"Are you otherwise fit and well?": Past medical history questions in UK paediatric consultations

Accurate diagnosis and treatment depend upon detailed knowledge of both the child's presenting symptoms and their past medical history. However, the process of soliciting past medical history has never been subject to systematic scrutiny in actual clinical practice.

OBJECTIVE

To examine the function of the question "are you otherwise fit and well?" to elicit a child's general medical history in UK paediatric allergy outpatient consultations.

METHODS

Examination of 30 video-recorded UK paediatric outpatient consultations involving children (2-10 years), caregivers, and one doctor. We identified, transcribed, and interrogated 13 examples, deploying the systematic and rigorous method of conversation analysis to elucidate the question's micro-design elements and their consequences for the consultation's trajectory.

RESULTS

Asking "Are you otherwise fit and well?" is built to efficiently solicit a problem-free report of good health. Nonetheless patients can and do raise other relevant matters. In practice, the question initiates several interactional matters simultaneously: establishing/resolving (mis)understandings of "fitness" and "wellness"; negotiating opportunities for children's participation; and importantly, a shift towards discussing more general wellbeing.

CONCLUSION

Past medical history questions unavoidably generate broader interactional matters which are skilfully resolved in real-time between clinicians, caregivers, and children.

PRACTICE IMPLICATIONS

Clinical training could be greatly enhanced by integrating insights into the interactional consequences of asking questions, particularly in the complex multiparty environment of paediatrics. While the question 'Are you otherwise fit and well' clearly serves an important function, clinicians should be alert to the possible problems it might raise, especially when directed towards younger children.

Understanding mixed emotions in organized helping through emotionography

Introduction

Emotionography studies emotion: (a) as it occurs naturally in display, reception, attribution, and avowal; (b) within and across diverse stretches of interaction and varied institutional contexts; (c) grounded purposefully in the perspectives of the interactants as those perspectives are displayed in real-time through unfolding talk; (d) using materials that are recorded and transcribed in sufficient precision to capture the granularity consequential for the interactants. We overview contemporary research on "mixed emotion" highlighting theoretical and methodological issues and explore the potential of emotionography as a generative alternative.

Methods

The analysis will use contemporary conversation analysis and discursive psychology to illuminate the workings of organized helping using a collection of recordings from a child protection helpline all of which include laughter alongside crying.

Results

Analysis shows, on the one hand, how crying and upset display the caller's stance on the trouble being reported, and mark its action-relevant severity; on the other, how laughter manages ongoing parallel issues such as advice resistance. We show that the "mixture" is public and pragmatic, displaying different concerns and stances, and dealing with different issues; all is in the service of action.

Discussion

When analyzing the specifics of interaction, the concept of "mixed emotion" loses clarity, and it is more accurate to observe competing pragmatic endeavors being pursued in an intricately coordinated fashion. These practices would not be captured by conventional emotion measurement tools such as scales, vignettes, or retrospective interviews. Broader implications for theories of emotion and methods of emotion research are discussed.

Authority in therapeutic interaction: A conversation analytic study

A paradigmatic shift toward postmodern, collaborative practice in family therapy raises questions about how therapists can use professional authority to facilitate change and how clients can assert their knowledge and agency. We used conversation analysis to investigate how the authority to know and to determine here-and-now action (i.e., who does what, and how, in therapy) was negotiated and accomplished in 10 sessions of emotion-focused therapy involving chair work. Therapists were observed to rely on a particular interactional sequence structure: stepwise entry into a directive, in which directives were preceded by a question-answer sequence. We show how instances where clients' views were elicited prior to the delivery of a directive resulted in different interactional consequences from instances where therapists straightforwardly directed clients to perform some action. The study offers evidence concerning how therapists can facilitate chair work collaboratively and responsively.

