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A atual crise civilizatória tem suscitado uma série de acontecimentos – agendas, conferências, comissões, relatórios – que buscam saídas para a emergência em que a humanidade e o planeta se encontram. Todas as agendas apontam a educação, na perspectiva da aprendizagem e educação ao longo da vida, como uma peça fundamental para superar os desafios que a própria humanidade criou. Considerando o contexto internacional contemporâneo e os artigos publicados na revista Em Aberto, analisa-se como o conceito da educação de adultos vem evoluindo nos últimos 40 anos. A hipótese proposta é que, ao longo desse período, a educação de jovens e adultos tem sido tratada majoritariamente como escolarização tardia/educação compensatória ou como um processo de formação/adaptação contínua de “recursos humanos” competentes para o mercado de trabalho. O enfrentamento da crise requer uma mudança de paradigma; consequentemente, a nova narrativa da educação de adultos deverá orientar-se por uma ecopedagogia que reestabeleça um equilíbrio entre seres humanos e natureza.

Aim Tissue samples taken during vascular surgical operations are commonly sent for microbiological analysis, owing to the relatively high incidence and serious consequences of infection in these cases. Delays in obtaining results from these samples can hinder clinical management, leading to prolonged inpatient stay and adverse clinical outcomes. The aim of this audit was to identify causes for delay in obtaining microbiology results and to improve the service. Method A closed loop quality improvement project performed at a tertiary vascular centre in London. We initially identified all tissue microbiology samples sent from vascular surgical operations performed during April 2019 and record the time when samples reach microbiology laboratory and the time when results were made available. Re-audit data was collected in November 2019. Results Initial audit showed that on average, results were available for clinicians 9.1 days after the sample was taken and 7.3 days after the sample had reached the laboratory. Samples required an average of 44 hours to transit to the laboratory and notably there is delay if surgery is performed on Friday (71 hours). Additionally, one sample was missing. Following utilization of the urgent sample pathway and raising awareness amongst staff, re-audit data showed significant reduction in average time of transit (33 hours) with much reduced transit time on Friday (36 hours). Results were available 7.7 days following sample date, compared to 9.1 days before. Conclusions Utilization of existing pathway and staff training can reduce delays in microbiology sample processing. However, further analysis is necessary to ensure sustained improvement.

We implemented team building activities to build a better resident during our orientation process and we have refined the choice of activities each year since. Resident satisfaction with their team building actives provided feedback to improve the following years' experience. While there is no definite way to demonstrate the effectiveness of our team building initiative, our expectation is it will improve the residency experience and work environment, and ultimately, result in better patient care. We focus on five aspects of team building - personal history sharing, creativity and imagination, common bonds, cooperation, and shared experience. The purpose of this paper is to recommend activities in each of these areas based on our experience.

In order to study cell proliferation in intact human cervical epithelium, a technique involving metaphase arrest has been utilized. Metaphase accumulation is observed following intraepithelial administration of vincristine sulphate, at a predetermined optimum dose of 50 micrograms/ml. A significant delay before the onset of stathmokinetic activity is demonstrated; thereafter linearity of accumulation is apparent over a 4-hr period following injection. The technique appears applicable to the estimation and comparison of cell production rates in vivo of normal cervical epithelium, cervical intraepithelial neoplasia, wart-affected cervical epithelium and early invasive carcinoma. However, individual values are likely to be imprecise in isolation, indicating the need to study relatively large numbers of subjects in each group. Some practical difficulties are discussed.

OBJECTIVE To examine the prognostic significance of early socioeconomic status (SES) on 24-hour blood pressure (BP) during early adulthood. Low SES has been related to poor health outcomes, in particular, cardiovascular morbidity and mortality. Recent cross-sectional research has also linked low levels of SES with several cardiovascular risk factors including poor nighttime BP dipping. METHODS A total of 174 undergraduate university students whose childhood SES was assessed by highest level of education completed by their parents underwent 24-hour ambulatory BP monitoring. RESULTS Initial correlation analyses revealed positive associations between childhood SES and BP dipping, indicating that lower levels of childhood SES were associated with less systolic BP (SBP) (r = .29, p < .01) and diastolic BP (DBP) dipping (r = .38, p < .01). A stepwise multiple regression analyses indicated that childhood SES explained 6.9% of the variance in SBP dipping and 11.5% of the variance in DBP dipping above and beyond other lifestyle-related factors including daytime BP, body mass index, alcohol use, smoking, and current SES. CONCLUSIONS These findings suggest that irrespective of adult achievement, childhood SES may have lasting health implications.

