Phased array Doppler reflectometry at Wendelstein 7-X.

A passive phased array Doppler reflectometry system has recently been installed in the Wendelstein-7X stellarator. In contrast to conventional Doppler reflectometry systems, the microwave beam can be steered on short time scales in the measurement plane perpendicular to the magnetic field in the range of ±25° without mechanical steering components. This paper characterizes the design and properties of the phased array antenna system and presents the first measurement results from the latest OP1.2a campaign.

Prevention of the spread of infection--the need for a family-centred approach to hygiene promotion.

Infectious diseases circulating in the home and community are a continuing and significant burden on the health and prosperity of the European community. They could, however, be significantly reduced by better standards of hygiene. Across Europe, public health is currently structured such that the separate aspects of hygiene in different settings (food hygiene, personal hygiene, handwashing, pandemic flu preparedness, patient empowerment etc.) are dealt with by separate agencies. If efforts to promote hygiene at community level are to be successful in changing behaviour, we need a concerted family-centred approach to ensure that a basic understanding of infectious disease agents and their mechanisms of spread, together with an understanding of a risk-based approach to hygiene, are promoted as part of the school curriculum and as part of public health campaigns. Alongside this, we also need unambiguous communication with the public on issues such as the hygiene hypothesis and environmental issues.

A biocompatible microdevice for core body temperature monitoring in the early diagnosis of infectious disease.

The early diagnosis of microbial infection is critical to the clinical instigation of effective post-exposure prophylaxis or therapy. However, diagnosis of infection is often attempted only when there are overt clinical signs, and for some of the serious human pathogens, this may jeopardize the efficacy of therapy. We have used a miniaturised sealed, implantable transponder incorporating a calibrated temperature sensor with an external receiver system, to monitor core body temperature (Tc) remotely. We have observed early changes in the diurnal rhythm of Tc, after infection of mice with bacterial pathogens. Changes in Tc preceded overt clinical signs by 3-10 h following challenge with Yersinia pestis, which causes acute infection, In contrast, changes in Tc were detected 11 days before clinical signs in mice exposed to Burkholderia pseudomallei, which causes a chronic syndrome. Significantly, mice pre-vaccinated against Y.pestis infection showed only slight and transient disruption to the diurnal rhythm for Tc, in the absence of clinical signs, when challenged with 10(6) median lethal doses of Y.pestis. This remote monitoring technology could be used to monitor changes in more than one physiological parameter and extrapolation of these data to the clinic would define the available therapeutic window in which diagnosis and post-exposure prophylaxis could be instigated, after a suspected exposure.

Multiple vaccine and pyridostigmine interactions: effects on EEG and sleep in the common marmoset.

Following active service during the 1990/1991 Gulf conflict, a number of UK and US veterans presented with a diverse range of symptoms, collectively known as Gulf Veterans' Illnesses (GVI). The administration of vaccines and/or the pretreatment against possible nerve agent poisoning, pyridostigmine bromide (PB), given to Armed Forces personnel during the Gulf conflict has been implicated as a possible factor in the aetiology of these illnesses. The possibility that long-term health effects may result from the administration of these vaccines (anthrax, pertussis, plague, yellow fever, polio, typhoid, tetanus, hepatitis B, meningococcal meningitis and cholera) and/or PB, have been investigated using a non-human primate model, the common marmoset. This paper reports the results from two aspects of the study, brain electrical activity (EEG, collected during performance of a touchscreen mediated discrimination task) and sleep. There were no marked long-term changes in EEG or sleep patterns that could be attributed to vaccines and/or PB administration. The changes that were detected were predominantly time related and independent of treatment. Where statistical differences were detected between treatments, the magnitudes of the difference were relatively minor and therefore not regarded as having long term biological significance.

Multiple vaccine and pyridostigmine interactions: effects on cognition, muscle function and health outcomes in marmosets.

Following active service during the 1990/1991 Gulf Conflict, a number of UK and US veterans presented with a diverse range of symptoms, collectively known as Gulf Veterans Illnesses (GVI). The administration of vaccines and/or the pretreatment against possible nerve agent poisoning, pyridostigmine bromide (PB), given to armed forces personnel during the Gulf Conflict has been implicated as a possible factor in the aetiology of these illnesses. The possibility that long-term health effects may result from the administration of these vaccines (anthrax, pertussis, plague, yellow fever, polio, typhoid, tetanus, hepatitis B, meningococcal meningitis and cholera) and/or PB, have been investigated using a non-human primate model, the common marmoset. This paper reports the results from three aspects of the study, cognitive behaviour (performance of a touchscreen mediated discrimination task), muscle function (performance of a simple strength test) and general health. There were no marked long-term changes in cognition, muscle function or health that could be attributed to vaccines and/or PB administration. Statistical differences related to treatments were only observed in two aspects of cognition and one of clinical chemistry. These changes were transient in nature and their magnitude were minor and, in consequence, was not regarded as having long-term biological significance.

