Meta-Analysis of Soybean Yield Response to Foliar Fungicides Evaluated from 2005 to 2018 in the United States and Canada

Random-effect meta-analyses were performed on data from 240 field trials conducted between 2005 and 2018 across nine U.S. states and Ontario, Canada, to quantify the yield response of soybean after application of foliar fungicides at beginning pod (R3) stage. Meta-analysis showed that the overall mean yield response when fungicide was used compared with not applying a fungicide was 2.7% (110 kg/ha). Moderator variables were also investigated and included fungicide group, growing season, planting date, and base yield, which all significantly influenced the yield response. There was also evidence that precipitation from the time of planting to the R3 growth stage influenced yield when fungicide was used (P = 0.059). Fungicides containing a premix of active ingredients from multiple groups (either two or three ingredients) increased the yield by 3.0% over not applying a fungicide. The highest and lowest yield responses were observed in 2005 and 2007, respectively. Better yield response to fungicides (a 3.0% increase) occurred when soybean crops were planted not later than 21 May and when total precipitation between planting and the R3 application date was above historic averages. Temperatures during the season did not influence the yield response. Yield response to fungicide was higher (a 4.7% increase) in average yield category (no spray control yield 2,878 to 3,758 kg/ha) and then gradually decreased with increasing base yield. Partial economic analyses indicated that use of foliar fungicides is less likely to be profitable when foliar diseases are absent or at low levels.

Does cannabis use lead to depression and suicidal behaviours? A population-based longitudinal study

OBJECTIVE

This study investigates the relationship between cannabis use and later depression, suicidal ideation and suicide attempts in a cohort of young Norwegians.

METHOD

Data were gathered through the Young in Norway longitudinal study, in which a population-based sample of 2033 Norwegians were followed up over a 13-year period, from their early teens to their late twenties. Data were gathered on: (a) exposure to cannabis use; and (b) depression, suicide ideation and suicide attempts. In addition, information about possible confounding factors was included.

RESULTS

In early adolescence, no associations with later depression or suicidal behaviours were observed. In the sample's twenties, we observed highly significant associations with suicide ideation and suicide attempts. When adjusting for confounders, the OR was 2.9 (95% CI 1.3-6.1) for later suicide attempts in the group who had used cannabis 11+ times during the past 12 months.

CONCLUSION

The findings suggest that exposure to cannabis by itself does not lead to depression but that it may be associated with later suicidal thoughts and attempts.

Further delineation of the 22q13 deletion syndrome

A chromosomal deletion syndrome associated with a 22q13 microdeletion has previously been reported in approximately 75 children. We report six cases from Denmark with a deletion of 22q13. One was cytogenetically visible by conventional karyotyping, one was diagnosed by high resolution karyotyping after the demonstration of low arylsulfatase A activity. Two were diagnosed by high resolution CGH analysis, one was diagnosed by multisubtelomeric FISH analysis and one was diagnosed serendipitously as lack of the control signal in a FISH analysis for 22q11 deletion. One of the cases was a mosaic with 16% of cells showing two signals. The phenotype of the children included: generalized developmental delay, compromised language development, hypotonia, normal or accelerated growth and minor facial dysmorphism. Other features were partial agenesis of the corpus callosum, bilateral ureteropelvic stricture, gastroesophageal reflux and hearing loss. One case had a different phenotype, and showed a deletion as well as a duplication. The extent of the deletion was studied by quantitative PCR analysis of a number of DNA markers in the 22q13 region. The deletions varied in size, extending from 4.0 to 9.0 Mb. The clinical phenotype seemed rather similar although some specific features might be attributable to differences in deletions.

Population-based risk estimates of Wilms tumor in sporadic aniridia. A comprehensive mutation screening procedure of PAX6 identifies 80% of mutations in aniridia

Aniridia is a severe eye disease characterized by iris hypoplasia; both sporadic cases and familial cases with an autosomal dominant inheritance exist. Mutations in the PAX6 gene have been shown to be the genetic cause of the disease. Some of the sporadic cases are caused by large chromosomal deletions, some of which also include the Wilms tumor gene (WAGR syndrome), resulting in an increased risk of developing Wilms tumor. Based on the unique registration of both cancer and aniridia cases in Denmark, we have made the most accurate risk estimate to date for Wilms tumor in sporadic aniridia. We have found that patients with sporadic aniridia have a relative risk of 67 (confidence interval: 8.1-241) of developing Wilms tumor. Among patients investigated for mutations, Wilms tumor developed in only two patients out of 5 with the Wilms tumor gene (WT1) deleted. None of the patients with smaller chromosomal deletions or intragenic mutations were found to develop Wilms tumor. Our observations suggest a smaller risk for Wilms tumor than previous estimates, and that tumor development requires deletion of WT1. We report a strategy for the mutational analysis of aniridia cases resulting in the detection of mutations in 68% of sporadic cases and 89% of familial cases. We also report four novel mutations in PAX6, and furthermore, we have discovered a new alternatively spliced form of PAX6.

Conduct problems and early cannabis initiation: a longitudinal study of gender differences

AIM

To investigate the relationship between early conduct problems and early onset of cannabis use, with special emphasis on possible gender differences.

DESIGN

A prospective longitudinal study of a national sample of 2436 adolescents. The sample was followed up over a year and a half, when the adolescents were in their early teens.

SETTING

Norway.

