Variations of invasive Salmonella infection in elderly people.

Four cases of elderly people with differing forms of invasive salmonella infection are presented. Vulnerability factors and patterns of presentation are discussed.

Resuscitation decisions in the elderly: a discussion of current thinking.

Decisions about cardiopulmonary resuscitation may be based on medical prognosis, quality of life and patients' choices. Low survival rates indicate its overuse. Although the concept of medical futility has limitations, several strong predictors of non-survival have been identified and prognostic indices developed. Early results indicate that consideration of resuscitation in the elderly should be very selective, and support "opt-in" policies. In this minority of patients, quality of life is the principal issue. This is subjective and best assessed by the individual in question. Patients' attitudes cannot be predicted reliably and surrogate decision-making is inadequate. Lay knowledge is poor. However, patients can use prognostic information to make rational choices. The majority welcome discussion of resuscitation and prefer this to be initiated by their doctors; many wish to decide for themselves. There is little evidence that this causes distress. The views of such patients, if competent, should be sought actively.

Immigrants, Germans and national identity in the new Germany: some policy issues.

"This paper considers how the role and status of Germany's diverse immigrant population has been affected by its new geopolitical situation, in particular unification, since 1989.... The paper shows how the integration prospects for Germany's older immigrant populations have been dented by the combination of economic restructuring and a huge upsurge in new types of immigration. Prominent among the latter are ethnic German resettlers (or Aussiedler), and the paper examines how these immigrants find themselves in a weak position.... The paper concludes that, although there would appear to be no major labour shortages within the economy, Germany has to develop a more extensive range of migration policies to cater for the huge demand for economically motivated migration. The alternative will inevitably be a further growth in illegal migration, which would not be helpful to the position of established immigrant populations."

Consumer assessment of the effect of electrical stimulation on the colour and colour stability of Semimembranosus muscles.

The influence of effective low voltage electrical stimulation on the colour stability of beef topside (semimembranosus) muscles, during storage and retail display was studied using objective measurements and subjective assessments. Earlier results obtained from objective measurements demonstrated that during a three day retail display period, stimulated topsides had a greater loss of colour than non-stimulated topsides, and primal cuts aged for 33 days at 0 °C before display suffered faster changes to colour during retail presentation than cuts aged for 5 days. To relate results obtained using objective methods to consumer perceptions of meat quality, consumer perceptions of samples of meat displayed for 3 days in the retail cabinets of a major local supermarket were recorded. A total of 960 consumers were asked to evaluate topside steaks for meat and fat colour, meat discolouration and acceptability. During 3 days of retail display, consumers did not perceive differences in the extent of discolouration of topside steaks from electrically stimulated and non-stimulated carcasses; for the majority of the treatment groups (high or low pH muscles, 5 or 33 day ageing, 1-3 day retail display) there were no significant differences, for any of the scored attributes, between stimulated and non-stimulated samples. However, for samples in the fresh (5 days ageing), high pH (5.8-6.0) treatments group, lean meat colour and acceptability for the stimulated samples were, on some of the days on display, given significantly (P < 0.05) better ratings by the consumers than those from corresponding non-stimulated samples.

Indomethacin and cognitive function in healthy elderly volunteers.

1. Cognitive function was studied after single and multiple doses of indomethacin (I) and matched placebo (P) in 20 healthy elderly volunteers using a double-blind crossover design. 2. Arousal, attention, integration, coordination, memory and mood were investigated using a battery of psychomotor tests and the Hospital Anxiety and Depression Scale. Assessments were performed before and after the first and last doses of a 7 day course of medication. 3. Critical flicker fusion threshold fell by a mean of 1.96% on indomethacin compared with a 1.13% rise on placebo 5 h after the first dose (P = 0.029). A beneficial effect on choice reaction time latency (P = 0.012) was seen both after acute and continuing administration of indomethacin. Performance at the most discriminating level (level 3) of the paired word association test was significantly better following 8 days of treatment with indomethacin in the younger (55-65 year-old) age group (P = 0.001). 4. There was no significant difference in performance on the symbol-digit substitution test and the continuous attention task. No change was seen in hospital anxiety and depression scale scores. 5. These results suggest that performance on tests of sensorimotor coordination and short term memory may improve in healthy volunteers following indomethacin administration, whereas tests of attention and psychomotor speed remain unaffected. However, further controlled studies in rheumatic patients are needed to evaluate fully the psychomotor effects of indomethacin and other NSAIDs in clinical practice.

Opening the frontier: recent spatial impacts in the former inner-German border zone.

