bluuebunny/crossref_metadata_2025 huggingface dataset:
The Nordic and the Continental European Dimensions in Scandinavian Integration: NORDEK as a Case Study
Authors: Nielsson Gunnar P.
Published: January 2017

This paper was delivered at the University of Aberdeen's conference on ‘Scandinavia and European Integration’ in March, 1971. There are four sections, the first of which is a chronological review of the Nordek case. Secondly, an analysis of the Nordek Draft Treaty provisions shows that the treaty represents the most far-reaching step in regard to the integration of social and economic policy spheres yet considered in Scandinavia.

Thirdly, the key factor in explaining the collapse of the Nordek plan is the increasing penetration of European ‘high politics' into Nordic cooperative arrangements. Political stalemate concerning expanded membership of the European Economic Community favored Nordek. That stalemate was broken after de Gaulle's political demise. The changed conditions brought into sharp relief the incompatibility of Finland's neutrality policy with participation in a Nordek which would include such potential EEC members as Denmark and Norway.

Finally, future prospects are examined through the construction of four basic choices presented as models. The Greater European model and the Divided Scandinavia model contain the international dimensions of the dilemma presently facing the Scandinavians.
The Antarctic Treaty Consultative Meetings — Form and Procedure
Authors: Hanevold Truls
Published: January 2017

The Antarctic Treaty of 1959 established a consultative system for the purpose of passing recommendations to the signatory governments in pursuit of the objects and principles of the treaty.

This article is a study in international negotiations. After an introduction detailing the background for the negotiations, attention is drawn to the possible long-term aims and strategies of the parties in view of their attitudes on the question of rights and claims in Antarctica and their capabilities for conducting scientific research there. In part two the preparations for the consultative meetings and their influence on the decision-making process are described. Part three deals with the consultative meetings themselves, how the delegations are composed, and their instructions and behaviour during the negotiations. Different types of sessions and their particular characteristics are discussed. The dynamics of the negotiations are treated in part four, which includes a discussion of strategies, types of arguments, self-commitments, concessions and strategies.
Actional Distances between the Socialist Countries in the 1960's
Authors: Harle Vilho
Published: January 2017

This paper examines the degrees of cooperation and conflict between the Socialist countries from January 1962 until the end of August 1968. The study is an experiment in the analysis of international interaction events. The sources of data are rather exceptional news media: the relevant editorials of five Finnish newspapers and the Chronology of Current History. However, the method is not a content analysis but an event analysis. The concept of actional distance is used to measure and combine (both explicitly and implicitly) cooperation and conflict. Actional distance between A and B includes both direct interaction between them and the behavior of A and B toward some object X. The distances among the Socialist countries are described in regard to the Sino-Soviet conflict. The bloc is found to be divided into two subgroups with the exception of five countries which do not belong to either of them. The theory tested is the Simmel/Coser cohesion hypothesis, which is strongly supported by the results. The results are compared with two content analysis studies and one transaction flow study; the comparison confirms the validity of the results of this paper. The validity problem is also discussed.
Swedish Elites and the EEC: Models of the Future
Authors: Hancock M. Donald
Published: January 2017

Utilizing principles of countersystem analysis, derived from earlier co-authored studies of domestic change in advanced industrial societies, the author considers alternative consequences of Sweden's 1972 free trade treaty with the expanded European Community. On the basis of interviews with a systematic sample of leading officials in the government, parliament, the administration, interest groups, and the communication media as well as a qualitative assessment of Swedish foreign policy requirements, the author posits three conceivable patterns of policy choice in Sweden's future relations with the Common Market: (1) expanded trade and technical cooperation, (2) ad hoc membership in the EEC, and (3) assertive neutrality. Elite expectations and contemporary economic-technological links between Sweden and Western Europe indicate that the most probable course among these alternatives is ad hoc membership.
Integration by Whom, for Whom, against Whom?
Authors: Hveem Helge
Published: January 2017

This paper is a partial critique of the ‘neo-classical’ integration schools, the ‘neo-functionalist’ inspired by Haas and the ‘transactional’ of Deutsch and followers. Discussing mainly the former, the author makes the plea that integration theory should be more clearly related to the distribution of power and to social structure. Seven aspects of the theoretical deficiencies of the ‘neo-classicists’ are identified and discussed: the atomism in the sense that national sovereignty is unduly assumed; the lack of recognition of asymmetric social relationships and the need to distinguish between vertical (asymmetric) and horizontal integration; the formalism or institution-bias resulting in the neglect of such crucial integration actors as the multinational corporations; a tendency towards theoretical encapsulation not relating duly a theory of integration processes to other relevant political and social theory; a Dias towards elites leading to undue assumption that what integration is good for elites is also automatically good for non-elites; an obsession with the process of integration as such almost leading to making the process a goal in itself; and a widespread tendency towards structural and/or cultural bias in comparative integration studies. The critique also points out ‘neo-classical’ propositions and hypotheses which may usefully be reformulated and reintegrated into an alternative functional theory. Some suggestions as to the contents of such a theory are made towards the end.
A Moderated Mediation Test of Minority Stress
Authors: Velez Brandon L. , Moradi Bonnie
Published: January 2017