How and why children instigate talk in pediatric allergy consultations: A conversation analytic account

Involving children in their healthcare encounter is a national and international priority. While existing research has examined the ways in which children are recruited to participate in the consultation, no work has examined whether and how children instigate talk, and the extent to which their contributions are successful. This paper presents a conversation analysis of a selection of 10 out of 30 video recordings in which children aged 4-10 years instigate talk during consultations they attend with their parents/carers at a UK pediatric clinic. The analysis reveals for the first time that children do successfully instigate talk without being asked or selected in 22 episodes during their consultation with the doctor. Children most frequently address their parent/carer (16/22). They capitalize on specific contexts within the consultation to instigate talk, for example: history-taking questions about what they ate or how they reacted (10/22); or discussions surrounding the child's feelings or sensations following the skin-prick testing (7/22) - aspects of experience to which they have access. Children's non-solicited talk necessarily occurs when they are not currently active participators and children engage in extra interactional work including various verbal strategies (summons and prosodic variations) and non-verbal resources (tapping and gaze) to break into the interaction. The benefits of their contributions include the opportunity to affirm the child's role as a legitimate contributor, and the potential for additional medically-relevant information to arise which could enrich the clinical process. Our analysis shows that the previously overlooked phenomenon of children instigating talk, although not common, can play a crucial role in the consultation. We suggest that strategies to increase such involvement have the potential to augment the healthcare process. Our findings offer a critical baseline for the introduction of new consultations models, such as digital appointments, which may exclude some children completely.

Shaming interrogatives: Admonishments, the social psychology of emotion, and discursive practices of behaviour modification in family mealtimes

This paper contributes to the study of admonishments, the operation of shaming in family interaction, and more broadly presses the virtue of a discursive psychological reconsideration of the social psychology of emotion. It examines the methodological basis of contemporary research on shame in experimental and qualitative social psychology, illustrated through the Test of Self-Conscious Affect (TOSCA) and qualitative work using shame narratives. Doubts are raised about how these methods can throw light on shaming practices in natural situations. The study uses a collection of video recordings of family mealtimes, focusing on admonishment sequences in which parents address the interrogatives 'what are you doing' or 'what did I say' to a 'misbehaving' child. Despite the interrogative syntax, rather than soliciting information we show that these interrogative forms pursue behaviour change by publicly highlighting both the problem behaviour and the child's active and intentional production of that behaviour. This is the sense in which the practice can be understood as shaming. Although this practice prosecutes shaming, ways in which the children can ignore, push back, or rework parents' actions are highlighted. This study contributes to a broader consideration of how enduring behavioural change can be approached as a parents' project.

How clients solicit medication changes in psychiatry

In psychiatry, practitioners are encouraged to adopt a patient-centred approach that emphasises shared decision-making. In this article, we investigate how clients with severe mental illnesses (e.g. schizophrenia) advocate for their treatment preferences in psychiatric consultations. The study uses Conversation Analysis to examine audio-recorded medication check appointments in a comprehensive treatment programme known as assertive community treatment (ACT). The analysis shows that clients solicit medication changes at activity boundaries and design them in one of the following ways: reporting a physical problem; reporting a medication problem; explicitly requesting a medication change; and demanding a change. These formats put pressure on the psychiatrist to respond by either offering a solution to the client's problem or by accepting or rejecting the client's request. Through a detailed analysis of clients' communicative behaviours, we show that, in soliciting a medication change, clients ordinarily respect boundaries of medical authority and present themselves as 'good' patients who are reliable witnesses of their own experiences. Overall, the paper advances our understanding of patient advocacy in psychiatry and mental health interactions more generally.

Derrida and Psychology

This paper assesses the role of deconstruction as an important orientation for critical and discursive psychologists. In order to understand what deconstruction involves, key aspects of Jacques Derrida's work are highlighted and explained, notably `undecidables' such as the trace, the supplement, differance. The ways in which undecidability can be incorporated into, and used to develop, critical and discursive work are explored. Previous attempts at incorporating deconstruction within critical psychology texts are examined, and it is suggested that the more radically anti-foundationalist features of a Derridean deconstruction are typically by-passed in this literature. It is argued that deconstruction in this broader sense offers political as well as critical possibilities. It is suggested that deconstruction provides a radical orientation to language and meaning, and a resource for showing us how identities and realities can be constituted in order to be recognizable as not constituted. It is concluded that deconstruction is important for the development of both critical and discursive psychology, allowing as it does a more profound reflection on both the supplementary character of psychological phenomena, and the processes of marginalization and exclusion which have put these subversive psychologies into play.