The authors examine the 1989 removal of the frontier region (Zonenrandgebiet) along the eastern border of the former Federal Republic of Germany. "The paper examines the socio-economic impacts on the North Bavarian section of the Zonenrandgebiet, which is characterized by its dispersed industrial base and lack of higher-order urban centres. Evidence is presented of rapid upturns in population growth and economic activity, together with a large inflow of commuters from the former East Germany and Czechoslovakia, following frontier opening. Traffic, environmental pressures and living costs have also increased. Both positive and negative impacts are strongest in districts contiguous with the former frontier. Long-term development prospects hinge on its newly-gained centrality within Germany. Substantial local benefits are anticipated...,but they are unlikely to induce a major reshaping of the German space-economy; this will be dominated by the rivalry between the largest metropolitan centres." (SUMMARY IN FRE AND GER)

Maximising the cost-efficiency of assay procedures.

Cortisol concentrations were measured in cattle plasma and pig muscle juice samples obtained from groups of animals slaughtered at different abattoirs. Statistically significant (P < 0·001) differences were obtained for between-abattoir comparisons for both the cattle and pig samples. Cortisol concentrations were determined using a radio-immunoassay kit. In accordance with the instructions, assays were performed in duplicate. An analysis of variance indicated that the use of a single determination on more samples, instead of duplicate determinations of fewer samples, would have led to an important increase in accuracy for detecting differences between means. It would have been more cost-efficient to collect additional samples and perform one assay only on each sample.

Western Germany's "third wave" of migrants: the arrival of the Aussiedler.

PIP: The authors analyze the migration of ethnic Germans from Eastern Europe and the former Soviet Union to West Germany during the 1980s. They note that many of the problems associated with the absorption of these migrants stem from their uneven geographical distribution and concentration in certain Lander such as North Rhine-Westphalia. Measures taken by the German government in the areas of employment and housing to relieve these problems are described.^ieng

Fitting mixture distributions to phenylthiocarbamide (PTC) sensitivity.

A technique for fitting mixture distributions to phenylthiocarbamide (PTC) sensitivity is described. Under the assumptions of Hardy-Weinberg equilibrium, a mixture of three normal components is postulated for the observed distribution, with the mixing parameters corresponding to the proportions of the three genotypes associated with two alleles A and a acting at a single locus. The corresponding genotypes AA, Aa, and aa are then considered to have separate means and variances. This paper is concerned with estimating the parameters of the model, and their standard errors, by using an application of the EM algorithm. This technique also caters for the fact that the sensitivity measurements are only known to lie between the endpoints of certain intervals and that the exact measurement of the attribute is not possible.

On collagen fibril diameter distributions.

Distributions of collagen fibril diameters, measured from electron micrographs, are compared using some of the common measures of the mean of the distribution. The role of mixture distributions in modelling these distributions is considered and a method of fitting such distributions to data observed in the form of histograms is described. The method is illustrated with six pairs of fibril diameter distributions used in assessing age and structural changes in various collagen samples from different species of animal. The extent of changes in diameter distributions is assessed in terms of the estimated means, variances and mixing proportions for the component distributions of the histograms in each pair.

The relationship between animal age and the thermal stability and cross-link content of collagen from five goat muscles.

The thermal stability of intramuscular collagen, as determined using differential scanning calorimetry, was measured in five muscles from 75 goats with known birth dates ranging in age from one day to 13 years. The collagen cross-link pyridinoline, and the collagen-associated, and putative cross-link, Ehrlich Chromogen were also measured. Five different muscles were examined and the effects of age compared to those found in the tendon of the longissimus dorsi muscle. The differences between intramuscular collagen and tendon collagen were found to be much greater than those between the intramuscular collagens of different muscles. Intramuscular collagen is more thermally stable than tendon collagen due to higher levels of heat-stable cross-links. However the increase in thermal stability of intramuscular collagen with age could not be explained simply in terms of the cross-links measured.

West Germany's declining guestworker population: spatial change and economic trends in the 1980s.

PIP: The author examines trends in labor migration to West Germany during the 1980s, with an emphasis on the spatial distribution of migrants. Urban and rural differentials in distribution and the effcts of rising unemployment on labor migration are discussed. Information is included on migrants' population size and their countries of origin. (SUMMARY IN FRE AND GER)^ieng

Asymmetrical pudendal nerve damage in pelvic floor disorders.