In the present study, we extended minority stress theory by testing expectations of stigma, internalized heterosexism, and outness as mediators of the relations of heterosexist discrimination with psychological distress and well-being; testing collective action as a mental health promoter by examining its unique relations with distress and well-being; and testing collective action as a moderator of the direct and indirect relations of the minority stressors with mental health among 514 sexual minority adults. Path analyses indicated that heterosexist discrimination, expectations of stigma, internalized heterosexism, and outness were uniquely related to psychological distress, whereas heterosexist discrimination, internalized heterosexism, outness, and collective action were uniquely related to well-being. Expectations of stigma mediated the positive discrimination–distress link. Collective action buffered the direct heterosexist discrimination–internalized heterosexism relation as well as the indirect heterosexist discrimination–well-being relation through internalized heterosexism. Limitations of the study and implications for future research are discussed.
Driver Behavior Effects on Fuel Consumption in Urban Driving
Authors: EVANS LEONARD
Published: January 2017

Data are examined from two published experimental studies in which drivers were instructed to drive other than normally, with the traffic: for example, to minimize fuel consumption or to minimize trip time. It is found that, in general, for each 1% increase (decrease) in trip time compared to driving normally with the traffic, the fuel consumption increases (decreases) by approximately 1.1%. However, expert drivers can save fuel without increasing trip time by skillfully adjusting their speed to avoid stops at traffic signals. It is shown that the formal problem to be solved to minimize fuel consumption on an urban trip is so complicated that even a “perfect” fuel economy meter would not enable a driver to achieve this minimum.
The Effects of Degraded Visual and Tactile Information on Diver Work Performance
Authors: BANKS WILLIAM W.
Published: January 2017

An attempt was made to provide direct, quantitative assessment of environmental and equipment variables on diver work performance. Five male volunteer divers were each given 12 training trials on a standardized, U. S. Navy work task before exposure to eight, randomly presented, experimental visual and tactile conditions. A two-factor repeated measures design was utilized with four levels of luminance degradation and two levels of tactile restriction. Divers were required to perform standardized work underwater while measures of heart rate, errors, and time to complete the task were taken. Results indicated that significant changes occur in measures of time to complete the task and errors, as a direct function of tactile and luminance degradation.
Information Transfer Characteristics of Moving Light Signals
Authors: BERKHOUT JAN
Published: January 2017

Eight different configurations and color combinations of rotating-beam emergency vehicle lights were evaluated in terms of information conveyed about rate and direction of travel when viewed at night. The lights were viewed moving toward or away from stationary observers at rates of 0, 5, and 10 m/s at overall ranges of 300 to 450 m.

Differences were found between individual lights in terms of illusions of motion, signal-to-noise ratios, and overall error scores. All-red lights conveyed more information than combinations of red and blue lenses in the same light. Twin lights were superior to single beacons, and twin models with a sequential mirror-generated flash pattern were superior to plain ones.

Several of the lights created an illusion of receding motion when actually at rest. This was most severe for a side-to-side alternate flash pattern using red signals. Lights considered to be highly conspicuous were not necessarily those with the best information transfer characteristics. The cues relevant to this perceptual task appeared to be provided by changes in light intensity with distance, rather than changes in angular displacement.
The Anthropometry of United States Army Men and Women: 1946–1977
Authors: WHITE ROBERT M.
Published: January 2017

A large amount of information on the body size of United States Army personnel, both men and women, has been collected during several anthropometric surveys carried out between 1946 and 1977. Changes in the body site of Army men between 1946 and 1966 and of Army women between 1946 and 1977 may be examined in an analysis of these anthropometric data. The data also may be utilized to define the contrasts in body size between Army men and women for application in the design and sizing of clothing and in the human engineering of equipment and materiel intended for use by both Army men and women.
Shiftwork and Performance
Authors: FOLKARD SIMON , MONK TIMOTHY H.
Published: January 2017

The recent increase in the incidence of shiftwork has been accompanied by a change in the type of task typically performed by the shiftworker. The technological advances which have produced both these effects have meant that the shiftworker is more likely to be engaged in cognitive, mentally taxing tasks than the predominantly perceptual-motor ones typical of earlier times. Contemporary research on time of day effects in performance efficiency has indicated that these task changes may be crucially important in determining on-shift performance, and hence the choice of the individual and shift system that is most suitable. Evidence is reviewed on task demands, the effects of different shift systems, and the role of individual differences. A descriptive model is proposed in which on-shift performance is seen to be dependent on the type of task, type of shift system, and type of person, with the three factors interacting via the worker's various circadian rhythms.
Impact of Highway Metrication on Traffic Accidents and Long-Term Trends in Vehicle Speeds for Roads with Resultant Increased Speed Limits
Authors: MATTHEWS MICHAEL L.
Published: January 2017

