Association between body mass index, bone bending strength, and BMD in young sedentary women

The rationale was to determine whether body mass index (BMI) is a predictor of bone bending strength and bone mineral density (BMD) in young sedentary women. Results show that BMI is not a predictor of bone bending strength and that young women with low BMI also have low BMD.

INTRODUCTION

The purpose of this study was to determine whether body mass index (BMI) is a predictor of tibial or ulnar bending strength and bone mineral density (BMD) in sedentary women.

METHODS

Sedentary women (n = 34), age 19-27 years, with low BMI (LBMI < 18.5 kg/m², n = 16), and normal or high BMI (NHBMI between 18.5 and 29.9 kg/m², n = 18) participated as study subjects. Study outcomes included tibial and ulnar bending strength (EI in Nm²) using a non-invasive mechanical response tissue analyzer (MRTA); BMD and bone mineral content (BMC) of the whole body (WB), femoral neck (FN), total hip (TH), lumbar spine 1-4 (LS1-4), and ulna; and bone turnover biomarkers.

RESULTS

The LBMI group have lower (p < 0.01) body weight [group difference (Δ) = 32.0%], lean mass (LM) (Δ = 23.1%), fat mass (FM) (Δ = 77.2%), and tibial bending strength (Δ = 22.0%), compared to the NHBMI. The LBMI group also have lower (all p < 0.025) BMC in WB (Δ = 19.9%), FN (Δ = 20.1%) and TH (Δ = 19.0%), compared to the NHMBI, not in BMD results. Multivariate regression analysis shows that significant predictors of tibial bending strength are tibia length (adjusted R² = .341), age (adjusted R² = .489), ulna BMD (adjusted R² = .536), and LM (adjusted R² = .580). BMI was positively correlated with tibial EI (p < 0.05), height, weight, FM, LM, body fat% (all p < 0.01), and BMD of WB, FN, TH, and LS 1-4 (p < 0.05 or < 0.01).

CONCLUSIONS

Our results show that BMI is not a significant predictor of tibial or ulnar bending strength in young sedentary women.

The Impact of Stigma, Autism Label and Wording on the Perceived Desirability of the Online Dating Profiles of Men on the Autism Spectrum

Those seeking romantic relations are increasingly using online dating sites, including young men on the autism spectrum. This study presented dating profiles with and without an explicit label of autism and positive or negative wording to 306 'females seeking a male partner'. Participants assessed the men's dating profiles in terms of perceived attractiveness, trustworthiness and desire-to-date. They also completed a questionnaire on their level of stigmatisation of, and familiarity with, autism. An explicit autism label and positive wording positively impacted perceived attractiveness. With positively worded profiles, those with highly stigmatising views reported decreased desire-to-date when an explicit label of autism was present; those with low levels of stigmatising reported increased desire-to-date when an explicit autism label was present.

Telemedicine strategy of the European Reference Network ITHACA for the diagnosis and management of patients with rare developmental disorders

BACKGROUND

The European Reference Networks, ERNs, are virtual networks for healthcare providers across Europe to collaborate and share expertise on complex or rare diseases and conditions. As part of the ERNs, the Clinical Patient Management System, CPMS, a secure digital platform, was developed to allow and facilitate web-based, clinical consultations between submitting clinicians and relevant international experts. The European Reference Network on Intellectual Disability, TeleHealth and Congenital Anomalies, ERN ITHACA, was formed to harness the clinical and diagnostic expertise in the sector of rare, multiple anomaly and/or intellectual disability syndromes, chromosome disorders and undiagnosed syndromic disorders. We present the first year results of CPMS use by ERN ITHACA as an example of a telemedicine strategy for the diagnosis and management of patients with rare developmental disorders.

RESULTS

ERN ITHACA ranked third in telemedicine activity amongst 24 European networks after 12 months of using the CPMS. Information about 28 very rare cases from 13 different centres across 7 countries was shared on the platform, with diagnostic or other management queries. Early interaction with patient support groups identified data protection as of primary importance in adopting digital platforms for patient diagnosis and care. The first launch of the CPMS was built to accommodate the needs of all ERNs. The ERN ITHACA telemedicine process highlighted a need to customise the CPMS with network-specific requirements. The results of this effort should enhance the CPMS utility for telemedicine services and ERN-specific care outcomes.

