Thermal expansion and magnetostriction of pure and doped RAgSb(2) (R = Y, Sm, La) single crystals.

Data on temperature-dependent, anisotropic thermal expansion in pure and doped RAgSb(2) (R = Y, Sm, La) single crystals are presented. Using the Ehrenfest relation and heat capacity measurements, uniaxial pressure derivatives for long range magnetic ordering and charge density wave transition temperatures are evaluated and compared with the results of the direct measurements under hydrostatic pressure. In-plane and c-axis pressure have opposite effects on the phase transitions in these materials, with in-plane effects being significantly weaker. Quantum oscillations in magnetostriction were observed for the three pure compounds, with the possible detection of new frequencies in SmAgSb(2) and LaAgSb(2). The uniaxial (along the c-axis) pressure derivatives of the dominant extreme orbits (ß) were evaluated for YAgSb(2) and LaAgSb(2).

Factors affecting the occurrence and enantiomeric degradation of hexachlorocyclohexane isomers in northern and temperate aquatic systems.

Concentrations of (alpha- and gamma-hexachlorocyclohexane (HCH), alpha/gamma-HCH ratios, and enantiomer ratios (ER) of alpha-HCH were measured in lakes in the arctic, subarctic, Great Lakes, Canada, and temperate regions, and temperate and arctic wetlands and streams. The highest concentrations of alpha-HCH were found in cold, large, and oligotrophic lakes such as those in the arctic, subarctic, and the upper Great Lakes, which is attributed to greater inputs from atmospheric deposition and slower loss rates relative to warmer, temperate lakes. High alpha/gamma-HCH ratios in northern systems indicate aged HCH that has undergone long-range transport to high latitude areas, whereas low ratios in the lower Great Lakes and small temperate systems indicate recent gamma-HCH usage and residual alpha-HCH concentrations. Enantioselective degradation (ERs ranged from 0.31 to 0.7) was greatest in small, high arctic lakes and streams and in large lakes in the subarctic in which alpha-HCH concentrations and contact time between chemical and sediments are highest and nutrient concentrations are lowest. Low ERs were found in wetlands and streams in which contact between chemical and sediments was greatest. Conversely, minimal enantioselective degradation occurred in temperate small lakes and wetlands (ERs ranging from 0.77 to 1.06), despite the warmer temperatures, greater microbial populations, and nutrient availability. The results suggest that enantioselective degradation is optimized by maximal contact between chemical and sediment substrates in nutrient-poor waters in which, it is hypothesized, oligotrophic bacteria may act as biofilms.

Sex discrimination and insurance for contraception.

Unintended pregnancy is a serious problem in the United States. Most private insurance plans do not pay for contraception even though they pay for other prescription drugs and devices. This Article argues that this pattern constitutes sex discrimination and is prohibited by Title VII of the Civil Rights Act of 1964, as amended by the Pregnancy Discrimination Act. It discusses the reasons this issue has been neglected and suggests ways federal and state officials might remedy this common form of gender discrimination.

Factors that influence the patient centredness of a consultation.

BACKGROUND: Research suggests that patients are more satisfied with patient-centred consultations than with doctor-centred consultations and that some health measures are positively influenced by this type of consultation. Research on the factors that influence the patient centredness of the consultation is sparse but suggests that women doctors are more patient centred than men doctors. AIM: A study was designed, first, to confirm or reject the suggestion that women general practitioners are more patient centred than men general practitioners and, secondly, to determine some of the factors that might influence the patient centredness of a general practitioner. METHOD: The audiotaped consultations of 41 general practitioners were analysed using an instrument designed to measure patient centredness. The general practitioners were selected from a group of volunteers to represent both sexes as well as a wide range of age and experience. RESULTS: The results of the analysis showed that women general practitioners, particularly trainers, had higher patient-centredness scores than men general practitioners. This behaviour is characterized by an increased frequency of open questions and greater attention to patient offers (anything of potential significance that a patient brings to the general practitioner consultation). Additionally, the combination of sexes in a consultation seemed to have an effect on the interaction, with woman general practitioner/female patient dyads (pairings) having the highest median patient-centredness score, woman general practitioner/male patient and man general practitioner/male patient dyads scoring the same as each other and man general practitioner/female patient dyads having the lowest median scores. CONCLUSION: The results suggest that women general practitioners, in this sample, were more patient centred than men general practitioners. The results also suggest that inherent inequalities exist, with female patients receiving a more patient-centred service from general practitioners of their own sex than from general practitioners of the opposite sex. Male patients, on the other hand, seemed to fare equally well, irrespective of the sex of their general practitioner. Training is required to address these inequalities and to improve the level of patient centredness in the consultation.

