Priming third-party social exclusion does not elicit children's inclusion of out-group members.

This study investigates how culture and priming 3- to 7-year-old children (N = 186) with third-party social exclusion affects their subsequent inclusion of out-group members. Children in societies that tend to value social independence (Germany, New Zealand) and interdependence (Northern Cyprus) were randomly assigned to minimal groups. Next, they watched video stimuli depicting third-party social exclusion (exclusion condition) or neutral content (control condition). We assessed children's recognition of the social exclusion expressed in the priming videos and their understanding of the emotional consequences thereof. We furthermore assessed children's inclusion behaviour in a ball-tossing game in which participants could include an out-group agent into an in-group interplay. Children across societies detected third-party social exclusion and ascribed lower mood to excluded than non-excluded protagonists. Children from Germany and New Zealand were more likely to include the out-group agent into the in-group interaction than children from Northern Cyprus. Children's social inclusion remained unaffected by their exposure to third-party social exclusion primes. These results suggest that children from diverse societies recognize social exclusion and correctly forecast its negative emotional consequences, but raise doubt on the notion that social exclusion exposure affects subsequent social inclusion.

The basic helix-loop-helix transcription factor HESR1 regulates endothelial cell tube formation.

Human endothelial cells can be induced to form capillary-like tubular networks in collagen gels. We have used this in vitro model and representational difference analysis to identify genes involved in the formation of new blood vessels. HESR1 (HEY-1/HRT-1/CHF-2/gridlock), a basic helix-loop-helix protein related to the hairy/enhancer of split/HES family, is absent in migrating and proliferating cultures of endothelial cells but is rapidly induced during capillary-like network formation. HESR1 is detectable in all adult tissues and at high levels in well vascularized organs such as heart and brain. Its expression is also enriched in aorta and purified capillaries. Overexpression of HESR1 in endothelial cells down-regulates vascular endothelial cell growth factor receptor-2 (VEGFR2) mRNA levels and blocks proliferation, migration, and network formation. Interestingly, reduction of expression of HESR1 by antisense oligonucleotides also blocks endothelial cell network formation in vitro. Finally, HESR1 expression is altered in several breast, lung, and kidney tumors. These data are consistent with a temporal model for HESR1 action where down-regulation at the initiation of new vessel budding is required to allow VEGFR2-mediated migration and proliferation, but re-expression of HESR1 is necessary for induction of tubular network formation and continued maintenance of the mature, quiescent vessel.

Assisting women to establish breastfeeding: exploring midwives' practices.

Breastfeeding is recognised by many mothers, families and health professionals to be important for the health and wellbeing of mothers and babies. Successful breastfeeding depends on the acquisition of basic skills, accurate information and practice, and is strongly influenced by the support provided following childbirth. Midwives' practices may therefore have the potential to influence breastfeeding outcomes. Correct positioning and attachment of the newborn at the breast is a crucial component of the successful establishment of breastfeeding. A literature review revealed that minimal research exists on the practices that midwives use when assisting women to initiate breastfeeding. A series of focus group interviews were therefore conducted to stimulate in-depth exploration of midwives' understanding and practices in the positioning and attachment of a newborn infant at the breast. Eighteen midwives, each of whom had worked at least 12 months in the postnatal environment of a large metropolitan hospital in Adelaide, participated in the focus group discussions. Using thematic analysis, the following broad themes emerged from discussions--education, problem-solving, support, midwives' views about breastfeeding and influences on midwives' practice. These themes identify the roles and practices that midwives take on when assisting women to establish breastfeeding following childbirth, and also raise awareness of influences on their practice.

The contribution of inducible nitric oxide and cytomegalovirus to the stability of complex carotid plaque.