CONCLUSIONS

We present the results of a long and fruitful process of interaction between the ERN ITHACA network lead team and EU officials, software developers and members of 38 EU clinical genetics centres to organise and coordinate direct e-healthcare through a secure, digital platform. The variability of the queries in just the first 28 cases submitted to the ERN ITHACA CPMS is a fair representation of the complexity and rarity of the patients referred, but also proof of the sophisticated and variable service that could be provided through a structured telemedicine approach for patients and families with rare developmental disorders. Web-based approaches are likely to result in increased accessibility to clinical genomic services.

Patient, parent and professional perception of the use of maintenance enteral nutrition in Paediatric Crohn's Disease

AIM

Maintenance enteral nutrition (MEN) is routinely used in Paediatric Crohn's Disease (CD) to prolong remission although there is limited evidence for efficacy and a lack of formal guidelines. This study surveyed patients', parents' and professional experience with MEN.

METHODS

Two questionnaires were developed to survey the experience of MEN; (i) Patients/Parents (children >10 years of age aimed to complete independently) and (ii) Dietitians. Questionnaires were sent to families prescribed MEN after exclusive enteral nutrition (EEN) between 2015-17 (n = 77) and dietitians working in paediatric regional centres in UK (n = 23).

RESULTS

Response rate to the questionnaires was 53% patients, 62% parents and 83% dietitians. Patients/parents reported medical/dietetic advice to be the primary factor affecting compliance, 30% patients reported side effects. Fifty-six per cent of patients/58% parents stated a preference for dietary advice rather than MEN. Dietetic responses indicated 79% used MEN after EEN as standard procedure and 79% did not have exit criteria for MEN. Sixty-eight per cent perceived the taste was the primary factor affecting patient compliance.

CONCLUSION

Patients' perception of the usefulness of MEN differs to professionals. This study highlights the extensive practice of MEN after EEN in clinical remission, which may not be nutritionally indicated. Patient preference is for dietary advice rather than MEN.

Nutritional support in paediatric Crohn's disease: outcome at 12 months

AIM

Paediatric Crohn's disease (CD) is associated with growth delay and poor nutritional status. Maintenance enteral nutrition (MEN) supplementation is a potential adjunct to improve growth/prolong remission.

METHODS

Newly diagnosed CD patients were identified. Anthropometry, treatments and outcomes were collected for 12 months following diagnosis. Data are presented as medians.

RESULTS

A total of 102 patients were identified (age = 13 years, 76% male), 58 (57%) completed exclusive enteral nutrition (EEN) as induction therapy, and 77 (75%) entered clinical remission. Following induction, 58 (57%) of all patients continued MEN and 44 (43%) consumed normal diet (ND). BMI Z-score increased (diagnosis-12 months) for EEN (-1.41 to -0.21 (p = <0.0001)) and steroid groups (-0.97 to -0.11 (p = 0.001)). BMI Z-score increased (post induction - 12 months) for MEN (-0.62 to -0.44 (p = 0.04)) but not ND (-0.33 to -0.4 (p = 0.79)). Height Z-score did not increase for any treatment group over 12 months. MEN and ND group relapse rates were similar at six months, MEN = 21/58 (36%); ND = 21/44 (48%) (p = 0.24) and 12 months, MEN = 24/58 (41%); ND = 13/44 (30%) (p = 0.22). Fewer patients treated with EEN then MEN relapsed less than six months, 14 of 43 (33%), compared to patients treated with steroids then ND 16/29 (55%) (p = 0.09).

CONCLUSION

BMI Z-score increased but height Z-score remained unchanged over 12 months for the MEN group. Use of MEN was not associated with prolonged time to relapse. Prospective studies are required to examine the utility of MEN.

