Selected chronic disease 'risk factors' in two elementary school populations. A pilot study

Ninety-five first-grade elementary school students (aged 5 to 6 years) in two New York City area schools participated in a pilot test of a chronic disease primary prevention program stressing nutrition, antismoking, and physical activity. Program components included a health knowledge questionnaire; measurement of height, weight, skin-fold thickness, total serum cholesterol level, and blood pressure; and a modified Harvard step test of pulse rate recovery after exercise and subsequent classroom health education. The proportion of students with test values higher than specified critical levels was much greater in school M compared with school S. These measures will be repeated after one year to determine the feasibility and potential effectiveness of certain classroom health education activities.

Inhibition of suckling in weaning-age rats: a possible serotonergic mechanism

The nature, development, and specificity of serotonergic involvement in the control of suckling behavior in rat pups from 10 to 35 days of age were studied. During development, suckling normally declines after 10 days and is abandoned after 30 days. It was found that (a) methysergide, a serotonin (5-HT) receptor blocker, reinstated suckling behavior in pups 15 days of age and older but had no effect on the suckling of 10-day old pups, (b) quipazine, a 5-HT receptor agonist, inhibited suckling of pups 10 days of age and older, (c) methysergide pretreatment blocked the quipazine inhibition of suckling, and (d) metergoline, another 5-HT blocker, also stimulated suckling, and fenfluramine, a 5-HT releaser, blocked suckling in deprived pups. Together, these data support the hypothesis that a serotonergic inhibitory mechanism modulates the suckling of weaning-age rats. These pharmacological manipulations of 5-HT appear to alter specific components of suckling behavior involved in its initiation and maintenance but do not appear to alter a general hunger system.

Motivating adolescents to reduce risk for chronic disease

Motivating children to reduce risk for future disease can only be effective within a framework of personal involvement and peer interaction. The 'Know Your Body' programme of disease prevention is attempting to achieve this goal by means of medical screening for risk factors, giving students their own results in a 'Health Passport', and following up with educational activities integrated into existing school curricula. Didactic teaching alone has been unsuccessful because children cannot relate information about diseases in adult life to themselves. Screening for risk factors provides the 'reality factor' which makes health education pertinent and personal, since approximately half of all students screened will already have one or more risk factors for heart disease, cancer or stroke. This high prevalence of risk factors among our children suggests that chronic-disease prevention must assume a critically important position within the health and science curricula of every school. It is as important to teach our children healthy ways of living as it is to teach reading, writing, and arithmetic.

Suckling behavior of the infant rat: modulation by a developing neurotransmitter system

Drugs which alter serotonin receptor activity modified the suckling behavior of 20-day-old rat pups. Suckling could be reinstated in nondeprived pups, which normally do not suckle, by blockade of serotonin receptors with methysergide. Stimulation of serotonin receptors with quipazine inhibited suckling in deprived pups, and this effect was prevented by methysergide pretreatment. This evidence suggests that suckling in weaning age pups is controlled by a serotonergic inhibitory mechanism.

A typology of parasuicide

Parasuicide is not a single syndrome. Subtypes at present recognized are based largely on clinically derived stereotypes. When considering a series of patients, the clinician is unable to handle more than a few attributes at a time. This paper describes the application of three very different clustering algorithms to a material of 350 treated parasuicide patients. Mathematically, three types emerge. Clinically, two of these are interpretable and make sense. The types established are: I (n = 107) a group not characterized by any of the variables we examined; this group is a puzzle, mainly because the reasons for the parasuicidal act are not clear. II (n = 132) a depressed, alienated group with high life-endangerment. III (n = III) a group whose act was highly operant: they felt alienated and were angry with others. These groups did not differ significantly on demographic variables. The usefulness of this typology, particularly for management, after-care and prevention, has now to be assessed.

