion drawn from this experiment was that group factors may constitute a set of mitigating conditions that intervene between the presence of stimuli and their effects on the manifest productions of personality. Group factors were believed to have operated in our experiment in two ways: first, via the task of making judgments of group performance, and second, via the anxiety-reducing presence of similar others in a group context when confronted with social evaluation.

Personality-wise the two communities were known to be different and the main object of the analysis was to see what differences, if any, would be reflected in the test.2 Protocols were secured according to Machover's directions (except that male-female pairs and notes on performance could not consistently be obtained). Sampling was not attempted. Eskimo children worked in the presence of the anthropologist (JJH) in a small private room. Cree Indian children drew their pictures in the classroom of the Roman Catholic mission school under direction of a nun, who had been briefed without being told to record subjects' behavior. Most of the analysis was carried out by the psychologist (RNC), who knew little about the artists other than that they consisted of Canadian Indian and Eskimo children, their ages, and sex. Apart from the general assumption that the test would reflect personality differences, we entertained the hypothesis that the intelligence of the Attawapiskat children, as measured by applying Goodenough (1926) norms to the drawings, would be higher than that of the Eskimo. This could be explained as a function of the Indian community's more intense involvement in Canadian society. Resident priests, brothers, nuns, and a school in Attawapiskat, and the fact that many adults have spent one or two years in a Roman Catholic residential school, are indicative of the community's greater assimilation to Canadian culture. Few Eskimo have gone to school.3 In both communities English is seldom spoken, but adults are literate in their respective languages. It was expected that intelligence might be below American norms in both cases. This, we assumed, could be explained in the light of the relative marginality of