A fluorescent analogue of tauroursodeoxycholic acid reduces ER stress and is cytoprotective

Tauroursodeoxycholic acid (TUDCA) is a cytoprotective ER stress inhibitor and chemical chaperone. It has therapeutic potential in a wide array of diseases but a specific macromolecular target or molecular mechanism of action remains obscure. This Letter describes an effective new synthetic approach to taurine conjugation of bile acids which we used to prepare 3α-dansyl TUDCA (4) as a probe for TUDCA actions. As a model of ER stress we used the hepatocarcinoma cell line HUH7 and stimulation with either deoxycholic acid (DCA, 200μM) or tunicamycin (5μg/ml) and measured levels of Bip/GRP78, ATF4, CHOP and XBP1s/XBP1u. Compound 4 was more effective than UDCA at inhibiting ER stress markers and had similar effects to TUDCA. In a model of cholestasis using the cytotoxic DCA to induce apoptosis, pretreatment with 4 prevented cell death similarly to TUDCA whereas the unconjugated clinically used UDCA had no effect. 3α-Dansyl TUDCA (4) appears to be a suitable reporter for TUDCA effects on ER stress and related cytoprotective activity.

The prevalence of diabetes, pre-diabetes and the metabolic syndrome in an Irish regional homeless population

BACKGROUND

Diabetes is a major chronic health condition. Prevalence is rising, superseding public health estimates. Chronic diseases are more common among lower socioeconomic groups, for example, the homeless population. There is paucity of data on the health status of the homeless population in Ireland, and the prevalence of diabetes and associated cardiovascular risk factors is unknown.

AIM

We aimed to assess the prevalence of diabetes, pre-diabetes and the metabolic syndrome (MetS) in an Irish regional homeless population.

DESIGN

This study is a cross-sectional study of the homeless population living in a regional university city of Ireland.

METHODS

After informed consent and following an overnight fast, blood was drawn for fasting plasma glucose, total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein and glycosylated haemoglobin (HbA1c). A 75 g glucose load was given orally and an oral glucose tolerance test completed. Anthropometric measurements and blood pressure were recorded. Smoking, alcohol and drug status were noted.

RESULTS

Of the 252 participants, 8% (n = 20), 10% (n = 24) and 21% (n = 54) were diagnosed with type 2 diabetes, pre-diabetes and MetS, respectively. Obesity (body mass index >30) was present in 22%, while 90% displayed abdominal obesity. Participants who screened positive for diabetes, pre-diabetes and MetS demonstrated an inferior cardiovascular risk profile.

CONCLUSION

The prevalence of diabetes, pre-diabetes and MetS in this homeless population is in keeping with national estimates. As this cohort is less likely to seek health care, this may result in later diagnosis and a greater risk of diabetic complications at presentation.

A nitrophenyl-based prodrug type for colorectal targeting of prednisolone, budesonide and celecoxib

Celecoxib is a COX-2 inhibitor drug that can be used to reduce the risk of colorectal adenocarcinoma. Glucocorticoids are used in the treatment of inflammatory bowel disease. A limitation to the use of both drug types is that they undergo absorption from the intestinal tract with serious side effects. The prodrug systems introduced here involve forming a nitro-substituted acylsulfonamide group in the case of celecoxib and a nitro-substituted 21-ester for the glucocorticoids. Drug release is triggered by the nitro reductase action of the colonic microflora, liberating a cyclization competent species. The release of the active parent drugs was evaluated in vitro using Clostridium perfringens and epithelial transport through Caco-2 monolayer evaluation was carried out to estimate the absorption properties of the prodrugs compared to the parental drugs.

An investigation of the motivations driving the online representation of self-injury: a thematic analysis

The objetive of the study was to identify a) the motivations for communicating about non-suicidal self-injury (NSSI) in a publicly accessible online forum, b) The significance (if any) of the "publicness" of the behavior. Using a Thematic Analysis of 423 text-based posts from an online NSSI forum, 5 motivations for using the site were identified: confessional, marking a turning point, acting as a deterrent, dispelling myths and offering or seeking support. Motivations for using the site differ markedly from motivations for engaging in NSSI and tend to be more outwardly focused. The publicness of the site therefore seems to be significant in terms of bearing witness, providing the opportunity to confront negative stereotypes, and the ability to seek and offer support to like-minded individuals.

