Planning processes for medical education and the health services in London.
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Biomedical subjects
Publications and source records attributed to M Norris.
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This study reported differences in agreement among four experienced listeners who analyzed the articulation skills of 97 four- and five-year-old children. Mean agreement percentages based on the identification of only misarticulated sounds were contrasted with mean percentages of agreement for decisions made on both correct and incorrect articulations of each sound for the entire population. In addition, the weighted average of the modal category of agreement for the specification of error type for misarticulated responses was determined for each sound tested over all subjects. Differences in agreement for evaluations of all responses, for error responses only, and for specification of error types were calculated and reported by place and manner of articulation, voicing characteristics, and syllabic function. Place and manner of articulation revealed differences of agreement, whereas voicing and syllabic function contributed little to agreement or disagreement.
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The ability of synthetic atrial natriuretic factor (ANF) to inhibit vasopressin (AVP) release, as well as its action to inhibit water intake and salt preference in the rat, suggest a role for the peptide in the hypothalamic control of fluid volume in addition to its established actions in the kidney. We report here evidence for a direct, hypothalamic site of action of ANF to inhibit, specifically, AVP secretion. Third cerebroventricular infusion of 1.0 (p less than 0.05) and 2.0 (p less than 0.025) nmoles ANF significantly inhibited AVP release in euvolemic, normally hydrated rats while IV doses of ANF failed to significantly alter AVP release except when 5 nmoles (p less than 0.05) were infused. No significant effects on oxytocin (OT) release were observed. Vasopressin release from median eminence or pituitary, neural lobe explants during static, in vitro incubations was not significantly altered by doses of ANF ranging from 10(-12) to 10(-7) molar. Release of AVP during perifusion of neural lobe explants in the presence of ANF was similarly unaffected. However, AVP and not OT release from hypothalamo-neurohypophysial system explants was significantly inhibited in the presence of 10(-8) and 10(-7) M ANF, suggesting an action of the peptide at the levels of the AVP-producing cell bodies in the included supraoptic nucleus either directly or via an action on an interneuron, and not at the AVP-containing terminal fields in the median eminence or neural lobe.
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OBJECTIVE: To evaluate the immunogenicity and reactogenicity of two lots of a combined hepatitis A-hepatitis B vaccine (HAV, HBV) in healthy 15 to 18 year olds. DESIGN: This was a double-blind, randomized clinical study. Vaccine was administered into the deltoid at 0, 1, and 6 months. Immunogenicity was assessed by anti-HAV and anti-HBs antibody levels at 2, 6, and 7 months after the first vaccine dose. Reactogenicity was assessed through use of 3-day diary cards following each vaccination, plus recording other unsolicited reactions. RESULTS: A total of 160 adolescents were vaccinated; 155 who were seronegative for hepatitis A and B at baseline and who completed the study were included in the immunogenicity analysis. The vaccine was well tolerated; most side effects were local, of low intensity and short duration. Good immunogenicity was determined by antibody titers. High rates of seropositivity (99.4%) were achieved after two doses against HAV, and after three doses for anti-HBs (seroprotection = 98.7%). CONCLUSIONS: This combination vaccine will be useful for immunizing selected high-risk groups in developed countries. In countries where endemicity is low for both diseases, targeting students prior to risk of acquisition would be a feasible preventive strategy.
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