Getting Closer at a Distance

In general it is very hard to document clear applications of the content of psychological theory. While deconstruction reveals the binary organization and contingency of accounts of theory and application in psychology, nevertheless there is a desire to be useful to the organizations that we engage with as researchers. This dilemma is illustrated through a personal narrative of my involvement as a researcher with a UK charitable organization—the National Society for the Prevention of Cruelty to Children (NSPCC). As the research has developed it has become an attempt to explicate and make visible current practice on the NSPCC helpline. This move will be illustrated using the example of extreme emotion, and in particular callers' crying. In terms of utility the research emerges as an attempt to turn practices into strategies, where the kinds of embodied, untheorized, practices in which people engage in a highly occasioned and finessed way are explicated, allowing them to be turned into strategies, for example of good practice or communication breakdown. These traces will help to interrogate simple stories about theory and application.

On the Alleged Incompatibility between Relativism and Feminist Psychology

This paper addresses the claim that research which makes relativist epistemological assumptions is incompatible with the moral and political commitments of feminism. This claim is treated as resting on four related but distinct arguments, that relativist feminist researchers: (a) have no basis for choosing between different accounts; (b) have no way to encompass real, material, worldly phenomena; (c) are unable to express commitment to a political position or set of values; (d) are less persuasive to colleagues and to the wider community because of the contingent and self-referential nature of relativist claims. The principal aim of this paper is to highlight a range of limitations with these anti- relativist arguments and thereby support the case for a coherent relativist feminist psychology. The paper concludes with some indication of the virtues and strengths of such an approach.

Designing the Recipient

In this paper we consider a collection of conversational practices that arise when a professional is faced with extended resistance to their offered advice. Our data is comprised of telephone calls to a UK child protection helpline. The practices we identify occur repeatedly across our corpus of advice resistance sequences and involve (1) the repackaging of resisted advice in more idiomatic form; (2) the combination of that advice with a tag question that treats the client as able to confirm the reformulated version despite their prior resistance to it; and (3) the dampening of the response requirement by continuing past the tag question, which would normally constitute a transition place for the advice recipient. We also discuss the tension between the contrasting projects of callers and call takers, which can lead to both delivery of advice and the resistance of that advice. In doing this we highlight the way in which advice may function as an element of broader institutional practices. In specifying these practices we draw upon analytic tools employed by conversation analysts, including various features of sequence organization (Schegloff 2007) and turn design (Sacks, Schegloff, and Jefferson 1974). The analysis is intended to contribute to three main areas of research: to the applied topic of managing advice resistance, to the growing literature on understanding institutional practices, and to broader concerns in conversation analytic and discursive psychological literature. These concerns include the status of the “psychological” in interaction and the specification of actions across turns and sequences of talk.

Threats: power, family mealtimes, and social influence

One of the most basic topics in social psychology is the way one agent influences the behaviour of another. This paper will focus on threats, which are an intensified form of attempted behavioural influence. Despite the centrality to the project of social psychology, little attention has been paid to threats. This paper will start to rectify this oversight. It reviews early examples of the way social psychology handles threats and highlights key limitations and presuppositions about the nature and role of threats. By contrast, we subject them to a programme of empirical research. Data comprise video records of a collection of family mealtimes that include preschool children. Threats are recurrent in this material. A preliminary conceptualization of features of candidate threats from this corpus will be used as an analytic start point. A series of examples are used to explicate basic features and dimensions that build the action of threatening. The basic structure of the threats uses a conditional logic: if the recipient continues problem action/does not initiate required action then negative consequences will be produced by the speaker. Further analysis clarifies how threats differ from warnings and admonishments. Sequential analysis suggests threats set up basic response options of compliance or defiance. However, recipients of threats can evade these options by, for example, reworking the unpleasant upshot specified in the threat, or producing barely minimal compliance. The implications for broader social psychological concerns are explored in a discussion of power, resistance, and asymmetry; the paper ends by reconsidering the way social influence can be studied in social psychology.