Traveller health: prevalence of diabetes, pre diabetes and the metabolic syndrome

Irish Travellers are an ethnic minority group exposed to a myriad of social and health inequalities. Their current life expectancy equals that of the background population in the 1940s and one of the main causes of death is cardiovascular disease (CVD). There is a paucity of information on CVD risk factor assessment in the research literature in this population. This study assesses the prevalence of Diabetes, Pre-Diabetes and the Metabolic Syndrome (MetS) in a sample population from this community. Working with the Galway Traveller Movement, and following an overnight fast we measured fasting plasma glucose, HDL-cholesterol and Triglycerides. In addition weight, height, waist circumference (WC) and blood pressure (BP) were recorded. Of the 47 subjects, there were 4 (8.5%) participants identified as having diabetes, 5 (10.6%) pre-diabetes and 25 (53.2%) with the metabolic syndrome. The point prevalence of diabetes was calculated as 8.5%, pre-diabetes 10.6% and the metabolic syndrome 53.2%. In addition abdominal obesity was present in 70% and hypertension in 43%. Targeted screening for glucose abnormalities and traditional CVD risk factors is needed. Based on current literature, appropriate interventions might reasonably be expected to lower mortality and increase life expectancy.

A comparative analysis of the attitudes of doctors and patients towards adherence behaviour and information provision

Abstract #6150

Background: Research into adherence to breast cancer therapies has primarily focused upon quantifying adherence rates of patients with an absence of research into the factors affecting adherence behaviour, however, the practitioner-patient relationship is the medium within which the importance of adherence may be discussed and extra support provided. This study is the first to directly compare the attitudes of clinicians and patients towards adherence and information provision using Fishbein's validated model of attitude measurement. Methods: Separate studies completed in 2008 measured attitudes towards adherence and patient information for Australian breast cancer specialists (n=41) and breast cancer patients enrolled in Verve, the Arimidex patient support programme (n=125). These studies were approved by the Southern Cross University Human Research Ethics Committee and survey response rates of 58% for patients and 68% for specialists were achieved. Independent sample t-tests were used to measure differences between clinicians and patients importance and belief strength ratings on the composite variables of disease, product information, lifestyle information, support materials and adherence behaviour. Differences between low and high-risk patient groups were a particular focus of data analysis. Results: Specialists significantly underestimated the importance low and high-risk patients place on many aspects of adherence and patient information. Specialists believe low-risk patients are less likely than high-risk patients to adhere to treatment and understand their condition, product information or lifestyle factors. This view is not supported by the patient data which showed there was no significant difference between patient risk categories in terms of the importance patients placed upon adherence behaviour and the provision of information. Conclusions: There are significant discrepancies between the importance Australian breast cancer specialists and breast cancer patients place on some aspects of their disease management. Specialists attitudes towards high-risk patients are more aligned than they are for low-risk patients. Conversely, these data show that a patientÂs breast cancer risk category does not correlate with the importance that patients place upon adherence behaviour and the provision of information. These data suggest that the provision of information should be extended equally to all early breast cancer patients regardless of their risk of recurrence.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6150.

Differential electron emission for single and multiple ionization of argon by 500 eV positrons

Triply differential electron emission cross sections are measured for single ionization of argon by 500 eV positrons. Data are presented for coincidences between projectiles scattered into angles of 3 degrees and electrons with emission energies less than 10 eV that are observed between 45 and 135 degrees along the beam direction. For interpretation, these are compared to cosine squared representations of the binary and recoil lobes which are convoluted over experimental parameters. Singly differential electron emission data for double and triple ionization by positrons are also presented.

Energy intakes of children with Crohn's disease treated with enteral nutrition as primary therapy

BACKGROUND

Enteral nutrition (EN) is widely used and is effective in the treatment of children with Crohn's disease given as an exclusive feed for 6-8 weeks. Current dietetic practice during EN is to recommend an energy intake based on estimated average requirement (EAR) for energy for age.

AIMS

To examine factors affecting energy intake and weight gain during EN in relation to disease site and nutritional status.

METHODS

A retrospective cohort study examining energy intake and weight gain during the exclusive EN feeding period in 40 patients newly diagnosed with Crohn's in relation to EAR, nutritional status, disease site.

RESULTS

All patients improved clinically and gained weight during EN with improvement in the CRP as a marker of the systemic inflammatory response. Energy intake was higher than EAR in 82% (33/40 patients), with the median 117.5% of EAR. Weight gain correlated with body mass index standard deviation score (P = 0.001) at start of treatment, but not energy intake or CRP.