The impact of metrication of roadside speed signs upon vehicle speeds was investigated for four different road types using concealed roadside radar. The study was conducted one year after metrication to determine whether there were any long-term changes in traffic patterns in addition to the short-term influences reported previously. There was no evidence for any tendency for drivers to increase traveled speed on roads for which metrication resulted in an increase in the speed limit. Analysis of accident statistics for the month following metrication revealed no significant increase in accident rate over that projected from nine-year accident trends. It is concluded that highway metrication does not present the safety hazard suggested by critics of the metrication program.
Experimental study of delamination and kerf geometry of carbon epoxy composite machined by abrasive water jet
Authors: Dhanawade Ajit , Kumar Shailendra
Published: January 2017

The present article focuses on mechanism of delamination and kerf geometry in abrasive water jet machining of carbon epoxy composite. In the present study, four process parameters of abrasive water jet machining namely hydraulic pressure, traverse rate, stand-off distance, and abrasive mass flow rate are considered. The experiments are performed on the basis of response surface methodology as a statistical design of experiment approach. Delamination in machined samples is observed by using scanning electron microscope. Analysis of variance is performed in order to investigate the influence of process parameters on delamination, kerf taper ratio, and kerf top width. It is found that delamination decreases with increase in pressure and abrasive mass flow rate and decrease in stand-off distance and traverse rate. Kerf taper ratio decreases with increase in pressure and decrease in traverse rate and stand-off distance. Kerf top width decreases with decrease in stand-off distance and increase in traverse rate. Based on analysis, mathematical models are developed to predict the maximum delamination length, kerf taper ratio, and kerf top width. Further, a multi-response optimization is performed on the basis of desirability function to minimize delamination, kerf taper ratio, and kerf top width.
How’d You Do It? Applying Structural Ritualization Theory to Drug Treatment Courts
Authors: Lanier Christina , DeVall Kristen E.
Published: January 2017

A wealth of studies have been conducted on drug treatment courts (DTCs) over the past two decades. However, relatively few studies have employed qualitative research methods, and even fewer are grounded in social science theory. Using structural ritualization theory (SRT), this research provides a theoretical framework for understanding specifically how DTC programs effect change in the lives of participants and the influence of DTC organizational structure on this process using qualitative methods. Data for this study were collected from semi-structured interviews with 23 DTC graduates previously enrolled in either Kalamazoo or Van Buren County DTC, both of which are located in southwest Michigan. Findings reveal support for SRT as a useful approach identifying the mechanisms of change within the DTC program that contribute to participant success.
Self-Regulation in Language Learning
Authors: Tseng Wen-Ta , Liu Heidi , Nix John-Michael L.
Published: January 2017

Self-regulated learning has been a widely researched subject for decades in educational psychology. Different instruments have been developed to understand learners’ self-regulated learning in a specific subject domain. This study developed a measurement scale to assess English-as-a-foreign-language learners’ self-regulatory capacity in English language learning and further examined the effects of gender on English-as-a-foreign-language learners’ self-regulatory capacity. A series of psychometric analyses including exploratory factor analysis, confirmatory factor analysis, and full structural equation modeling were undertaken to answer the research questions raised. The findings suggest that the scale can attain high reliability and strong validity in two different samplings, and the underlying construct of self-regulation in English language learning is shown to be multidimensional with a significant impact by gender. Theoretical and pedagogical implications are further put forward in light of the research findings.
The HEXACO Model of Personality and Risky Driving Behavior
Authors: Burtăverde Vlad , Chraif Mihaela , Aniţei Mihai , Dumitru Daniela
Published: January 2017

This research tested the association between the HEXACO personality model and risky driving behavior as well as the predictive power of the HEXACO model in explaining risky driving behavior compared with the Big Five model. In Sample 1, 227 undergraduate students completed measures of the HEXACO personality model, the Big Five model, and driving aggression. In Sample 2, 244 community respondents completed measures of the HEXACO personality model, the Big Five model, and driving styles. Results showed that the Honesty–Humility factor is an important addition to personality models that aim to explain risky driving behavior as being related to all forms of driving aggression as well as to maladaptive and adaptive driving styles and having incremental validity in predicting verbally aggressive expression, risky driving, high-velocity driving, and careful driving. Moreover, compared with the Big Five model, the HEXACO model had better predictive power of aggressive driving.
Supporting State-approved Materials with the Values Clarification Task
Authors: Manning Shaun J.
Published: January 2017

Many teachers in Asian EFL situations report difficulties integrating communicative tasks into their classrooms. This study reports on an innovation in which opinion gap tasks were used to support the regular classwork of a middle school English class in Seoul, South Korea. The task had to reflect the learning objectives of the state-mandated textbook while encouraging students to speak up and express their opinions. The classroom teacher wanted to ensure students who had pre-studied the materials at after-school classes would still be engaged with the task. A values clarification (VC) task was developed for this purpose. This study reports how the VC task performance reflects the types of talk theorized to benefit language learning.
Rapid Access Chest Pain Clinics — Can They be Justified?
Authors: McGavigan A. D. , Begley P. E. , Moncrieff J. , Hogg K. J. , Dunn F. G.
Published: January 2017