MEASUREMENTS

On the basis of an earlier study, conduct problems (CP) closely related to the criteria for conduct disorder (CD) in DSM-III-R were decomposed into three dimensions, labelled serious, aggressive and covert. Further, information was collected about alcohol intoxication, daily smoking and use of cannabis. A number of questions were posed about sexual interactions and perceived puberty development. Parental socio-economic status was measured according to the ISCO-88. Separate information was collected as to whether the parents were on social welfare or unemployed. A parental bonding measure (PBI) was used to measure the emotional relationship between respondents and parents. Further, a measure of parental monitoring was used, and information was also collected on other aspects of the family milieu, and on the adolescents' peers. Statistical models. Logistic regression analysis was employed. As the sample consisted of pupils clustered within classes within schools, a three-level error structure for the logistic regression model was estimated.

FINDINGS

There was a strong association between early conduct problems and subsequent cannabis initiation. Also conduct problems at a potential subclinical level seemed to have great impact. The effect was significantly stronger in girls than in boys. Serious CP was found to have a moderate effect upon cannabis initiation in boys, whereas aggressive and covert CP had strong effects in girls. Early onset of puberty and early sexual involvement had no impact, whereas early use of cigarettes proved an important precursor to cannabis use.

CONCLUSIONS

Conduct problems are important precursors of early onset cannabis use, but probably represent gender-specific aetiologies. There might be an important potential for prevention of early onset drug use in the prevention of early conduct problems, in particular for girls.

Use of anabolic-androgenic steroids in adolescence: winning, looking good or being bad?

OBJECTIVE

To investigate the prevalence of anabolic-androgenic steroid (AAS) use among Norwegian adolescents and to contrast three perspectives on AAS use: performance enhancement in sports competition, body image and eating concerns, and AAS-use as belonging to a cluster of problem behaviors.

METHOD

A nationally representative sample of 8,877 (53.8% female) Norwegian youths (15-22 years of age) were surveyed (response rate 78%). Sports participation included measures of participation in strength sports, participation in competitive sports, strength training and perceived athletic competence. Body image and eating concerns included measures of disordered eating, perceived physical appearance and satisfaction with body parts. Problem behavior was measured by three dimensions of conduct problems (overt destruction, overt nondestruction and covert destruction), illicit drug use and sexual involvement.

RESULTS

Information about AAS was obtained from 8,508 subjects. Lifetime AAS use was 0.8% (1.2% male and 0.6% female), 12-month prevalence was 0.3% and 5.1% had been offered AAS. AAS use did not vary according to sports involvement and demographics. Logistic regression analyses showed that AAS use was associated with such problem behavior as marijuana (cannabis) involvement and overt nondestruction (e.g., aggressive-type conduct problems) and, to some extent, with involvement in power sports and disordered eating. AAS users differed little from those who had been offered but refrained from using AAS, except that they were more likely to be current marijuana users.

CONCLUSIONS

Adolescent AAS use seems primarily to be another type of problem behavior and only secondarily is it associated with strength-sport participation and disordered eating.

[Children and adolescents selling sex]

Our knowledge about prostitution is shaped by female street prostitutes, many of whom are drug addicts. Less is known about children and adolescents from the normal population who sell sex. Total cohorts of pupils in all Oslo's schools (N 10,812) in the age groups 14-17 filled in a questionnaire at school. 1.4% of the adolescents had sold sex at least one time, more than three times as many boys as girls. Mean age for first episode was 12.6 years in boys, and 14.1 years in girls, and seventy per cent had sold sex more than three times. There were no associations to indicators of parental social class or residential area in Oslo. The adolescents who had sold sex were more lonely and more often reported symptoms of depression and anxiety than others. A multivariate analysis showed that associations to conduct problems, alcohol problems and use of drugs were most important. The majority reported no contact with public services aiming at helping adolescents with psychosocial problems. A group of children and adolescents in Oslo sell sex. Boys are involved more often than girls, their customers are assumed to be bisexual or homosexual men. These behaviours fall into a pattern of conduct and substance problems, and some of these adolescents could have high long-term risk of antisocial problems and drug abuse. More knowledge is needed, and preventive work should be intensified.

Ecstasy and new patterns of drug use: a normal population study

AIMS

(i) To describe illegal drug use patterns in an adolescent normal population sample with special emphasis on MDMA, ecstasy; (ii) to investigate where ecstasy is introduced in a hypothesized drug use sequence, and (iii) to contrast the predictors of ecstasy use with those of other illegal substances. Special attention was given to the relationship to subcultural music preferences and house-party-going.

DESIGN

A school-based survey of the total cohort of adolescents enrolled in the school system in a city.

PARTICIPANTS

10,812 adolescents, age 14-17 years, response rate 94.3%.

SETTING

Oslo, the capital and only metropolitan town in Norway.

MEASUREMENTS

Social class was measured by the occupation standard ISCO 88, questions were posed as regards frequency of alcohol use and alcohol intoxication, cigarette smoking and use of cannabis, amphetamines, ecstasy and heroin. Alcohol problems were measured by a shortened version of Rutgers Alcohol Problem Index (RAPI), conduct problems were measured according to the four categories of acts forming the basis of the diagnosis conduct disorder in DSM-IV, internalizing mental health problems were measured using items from Hopkins Symptoms Checklist (HCL). A number of questions were asked as regards subcultural music preferences and house-party-going. STATISTICAL MODELS: A hypothesized cumulative sequence in drug use was investigated by means of latent class analysis, and the predictors of the various patterns of drug use were estimated and compared by means of multinominal logistic regression analysis.