BACKGROUND: Although the association between inflammation and atherosclerosis is well established, the biologic events that trigger the local inflammatory response within plaque are not fully understood. Cytotoxic free radicals and infectious agents, both of which are associated with an inflammatory response, have previously been implicated in the initiation and progression of atherosclerosis. In this study, we analyzed carotid plaque for evidence of oxidative vascular injury by determining the presence and distribution of inducible nitric oxide synthase (iNOS) expression and nitrotyrosine formation and for evidence of infection with cytomegalovirus. METHODS: Carotid plaque from 51 patients who underwent endarterectomy for either primary (n = 37) or recurrent (n = 14) stenosis were examined histologically (hematoxylin-eosin staining and Masson's trichrome staining) and with immunohistochemistry with specific antibodies to alpha-smooth muscle actin, macrophages (CD68), T-lymphocytes (CD3), and T-cell activation (human leukocyte antigen-DR). Twenty-eight specimens from patients with primary (n = 15) and recurrent (n = 13) stenosis were examined for the presence of iNOS and nitrotyrosine with immunohistochemistry and in situ hybridization (iNOS). Twenty-three additional specimens (22 primary, and 1 recurrent) were analyzed with antibodies to p53, cytomegalovirus, and the polymerase chain reaction (cytomegalovirus, n = 8). RESULTS: Primary atherosclerotic lesions were either complex heterogenous cellular plaques (n = 29) or relatively acellular fibrous plaques (n = 8). Ten of 14 recurrent plaques were either complex or fibrous lesions, and the remaining four were typical of myointimal thickening. CD68-positive staining cells were detected in all specimens regardless of their structural morphology. CD3-positive cells were interspersed between macrophages in all heterogeneous cellular plaques and only infrequently noted in fibrous plaques. iNOS and nitrotyrosine immunoreactivity were detected in macrophages and smooth muscle cells in all complex and fibrous plaques and in two of four myointimal plaques. The presence of iNOS and nitrotyrosine in plaque correlated with the existence of symptoms in 80% of primary and 62% of recurrent lesions. Cytomegalovirus was detected in only two of 23 carotid specimens (9%). CONCLUSION: The association between ischemic cerebrovascular symptoms and iNOS and nitrotyrosine immunoreactivity in complex primary and recurrent carotid plaque and the infrequent occurrence of cytomegalovirus in primary carotid lesions suggests that ongoing free radical oxidative damage rather than viral infection may contribute to plaque instability in patients with complex and fibrous carotid plaques.

Mixed messages about the meanings of breast-feeding representations in the Australian press and popular magazines.

The popular press is an influential medium for the communication of messages and meanings about health and lifestyle issues (Lupton 1993). Through language and images, the print media present selected phenomena, events and issues to readers. The choice and connections between works used can impress upon the reader specific images of the world and the attitudes toward the presented issues and ideas (Nunan 1993). Discourse analysis is used in this study to examine representations of breast feeding in articles published in the Australian press and popular magazines over a six-month period. Discourse analysis is a method of inquiry that focuses on sociocultural and political contexts in which communication occurs (Lupton 1992). Discourses revealed mixed messages and meanings. Breast feeding was seen as natural and the best way of feeding but also as problematic in practice. Dominant ideologies of power and persuasion were also evident. The media portrayed predominantly negative views about breast feeding. Such discourses may influence decisions to breast feed and have wider implications for midwives in their roles as supporters and educators of women and their families.

Lead poisoning in an electrician: a bad substitute for a bad habit.

An electrician presented with a four-month history of unexplained abdominal pain and constipation, which had prompted four hospital admissions and numerous investigations. Blood-film results suggested lead poisoning, and an occupational history revealed that he had chewed about a metre of electrical cable (which contains lead) daily for 10 years as a substitute for smoking.

Activation of hepatic proliferation-associated transcription factors by lipopolysaccharide.

BACKGROUND: The hepatic acute-phase response is the result of reprogramming of gene expression in the liver. Similar acute-phase responses occur in regenerating liver after partial hepatectomy and are preceded by increases in the expression of a set of transcriptional regulatory proteins that are encoded by "immediate-early" genes. The purpose of this study was to determine whether acute systemic inflammation after lipopolysaccharide injection induces hepatic immediate-early genes that are induced by partial hepatectomy. METHODS: Two- to 4-month-old Balb/c mice received intraperitoneal Escherichia coli lipopolysaccharide (0111:B4; 100 micrograms), and total liver RNA, nuclear protein extracts, or total liver protein lysates were obtained at 0, 1, 3, 12, and 24 hours. RNA blot hybridization analysis was used to determine steady-state messenger RNA levels for c-jun, jun-B, jun-D, c-fos, fos-B, fra-1, nup475, and zif268. Specific nuclear protein-binding activity was determined by gel mobility shift assay. The protein c-Jun was detected by antibody-blocking experiments, and Jun-B was detected by gel supershift assay of the activating protein (AP-1) complex. Steady-state Jun-B levels were determined by immunoblot analysis. RESULTS: Intraperitoneal injection of lipopolysaccharide is followed by induction (from fivefold to 13-fold) of c-jun, jun-B, c-fos, zif268, and nup475 messenger RNAs in the liver. Lipopolysaccharide induced increases in AP-1 and Zif268 consensus DNA-binding activity in mouse liver. The proteins c-Jun and Jun-B are detected in the AP-1 complex after administration of lipopolysaccharide. CONCLUSIONS: The induction of hepatic immediate-early genes after lipopolysaccharide is similar to that that follows partial hepatectomy. These transcription factors likely have important roles in the reprogramming of gene expression that leads to the acute-phase response.