Advice-implicative Interrogatives

Interactional research on advice giving has described advice as normative and asymmetric. In this paper we examine how these dimensions of advice are softened by counselors on a helpline for children and young people through the use of questions. Through what we term “advice-implicative interrogatives,” counselors ask clients about the relevance or applicability of a possible future course of action. The allusion to this possible action by the counselor identifies it as normatively relevant, and displays the counselor’s epistemic authority in relation to dealing with a client’s problems. However, the interrogative format mitigates the normative and asymmetric dimensions typical of advice sequences by orienting to the client’s epistemic authority in relation to their own lives, and delivering advice in a way that is contingent upon the client’s accounts of their experiences, capacities, and understandings. The demonstration of the use of questions in advice sequences offers an interactional specification of the “client-centered” support that is characteristic of prevailing counseling practice. More specifically, it shows how the values of empowerment and child-centered practice, which underpin services such as Kids Helpline, are embodied in specific interactional devices. Detailed descriptions of this interactional practice offer fresh insights into the use of interrogatives in counseling contexts, and provide practitioners with new ways of thinking about, and discussing, their current practices.

Discursive psychology as a qualitative approach for analysing interaction in medical settings

PURPOSE

To introduce some features of the perspective of discursive psychology that may be useful for studying interaction in a range of medical settings.

OVERVIEW

Discursive psychology considers the way psychological words and displays play a practical part in the activities that are performed in particular settings. It offers a way of understanding the role of psychological issues that is distinct from, and is sometimes obscured by, traditional social cognitive approaches. The approach is illustrated by the example of crying on a child protection helpline. The way crying is built from different elements, the way these elements are organised, and the way they are receipted are all highlighted. Crying is both performing and potentially disrupting actions. The virtues of high quality transcription, and of understanding the way crying is situated in the turn organisations of conversation, are demonstrated.

EVALUATION

Discursive psychology involves particular ways of considering reliability and validity. The broader potential for such an approach in medical settings is discussed.

Translocation of amino acids in the xylem of apple (Malus domestica Borkh.) trees in spring as a consequence of both N remobilization and root uptake

Nitrogen is remobilized from storage for the growth of Malus domestica leaves each spring. Seasonal patterns of N translocation in the xylem sap as a consequence of remobilization were determined in 2-year-old 'Golden delicious' trees grafted on M9 rootstocks. The trees were grown in sand culture and (15)NH(4)(15)NO(3) at 10.4 atom% abundance supplied during August-September. The following year no further N was supplied and destructive harvests were taken during bud burst and leaf growth to determine the patterns of N remobilization together with the isolation of xylem sap for an analysis of their amino acid profiles and (15)N enrichments by GC-MS. The concentration of amino acids in the xylem sap rose following bud burst, peaked at full bloom and then fell again during petal fall and fruit set. The peak in amino acid concentration corresponded with the period when the rate of N remobilization was the fastest. The majority of labelled N was recovered in Asn, Gln + Glu and Asp demonstrating that they were being translocated as a consequence of remobilization. In a second experiment, 8-year-old trees growing in an orchard were fertilized with N either in the autumn or spring. Xylem sap samples were collected in the spring and early summer and, by comparison with the amino acid profiles recovered in trees from both treatments, Asn was identified as the main compound translocated as a consequence of both remobilization and root uptake of N, although there was evidence that root uptake of N occurred later. The data are discussed in relation to quantifying the internal cycling of N in trees.

Eosinophilic cholecystitis as a possible late manifestation of the eosinophilia-myalgia syndrome

We describe a case of acute acalculous cholecystitis occurring in a 43-year-old woman with a history of the eosinophilia-myalgia syndrome, associated with the ingestion of 1-tryptophan. The patient underwent a laparoscopic cholecystectomy and subsequent histological examination of the gallbladder revealed an infiltrate predominantly of eosinophils, suggesting a possible relationship to the underlying condition. This may represent a late complication of the eosinophilia-myalgia syndrome--such an association has not previously been reported in the literature. The gastrointestinal and hepatic complications of this syndrome are discussed.