Rapid access chest pain clinics are expanding across the country with marked resource implications despite a paucity of data regarding their efficacy. Early assessment of patients in this manner potentially delays review of patients referred via the traditional route. We conducted a prospective observational study of patients referred with chest pain to the Cardiology Outpatient Department over a four-week period in a District General Hospital to compare demographics and outcomes in patients referred to the rapid access with those referred to the general cardiology clinics. There were no significant differences in baseline demographics, exercise test result or clinic outcome. Both populations were low risk. Discussion is needed between primary and secondary care to achieve a consensus as to the purpose of a rapid access system and how best to utilise the service appropriately. Further studies are required to assess the efficacy and health economics of this system.
A Prospective Study of Early Diagnostic Investigations in the Diagnosis of Ankylosing Spondylitis
Authors: Eastmond C. J. , Robertson E. M.
Published: January 2017

This study was designed to assess the relative values current of locally available investigations in the early diagnosis of inflammatory sacroiliitis. Consecutive patients attending routine rheumatology clinics in Aberdeen clinically considered by consultant rheumatologists to have inflammatory back disease but with insufficient criteria to firmly establish a diagnosis of ankylosing spondylitis were included. Patients were assessed using a standard questionnaire, clinical examination of spinal movements, plain radiology of the sacroiliac joints, computerised tomographic scanning of the sacroiliac joints and HLA-B27 typing. Patients were systematically followed up using repeated clinical and radiological examination for five years. Plain film evidence of grade 2 radiological sacroiliitis (bilateral or unilateral) was found to be the most reliable predictor for the development of ankylosing spondylitis satisfying the New York criteria at 5 year follow up. CT scanning and HLA-B27 typing were of no added value in this series and the clinical questionnaire lacked specificity. It is concluded that the combination of clinical history, examination and plain film radiology are currently reliable criteria for diagnosing the subsequent development of ankylosing spondylitis satisfying established criteria.
Respiratory Syncytial Virus Bronchiolitis in Ex-Preterm Infants in the Scottish Highlands: Review of Hospital Admissions and An Analysis of Hospital Cost
Authors: Zaw W , McDonald J
Published: January 2017

Ex-preterm infants are vulnerable to respiratory syncytial virus (RSV) bronchiolitis and their hospital admission is associated with increased morbidity. Palivizumab is currently available as prophylaxis against RSV infection but its use in ex-preterm infants is controversial. A retrospective case review study was, therefore, carried out to determine the rate of readmission with RSV bronchiolitis among ex-preterm infants in the Highland Region of Scotland and to estimate the hospital cost per admission. Between 1995 and 1999, a total of 3,046 children under 2 years of age were admitted to Raigmore Hospital, 1,691 of whom (60.4%) lived outwith Inverness. 507 children had acute bronchiolitis and ex preterm infants with RSV positive bronchiolitis accounted for 3.6% of total admissions with acute bronchiolitis. 72% of these children lived outwith Inverness. The median length of hospital stay for children born at less than 30 weeks and for children who had had bronchopulmonary dysplasia (BPD) was 6 and 10.5 days respectively. The average hospital costs per admission for children of less than 30 weeks and children of more than 30 weeks were £3,376 and £2,074 respectively. It was more expensive for children with BPD (£4,431 per admission) when compared with those without BPD (£1,959 per admission). This study has shown that most of the children admitted to hospital lived outwith Inverness, many at some considerable distance, and this, as much as severity of illness, may have contributed to hospital admission. Further studies are required to determine productivity losses associated with RSV infection and justification of use of Palivizumab in ex preterm infants of less than 30 weeks gestation and of BPD living in remote areas of Scottish Highlands.
Analysis of Alcohol-Related Admissions in Gastroenterology, Cardiology and Respiratory Medicine
Authors: Waddell T S , Hislop W S
Published: January 2017

A 4 week study of medical inpatients was performed to look at prevalence of alcohol- related problems in three different sub-specialties. Alcohol-related conditions accounted for 51% of gastroenterology inpatients, and 65% of these patients had alcoholic liver disease. In contrast, the cardiologists and respiratory physicians managed far less alcohol-related pathology, accounting for only 6% of inpatients in each specialty. Alcohol-related conditions were three times commoner in men. Patients admitted due to alcohol had longer lengths of stay, and experienced higher morbidity and mortality. These findings have important implications for health care planning and provision. They highlight a need for specialist training to be given to staff who deal with alcohol-related conditions on a daily basis. There is also a significant public health issue raised by these results regarding public attitudes in Scotland towards alcohol abuse and the increasing burden it is placing on the NHS.
Do We Practise What We Preach?
Authors: Peel R K , Bhandari S
Published: January 2017