3-Methoxybutylcyanoacrylate: evaluation of biocompatibility and bioresorption.

The biocompatibility and bioresorption of 3-methoxybutylcyanoacrylate (MBCA) was evaluated in vivo using female Wistar albino rats. MBCA was found to elicit slight to moderate tissue reaction similar to isobutylcyanoacrylate (iBCA) which has been sold commercially as a surgical adhesive (Bucrylate, Ethicon). MBCA was judged less reactive to tissue than ethylcyanoacrylate (ECA). The MBCA implants in rat gluteal muscles also resorbed within approx. 16 wk while iBCA implants remained essentially unchanged at 36 wk in vivo. In vitro resorption in phosphate buffer (pH 7.2) at 37 degrees C showed the same trend. The MBCA performed similarly to iBCA as a haemostat on excised rat livers and as an adhesive on rat skin incisions and had comparable adhesive bond strength.

An assessment of postoperative oxygen therapy in patients with fractured neck of femur.

Arterial oxygen tension was studied in sixty patients with fractured neck of femur. The mean preoperative arterial oxygen tension was 63.7 mmHg (SD 12.8). Half of the patients received nasal oxygen for five days postoperatively. In these patients, mean arterial oxygen tension was greater at all times than preoperative values, and exceeded values in those not receiving oxygen in whom no change in oxygen tension occurred until an increase on the fifth postoperative day.

Inspired oxygen and nitrous oxide concentrations in volunteers during nitrous oxide sedation with a Hudson mask.

Ten volunteers were given varying ratios of oxygen and nitrous oxide at 4, 6 and 8 litres per minute using a Hudson mask delivery system. Maximum and minimum inspired oxygen concentrations, maximum inspired nitrous oxide concentrations and end tidal carbon dioxide concentrations were measured using the Datex Cardiocap CCI-104 monitor. Although pharyngeal oxygen fraction varies with the Hudson mask because the inspiratory flow exceeds the entrainment of the mask by a variable amount during much of the cycle, at 8 litres/minute flow with a ratio of 3 to 5, oxygen to nitrous oxide, safe levels of oxygen were delivered (range of means 26-31%) with basal nitrous oxide levels (mean maximum inspired N2O, 34%). When nitrous oxide sedation is used clinically, nitrous oxide must be used with consideration of safe oxygen levels. This study did not detect unsafe pharyngeal oxygen levels in the ratios investigated, where the maximum delivered nitrous oxide concentration was 75%.

Endoscopic cleaning and disinfection procedures for preventing iatrogenic spread of human immunodeficiency virus.

With estimates as high as 1.8 million individuals infected with human immunodeficiency virus (HIV) in the United States, the majority asymptomatic, it is crucial that all physicians routinely use adequate disinfection procedures for medical instruments. The protosigmoidoscopic disinfection procedures used by US family physicians were evaluated for adequacy in inactivating HIV. Sixty-seven percent of 1,585 randomly selected American Academy of Family Physicians members completed a mail survey regarding these procedures. Comparing procedures used with those recommended by the Centers for Disease Control or documented to inactivate HIV, 32.4 percent were judged to be appropriate procedures; 54.4 percent of the procedures were not tested or recommended; and 13.2 percent used appropriate solutions but at inadequate concentrations or exposure times. Therefore, a substantial proportion of US family physicians performing endoscopic procedures use disinfection procedures that may not inactivate HIV. The ever-increasing prevalence of HIV demands that standardized adequate disinfection procedures be implemented by all physicians to prevent the potential nosocomial spread of HIV.

Anaesthesia in the prune-belly syndrome. A review of 36 cases.