FINDINGS

The use of ecstasy was often intermingled with the use of cannabis, amphetamines and heroin, in a pattern of polydrug use. The latent class analysis revealed the following drug use sequence: (1) alcohol, (2) cigarettes, (3) cannabis, (4) amphetamines, (5) ecstasy and (6) heroin. There was no significant association between ecstasy use and parental social class or residential area of the town. All patterns of illegal drug use were highly associated with cigarette smoking, alcohol use, alcohol problems and conduct problems, whereas the associations with internalizing mental health problems were of less magnitude. Multinominal logistic regression analysis revealed that the use of ecstasy (E) was significantly more weakly associated with cigarette smoking than were the use of cannabis only (C), amphetamines (A) and the combination of ecstasy and amphetamines (A + E). The association between E and conduct problems (CP) was weaker than the association between CP and A and A + E. Finally, there were associations between E and A + E and House/Techno preferences and house-party-going, which were not found for C and A.

CONCLUSIONS

Ecstasy is used by adolescents who use other legal and illegal substances in a polydrug-use pattern. The substance is introduced late in a hypothesized drug use sequence. Even so, ecstasy use seems to differ from the use of, e.g. amphetamines, in that the association with smoking and conduct problems is weaker and that the associations with subcultural music preferences and house-party-going are much stronger.

Daily Inoculum Levels of Gibberella zeae on Wheat Spikes

The inoculum level of Gibberella zeae on wheat spikes was measured during 1995 and 1996 in nine locations of Canada and the United States prone to Fusarium head blight of wheat. Spikes were exposed after exsertion and until kernel milk or soft dough stage in fields with wheat or corn residue as a source of inoculum; other spikes were exposed in a location remote from any obvious inoculum source; and in 1995 only, control plants remained in a greenhouse. After 24 h, spikes were excised and vigorously shaken in water to remove inoculum. Propagules were enumerated on selective medium and identified as G. zeae from subcultures. Significantly more inoculum was detected from fields in epidemic areas than from remote sites in an epidemic and from fields in nonepidemic areas. The median inoculum level was 20 CFU of G. zeae per spike per day in fields experiencing an epidemic, 4 CFU in locations remote from epidemic fields, 2 CFU in nonepidemic fields, and 1 CFU in locations remote from a source of inoculum in non-epidemic areas. In an epidemic region, inoculum levels near corn stubble reached up to 587 CFU of G. zeae per spike per day, and the median inoculum level of 126 CFU was significantly higher than the median of 13 CFU found near wheat residue. Inoculum was not detected or occurred sporadically during extended dry periods. While inoculum increased during rainy periods, timing of increased levels was variable. Fusarium head blight epidemics were associated with multiple inoculation episodes and coincident wet periods.

[Young victims in Oslo--a problem of immigration?]

There has been considerable concern over victimization from violence in Norway over the last couple of years. This study investigated risk groups for victimization with special emphasis on the importance of immigrant background. All students enrolled in the secondary school system in Oslo (ages 13-18, N = 10,812) filled in a questionnaire at school. 79% had a background from Norway, the rest had a background from other countries. 32% had experienced mild victimization, 12% had experienced moderately serious victimization, while 6% had experienced serious victimization--defined as being hurt so hard as to need medical treatment. Serious victimization was related to working-class background, having parents who were economically inactive, living in the eastern part of Oslo, and to immigrant background. However, immigrant adolescents also had low rates of mild and moderate victimization, and thus high rates of non-victimization. These associations to immigrant background persisted, also when we controlled for other variables. Overall, immigrant background is associated with reduced risk for victimization. However, a sub-segment of immigrants are at increased risk of serious violent victimization, also when we control for other risk factors.

Nasal inhalation of budesonide from a spacer in children with perennial rhinitis and asthma

The standard treatment of allergic rhinitis and asthma consists of topical corticosteroids administered intranasally and inhaled through the mouth. Although this therapy is highly effective, and side-effects are few and mild, it may be possible further to improve the therapeutic index and patient compliance with the treatment. In the present study, we evaluated a nasal inhalation system used for the simultaneous treatment of rhinitis and asthma. In principle, it results in an airway deposition of the corticosteroid similar to that of inhaled allergens. Twenty-four children with perennial rhinitis and asthma inhaled budesonide through the nose from a pressurized aerosol, attached to a spacer device, in a double-blind, placebo-controlled, crossover study. Compared with placebo, budesonide treatment resulted in a significant reduction of nasal symptoms (P<0.01) and of asthma symptoms (P<0.05), and in an increase of nasal peak inspiratory flow (P < 0.001) and of oral peak expiratory flow (P=0.01). There were no differences between budesonide and placebo in local side-effects, such as dry nose, nosebleed, and hoarseness. We conclude that nasal inhalation of a corticosteroid from a spacer offers a simple and effective treatment for both rhinitis and asthma in children, but it is an open question whether the nasal inhalation system can improve the ratio of antirhinitis/antiasthma effects to side-effects.

Alcohol consumption debut: predictors and consequences

OBJECTIVE

The aim of this study was to investigate the predictors of the timing of alcohol consumption debut and to analyze possible associations between the timing of debut and later alcohol consumption and possible alcohol-related problems.