There are recommendations regarding many facets of lifestyle. We proposed to look at hospital doctors' habits in East Yorkshire. Method. A simple questionnaire was sent out to 574 doctors in the Hull and East Yorkshire Hospitals NHS Trust. Non-responders were re-mailed. Age, sex, grade, specialty, number of portions of fruit and vegetable per day, alcohol intake, smoking, exercise and hours worked. Results. 301 doctors (238 males, 60 females) responded (response rate 58%). Approximately half of doctors who responded were consultants. Few respondents smoked (6.6%), and the mean alcohol consumption, 8.35 units per week (SE 0.34), was less than the recommended limits for men and women. Most doctors fell short of the ‘recommended” 5 portions of fruit and vegetables per day (median 3 per day) and nearly half worked more than 56 hours per week. Most respondents took at least the recommended amount of exercise per week (112 SE25 minutes) although 26% of doctors took no exercise at all.
Is ‘Clicky Hip’ a Risk Factor in Developmental Dysplasia of the Hip?
Authors: Kamath S , Bramley D
Published: January 2017

Background: The role of the ‘clicky hip’ symptom as a prognostic predictor of developmental dysplasia of hip (DDH) is controversial. We aim to study the role of isolated hip clicks as a prognostic predictor of DDH. Material and methods: 235 babits with persisting or referred with clicky hip beyond six weeks of age were prospectively followed up to note the incidence of DDH. Of these 176 babies were referred for a hip click without additional risk factors. Results: 7 out of 176 cases (4 - IIa, 2 - IIb, 1 - IIc) had initial abnormal ultrasound examination based on Graf classification. However, all babies with isolated hip clicks eventually had normal hips on clinical and radiographic examination. Discussion: While screening of babies with clicky hips does help in diagnosing the odd case of DDH this is not consistently reproducible. Modifying the targeted ultrasound screening by including clicky hip as a risk factor will not reduce the incidence of missed cases. Isolated clicks in the hip joint beyond six weeks age are rarely a predictor of DDH. However when in doubt such cases should be referred to be reviewed by an orthopaedic surgeon or a radiologist experienced in hip ultrasound.
Weight Changes after Vertical Banded Gastroplication
Authors: Lara J J , Murray L , Carter R , Stuart R , Lean M E J
Published: January 2017

Aims: This study assessed the patterns of weight change in response to surgical treatment for obesity. Methods: Vertical Banded Gastroplication (VBG) was performed during the period 1994–2000. Patients were required to follow a liquid diet (8oo kcals) for 12 weeks before surgery. The same diet plus a multivitamin capsule (Forceval) was followed for 12 weeks postoperatively, after which normal foods were introduced. Data from 23 patients, 16 women and 7 men, aged 33–63 years (mean, SD; 42±8yrs), with BMI from 38 to 69 kg/m2 (52.5 ± 8.1 kg/m2) at the time of the surgery were available for analysis. Follow up was 3 to 7 years (mean 4 years). Results: An initial weight loss of 44.4 ± 24.3 kg (min 11.5, max 110.5 kg) was reached during the first two years (mean BMI decrease 15.8 kg/m2). However a regain in weight (36% of the initial weight loss = 5.6 kg/m2) up to 3 to 7 years after surgery was usual. Average annual regain was 13.6 kg (n=17), 9.45 kg (n=11) and 0.8 kg (n=8) during the 3rd, 4th and 5th year after surgery). Five participants reached a BMI below 30 but only one, BMI<25, has maintained all the weight loss after 5 years. Conclusions: Weight loss following VBG ceased after two years with a subsequent substantial weight regain. Auxiliary therapies to counteract weight regain are necessary after VBG.
Psychiatric Characteristics of Frequent Attenders at Accident and Emergency: A Case Register Comparison with Non Frequent Attenders
Authors: Robertson C , McConville P , Lefevre P
Published: January 2017

Background and aims: Patients attending Accident and Emergency (A&E) on a frequent basis consume a large amount of NHS resources and often frustrate health workers employed in the service. This audit aimed to identify the personal and psychiatric characteristics of these patients and highlight areas where intervention may be helpful. Method and results: Patients presenting to A&E more than 20 times in four years were comparison to non-frequent attenders using case register information. The study demonstrates that frequent attenders are well known to psychiatric services, but are not engaged in ongoing contact. This is not due to a difference in attendance rate between frequent attenders and controls but may represent reluctance for follow up either on the part of the patient or the psychiatrist. Conclusions: These patients have a combination of physical, psychiatric and social pathologies and the services to address these needs does not seem to currently exist but should be considered.
Does a Hospital Formulary Influence Prescribing Practice in an Acute Medical Admissions Unit?
Authors: Murray M , Padfield P L , Maxwell S R J
Published: January 2017

Aim: To assess the extent to which prescribing of cardiovascular medications in a busy medical unit deviates from the local joint primary and secondary care drug formulary guidelines. Method: A retro spective audit of the case notes, prescription charts and discharge summaries oj 150 randomly selected emergency medical admissions overa 4 month period. Results: No patient receiving a non-formulary cardiovascular drug on admission had the choice reviewed in line with formulary recommendations. One third of new cardiovascular medications commenced in hospital were not compliant with formulary recommendations. Decisions about drug therapy were rarely justified in the written hospital record. Conclusions: Our results demonstrate that in a busy acute medical admissions' unit there is a clear jailure to amendor query non formulary prescribing at the time of admission and a tendency to exacerbate it during theinpatient period. This potentially undermines the purpose of a joint drug formulary as a guideline for safe, evidence-based and cost-effective prescribing.
Niemann-Pick Disease Type C and Crohn's Disease
Authors: Steven LC , Driver CP
Published: January 2017