Power lines: Derrida, discursive psychology and the management of accusations of teacher bullying

This study connects broad issues of classroom control and the disciplining of pupils by teachers with a detailed examination of the way teachers deal with an implied accusation that they have been bullying. The analysis of interviews develops with reference to discursive psychology and Derrida's development of deconstruction. Billig's (1992) insights into ways that participants' accounts can neutralize threats to established social arrangements are employed in relating detailed analytic points to the broader power relations between teacher and pupil. Interviews were conducted with Scottish secondary school teachers, and subjected to close textual analysis. This resulted in the development of three themes: (1) Subjectivity Construction, in which the functional role of the construction of mental entities is examined; (2) Normalizing Techniques, identifying strategies whereby intimidation can be constructed as normal; and (3) Figuration, examining the utility of figurative language--metaphors, maxims, and so on. These themes display the subtlety and complexity of teachers' strategies for distancing themselves from being held accountable for reported intimidation. To conclude, three broader features of the study are discussed: the contribution to discursive psychology that Derrida's deconstructive philosophy can make; the respecification of psychology and subjectivity as participants' resources for action; and the contribution that this type of detailed study can make to issues of power and social critique.

Clinical experience with an inactivated hepatitis A vaccine

Clinical trials of an inactivated hepatitis A vaccine have encompassed 104 studies completed by December 1993 in 27 countries. Studies involved 50,677 subjects and administration of > 120,000 vaccine doses. Results show that the vaccine is safe, clinically well-tolerated, and highly immunogenic in all age groups. A seroconversion rate of 100% is achieved 1 month after primary vaccination. Vaccine-induced antibody titers persist after a primary vaccination course for > or = 1 year with a single dose of 1440 ELISA units (EL.U.) in adults and after two doses of 360 EL.U. in children. A booster dose 6-12 months after the first vaccine dose induces very high antibody titers, which according to a mathematical model, are expected to protect against hepatitis A for > 20 years. The vaccine is equally immunogenic when administered simultaneously with other traveler vaccines, therefore enabling flexible and convenient vaccination against hepatitis A.

A simple procedure for the expression of genes in transgenic soybean callus tissue

Cotyledons from germinating seeds of the soybean cultivar Peking were inoculated with virulent Agrobacterium tumefaciens strain A281:pZA-7 which carries a wild type Ti plasmid pTiBo542 and a disarmed Ti plasmid (a binary vector)pZA-7 which contains the βglucuronidase (uidA) and neomycin phosphotransferase (nptII) genes. Tumors were produced on all inoculated explants and 82% of these tumor lines were cotransformed by the nptII gene from the binary vector pZA-7 as shown by PCR analysis (18 of 22 lines tested). Eleven of these 18 lines were also resistant to kanamycin. Eleven lines expressed β-glucuronidase activity (GUS), six of which were also kanamycin resistant. Since there is a high rate of coexpression of genes carried by the binary vector, this system provides a simple and rapid method for the expression of genes of interest in transformed soybean tissue which has been used successfully to test constructs designed for soybean transformation.

The role of inositol lipids in the activation of monocytes by interleukin-1 and bacterial endotoxin

The effect of interleukin-1 (IL-1) and bacterial endotoxin (lipopolysaccharide, LPS) on the activation of phosphoinositidase C (PIC) and on prostaglandin E2 release was studied in monocytes (M phi). Both IL-1 alpha and IL-1 beta increased the release of PGE2 in a concentration-dependent manner, with EC50s of 0.48 nM and 0.12 nM, respectively. Intact M phi were prelabelled with [3H]inositol and the formation of inositol phosphates (IPs) was estimated by ion exchange chromatography. PIC activity was estimated directly by measuring the conversion of [3H]phosphatidylinositol-4,5-bisphosphate to aqueous soluble radioactivity by M phi homogenates. IL-1 alpha (5.8 nM) increased the accumulation of IPs within 1-4 minutes and increases in IP3 and IP4 occurred before the increase in IP1+2 whereas LPS only increased the IPs level after at least 30 min. IL-1 alpha increased PIC activity in M phi homogenates within 15 min with an EC50 of 0.58 nM and IL-1 beta (0.1 nM) also increased activity. Neither IL-1 alpha nor IL-1 beta affected the PIC activity of membrane or cytosolic fractions. LPS decreased activity in all fractions. These data indicate that IL-1, but not LPS, can directly lead to an increased activity of PIC which may be involved in eicosanoid formation in M phi.