Between 1959 and 1984, 36 children with the prune-belly syndrome underwent 133 operations at the Hospital for Sick Children, Great Ormond Street. The anaesthetic and surgical problems have been reviewed. Minor postoperative respiratory tract infections followed eight anaesthetics. Three deaths occurred in the postoperative period. In two of these there were multifactorial causes, not directly related to the prune-belly syndrome. One death was related to the sequelae of the syndrome. Normal doses of muscle relaxants are recommended when intermittent positive pressure ventilation is used during anaesthesia. Monitoring of the patient's respiratory state and active physiotherapy are advisable postoperatively. Analgesics should be used with caution.

Beta-adrenoceptor blockade and suxamethonium-induced rise in plasma potassium.

The effects of beta-adrenergic blockade on the suxamethonium-induced rise in arterial plasma potassium were studied in patients who presented for open heart surgery. No potentiation of the immediate rise in plasma potassium was observed.

Cardiac surgery in Jehovah's witnesses. A review of 36 cases.

Between January 1971 and January 1985, 31 Jehovah's witnesses underwent 24 bypass and 12 non-bypass cardiothoracic operations at the National Heart Hospital. Fifty-eight% of the group were under 16 years of age. There was one death in the non-bypass group unrelated to blood loss. Six deaths occurred in the bypass group. In one of these, blood loss contributed to the cause of death and in two patients, blood loss was directly related to the cause of death. The anaesthetic management of Jehovah's witnesses undergoing cardiac surgery is discussed.

Genetic variance in dental dimensions of Punjabi twins.

Genetic variance analysis of 56 tooth size traits was based on a sample of 58 pairs of twins (23 MZ and 35 DZ) from Chandigarh, India. Results of a t-test for equality of means showed no association of zygosity with any of the traits. Heterogeneity of total variance was found in 18 traits, which invalidates conventional genetic variance estimates and reveals considerable hidden environmental determinance. In contrast to other studies, Indian MZ twins had higher variance than did DZ twins, in most instances. There was also evidence of stronger environmental covariance for MZ and DZ twins. The study revealed substantial, complex environmental determination for some dental dimensions, especially of incisors and second molars.

Double-blind, multicenter controlled trial comparing topical dimethyl sulfoxide and normal saline for treatment of hand ulcers in patients with systemic sclerosis.

A prospective, randomized, double-blind trial compared topical therapy with 0.85% normal saline, 2% dimethyl sulfoxide (DMSO), and 70% DMSO for treatment of digital ulcers in 84 patients with systemic sclerosis. There were no statistically significant differences among the 3 treatment groups in the improvement in the total number of open ulcers, total surface area of open ulcers, average surface area per open ulcer, number of infected ulcers, number of inflamed ulcers, or patient pain assessment. While some patients improved during the study, improvement could not be attributed to a specific treatment. Over one-quarter of the patients treated with 70% DMSO were withdrawn for significant skin toxicity.

Bite-force variation related to occlusal variation in rural and urban Punjabis (North India).

Occlusal variation from defined norms was much less in traditional rural youths eating a rough unprocessed diet. Bite forces were significantly higher in the rural youths; their habitual harder chewing may help to being about their better occlusal development. Rural youths showed stronger increase with age and sex dimorphism than urban youths in bite force; thus, rurally the development of masticatory and facial structures may depend on functional masticatory demand.

Late perforation by central venous cannulae.

Three cases of hydrothorax secondary to late perforation of the superior vena cava by central venous cannulae are presented. The care of central venous cannulae is discussed.

A system for the continuous measurement of oxygen uptake and carbon dioxide output in artificially ventilated patients.

A continuous, non-invasive system is described for measuring oxygen uptake (VO2) and carbon dioxide output (VCO2) in mechanically ventilated patients. Inspiratory and mixed expiratory gas samples were pumped through fine-bore tubing to a remote mass spectrometer for analysis. The expiratory flow transducer of a Siemens Servo 900B ventilator was used for expiratory flow measurement and inspiratory flow was calculated from this using the Haldane transformation. A desk-top computer calculated VO2, VCO2 and respiratory quotient. The system has been validated against standard methods of gas analysis and flow measurement (VO2 mean difference -10 ml min-1: SD 9.13; VCO2 mean difference 8.12 ml min-1: SD 4.66). Comparison with Douglas bag measurements in patients has been made (VO2 mean difference 10.7 ml min-1: SD 9.8; VCO2 mean difference -1.07 ml min-1: SD 4.7).