CONCLUSION

Estimated average requirement underestimates energy intakes in most children with newly diagnosed Crohn's disease. During EN, an energy intake in the range of 100-149% (median 117.5%) EAR for energy for age may be required. Energy balance studies in children with active disease are required.

Age/sex/location: uncovering the social cues in the development of online relationships

Past research on online relationships has predominantly been concerned with how the quality of online relationships compares with offline relationships. This research has been more concerned with the medium itself than with the meanings that users construct around their interpersonal interactions within this medium. The current paper seeks to redress this imbalance by exploring the ways that available social cues are used to shape the meanings of online relationships. Sixty Internet users, ranging in age from 19-51 years, were interviewed about their online relationships. It was found that ideals that are important in traditional relationships, such as trust, honesty, and commitment are just as important in online relationships; however, the cues that signify these ideals vary.

Vascular disease prevention in patients with diabetes

Prevention is the key to reducing the vascular sequelae of diabetes. Prevention starts with good glycaemic control and continues with a comprehensive programme of risk modification, such as lipid-lowering therapy, antihypertensive treatment, and improved lifestyle. With regard to lipid modification, agents such as statins may provide additional, non-lipid effects in both the diabetic and non-diabetic patient. This review discusses recent studies supporting risk reduction, available treatments, and recommendations applicable to the diabetic patient.

Observation of soft contact lens disinfection with fluorescent metabolic stains

A rapid fluorescent staining method using a tetrazolium dye and propidium iodide for the in-use assessment of disinfection of Pseudomonas aeruginosa biofilms on soft contact lenses showed that 11 to 13% of cells on lenses remained actively respiring and recoverable by culture methods after 30 min of exposure to 3% hydrogen peroxide.

Dietary fibre and the occurrence of gut symptoms in cystic fibrosis

OBJECTIVE

To evaluate the effect of currently recommended energy rich cystic fibrosis diets on fibre intake and to investigate the relationship between fibre intake and the occurrence of gut symptoms.

METHOD

Prospective completion of non-weighed five day food diaries by 28 children with cystic fibrosis and comparison of mean daily fibre intake with age matched controls who did not have cystic fibrosis. Prospective completion of similar diaries to a total of 68 children with cystic fibrosis and comparison of fibre and lipase intake with the occurrence of gut symptoms.

RESULTS

Mean daily fibre intake in children with cystic fibrosis was 7.00 g compared with 14.65 g in controls (p < 0.001). Mean daily fibre intake in eight patients troubled with moderate or severe abdominal pain was 0.144 g/kg. This was significantly lower (p < 0.01) than mean values for 22 patients with occasional but mild symptoms (0.249 g/kg) and 38 with no gut symptoms (0.312 g/kg). There was a trend towards higher pancreatic enzyme doses (lipase/kg/day) in children with abdominal pain.

CONCLUSIONS

Currently recommended cystic fibrosis diets have a low fibre content. A low residue diet might be an important factor in the pathogenesis of gastrointestinal symptoms.

Endothelin-3-induced microvascular incompetence and mitochondrial damage in rat myocardium

1. To determine the possible role of an endothelin in the development of postischaemic microvascular incompetence, isolated buffer-perfused rat hearts were perfused with endothelin-3 (ET-3) in phosphate buffer. 2. ET-3 produced a reduction in coronary flow rate, heart rate and arrhythmia. There was a marked reduction in the density of competent capillaries, and the myocytes showed vacuolation and mitochondrial damage in regions where microvascular incompetence was most severe. 3. These results indicate that ET-3 can substantially reduce microvascular perfusion in the heart and can also cause damage to the myocyte.

Anti-oxidant therapy improves microvascular ultrastructure and perfusion in postischemic myocardium