METHOD

A population sample of 465 adolescents (249 girls) from the greater Oslo area was followed up through five data collections over a 6-year span. By means of generalized structural equation modeling--accommodating survival variables--parental and friends' influences on debut age were estimated. Further, the consequences of the age of debut on subsequent alcohol consumption and alcohol problems were studied, taking other influences into consideration. In particular, possible gender differences were investigated.

RESULTS

The mean age for alcohol consumption debut was 14.8 years. The age of alcohol debut had an independent effect on both future alcohol consumption and the development of alcohol-related problems, and the effects were invariant across sex. According to the estimated model, a 10% delay in debut age will lead to a 35% decrease in subsequent expected alcohol consumption.

CONCLUSIONS

Alcohol debut was an excellent predictor of subsequent alcohol consumption and alcohol problems. The strong preventive implication is that interventions should be implemented in order to postpone alcohol debut age. A weak implication is that preventive measures should be implemented for the early onset drinkers. Further, it seems to be important to give high priority to more thorough studies on the exact nature of the relationships we have investigated here.

[Victims of violence in the general youth population. A longitudinal study of risk factors]

This paper presents new knowledge on risk factors involving violent victimization. The data stem from a representative survey of youths living in the Oslo area (n 447, response rate 86%). Questions on victimization experiences, drinking habits, alcohol problems, violence towards others and conflict-provoking behavior were first asked between the ages of 18 and 20 years (1993), and were repeated in the follow-up two years later. More men than women had been victimized. In both sexes there was a significant connection between alcohol problems and experiences as a victim. However, the consumption of alcohol and frequency of intoxication were only slightly related to such experiences. In men, both cross-sectional and longitudinal analyses showed that violence towards others had a much greater statistical effect than any of the variables relating to drinking behavior. In fact, the effect was greater than that of any other variable in the study. In women, previous victimization was, without doubt, the most significant predictor for future victimization. Stability over time of such experiences was also much higher for women than for men. As regards preventive efforts targeted towards victimization among youths, our findings suggest that a specific programme for each of the sexes needs to be developed and implemented.

Partial trisomy 17q22-qter and partial monosomy Xq27-qter in a girl with a de novo unbalanced translocation due to a postzygotic error: case report and review of the literature on partial trisomy 17qter

Partial trisomy 17q22-qter is a rare but well-recognized clinical entity. We present a case of partial trisomy for the long arm of chromosome 17, which was detected in a female infant with severe psychomotor and somatic retardation, Stargardt disease, short limbs, and numerous minor anomalies. Differential chromosomal staining demonstrated an excess of genetic material on the long arm of the late replicating X chromosome. FISH and DNA polymorphism analysis showed that the extra material belonged to the distal part of the long arm of chromosome 17 and that there was a partial monosomy of the distal part of the long arm of the derivative X chromosome. The breakpoint regions of this translocation were identified by molecular analysis using polymorphic microsatellite markers on human chromosomes 17 and X. The origin of the abnormal X chromosome was found to be paternal, whereas the origin of the duplicated part of chromosome 17 was maternal. The unbalanced translocation between the paternal X and the maternal chromosome 17 is, therefore, suggested to be due to a postzygotic error.

Investigation of deletions at 7q11.23 in 44 patients referred for Williams-Beuren syndrome, using FISH and four DNA polymorphisms

Williams syndrome (WS) is associated with a submicroscopic deletion of the elastin gene (ELN) at 7q11.23. The deletion encompasses closely linked DNA markers. We have investigated 44 patients referred for possible WS using fluorescence in situ hybridization (FISH) analysis with a P1 clone containing an insert from the ELN, as well as performing genotype analysis of patients and parents with four DNA polymorphisms. Twenty-four patients were found to have deletions, 19 of whom were found clinically to have typical WS. The facial features were especially characteristic. None of the patients without detectable deletions was reported to have typical WS features, although one had supravalvular aortic stenosis, hypercalcemia, and mental retardation. No evidence was found in this material for variability of the size of the deletion. Our study supports the usefulness of analysis of ELN deletion in WS patients, both for confirmation of diagnosis and for genetic counselling.

Fluticasone propionate compared with budesonide: a double-blind trial in asthmatic children using powder devices at a dosage of 400 microg x day(-1)

The aim of this study was to compare fluticasone propionate (FP) with budesonide (BUD) at a dose of 400 microg x day(-1) in the treatment of children with asthma. Two hundred and twenty nine children with mild-to-moderate asthma, currently receiving 200-400 microg x day(-1) of inhaled corticosteroid, were randomized to receive either 400 microg x day(-1) of FP from the Diskhaler (registered trade mark of the Glaxo Group of Companies) or 400 microg x day(-1) of BUD from the Turbuhaler (registered trade mark of Astra Pharmaceuticals Ltd) for 8 weeks, in a parallel-group, double-blind, double-dummy study. Primary efficacy was assessed by measurement of daily peak expiratory flow (PEF). In addition, pulmonary function tests were performed at each clinic visit and a self-administered patient-centred questionnaire was completed by one parent of each patient at the start and end of study treatment. Mean morning PEF increased following treatment both with FP and BUD, but was significantly higher following treatment with FP during Weeks 1-4 (p=0.015) and Weeks 1-8 (p=0.019). Similar results were found for mean evening PEF and percentage predicted morning and evening PEF. Children receiving FP experienced significantly less disruption in their physical activities (i.e. sports, games) because of their asthma compared to children treated with BUD (p=0.03). Mean cortisol levels increased in both groups, but the increase was significantly higher in the FP group at 4 weeks (p=0.022). Serum and urine markers of bone formation and resorption changed very little and showed no consistent pattern of change. Fluticasone propionate at a dosage of 400 microg x day(-1) from the Diskhaler provided a more rapid and greater improvement in lung function in children with mild-to-moderate asthma than BUD 400 microg day(-1) from the Turbuhaler. Both treatments were well-tolerated, with a similar safety profile.