Intensive chemotherapy of small cell bronchogenic carcinoma

Thirty-two patients (27, extensive disease; five, regional disease) with histologically documented small cell carcinoma entered a randomized study to determine the efficacy of intensive induction chemotherapy. The necessity of a protected environment (laminar air flow room) during this treatment was also evaluated. Patients received high-dose or standard-dose cyclophosphamide, methotrexate, and CCNU (CMC) during the first 6 weeks of treatment. Subsequent maintenance therapy consisted of standard-dose CMC until disease progression. In 23 patients treated with high-dose chemotherapy there were responses in 96% (30% complete). Standard-dose chemotherapy gave responses in 45%, none of which were complete. Median survival correlated with completeness of response and was 16+ months for the seven complete responders. Patients receiving high-dose CMC spent an average of 10 days with neutrophil counts less than 1000/mm3. There was only one documented, non-fatal infection. High-dose chemotherapy gives better responses and longer survival than previously utilized standard doses of the same drugs. Patients could safely be treated in the hospital ward.

Correlates of impulsive suicidal behaviour

Up to two-thirds of reported suicidal acts are impulsive in nature. In a series of patients presenting at a general hospital as a result of suicidal behaviour, it was concluded that over half the acts were impulsive in nature. A number of variables were found to be related to the occurrence of impulsive suicidal behaviour and they included the following: a past history of suicidal behaviour, the tablets being in the same room when the decision to engage in the act was reached, the ingestion of more than half the available tablets, and finally, the tablets tending to be bottled rather than foil packaged. Findings were discussed in terms of the aetiology and prevention of impulsive suicidal behaviour.

Effect of oral prophylactic broad spectrum nonabsorbable antibiotics on the gastrointestinal absorption of nutrients and methotrexate in small cell bronchogenic carcinoma patients

Patients with small cell bronchogenic carcinoma, in a study utilizing laminar-air-flow-protected environments, oral prophylactic broad spectrum non-absorbable antibiotics (PNAA), and intensive combination chemotherapy, were examined to determine the effects of PNAA on serum biochemical values and on gastrointestinal absorption of both nutrients and methotrexate. With use of PNAA the following abnormalities were observed; serum carotene and folate decreased, D-xylose absorption was impaired, fat globules and muscle fibers were demonstrable in the stool, and the mean weight loss in 6 weeks was 10.2% as compared with 4.3% in patients not treated with antibiotics. Methotrexate absorption decreased from a mean of 69% prior to antibiotic use to 44% on PNAA. Thus, PNAA causes malabsorption of both nutrients and drugs. It appears unwise to treat patients on PNAA with oral antineoplastic drugs. Nutritional status must also be closely monitored and supplemental nutrition, either intravenously or with elemental diets, must be considered.

Attempted suicide: an operant formulation

An alternative formulation of attempted suicide is offered, in which the phenomenon is considered within the context of social learning theory. The suicidal behaviour is viewed as an operant which is reinforced and maintained by the consequent interpersonal contingencies. The modification of the suicidal behaviour then involves alteration of the contingent consequences. This theoretical formulation is elaborated and the treatment principles and practice are outlined.

On the prevention of parasuicide

Parasuicide rates have shown a marked increase in recent years and now consume a substantial proportion of medical services. To reduce hospital admission rates for parasuicide is probably desirable. While there has been considerable research on parasuicide, it is apparent that many of the findings have limited application to prevention. It is argued that attempts at primary prevention should be directed at those factors in the population considered to have a substantial function in promoting this group of behaviours. The first step in such a program should be the empirical delineation of a typology of parasuicide, since it is not a unitary phenomenon and a single preventive measure is therefore unlikely to have widespread success. Following the recognition of different requirements for different population groups, an experiment in prevention might be attempted by monitoring the parasuicide rates in two closely similar populations, one of which has alterations made sequentially to variables such as the following: the availability of tablets and the form of their presentation; the availability of personal advisory services; and community attitudes to parasuicide. Possible dangers inherent in such experimental epidemiology are acknowledged but it is argued thai aspects of the current approach to the problem of parasuicide may be in need of revision.

Paired associate rote learning in deaf and hearing subjects

Ninety-two deaf and 92 hearing subjects were administered a four-pair and an eight-pair word-numeral task under three methods for demonstrating the correct pairs. On each task, the deaf and hearing groups did not differ in number of pairs learned. Neither did they respond differentially to the three methods. For both groups, the effects of the methods varied with task length. On the four-pair task, list-demonstration and item-demonstration were similarly effective, while both methods were more effective than no-demonstration; on the eight-pair task, list-demonstration was most effective, while item-demonstration and no-demonstration did not differ in effectiveness.