To determine the contribution of oxygen-derived free radicals to the changes in microvascular structure and function which follow reperfusion of ischemic myocardium, isolated perfused rat hearts were subjected to 15 or 45 min of global ischemia followed by 5 min of oxygenated reperfusion. Hearts were then fixed by perfusion with glutaraldehyde and perfused with nuclear track photographic emulsion to identify competent capillaries in scanning and transmission electron micrographs. Reperfusion after 15 min caused a significant reduction in the density of competent capillaries in the subendocardial third of the left ventricle, but this reduction was lessened but not eliminated by the addition of 0.61 mmole/liter desferrioxamine, but not by 60,000 U/liter superoxide dismutase plus 60,000 U/liter catalase, to the perfusate. After 45 min of ischemia both interventions prevented the myocyte swelling, endothelial cell changes, bleb formation, and reduction in microvascular lumina characteristic of unprotected reperfusion, but only desferrioxamine significantly improved microvascular competence. This suggests that the hydroxyl radical rather than superoxide and/or hydrogen peroxide has a pathogenic role, although desferrioxamine may have other effects as nonspecific chelator. Postischemic reductions in capillary function also occur in reversibly injured myocardium in the absence of structural abnormality. Preventing postischemic microvascular incompetence has the potential to minimize ischemic cell injury and to enhance repair following myocardial infarction, but it also may increase the risk of hemorrhage from venules.

Effect of rapid normalization of plasma glucose levels on microvascular dysfunction and polyol metabolism in diabetic rats

Effects of rapid normalization of plasma glucose levels (by insulin infused via Alzet pumps implanted intraperitoneally) on plasma insulin-like growth factor I (IGF-I) levels, granulation tissue polyol levels, and vascular permeation by 125I-labeled albumin were examined in male Sprague-Dawley rats with streptozocin-induced (60-65 mg/kg) diabetes. Two days after implantation of pumps, plasma insulin levels were twice normal levels and remained elevated (1.4-2.5 times normal) throughout the remainder of the study. Plasma glucose levels and granulation tissue polyol levels were normalized within 2 days after initiation of insulin treatment. Plasma IGF-I levels were significantly increased (2 times) by 2 days, but were not normalized until 7 days. In contrast, 125I-albumin permeation normalized at a much slower relatively linear rate and was still not completely normal after 14 days of insulin treatment. In view of 1) previous studies demonstrating that diabetes-induced increases in 125I-albumin permeation in this tissue are linked to increased metabolism of glucose to sorbitol and 2) the rapid normalization of tissue polyol levels in this study, the relatively linear rate of normalization of vascular permeability over 14 days in these studies suggests that impaired vascular barrier functional integrity in this model is mediated by structural and/or functional vascular alterations associated with sustained increased polyol metabolism rather than by increased polyol levels per se and/or by readily reversible functional and metabolic alterations associated with acute increases in polyol metabolism.(ABSTRACT TRUNCATED AT 250 WORDS)

Metabolic responses to exercise in young and older athletes and sedentary men

This study evaluated the effects of aging and endurance training on the metabolic responses of trained and sedentary young (age 20-32 yr) and older (age 60-70 yr) men to exercise at the same relative exercise stress (70% of maximal O2 consumption). Plasma growth hormone concentrations at rest were similar in all four groups, but both older groups had an attenuated response to exercise. The older trained men appeared to have avoided the age-associated changes that were evident in their sedentary peers with respect to resting plasma insulin, C-peptide, and norepinephrine concentrations. Plasma glucagon concentrations were lower in both older subject groups at rest. Both sedentary groups decreased their plasma glucose concentrations and increased their plasma glucagon concentrations during exercise, whereas the trained groups had increases in their plasma glucose concentrations but had no change in their glucagon concentrations. Thus, although the concentrations of some hormones at rest and during submaximal exercise are unaffected by aging or by training, others are markedly altered by aging, training, or the interaction of the two. However, it appears that older healthy sedentary men undergo less physiological stress than young untrained men during submaximal exercise at the same relative exercise intensity, and they have no responses that would contraindicate their participation in exercise of the duration and intensity usually prescribed in exercise-training programs.

Community and job satisfactions: an argument for reciprocal influence based on the principle of stimulus generalization

The principle of stimulus generalization provided the underlying argument for a test of hypotheses regarding the association of community and job satisfactions and a critique of related theory and research. Two-stage least squares (2SLS) analysis made possible the examination of reciprocal causation, a notion inherent in the theoretical argument. Data were obtained from 276 employees of a Western U.S. coal mine as part of a work attitudes survey. The 2SLS analysis indicated a significant impact of community satisfaction on job satisfaction and an effect of borderline significance of job on community satisfaction. Theory-based correlational comparisons were made on groups of employees residing in four distinct communities, high and low tenure groups, males and females, and different levels in the mine's hierarchy. The pattern of correlations was generally consistent with predictions, but significance tests for differences yielded equivocal support. When considered in the context of previous studies, the data upheld a reciprocal causal model and the explanatory principle of stimulus generalization for understanding the relation of community and job satisfactions. Sample characteristics necessitate cautious interpretation and the model per se might best be viewed as a heuristic framework for more definitive research.