Fitness and lifestyle parameters fail to predict back injuries in nurses.

Performance on fitness and back related isometric strength tests, as well as the response to a lifestyle questionnaire, were related to the subsequent occurrence of back injuries in 119 nurses. In all, 22% of subjects sustained injuries during the 18-month study. Injured nurses were more likely to be from high-risk wards and to have received worker's compensation pay for past back injuries. Fitness and lifestyle characteristics did not differ significantly between injured and not-injured groups. Using backward stepwise logistic regression, a model was developed that accounted for 41% of the variability between groups and predicted 67% of those injured. Prior compensation pay, smoking status, and job satisfaction were the most useful discriminators. It was concluded, however, that the fitness and lifestyle parameters measured did not effectively predict back injury in nurses.

Leukocytes from four patients with complete or partial Leu-CAM deficiency contain the common beta-subunit precursor and beta-subunit messenger RNA.

Deficiency of a family of three leukocyte adhesion molecules (Leu-CAM) is associated with recurrent and life-threatening bacterial infections in man. Each of the three antigens, Mo1, LFA-1, and Leu M5 has a distinct alpha subunit noncovalently associated with a common beta subunit that appears to be required for the expression of these antigens on the cell surface. To investigate the molecular basis of Leu-CAM deficiency, we studied leukocytes from four unrelated patients suffering from complete or partial Leu-CAM deficiency using immunoprecipitation of metabolically labeled proteins, RNA extraction, and Northern blot analysis. We found that B cells from all four patients synthesized a normal sized beta subunit precursor that either failed to "mature" or matured only partially to the membrane expressed form. B cells from all four patients also had a single normal sized beta subunit mRNA of approximately 3.4 kb. Leu-CAM deficiency, in these unrelated patients, is not due to the absence of the beta chain gene or to aberrant splicing of its mRNA and are consistent with a defective beta subunit gene resulting in abnormal posttranslational processing of the synthesized molecule.

The teaching of medical ethics from a junior doctor's viewpoint.

This is a short paper covering my own views on the methods and reasons behind the teaching of medical ethics. All the whys and wherefores are discussed and some conclusions reached. This paper is given from a junior doctor's viewpoint but could equally apply to many others.

KIE: The author, a Royal Air Force junior physician participating in a General Medical Council conference, offers her views on the methods and reasons behind the teaching of medical ethics. She briefly addresses the issues of what medical ethics is, who shall be taught and who shall teach, and how and where instruction should take place. Law concludes that the teaching of medical ethics begins before medical school, with a sound upbringing, and that it should continue until a physician retires.

Bellotti v. Baird: A victory for minor's rights of reproductive choice.

PIP: The Supreme Courts's 1979 ruling in Bellotti vs. Baird held that mature minors have a right to make their own decisions about abortion. Both mature and immature minors must have the opportunity, through an alternative judicial or administrative procedure which must be prompt, expeditious and assure the minor's anonymity. The sole criterion for immature minors is what is in their best interest. The Bellotti decision reaffirmed Planned Parenthood of Central Missouri vs. Danforth decision that ruled state laws requiring all minors to have parental consent for abortion are unconstitutional. The Bellotti decision also reinforces the minor's right of access to contraception. The ruling allows states to establish procedures for determination of maturity of the minor but requires that the procedure be prompt. Nonlegal mechanism, e.g. physician's consent, may be the most suitable for preserving both family harmony and the rights of minors.^ieng