A five year old girl with Neimann-Pick disease type C subsequently developed Crohn's Disease. This association has only been presented once previously in the literature. This report discusses the options for managing one chronic disease in the presence of another life limiting condition.
Clinical and Radiographic Examination of the Breast in Well Women
Authors: Irvine R. W. , James W. B.
Published: January 2017

A survey to detect breast cancer in well women volunteers by clinical and mammographic techniques is described. Nine hundred and twelve such volunteers were examined by both methods and no carcinoma was found. One patient however presented 18 months later with a small palpable carcinoma. The reasons for the failure to detect significant disease are discussed and the incidental findings recorded. It is suggested that at the present time such surveys yield too little benefit to justify the work and expense entailed. Future developments in technique by reducing the cost might make such schemes more feasible hut at present they should be confine***d to screen certain ‘high risk’ populations.
The Control of Aldosterone Secretion and Its Relationship to the Diagnosis of Hyperaldosteronism
Authors: Fraser R. , Brown J. J. , Chinn R. , Lever A. F. , Robertson J. I. S.
Published: January 2017

Current concepts of the control of aldosterone secretion in man have been reviewed with particular reference to the role of the kidney. On the basis of these concepts, it is concluded that hyperaldosteronism is most conveniently diagnosed by repeated estimation of plasma potassium, which is usually persistently or intermittently reduced in this disease. Occasional cases fail to show hypokalaemia. Distinction between primary and secondary hyperaldosteronism is made by means of measurement of plasma renin concentration. Subnormal values are usually obtained in the first instance and supranormal values in the second.
Machine Recognition in Medical Microscopy
Authors: Ward A. , Bantugan G. A.
Published: January 2017

Some general aspects of machine recognition are discussed. The advantages and limitations of machine systems are compared with those of trained human observers and the problems involved in introducing machines into classification systems designed for human observers are outlined.

The present classification system for the cellular components of blood samples is described, with emphasis on the different types of white cell encountered. Cervical samples and chromosomes are described and discussed from the machine recognition point of view.

All proposed machine recognition systems in microscopy must satisfy certain technical criteria; these are listed and discussed briefly.

A number of earlier attempts to recognise cells are described; the results obtained and the difficulties encountered are outlined.

The work of a number of university, medical and industrial research groups actively engaged in this field is described.

The likely developments in this field are discussed from the point of view of improvements which may occur in the hardware of scanning and computing and also the better understanding, integration and exploration of machine systems in medical research and in routine medical diagnostic procedures.
The Use of Tape and Slide Material
Authors: Harden R. McG.
Published: January 2017

A wide range of equipment is available to present tape/slide presentations. It has been emphasised that although there is a place for simple equipment, in a teaching centre automatic equipment has many advantages. It is possible to have a system in which the slides change automatically and the tape stops automatically in order that the student may make a response. Filmstrip should be considered as an alternative to slides.
Programmed Learning—Some Practical and Theoretical Aspects
Authors: Dunn W. R.
Published: January 2017

The process of programmed learning is outlined and it is suggested that there is nothing in the process which could not be accepted as sound teaching practice. Some of the problem areas are pointed out when the process is applied to tape/slide presentations. These are problems that any institution adopting the innovation will face.
Single-Concept Films
Authors: Lawrence Andrea D.
Published: January 2017

We see short films as being of two types with two purposes: (1) educational films presenting limited topics; and (2) teaching films—discrete clips presenting stimuli and perhaps confirmation of response. It is this latter which we are calling ‘single-concept films,’ and which we feel contribute most effectively to the instructional process.

Where do you get single-concept teaching films? First, since there are few available to meet your teaching needs, consider excerpting sequences from longer films; and second, assuming you still have unmet needs, consider the value of producing your own.
An Overview of Medical Television in the United States
Authors: Cole N. L.
Published: January 2017

As a minimum, we recommend that preparation of a presentation in any form—whether it is designed to be delivered as a ‘live’ or televised lecture, or through other means as, for example, a multi-media self-instructional package—should begin with a clear and careful analysis of objectives and audience needs. Built into it should be those experiences and activities, both overt and covert, in which the student must engage in order to learn those skills that we want him to learn. Whether or not we are successful will depend in part on the degree to which we take advantage of the strengths of the medium. More frequently, it will depend upon the skill, care, and imagination with which we build the learning experience itself.
Effective Photography
Authors: Craig R. S.
Published: January 2017

Correct focus, proper exposure, careful lighting of the subject, good composition, visiual continuity, and meaningful camera movement result in effective teaching photographs.
Voluntary Vasectomy
Authors: Scott L. S.
Published: January 2017