Alcohol and sexual victimization: a longitudinal study of Norwegian girls

In a study of sexual victimization and alcohol consumption, a population sample of Norwegian adolescents from the Oslo area was followed-up through five data collections over a 6-year time span. By means of generalized structural equation modeling, alcohol-related predictors and consequences of sexual assaults were investigated; 17% of the girls reported that they had been sexually assaulted at some time: 7% in childhood, 6% in early adolescence (13-16 years) and 4% in late adolescence (17-19 years). Only 1% of the boys reported having been sexually victimized. Female childhood sex victims reported increased alcohol consumption from their mid-teens, with dramatic increase in alcohol-related problems (using DSM-III-R criteria) at the end of their teens. However, the analyses showed that alcohol consumption was not influenced by childhood sexual abuse when parental use of tobacco and alcohol and normative standards imparted to their children were taken into consideration as confounding variables. There was, on the other hand, a strong effect on alcohol problems. Thus, the victims of childhood sexual abuse seem to be at high risk for alcohol abuse and dependency. Further, early alcohol debut and high alcohol consumption combined with permissive parental norms increased the risk of sexual assault in early adolescence. The girls who were assaulted in early adolescence also reported a high number of sexual partners and early intercourse debut. There was no increase in subsequent alcohol consumption after assaults in this group. Late adolescent victims did not report increased alcohol consumption either prior to or after the assault.

Sexual victimization in Norwegian children and adolescents: victims, offenders, assaults

A random sample of 465 Norwegian adolescents (mean age 19.3 years) from the general population answered a questionnaire related to sexual victimization. 17.2% of the girls reported being sexually assaulted, 6.8% in childhood and 10.4% during their teens. Only 0.9% of the boys reported such experiences. Three patterns of victimization were identified: (1) Prepubertal girls abused by adult men, usually relatives or other trusted superiors. (2) Adolescent girls victimized by their boyfriends, other peers and-to a lesser degree-unknown persons. (3) A small group of girls reporting continual assaults by several offenders. By the end of their teens, it is assumed that 2.8% of the girls have experienced 'grave' and prolonged sexual abuse, which invariably started during childhood. Another 7.6% have experienced 'serious' assaults, either in childhood or in adolescence.

Parental relations, mental health, and delinquency in adolescents

This paper presents a shortened, 20-item version of The Parental Bonding Instrument (PBI), used in a sample of 573 Norwegian adolescents aged 15-19. The instrument measures mothers' and fathers' "care" and "control/overprotection" as perceived by the adolescent. The two dimensions of the instrument were clearly defined using factor analyses. In addition, they were shown to be related to measures of both depression/anxiety and delinquency, showing that PBI scores may indicate general and nonspecific risk factors in a broad range of psychosocial problems.

[Spinal cord injuries caused by suicide attempts]

During 1965-1987 45 patients were admitted to the Rehabilitation Hospital in Hornbaek, Denmark because of spinal cord injury (SCI) due to suicide attempts. The proportion of traumatic SCI due to this cause increased significantly during the period: 1965-1974: 3.5%, 1975-1984: 8%, 1985-1987: 13%. The median age at injury was 31 years, and the female to male ratio 1.6. In 38 instances (84%), SCI was caused by jumps from buildings. At the time of the SCI 62% were unemployed or receiving an early pension; 60% were living without a partner; 62% had previously been admitted to psychiatric hospitals, and 31% had previously attempted suicide. A follow up study was conducted in 1988-1989. At follow up 11 patients had died, three from suicide. Of the 34 alive at follow up, seven had attempted suicide, and two reported suicidal thoughts; 71% were living without a partner, 44% had had a psychiatric admission since the SCI; and 56% were taking psychiatric medication.

[Youth, friendship and use of drugs]

The relationship between self-reported friendships and the use of tobacco, alcohol and cannabis was investigated in a study of 1.968 adolescents aged 12-19 from the greater Oslo area. Bivariate analyses showed that the adolescents who reported the closest friendships also had the highest consumption of all three drugs. Multivariate analyses were used to "control" for the friends' use of drugs. However, the effect of the friendships still remained positively correlated with the use of drugs. The findings indicate that experimental use of the highly prevalent drugs in particular is common in active and social groups of adolescents.