Factors affecting transient gene expression in electroporated Glycine max protoplasts

Electroporation was used to evaluate parameters affecting transient gene expression in Glycine max protoplasts. Protoplast viability and reporter enzyme activity for chloramphenicol acetyl transferase (CAT) and ß-glucuronidase (GUS) depended on the field strength employed. Maximum CAT and GUS activity was obtained when a field strength of 500 V/cm at 1000 μF and a protoplast concentration of 1-3 × 10(6)/ml was used. Transformation efficiencies up to approximately 1.6% GUS positive protoplasts were obtained. Transient gene expression increased with increasing plasmid DNA concentration and with the time after electroporation, reaching a maximum after 48 hr. Addition of polyethylene glycol at 5.6% and heat shock (5 rain at 45 °C) given to the protoplasts before adding DNA further enhanced the transformation efficiency. Under the optimized experimental conditions, CAT and GUS activity increased simultaneously, thereby indicating that the increased expression is caused by DNA uptake by more cells rather than greater DNA uptake by the same cells. Our results demonstrate that both GUS and CAT can be used as efficient screenable markers for transformation studies in soybean.

Diadenosine 5',5'''-P1,P4-tetraphosphate (AP4A) levels under various proliferative and cytotoxic conditions in several mammalian cell types

Diadenosine 5',5'''-P1,P4-tetraphosphate (Ap4A) has been proposed as an intracellular signal for growth. In order to test this hypothesis Ap4A levels were followed in several cell types under various conditions. Quiescent dog thyroid cells in a primary culture were induced to proliferate by addition of a mixture of epidermal growth factor, thyrotropin and foetal calf serum; V79 cells were synchronized by serum depletion then stimulated to proliferate by addition of foetal calf serum. Protein and DNA synthesis increased in both cases, although no significant changes in Ap4A levels per cell could be demonstrated. HeLa D98/AH2 and L929 cells were treated with human recombinant tumour necrosis factor alpha which caused marked cell death. This was measured by a decrease in DNA content and a release into extracellular medium of incorporated radioactive precursor. No concomitant variations in Ap4A concentrations could be observed under these conditions. The data from these various systems do not support the hypothesis that changes in Ap4A levels regulate cellular proliferation.

Tumor necrosis factor-alpha induces the phosphorylation of 28kDa stress proteins in endothelial cells: possible role in protection against cytotoxicity?

Tumor necrosis factor-alpha has been shown to rapidly increase the phosphorylation of three 28 kDa proteins in bovine aortic endothelial cells but not in L929 cells. Tumor necrosis factor-alpha induces the necrosis of the latter cells but not of the former. Arsenite enhanced the phosphorylation of the same 28kDa proteins as tumor necrosis factor-alpha in the endothelial cells. As stress proteins often play a protective role, we suggest that the phosphorylation of these proteins in endothelial cells may be responsible for the resistance of these cells to tumor necrosis factor-alpha.

Endocytic pathway of recombinant murine tumor necrosis factor in L-929 cells

The fate of TNF after binding to the surface of L-929 cells was followed by using murine rTNF coupled to colloidal gold as a probe. A time-course study using electron microscopy was performed. Our results confirm previous indications obtained from biochemical studies suggesting that TNF is internalized by this cell type. They further directly show that internalization proceeds through the classical receptor-mediated endocytosis pathway, i.e., via clathrin-coated structures and endosomes before accumulation in secondary lysosomes.

Endocytic pathway of recombinant murine tumor necrosis factor in L-929 cells

The fate of TNF after binding to the surface of L-929 cells was followed by using murine rTNF coupled to colloidal gold as a probe. A time-course study using electron microscopy was performed. Our results confirm previous indications obtained from biochemical studies suggesting that TNF is internalized by this cell type. They further directly show that internalization proceeds through the classical receptor-mediated endocytosis pathway, i.e., via clathrin-coated structures and endosomes before accumulation in secondary lysosomes.