Vasectomy, in experienced hands, is a simple procedure which produces lasting sterility provided a careful follow-up of seminal tests is performed, and continued, until two consecutive negative tests have been produced. Loss of working time is negligible, and unpleasant sequelae are extremely rare. Sexual performance is, if anything, improved after the operation and it is extremely rare to encounter anyone who has later regretted it.
Plasma Lipoprotein Lipase Activity in Primary Type IV Hyperlipoproteinaemia
Authors: Weir J. J. R. , Cox D. , Moore J. H. , Lawrie T. D. V.
Published: January 2017

Lipoprotein lipase activity has been measured in both pre- and post-heparin plasma samples from 6 patients with Primary Type IV hyperlipoproteinaemia and from 6 normal subjects. Post-heparin lipoprotein lipase activity was of the same order in plasma from both groups. Appreciable activity was, however, noted in plasma collected from the Type IV patients prior to administration of heparin. Lipase activity was minimal in such samples from normal individuals.
Excessive Total Body Potassium in Patients with Chronic Renal Failure
Authors: Lindsay R. M. , Boddy K. , King P. C.
Published: January 2017

In a study of potassium metabolism in patients with advanced chronic renal failure, total body potassium was measured in 36 non-dialysed patients using the Merlin mobile whole-body monitor. These values were compared with the expected ‘normal’ values as estimated from known regression relationships of total body potassium on height and age and on height, weight and age. Five of the 36 patients had measured total body potassiums significantly greater than expected. A clinical condition in which excessive total body potassium exists does not appear to have been previously reported.
Leptospirosis in the West of Scotland
Authors: Lawson James H.
Published: January 2017

Of 73 patients admitted to hospitals in the West of Scotland suffering from clinical leptospirosis during the 10 years 1960–69, 63 (86%) suffered from infection by strains of the serogroup canicola; of these, 22 (34%) were piggery workers employed on infected premises. In 16 other patients infected by canicola the presumed source of infection was a dog, while in the remaining 25 the source was unknown. Ten patients (14%) were infected by strains of the serogroup icterohaemorrhagiae, 9 with a history of exposure to rats and one a pig farmer. These observations, with the results of a serological survey to detect past infection, indicate that in the West of Scotland canicola fever is an occupational risk in persons whose work involves continuous close contact with pigs. The risk is probably greater in farms fattening purchased stock than in breeding farms. One farm, responsible for more than half of the pig-transmitted canicola illnesses, illustrates the persistence for many years of enzootic leptospirosis. There is no evidence of pig-transmitted canicola infection in England and Wales. In common with England and Wales, there is evidence in Scotland that infection by leptospirae of the serogroup hebdomadis is an occupational risk in dairy farmers.
Airways Obstruction in the Carcinoid Syndrome a Study of the Effect of Drugs and other Factors
Authors: Turck W. P. G. , Zeitlin I. J. , Smith A. N. , Grant I. W. B.
Published: January 2017

A case of carcinoid syndrome is reported in which wheeze was the predominant complaint. Studies indicate the presence of abnormalities of both the kinin-forming system and the patient's indole metabolism. Nevertheless, provocation of airways obstruction by intravenous adrenaline did not produce any elevation of circulating levels of kinin, 5-HT or prostaglandin-like activity. The formation of kinin and its disposal was examined. A significant rise in urinary free histamine was obtained.
Infective Agents and Embryopathy in the West of Scotland 1966–70
Authors: Ross C. A. C. , Bell E. J. , Kerr M. M. , Williams K. A. B.
Published: January 2017

Firm or suggestive evidence of congenital infection was obtained in 25 (10.5%) of 239 children under 1-year-old with suspected embryopathy in the west of Scotland during the 4-year period from September 1966. The numbers of infections associated with the various agents studied were: rubella 11, coxsackievirus 4, cytomegalovirus 3, herpes simplex 3, toxoplasma 3, mumps 1. Persisting residual defects were found in 17 of these 25, 9 being associated with congenital rubella.
Coeliac Axis Stenosis
Authors: Watt J. Kennedy
Published: January 2017

Eleven cases of coeliac axis stenosis were operated on during 1966 to 1969. Each patient complained of persistent abdominal pain and loss of weight and investigation for carcinoma proved negative. Auscultation revealed the presence of an epigastric bruit and aortography demonstrated stenosis of the coeliac axis in each case with additional stenosis of the superior mesenteric artery in 3 patients. Operative findings showed that constriction was caused by the median arcuate ligament of the diaphragm in seven cases and by periarterial fibrosis in 4. Operative division of the constricting agent gave complete relief in 9 patients and improvement in 1, the other being unchanged.
Intra-Uterine Transfusion in a County Obstetric Service
Authors: MacDougall Jean Y. , Black M. D. , Dempster W. H.
Published: January 2017

A review of 46 patients treated by intra-uterine transfusion on account of Rhesus isoimmunisation from a County Obstetric Service is given. The patients treated were those considered to have a very high risk of intra-uterine death before the 34th week of pregnancy.