A long-term study of the effects of diazinon on sleep, the electrocorticogram and cognitive behaviour in common marmosets.

The long-term sequelae of exposure to low doses of organophosphate compounds are ill defined, with effects variously reported on a range of indices of central nervous system functions such as sleep, cognitive performance and electroencephalogram (EEG). These indices were examined in common marmosets exposed to a range of doses of the organophosphorous sheep dip, diazinon. Cognitive performance was assessed by means of elements from the Cambridge Neuropsychological Test Automated Battery (CANTAB), and radiotelemetry techniques were employed to monitor the electrocorticogram and sleep patterns. Data were collected for 12 months following intramuscular administration of a single dose of diazinon (10, 90 or 130 mg.kg (-1)) or vehicle. Although high levels of erythrocyte acetylcholinesterase (AChE) inhibition (up to 82%) and short-term changes in sleep patterns were seen, there was no evidence of biologically significant long-term changes in any measures. The effects of multiple exposures, impurities or mixtures of OP compounds remain to be investigated.

A novel method for activity monitoring in small non-human primates.

Patterns of spontaneous activity are valuable reflections of well-being in animals and humans and, because of this, investigations have frequently incorporated some form of activity monitoring into their studies. It is widely believed that activity monitoring, alongside assessments of general behaviour, should be included in initial CNS safety pharmacology screening. As the number of marmoset studies having actimetry as their focus, or as an adjunct, is increasing, we wished to evaluate an alternative approach to those commonly used. The method is based on miniaturized accelerometer technologies, currently used for human activity monitoring.Actiwatch-Minis were used to monitor the activity of two groups of differently housed marmosets for 14 consecutive days. Group A consisted of four mixed-sex pairs of animals and group B comprised eight group-housed males. Activity profiles were generated for weekday and weekend periods. The devices captured quantifiable data which showed differences in total activity between the two differently housed groups and revealed intragroup variations in the temporal spread of activity between weekdays and weekends. The Actiwatch-Mini has been shown to generate retrospective, data-logged activity counts recorded from multiple animals in a single arena by means of non-invasive monitoring.

A simple method for assessing muscle function in common marmosets.

A novel method of assessing muscle function in the common marmoset was developed as part of a multidisciplinary long-term study. The method involved home cage presentation of a weight-pulling task. Over a 4-5 month period, 38 of 42 animals were successfully trained to displace weights of up to 920 g (mean 612+/-20 g). Performance, following initial training, was stable and independent of gender or body weight.

Developing an effective policy for home hygiene: a risk-based approach.

Evaluation of the infection potential in the home suggests that improved hygiene practice could significantly reduce the impact of infectious diseases. Fundamental to developing infection prevention policy for the home is the need to recognise that people live in an environment where all human activities occur, including food and water hygiene, hand hygiene, and hygiene related to care of vulnerable groups. In all these situations, reducing infection risks is based on the same underlying microbiological principles. In developing countries, disposal of human and animal excreta and other waste is often also the responsibility of the family and community. Adopting a holistic approach provides the opportunity for a rational approach to home hygiene based on risk assessment. The International Scientific Forum on Home Hygiene (IFH) believes that to deliver hygiene policy with real health benefits, a risk-based approach must be developed and promoted for the home. A risk-based approach starts from the principle that pathogens are introduced continually into homes on people, food and water, pets, insects and air. Inadequate disposal of human and animal excreta serves to increase this risk. Additionally, sites where stagnant water accumulates, such as sinks, toilets and cleaning cloths can support microbial growth and become a source of infection. By assessing the frequency occurrence of pathogens and potential pathogens on hands, hand and food contact surfaces, laundry, reservoir and reservoir/disseminator sites, together with the potential for transfer in the home, the exposure risk can be assessed.

Assessment of a combination of physostigmine and scopolamine as pretreatment against the behavioural effects of organophosphates in the common marmoset (Callithrix jacchus).