Effect of adenosine 3',5' monophosphate on the mutation frequency induced by N-methyl-N'-nitro-N-nitrosoguanidine

The effect of increased cellular concentrations of adenosine 3',5' monophosphate (cAMP) upon mutation frequency induced by N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) was studied in V79 Chinese hamster lung cells. Incubation with either forskolin, which increased the accumulation of cAMP, or 8BrcAMP, an analogue of cAMP, resulted in an increase in the mutation frequency which was concentration-dependent, regardless of whether these agents were added before or after mutagen treatment. Increased cAMP concentrations were shown in these cells to inhibit growth; however, this does not seem to be the mechanism responsible for the increase in mutation frequency as low serum concentrations which also retard growth reduced the mutation frequency observed with MNNG.

Rapid phosphorylation of a 27 kDa protein induced by tumor necrosis factor

Tumor necrosis factor (TNF) has been shown to induce the phosphorylation of a 27 kDa protein in a time- and concentration-dependent manner in HeLa D98/AH2, ME 180 and bovine aortic endothelial cells. This phosphorylation could be reproduced by the calcium ionophore, A23187. However, this phosphorylation was not observed in L929 cells, for which TNF is highly cytotoxic, suggesting that it might play a role in actions of TNF other than the induction of cell death.

Modulation of tumor necrosis factor-alpha cytotoxicity in L929 cells by bacterial toxins, hydrocortisone and inhibitors of arachidonic acid metabolism

L929 cells were incubated with tumor necrosis factor-alpha (TNF-alpha) in the presence or absence of various inhibitors of arachidonic acid metabolism. The addition of either hydrocortisone or nordihydroguaiaretic acid (NDGA) decreased the cytotoxic effect of TNF-alpha but exogenously added arachidonate or linoleate, indomethacin and eicosatetraynoic acid (ETYA) were without effect. While it was found that TNF-alpha stimulated arachidonic acid release, no metabolites of this fatty acid could be evidenced. Cytotoxicity of TNF-alpha could also be decreased by the addition of either cholera or pertussis toxin. These results suggest that a GTP-binding protein is involved in the cytotoxic action of TNF-alpha. Arachidonic acid, released possibly by a phospholipase A2, might also play a role, but probably not via its conversion to known metabolites.

Action of TSH on nuclear ADP-ribosylation in dog thyroid slices

Treatment of dog thyroid slices with thyrotropin (TSH) results in an increase in ADP-ribosylation in nuclei isolated thereafter. This increase is time-dependent and is observed with concentrations of TSH eliciting physiological responses. The technique described here does not involve permeabilization of cell membranes, thereby avoiding artefacts which could arise from hypotonic shock. Cyclic AMP mimicked the stimulatory action of TSH.

Verbal and nonverbal aspects of mothers' directives

Maternal directives to children aged 10 and 18 months were analysed with respect to both verbal and concomitant nonverbal aspects. The findings emphasize the multimodal nature of mothers' communicative messages and draw attention to the way in which language occurs in an action context and not as an isolated output. No indication was found for this age range that verbal devices come to replace nonverbal ones. At both ages most utterances were accompanied by some form of nonverbal behaviour; the precise nature of the association, however, gives little support to the idea of parallel coding. The child's own behaviour is also shown to form part of the context in which maternal speech takes place.

Evidence for the existence of actomyosin ATPase in the rat pancreas. Isolation and biochemical characterization

In a crude extract of rat pancreas, myosin was associated with a protein having the same electrophoretic mobility as actin. This myosin was purified after dissociation of the actomyosin complex with KI-ATP. On sodium dodecylsulfate/acrylamide gel electrophoresis, the isolated pancreatic myosin showed a major component of approximately 200 kDa, and two smaller components with apparent molecular weight of 22 and 15 kDa, respectively. This purified myosin exhibited high ATPase activity in the presence of K+ + EDTA or Ca2+ and very little activity in the presence of Mg2+. (K+ + EDTA)-ATPase activity showed one pH optimum at 8.0, while Ca2+-ATPase activity showed two pH optima at 6.0 and 9.0, respectively. (K+ + EDTA)-stimulated enzyme activity was specific for ATP whereas Ca2+-stimulated activity showed low specificity for nucleoside triphosphates.