The main criteria for their selection were liquor amnii optical density readings at 450n. in the upper part of a Liley type prediction graph or an initial reading in the upper part of the middle zone with a subsequent reading rising steeply towards or entering the upper zone. Amniocentesis was usually carried out at 29 and 31 weeks' gestation but, in cases with a history of previous stillbirth or neonatal death, it was carried out at 25 weeks and repeated as necessary. The technique which evolved in the light of experience and with a view to minimal radiation exposure is described in detail.

There were 18 surviving babies out of 46 cases giving a survival rate of 39.1 per cent. Of these 18 surviving babies 17 were perfectly normal on follow-up but one is spastic, probably due to an anoxic episode during an exchange transfusion. No maternal ill-effects, which could be definitely attributed to the procedure, were encountered.
Chlorpropamide Poisoning in Non-Diabetics
Authors: Dowell R. C. , Imrie A. H.
Published: January 2017

Two non-diabetic girls were observed following self-poisoning with chlorpropamide. The dominant feature was prolonged hypoglycaemic coma, which lasted 3 days in one case, and led to death in the other. High serum levels of chlorpropamide were demonstrated and this was correlated with sustained high levels of plasma insulin. In the light of the results obtained, the role of glucagon in the management of such cases is discussed, and the requirement for observation in an intensive care unit is emphasised.
Lead Poisoning and Blistering of the Skin
Authors: Allen B. R. , Hunter J. A. A. , Beattie A. D. , Moore M. R.
Published: January 2017

Three patients with blistering on exposed areas of the skin had biochemical evidence of lead poisoning, and a causal relationship through abnormalities in porphyrin metabolism is suggested.
Social and Environmental Aspects of Self-Poisoning
Authors: Mitchell I. , Lawson A. A. H.
Published: January 2017

Six hundred and thirty seven admissions (331 males and 416 females) to a General Medical Unit (1965–1971) because of self-poisoning are studied. There was an increase in the incidence in both sexes and all ages throughout the period, but the increase was most marked in young females in 1970 and 1971. The admission rate varied from area to area, as did the drugs involved, although salicylates, barbiturates, benzodiazepines and Mandrax accounted for most poisonings. The major adverse social factors were marital disharmony, unemployment, disagreement with a close relative and chronic physical disability. Of males 41.2 per cent and of females 38.1 per cent were thought to be mentally normal. Differences between different studies are discussed and it is suggested that results obtained from one area should be applied with caution to another area.
Uncommon Connective Tissue Disorders in Childhood
Authors: Goel K. M. , Shanks R. A.
Published: January 2017

Nineteen cases of the rarer connective tissue disorders diagnosed between 1948 and 1972 have been reviewed. Of these 6 were of systemic lupus erythematosus (SLE), 3 of dermatomyositis and 5 each of progressive systemic sclerosis (PSS) and polyarteritis nodosa (PAN).

Of the 6 cases of SLE, 4 were of true SLE, one of ethosuximide induced lupus syndrome and one newborn with placental transfer of lupus erythematosus factor. Three cases of true SLE died of renal failure.

None of the patients with dermatomyositis or PSS died. Of the 5 cases of PAN, 2 died and one could not be traced. The disease is quiescent in the other two.
Human Leucocytes and Infection
Authors: Raeburn J. A.
Published: January 2017

When infection has occurred almost every type of leucocyte has a function which can contribute to the patient's recovery. Cooperation between different leucocytes takes place, and these cellular activities persist until all microorganisms have been controlled. A deficiency of one particular leucocyte function can often be compensated for by extra activity of another.

In the presence of severe infection many leucocyte functions in vitro, have been shown to be altered, often in a direction which might indicate immunodeficiency. These findings are probably secondary phenomena caused by a relative excess of antigen or of particulate debris. Various drugs can also reduce leucocyte function. All these points need consideration during the investigation of children or adults who have chronic refractory infections.
The Inheritance of Mild type II Hyperlpoproteinaemia
Authors: Ballantyne D. , Lawrie T. D. V.
Published: January 2017

The distribution of plasma total and low density lipoprotein cholesterol concentration was investigated in 158 first degree relatives (105 progeny, 53 siblings) of 55 index patients with mild type II hyperlipoproteinaemia. No evidence of bimodality was found. Our findings support the view that mild type II hyperlipoproteinaemia is inherited in a polygenic manner.
The Work of a Rural Practice
Authors: Wilson J. B.
Published: January 2017

Study of the work load in the month of November over some years in a single handed rural practice has revealed several interesting trends, one being the way in which the work is gradually increasing. A more detailed study of the work over 12 months has demonstrated how fallacious impressions about one's work can be—the work being spread over a very much larger proportion of the patients than had been originally suspected.
Rifampicin Overdosage—The Red Man Syndrome'
Authors: Newton R. W. , Forrest A. R. W.
Published: January 2017

A patient is described who was admitted to hospital 5 hours after a massive overdose of rifampicin.

The unusual clinical features and the lack of severe hepatotoxicity following self-poisoning by this drug do not seem to have been reported previously.