Summer Ice and Carbon Dioxide

The extent of Antarctic pack ice in the summer, as charted from satellite imagery, decreased by 2.5 million square kilometers between 1973 and 1980. The U.S. Navy and Russian atlases and whaling and research ship reports from the 1930's indicate that summer ice conditions earlier in this century were heavier than the current average. Surface air temperatures along the seasonally shifting belt of melting snow between 55 degrees and 80 degrees N during spring and summer were higher in 1974 to 1978 than in 1934 to 1938. The observed departures in the two hemispheres qualitatively agree with the predicted impact of an increase in atmospheric carbon dioxide. However, since it is not known to, what extent the changes in snow and ice cover and in temperature can be explained by the natural variability of the climate system or by other processes unrelated to carbon dioxide, a cause-and-effect relation cannot yet be established.

Nea, new blood group antigen in Finland

A previously unrecognized blood group antigen is described. The antigen was shown to be different from many rare blood group antigens, to be inherited as an autosomal dominant character and not to be closely linked to the established blood group systems nor to several other polymorphic markers of blood. The antigen is well developed at birth. About 5% of Finns have this antigen. In contrast only 1 donor in 502 Swiss blood donors and 2 unrelated donors in 395 Swedish blood donors were found to be positive for the antigen. The antigen is provisionally called Nea and the respective antibody anti-Nea. At least three Na(a+) blood units were given to a patient on different occasions before anti-Nea was detected in compatibility tests. Since the discovery of the first anti-Nea, three additional examples of this antibody have been identified in serum from multitransfused patients. Anti-Nea is capable of shortening the in vivo survival of transfused incompatible Ne(a+) cells.

The first example of a Raddon-like antibody as a cause of a transfusion reaction

A serum Raddon defining a low-frequency red blood cell antigen FR, and its association with the Miltenberger complex of antigens, were reported in 1977. An antibody of the same serological specificity was the cause of a transfusion reaction. The patient's reaction and serological response, as well as the frequency of Raddon and its inheritance, are described.

Selecting the optimum method of contraception for each patient

The factors relating to the choice of the optimal method of contraception are discussed, indicating the wide range of variables which must be evaluated. Religious, cultural, educational and social factors are considered, as well as age and family size. Facts elicited through discussion of general medical, family, obstetric and menstrual histories help to indicate the advantages and disadvantages of available methods. The influences of the doctor, relatives, friends, and publicity are shown to affect the patient's choice and indicate that the theoretical effectiveness of a particular method forms only one part of a complex situation.

Unusual XX/XY chimerism

Apparently identical twin boys are both XX/XY and have two populations, A1 and B, of cells in their peripheral blood. Chimerism in somatic tissue outside the blood cells can be demonstrated in only one of the twins. From analysis of chromosomes and many gene markers the mechanism of origin of the unusual twins remains unclear.

The red cell antigen once called Levay is the antigen Kpc of the Kell system

The antigen corresponding to the 'new' allele Kpc postulated in a Japanese family is the low frequency antigen Levay recognized in England 33 years ago.

The Rh antigen Evans

Two families are described which clearly show that the low frequency antigen Evans is a part of the Rh system, in which it defines a 'new' gene complex.

An Alberta Cree Indian with a rare Duffy antibody, anti-Fy 3

Anti-Fy3, found in the serum of an Fy(a-b-) Cree Indian woman believed to have been transfused 5 years previously, caused moderate hemolytic disease of the newborn in her eighth live-born baby. Only three examples of anti-Fy3 are know. It is striking that two were made by non-negro people, amongst whom Fy(a-b-) is extremely rare, and only one by a Negro, in whose people Fy(a-b-) is by far the commonest phenotype. This suggests that Fy(a-b-) may be a heterogeneous phenotype, with the negro version conferring some impediment to immunization by Fya, Fyb or Fy3 antigens. The rare allele Fyx is also present in the kindred of the propositus, and is shown to correspond to weak Fy3 as well as weak Fyb anitgen.