Spinal cord injury due to suicide attempts

During 1965 to 1987 45 patients were admitted to the Rehabilitation Hospital in Hornbaek, Denmark because of spinal cord injury (SCI) due to suicide attempts. The proportion of traumatic SCI due to this cause increased significantly during the period: 1965-74: 3.5%, 1975-84: 8%, 1985-87: 13%. The median age at injury was 31 years, and the female to male ratio 1.6. In 38 instances (84%), SCI was caused by jumps from buildings. The neurological level of the lesion was: 7 cervical, 8 thoracic, 22 lumbar; the remaining 8 had minor spinal cord/cauda equina lesions. At the time of the SCI 62% were unemployed or receiving an early pension; 60% were living without a partner; 62% had previously been admitted to psychiatric hospitals, and 31% had previously attempted suicide. A follow up study was conducted in 1988-89. At follow up 11 patients had died, 3 from suicide. Of the 34 alive at follow up, 7 had attempted suicide, and 2 reported suicidal thoughts; 71% were living without a partner; 9% were employed; 18% abused alcohol; 44% had had a psychiatric admission since the SCI; and 56% were taking psychiatric medication.

Exclusion of atrial thrombus by transesophageal echocardiography

To determine whether transesophageal echocardiography (TEE) is useful in ruling out the presence of atrial thrombus, we performed TEE in 20 patients immediately before valve replacement or valve repair and within 3 days of an autopsy in one patient. Mitral stenosis was the predominant lesion in three patients, mitral regurgitation was seen in 11 patients, five patients had mitral prosthesis malfunction, one patient had a tricuspid prosthesis malfunction, and one patient had aortic stenosis. Eight patients were in atrial fibrillation. Four patients demonstrated spontaneous contrast in the associated atria. Nine patients were receiving oral anticoagulation. Mean left atrial diameter was 5.3 +/- 1.3 mm. TEE revealed no evidence for atrial thrombus in 18 of the 21 patients; this finding was confirmed by careful inspection of the atria including the appendages. TEE demonstrated a left atrial thrombus in two patients and a right atrial thrombus in another (confirmed at the time of surgery or at autopsy). In all cases transthoracic echocardiography was negative. Our data suggest that TEE is useful in ruling out atrial thrombus, and therefore may be a useful test preceding interventions associated with an increased risk of embolism from the atria such as cardioversion, mitral valvuloplasty, or valve replacement.

Eating behaviour, drug use, psychopathology and parental bonding in adolescents in Norway

A 12-item version of the Eating Attitudes Test (EAT-12) was constructed and applied at 1-year intervals in a non-referred cohort of 1193 adolescents in Norway aged 13-18 years. Eight percent of the girls scored beyond the chosen cut-off point of 9/10 the first time and 9% the second time. Factor analysis demonstrated 3 factors--dieting, bulimia and food preoccupation and oral control. Both the total scores on the EAT-12 and the 3 different factor scores showed a significant relationship between eating behaviour and smoking, level of alcohol consumption, alcohol intoxication, psychopathology and parental bonding.

Adolescents and benzodiazepines: prescribed use, self-medication and intoxication

In a longitudinal study of 1230 people aged 13-18 years from the Greater Oslo Area, the past-year prevalence of anxiolytic or hypnotic use was 10%, which is higher than previously reported. The majority gave therapeutic reasons as a motive for using these drugs. However, most of the use was unprescribed. The parents, and especially the mother, were the most important suppliers. A minority gave intoxication as a motive for using these drugs. In this group, the suppliers were mainly peers and the illegal market. Neither the unprescribed nor the prescribed therapeutic use show any association with use of drugs such as alcohol and cannabis. There is, however, a strong association between the unprescribed use of benzodiazepines by young people and by their parents. This suggests a pattern of learning and role modelling, which must be regarded as problematic for public health policy. Those who use the drugs to become intoxicated have particularly poor mental health, and they use many other drugs as well. This group probably runs a special risk of developing more serious drug abuse.

Role modelling and cigarette smoking: vulnerable working class girls? A longitudinal study

Risk factors for the onset of cigarette smoking were examined by means of a prospective longitudinal study in 1230 Norwegian adolescents aged 12-18. In particular the importance of role modelling was focused. The findings revealed that the age period between 12 and 15 is most important when it comes to the initiation of smoking. Among those who initiate smoking, the incidence rates of quitting is low, indicating that most of the initiators quickly seem to develop a relatively stable smoking habit. Smoking initiation can be divided into two stages. The first, experimental one, is predicted by peer modelling and low socioeconomic status (SES). The second, establishing a regular pattern of use, is predicted by modelling of parental smoking and the interaction between female sex and low SES. Studying the characteristics of the regular smokers cross-sectionally, peer modeling showed the strongest correlates. Studying the predictors of the transitions longitudinally, the more complex picture described above was uncovered. This indicates that the complexity of the role modelling process can only be simulated adequately by means of prospective research methods and by paying attention to such parameters as gender, age, SES and stage in the smoking acquisition process.

Mental health, sensation seeking and drug use patterns: a longitudinal study

To examine the longitudinal stability of mental health and sensation seeking, a sample of 553 adolescents aged 16-18 years, was followed over a period of 20 months. Further, the predictive power of the two constructs with regard to future drug use was investigated. The stability of reported mental health was relatively low. Accordingly, the variable was a poor predictor of future drug use. Sensation seeking, however, had a relatively high degree of stability. In addition, the different subdimensions of the trait were strong predictors of future drug use: 'Disinhibition' (DIS) was a general drug use factor in both sexes. 'Thrill and adventure seeking' (TAS) predicted moderate alcohol consumption in boys. 'Experience seeking' (ES) predicted cannabis use in boys. A separate analysis of those who seek a milieu highly exposed to cannabis, without themselves using the substance, revealed interesting sex differences: the boys in this situation had sensation seeking scores and mental health which were not different from other adolescents. However, the girls had high DIS and ES scores and also poor mental health. Possible interpretations of this finding are discussed.