RATIONALE: There is a requirement to ensure that UK armed forces are provided with the best possible medical countermeasures to prevent or mitigate the effects of exposure to nerve agents. When pretreatments are under consideration, it is of particular importance to ensure that they do not in themselves give rise to adverse effects and do not exacerbate the effects of agent exposure. OBJECTIVES: The present study was designed to address these considerations for a combination of physostigmine and scopolamine as a potential pretreatment regimen. METHODS: Common marmosets were trained to perform a two-choice discrimination serial reversal task, and baseline data were collected. Subjects received a dose of either soman or sarin after 2 weeks of pretreatment with either saline or physostigmine and scopolamine via miniosmotic pump. RESULTS: No effects of physostigmine and scopolamine were seen on task accuracy or response rates. Neither accuracy of reversal performance nor number of responses made were significantly changed by administration of either soman or sarin subsequent to pretreatment with physostigmine/scopolamine. In the groups pretreated with saline, performance of the behavioural task, in terms of responses made, was virtually abolished on the day the OP was administered, but a significant increase in accuracy of performance was seen over the 2- to 14-day period following administration. CONCLUSIONS: A combination of physostigmine and scopolamine, which is known to protect against nerve-agent lethality, offers protection against the effects of soman and sarin on behavioural performance, as measured by a discrimination reversal task. The improved performance observed following nerve agent requires further investigation.

Investigation of the sleep electrocorticogram of the common marmoset (Callithrix jacchus) using radiotelemetry.

OBJECTIVE: To evaluate the use of a totally implantable radiotelemetry system for recording the sleep electrocorticogram (ECoG) of a small new world primate, the common marmoset (Callithrix jacchus) without restraint during data collection. METHODS: Under anaesthesia a telemetry transmitter, which allowed the recording of a single ECoG channel, was implanted intraperitoneally. This system allowed ECoG data to be recorded overnight from animals living in pairs within their habitual laboratory environment over a period of 12 months. Data were subsequently scored using modified Rechtschaffen and Kales criteria (A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects. Los Angeles, UCLA Brain Information Service/Brain Research Institute, 1968) into stages of waking, light sleep, deep sleep and probable rapid eye movement sleep (pREM). Concurrent video recording was used to assist in the categorising of pREM. RESULTS: Results showed that, as in man, the marmoset exhibits sleep cycles with stages alternating between non-REM (deep sleep and light sleep) and pREM sleep throughout the night. In common with other non-human primates the duration of each of the sleep stages was relatively short and punctuated with frequent waking. CONCLUSIONS: These data suggest that sleep in marmosets housed under laboratory conditions (a) can be recorded without restraint and (b) has potential to be used as a model for human sleep.

The effects of acutely administered low dose sarin on cognitive behaviour and the electroencephalogram in the common marmoset.

Previous studies have suggested that administration of a clinically sign-free dose of sarin to non-human primates gives rise to subtle changes in brain electrical activity as measured by electroencephalography (EEG) several months following exposure. The functional significances of such changes are unclear. The present study monitored EEG by using implantable radiotelemetry, and also assessed the performance of complex behavioural tasks, in non-human primates for up to 15 months following exposure to a low dose of sarin. Baselines of EEG and behaviour were shown to be stable over several months in control animals. The doses of sarin administered caused erythrocyte cholinesterase inhibitions of 36.4% to 67.1%. Overall, no significant changes in EEG patterns were observed although there were increases in beta 2 amplitude which approached significance (p=0.07). No deleterious effects on performance were seen on the touchscreen mediated discrimination tasks presented from the Cambridge Neuropsychological Test Automated Battery (CANTAB). This study illustrates the validity of the approach employed and makes an important contribution to the investigation of the long-term effects of organophosphorous compounds.

Effects of client interviewers on client-reported satisfaction with mental health services.

A study at two outpatient facilities compared two methods of collecting data on client satisfaction with mental health services provided by case managers and by physicians. A satisfaction survey instrument was developed with input from clients. A total of 120 clients were randomly assigned to be interviewed by either a staff member or a client. Clients from both facilities reported high levels of satisfaction regardless of the type of interviewer. Clients gave a significantly greater number of extremely negative responses when they were interviewed by client interviewers. No difference between the two groups was found in overall satisfaction with services received from case managers or physicians.

Inflammatory bowel disease in horses: 11 cases (1988-1998).

OBJECTIVE: To determine clinical and surgical abnormalities in, and long-term outcome of, horses that undergo surgery because of colic secondary to inflammatory bowel disease (IBD). DESIGN: Retrospective study. ANIMALS: 11 horses. PROCEDURE: Medical records of horses that had undergone abdominal surgery and in which IBD had been diagnosed on the basis of histologic examination of intestinal biopsy specimens were reviewed. RESULTS: 5 horses were examined because of acute colic and 6 were examined because of chronic colic. At surgery, all 11 horses had edematous or hemorrhagic bowel segments suggestive of IBD. In addition, 6 horses had circumferential mural bands (CMB) causing constriction of the small (4 horses) or large (2) intestine. Intestinal resections were performed in 7 horses. All 11 horses survived surgery and were discharged from the hospital; 10 horses were still alive at the time of follow-up (1.5 to 7 years after surgery). CLINICAL IMPLICATIONS: Results suggest that IBD is an uncommon cause of colic in horses. Surgical resection of segments of intestine with constrictive CMB may relieve clinical signs of colic. Horses with IBD that had surgery had a good prognosis for long-term survival.