Differences in the left and right pudendal nerve terminal motor latencies have been observed in patients with pelvic floor disorders. Until now the mean value of the left and right pudendal latencies has been used as the index of pudendal neuropathy. In 22 patients of a group of 156 patients studied the pudendal nerve terminal motor latency was abnormally raised on one side only. These patients are thought to have pudendal neuropathy whether or not the mean value of the left and right pudendal latencies is also raised. This observation may have therapeutic implications.

Fitting mixture models to grouped and truncated data via the EM algorithm.

The fitting of finite mixture models via the EM algorithm is considered for data which are available only in grouped form and which may also be truncated. A practical example is presented where a mixture of two doubly truncated log-normal distributions is adopted to model the distribution of the volume of red blood cells in cows during recovery from anemia.

The comparison of electroencephalograms recorded before and after electrical stunning of cattle.

Electroencephalograms (EEGs) were recorded before and after 'head-only' electrical stunning of adult cattle. Epochs of 8·5 s duration derived from the pre-and the post-stun EEG signals were compared for differences in scale and frequency. The frequency structures of two selected epochs from the one animal were evaluated using the periodogram ordinates derived by calculating the Fast Fourier Transform. The comparison of the two pre-stun epochs indicated that, within the one animal, the pre-stun EEG signal had a consistent frequency pattern. Similarly, a comparison of two post-stun epochs indicated that the post-stun EEG signal also had a consistent frequency pattern. The comparison of pre- and post-stun epochs indicated a consistent increases in amplitude after stunning. Additionally, after stunning, there was an increase in the power of frequencies in the range 4-8 Hz and a decrease in the power of certain frequencies in the range 15-25 Hz. Although there was considerable animal-to-animal variation it was demonstrated that electric stunning produced definable changes in the EEG signal.

Is paradoxical contraction of puborectalis muscle of functional importance?

Paradoxical contraction of the puborectalis muscle during simulated defecation straining (anismus) has been cited as a cause of constipation. The functional specificity of this phenomenon was evaluated in 79 patients, 50 with constipation, 21 with idiopathic perineal pain, and eight with solitary rectal ulcer syndrome. Electromyogram evidence of paradoxical puborectalis contraction was observed in 38 (76 percent), ten (48 percent), and four (50 percent) of these patients, respectively. All patients with solitary rectal ulcer syndrome had difficulty defecating; defecation was normal in all patients with perineal pain. These observations suggest that paradoxical contraction of the puborectalis muscle is not a specific finding, and that it is not the sole cause of constipation in patients with anismus.

Relation between perineal descent and pudendal nerve damage in idiopathic faecal incontinence.

In 60 patients with idiopathic anorectal incontinence, without neurological disease, there was a significant relationship, shown by regression analysis, between the pudendal nerve terminal motor latency and the extent of perineal descent during straining (r 0.59; p less than 0.001), and the plane of the perineum on straining (r -0.61; p less than 0.001). These data are consistent with the suggestion that perineal descent can lead to stretch-induced damage to the perineal nerves in this condition.

Binding of comminuted meat: Effect of high pressure.

Patties prepared from comminuted meat were pressure-treated at up to 150 MPa at 0-3°C and the cohesion between meat particles in the cooked patty investigated from tensile strength measurements. Pressure treatment increased tensile strength, the magnitude of the increase depending upon the intensity and duration of pressure treatment, the concentration of salt in the patty and pH value. The effect was most pronounced in patties of pH 5 to 6 and with 1% salt in the aqueous phase. Under these conditions cooking losses were reduced. When compared with the effect of addition of 0·5% tetrasodium pyrophosphate in a patty with 1% salt, pressure treatment retained its effect at lower pH values.

Pressure treatment of meat: Effects on thermal transitions and shear values.

The effects of pressure treatment (150 MN m(-2) for 3 h at 0°C) on the pH, thermal transitions, ultrastructure and Warner-Bratzler shear values of post-rigor beef semimembranosus and longissimus dorsi muscles have been investigated. Pressure treatment resulted in a slight but significant increase in pH. Differential scanning calorimetry revealed large changes in the thermograms of muscle samples as a result of pressure treatment, in particular a transition attributed to F-actin was absent in the pressure-treated sample. Examination of the ultrastructure also revealed extensive change as a result of pressure treatment, particularly in the I-band and M-line region. Pressure treatment either did not change shear values or increased them, according to whether the muscle was in the stretched or contracted state, respectively. The results are thought to support a theory for contraction state toughness proposed by Voyle (1969) in which increasing toughness is caused by an increasing incidence of sarcomeres in which thick filaments have been compressed onto the Z-line, thus removing the I-band as a zone of weakness.