Adolescents initiating cannabis use: cultural opposition or poor mental health?

In Norway, the use of cannabis was introduced by a resourceful group of oppositional middle-class adolescents in the late 1960s. At the beginning of the 1970s there were, however, signs of a change in the recruitment of the users: youths in trouble from lower social levels gradually started to use the drug. In a prospective longitudinal study of 1311 Norwegian pupils aged 13-19, the possible links between normative and political opposition, mental health and the use of cannabis were investigated. The findings indicate that the group that experiments with cannabis, and use the drugs a few times, is still mainly characterized by a political and normative "oppositional" engagement. Heavy users of cannabis, however, also have family problems and suffer from poor mental health. Thus, the study draws attention to the importance of distinguishing between two different clusters of longitudinal predictors for adolescent cannabis use: the first consists of subcultural opposition and certain personality traits, and seems to predict the earlier stages of use. The second consists of psychosocial problems and poor mental health. From this study one may not conclude that this second cluster predicts heavy cannabis involvement. We have, however, shown that it correlates with heavy involvement, cross-sectionally.

Drinking games adolescents play

In a study of 1230 Norwegian adolescents aged 14-19, the prevalence of participation in 'drinking games' and the consequences thereof were investigated. The findings indicate that drinking games are very common among Norwegian youth. Further, there is a substantially higher alcohol consumption among those who participate in these games than among other youth, even when we 'control' for other indicators of network 'wetness'. In particular, a high consumption of beer among the boys seems to be connected with these games. It seems reasonable to assume that the drinking games are of importance for many young people, in particular as a means of being accepted by social groups of the same age. The games provide an organized, yet exciting frame around the interaction. It seems reasonable to assume that the participants usually take part in the games as a result of an intention to drink. Even so, it might be argued that the games are probably often more than 'neutral tools' to fulfil this intention: first of all, the games involve intense contact precisely in connection with alcohol consumption. Secondly, we know from previous studies that match rates and role modelling in connection with consumption increase with an increase in the intensity of group member contact. Finally, the individual member loses control and steering of his/her own consumption to a large extent: consumption becomes to a large degree a function of other people's actions and the rules of the game in question.

[Parents as alcohol pushers?]

In a study of 834 adolescents, age 14-17, in the Oslo area, the relationship between parental 'alcohol pushing' and the adolescents' own drinking behaviour, was investigated. 'Alcohol pushing' defined as parents who give alcohol to children under the age of 18, was quite common. This was the case in particular in the age group 16 to 17. There were big differences, however, as regards the kind of situations when this occurred. This kind of parental behaviour was most prevalent on 'special occasions' like New Years Eve, but also occurred relatively often in situations such as 'Sunday dinner'. The alcohol consumption of the adolescents, measured in liters per year, was strongly correlated with the degree to which their parents gave them alcohol. Similar relationships existed as regards the frequency of drinking episodes which resulted in intoxication. A multivariate analysis was conducted. It revealed that parental 'alcohol pushing' was the most important factor relative to the adolescents' role modelling of their parents' own alcohol consumption. The conclusion seem to be that adolescents who get alcohol from their parents also drink most heavily with their peers outside the home.

Thermodilution cardiac output values obtained by using a centrally placed introducer sheath and right atrial port of a pulmonary artery catheter

Thermodilution cardiac output measurements obtained using a centrally placed introducer sheath were compared with thermodilution cardiac outputs obtained using the right atrial port of a balloon-tip, flow-directed pulmonary artery catheter in 15 patients with cardiac failure. Cardiac output values were obtained by manually injecting 10 ml of iced, D5W alternately through the introducer sheath and the right atrial port of the flow-directed catheter. Thirty cardiac output readings were obtained in the 15 patients. Cardiac outputs obtained using the right atrial port (CORA) did not differ significantly from cardiac outputs obtained using the introducer sheath (COSP) (5.3 +/- 0.2 vs. 5.2 +/- 0.2 L/min). The correlation between CORA and COSP was significant (r = .94, p less than .0001) and could be described by the formula CORA = 0.33 + 0.96 COSP. We conclude that when the right atrial port of a flow-directed catheter is nonfunctional, a thermodilution cardiac output obtained using a centrally placed introducer sheath offers a reliable alternative.

Reliability of drug use responses in a longitudinal study

In a prospective longitudinal study of adolescents' drug use, the trustfulness of the self-reports about drug use was investigated by means of a test for logical consistency. A sample of 1936 high school students completed a written survey in the fall of 1987 and again in spring 1988, seven to eight months later. The findings indicate that the information obtained is logically consistent at one particular point in time. Analyses show, however, that the consistency drops somewhat over time. The legal drug use responses show the highest consistency, the answers regarding hard drugs like amphetamine and heroin show the least favourable consistency, with cannabis and inhalants somewhere in the middle. There seem to be two main reasons for the inconsistent answers: some respondents wilfully underreport their drug consumption. This seems partly to be a function of the level of illegality of the drug. However, poor memory and episodic uses of such drugs seem also to be important. Generally this study agrees with other studies and indicates an overall relatively high level of longitudinal consistency regarding drug use responses. This kind of survey must therefore be regarded as a relatively reliable instrument in collecting information regarding drug use.