Discharge planning in mental health: the relevance of cognition to community living.

OBJECTIVE: The purpose of this study was to investigate the relationship between cognitive disability and performance of daily living skills and stability of cognitive level after discharge in a sample of adult psychiatric inpatients (N = 40). METHOD: The Allen Cognitive Level Test-90 (ACL-90) was administered at time of discharge (Time I) and at 21 days to 28 days after discharge (Time II). The self-report version of the revised Routine Task Inventory (RTI-2) was also administered at Time II. RESULTS: No significant correlation was found between the ACL-90 at Time I and the RTI-2 scores; however, significant correlations were found between the ACL-90 scores at both times and between the ACL-90 score at Time II and the RTI-2 scores. CONCLUSION: The findings suggest that cognitive level remains relatively stable over a 1-month period in the postacute stage of a psychiatric illness. Cognitive level and performance of daily living skills are related, but the relationship is sensitive to time. Implications for occupational therapy assessment include recognizing the temporal constraints of functional assessments and refining instruments to be more sensitive to performance of familiar tasks, taking into consideration client adaptation to exigencies.

Perceptions of the General Medical Council: the views of executive directors.

The regulation of the medical profession has recently been the subject of considerable debate. This paper describes a survey of the views of Trust medical directors and health authority directors of public health in the Northern and Yorkshire region on the way the GMC operates. A total of 46 out of 50 (92 per cent) gave a substantive response to the survey, of whom 16 (35 per cent) had not had cause to contact the GMC during the previous year, nine (20 per cent) were happy with their contact with the GMC and 21 (46 per cent) expressed some concern. The most commonly cited causes for concern were the length of time taken to process a complaint and lack of communication. While the individual opinions expressed are entirely subjective, it is argued that collectively they identify issues which the GMC and executive directors need to address.

Home cage presentation of complex discrimination tasks to marmosets and rhesus monkeys.

The study reported here demonstrates the feasibility of presenting cognitive tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB) to either marmosets or rhesus monkeys in their home cages. This location of testing offers opportunities for the measurement of additional indices, for example spontaneous behaviour (Prowse et al. 1995) and electrophysiology (Pearce et al. 1998) as well as facilitating repeated test presentation. Results from 12 marmosets and 4 rhesus monkeys which have completed several sequences of an eight-stage discrimination task involving simple discriminations, compound discriminations and reversals are reported. The paradigm developed has application in long-term studies. Tests from CANTAB have been used extensively in normal humans (Robbins et al. 1994) as well as a range of patient groups (Owen et al. 1992, Elliott et al. 1995) and to assess drug effects (Coull et al. 1996). Additionally some of these tests have been presented to marmosets (Roberts et al. 1988) to examine neuropsychological functioning. This comparative approach facilitates meaningful cross species comparison, particularly in the study of the effects of pharmacological intervention.

Environmental health concerns in urban and rural family practice.

OBJECTIVE: To describe environmental health problems encountered in some Ontario family practices and to describe differences between the environmental concerns of urban (small and large) and rural physicians. DESIGN: A self-completed questionnaire was mailed to 536 family physicians with hospital affiliations in three areas of Ontario. SETTING: Family practices (rural, small urban, and large urban) in Ontario. PARTICIPANTS: Of 521 eligible community family physicians with hospital affiliations, 214 returned usable questionnaires for a 41% response rate. MAIN OUTCOME MEASURES: Environmental health problems encountered in practice were measured using questions about physician concerns, reported patient questions, physician-identified high-risk groups, problems related to environmental exposure, self-rated knowledge, and current and preferred sources of information on environmental health effects. RESULTS: Physicians were highly concerned and reported many patient questions about the health effects of environmental exposures. Pregnant women, agricultural workers, and children were considered important at-risk groups. Self-ratings of knowledge were generally very low. Rural physicians were concerned about agricultural pesticide exposure and their patients about moldy hay. Urban physicians had different concerns about lead and reported patient concerns about exposure to Great Lakes fish. All groups used similar sources of current environmental health information. CONCLUSIONS: Family physicians who participated in this study identified important patient and professional concerns about environmental health issues and reported a lack of resources to meet those concerns. This study provides information to family medicine residency programs and continuing medical education providers to help them enhance their focus on environmental health.