Creativity in later life.

The ageing population presents significant challenges for the provision of social and health services. Strategies are needed to enable older people to cope within a society ill prepared for the impacts of these demographic changes. The ability to be creative may be one such strategy. This review outlines the relevant literature and examines current public health policy related to creativity in old age with the aim of highlighting some important issues. As well as looking at the benefits and negative aspects of creative activity in later life they are considered in the context of the theory of "successful ageing". Creative activity plays an important role in the lives of older people promoting social interaction, providing cognitive stimulation and giving a sense of self-worth. Furthermore, it is shown to be useful as a tool in the multi-disciplinary treatment of health problems common in later life such as depression and dementia. There are a number of initiatives to encourage older people to participate in creative activities such as arts-based projects which may range from visual arts to dance to music to intergenerational initiatives. However, participation shows geographical variation and often the responsibility of provision falls to voluntary organisations. Overall, the literature presented suggests that creative activity could be a useful tool for individuals and society. However, further research is needed to establish the key factors which contribute to patterns of improved health and well-being, as well as to explore ways to improve access to services.

Determinants of muscle carnosine content.

The main determinant of muscle carnosine (M-Carn) content is undoubtedly species, with, for example, aerobically trained female vegetarian athletes [with circa 13 mmol/kg dry muscle (dm)] having just 1/10th of that found in trained thoroughbred horses. Muscle fibre type is another key determinant, as type II fibres have a higher M-Carn or muscle histidine containing dipeptide (M-HCD) content than type I fibres. In vegetarians, M-Carn is limited by hepatic synthesis of ß-alanine, whereas in omnivores this is augmented by the hydrolysis of dietary supplied HCD's resulting in muscle levels two or more times higher. ß-alanine supplementation will increase M-Carn. The same increase in M-Carn occurs with administration of an equal molar quantity of carnosine as an alternative source of ß-alanine. Following the cessation of supplementation, M-Carn returns to pre-supplementation levels, with an estimated t1/2 of 5-9 weeks. Higher than normal M-Carn contents have been noted in some chronically weight-trained subjects, but it is unclear if this is due to the training per se, or secondary to changes in muscle fibre composition, an increase in ß-alanine intake or even anabolic steroid use. There is no measureable loss of M-Carn with acute exercise, although exercise-induced muscle damage may result in raised plasma concentrations in equines. Animal studies indicate effects of gender and age, but human studies lack sufficient control of the effects of diet and changes in muscle fibre composition.

Localization and characterization of an intermediate filament-associated protein.

A monoclonal antibody designated Mab G3.5 was used to test for the presence of reactive antigen in rat skeletal and cardiac muscle cells. Standard indirect labelling methods for immunofluorescence microscopy and immuno-gold localization for electron microscopy were applied to paraformaldehyde-fixed muscle tissues. In longitudinal sections, the reactive antigen was found to localize appropriately for Z-disks. In transverse sections of skeletal muscle, the antigen was apparent as a strongly fluorescent reticular network. Gold particles were observed by transmission electron microscopy in association with filamentous structures on either side of sarcomeres, and on either side of, but not adjacent to the Z-disk. This appearance is consistent with the exosarcomeric cytoskeleton and the known distribution of desmin. In competition binding experiments, neither antidesmin nor Mab G3.5 interfered with the binding of each other and co-localization was observed. Desmin (M(r) 52,000) differs in its relative molecular weight from the G3.5 antigen (M(r) 100,000), which was isolated and analysed by SDS-PAGE. The antigen was found to co-isolate with the cytoskeletal fraction from cell homogenates, and could be released from this fraction with the addition of reducing agents. Preliminary sequence analysis indicates that the G3.5 antigen may be an isoform of alpha-actinin which interconnects intermediate filaments and actin.

Teaching trauma management in the accident and emergency department.

Since their introduction into the United Kingdom, Advanced Trauma Life Support Courses (ATLS) have preferentially offered places to Consultants and Senior Registrars. It is usual, however, for the initial resuscitation of the seriously injured patient to be performed by relatively inexperienced junior staff. It is incumbent upon those medical staff who are ATLS providers or instructors to design local courses, based upon ATLS principals, to train their junior staff in a structured approach to managing these patients. We describe one such local course which may serve as a model for others.

Polycythaemia following renal transplantation: an association with azathioprine dosage?

Patients from a renal transplantation unit with an unusually high incidence of polycythaemia were divided into polycythaemic and control groups. The rate of rise of haemoglobin concentration was not significantly different in the two groups. The polycythaemic group received a significantly lower dose of azathioprine (p less than 0.005) and included more patients with polycystic disease than the control group (p less than 0.05). An effect of azathioprine on bone marrow function was suggested by the polycythaemic group also having a higher mean white cell count (p less than 0.02). Azathioprine dosage correlated negatively with post-transplantation polycythaemia regardless of the original cause of renal failure.

Effect of halothane on isometric twitch and tetanus response and the associated heat production in striated muscle of frogs.

The purpose of these investigations was to determine the effect of halothane on isometric contraction of striated muscle and to measure the associated heat production. This basic information is necessary before studies more directly relating to malignant hyperthermia are undertaken. Sartorius muscles were isolate from Rana pipiens during winter and summer months. It appears from these experiments that there is a prolongation of the relaxation phase of the twitch and tetanus responses with low concentrations of halothane, with a more diffuse effect on the contractile process evident at higher administered concentrations. The results of heat measurements, using a sensitive thermopile-galvanometer system, are compatible with the hypotheses that this effect on relaxation could result from either an interference with calcium reuptake by the sarcoplasmic reticulum or an increased affinity of the troponintropomyosin complex for available calcium.