[Starting to smoke--vulnerability of girls]

Smoking habits were highlighted in a longitudinal study of 1,230 secondary school students from the Oslo area. In the age group 16-19, 31% of the adolescents were daily smokers, rather more girls than boys. Most seem to start smoking between the ages of 12 and 15. These cohorts were selected for a closer analysis of the importance of modeling the roles of parents and peers. Both boys and girls copy their fathers' smoking habits, but girls also copy their mothers habits. For both sexes, parents' serving alcohol to their children strongly correlated with the childrens smoking habits. Reduced subjective well-being also seems to be important in the case of girls. The conclusion is that modeling roles on parents and peers is important for the development of smoking habits. Girls seem to be more vulnerable than boys to the influence of parents and peers, and there is also some evidence that girls often start smoking as a response to reduced subjective well-being.

Intravenous amiodarone for the rapid treatment of life-threatening ventricular arrhythmias in critically ill patients with coronary artery disease

This study examined the effectiveness of intravenous amiodarone for rapid control and prevention of recurrent life-threatening ventricular tachyarrhythmias associated with cardiovascular collapse. In 22 critically ill patients with coronary artery disease (mean ejection fraction 27 +/- 13%), recurrent ventricular tachyarrhythmias proved refractory to 3.7 +/- 1.1 (mean +/- standard deviation) conventional antiarrhythmic drugs. In the 24-hour period before intravenous amiodarone treatment, patients experienced 2.4 +/- 2.3 (range 1 to 9) episodes of life-threatening ventricular tachycardia, ventricular fibrillation or both, requiring 4.0 +/- 3.9 direct current cardioversions. Within the 24 hours after initiation of intravenous amiodarone therapy (900 to 1,600 mg/day), 20 of 22 patients remained alive and had 1.1 +/- 1.6 episodes of life-threatening ventricular arrhythmias, requiring 1.9 +/- 3.1 direct current cardioversions. In the second 24-hour period, there were 19 survivors and life-threatening arrhythmias were reduced to 0.4 +/- 0.7 episode/patient requiring 0.4 +/- 0.9 direct current cardioversion. Overall, arrhythmias were controlled in 11 of 22 (50%) patients within the first 24 hours, and in 14 of 22 (64%) in the second 24 hours. Intravenous amiodarone therapy was well tolerated. Twelve patients were discharged from the hospital and 8 remained alive at a mean follow-up of 22 +/- 14 months. Thus, in critically ill patients, intravenous amiodarone may be useful for rapid control of spontaneous, refractory, life-threatening ventricular tachyarrhythmias.

[Young people's use of psychopharmaceuticals--self medication and intoxication]

In a study of 1968 young people aged 12-19, from the greater Oslo area, we found that 12% had used tranquillizers or hypnotics last year. This is more than reported earlier. The majority give as a motive that they use the substances as medication against insomnia, worry or depression, but a minority say that they use them for intoxication. In the first group, the mother was the most main supplier. In the second group, the suppliers were peers and the illegal market. Analyses show that both groups of users report a lower level of well-being, but also a higher consumption of legal and illegal drugs than other young people. The use is clearly more frequent among youth whose parents and friends also use much psychopharmacological drugs and intoxicants.

Patterns of drug use and sensation-seeking among adolescents in Norway

The relationship between personality and drug use was investigated by studying patterns of sensation-seeking behaviour and drug use among adolescents. A questionnaire was distributed to a sample of 1027 Norwegian senior high school students aged 16 to 19 in the greater Oslo area. The response rate was 97%. The sensation-seeking subscores showed moderate to strong association with the use of the different drugs. A canonical correlation analysis yielded 3 significant variates: in the drug use domain the first dimension correlated with the use of legal drugs and inhalants, the second with cannabis and tranquillizers and the third with tobacco. In the sensation-seeking domain the first dimension was almost synonymous with the disinhibition scale, the second with experience-seeking, and the third correlated highly negatively with thrill-, adventure- and experience-seeking. The results support the assumption that a strong link exists between sensation seeking and drug use. They further show the importance of taking different subdimensions of the sensation-seeking trait into account for prevention and treatment of drug use and abuse.

Jet-nebulized beclomethasone dipropionate in the management of bronchial asthma. Topical steroids for asthmatic children younger than 4 years

The efficacy of jet nebulized beclomethasone dipropionate (BDP) in the management of asthma was evaluated in 18 children, 2-26 months old (mean 10 months). The children were selected on the basis of the severity of their symptoms and the lack of effect of conventional treatment. The effect of BDP was evaluated by comparing clinical data before and after the initiation of treatment. Fifteen of the 18 patients experienced a significant clinical improvement during treatment with BDP. BDP "nebulizer solution" is a valuable contribution to the management of severe asthma in young asthmatics.

Age-dependent decreases in human submandibular gland flow rates as measured under resting and post-stimulation conditions

Submandibular saliva samples were obtained with a new collection device, under resting and post-stimulation conditions, from 28 healthy individuals between 70 and 91 years of age, and from 30 healthy individuals between 18 and 39 years of age. The salivary flow rates were significantly decreased in the aged group compared with the control group. The mean resting and post-stimulation flow rates for the aged group averaged 22% and 39%, respectively, of control values.