Global effects in functional MRI are temporal modulations in signal intensity resulting from various scanner and subject phenomena. These effects contribute to the overall variance, reducing the effect size associated with an experimental paradigm. Statistical estimations that include an approximation for concurrent global effects will reduce the residual error within the model and so improve statistical power of the study. Conventionally, estimates of global effects are derived from mean intracerebral signal intensities, but these may be prone to contributions from localised experimentally evoked signal changes. In such cases, inaccurate estimates of global effects may result in erroneous inferences of neural modulations based on statistical artefact. A novel, computationally simple, method of estimating global effects is proposed using muscle tissue acquired within the same acquisition volume. Quantitative improvements in sensitivity are reported for a somatosensory stimulation paradigm using global muscle signal intensities as a covariate of no-interest. The method is independent of local neurogenic signal changes and, under particular experimental conditions, may be more representative of true global effects. The utility of this strategy to applications in small-animal functional MRI that evoke systemic physiological changes as a result of the experimental manipulation is critically discussed. Copyright © 2007 John Wiley & Sons, Ltd.

A prototype scintillating-fibre detector system has been developed at the University of Glasgow in collaboration with the UK National Nuclear Laboratory (NNL) for the non-destructive assay of UK legacy nuclear waste containers. This system consists of four tracking modules, two above and two below the container under interrogation. Each module consists of two orthogonal planes of 2 mm-pitch fibres yielding one space point. Per plane, 128 fibres are read out by a single Hamamatsu H8500 64-channel MAPMT with two fibres multiplexed onto each pixel. The configuration allows the reconstruction of the incoming and scattered muon trajectories, thus enabling the container content, with respect to atomic number Z, to be determined. Results are shown from experimental data collected for high-Z objects within an air matrix and within a shielded, concrete-filled container. These reconstructed images show clear discrimination between the low, medium and high-Z materials present, with dimensions and positions determined with sub-centimetre precision.

Cervical cancer is a common cause of death worldwide. In the developed world, cervical cancer screening has successfully reduced the incidence of and mortality from the disease. Mortality remains high among developing nations. Over the past decade, there have been various developments in management strategies, based on currently available evidence. This review explores such evidence and recommends current management strategies, including fertilitysparing surgical options for early-stage disease.

Background: Osteoclasts, specialised bone resorbing cells regulated by RANKL and M-CSF, are implicated in rheumatoid joint erosion. Lymphocyte-monocyte interactions activate bone resorption, this being attributed to tumour necrosis factor α (TNFα) and interleukin 1 β (IL1β) enhanced osteoblast expression of RANKL. In animal studies, TNF potently increases osteoclast formation in the presence of RANKL. RANKL-independent osteoclastogenesis also occurs, though IL1 is required for resorptive function in most studies. These inflammatory cytokines have a pivotal role in rheumatoid arthritis, Objective: To study the interactions of TNFα and IL1β with RANKL, particularly the time course of the interactions and the role of lymphocytes. Method: Cultures of lymphocytes and monocytes (osteoclast precursors) or of purified CD14 + cells alone (osteoclast precursors) were exposed to various combinations of TNFα, RANKL, and IL1β or the inhibitors osteoprotegerin, IL1 receptor antagonist, or neutralising antibodies to RANKL or to IL1. Osteoclastogenesis and resorptive activity were assessed on microscopy of dentine slices. Results: TNFα potently increased osteoclast proliferation/differentiation in the presence of RANKL. This effect was greatest when RANKL was present before but not after exposure of osteoclast precursor cells to TNFα. The resorptive activity of osteoclasts generated by TNFα in the absence of RANKL was critically dependent upon IL1, which was expressed by lymphocyte-monocyte interaction. Conclusion: TNFα potently enhances RANKL mediated osteoclast activity. Interactions between TNFα and IL1 also result in osteoclastic activity independently of RANKL. These findings will inform therapeutic approaches to the prevention of joint erosion in rheumatoid arthritis.

Background: Some aspects of diet are relatively newly recognized potential risk factors for asthma, but the evidence to date is conflicting. Objective: The goal was to determine whether the food and nutrient intakes of adults with asthma differ from those of adults without asthma. Design: This was a community-based, cross-sectional study of 1601 young adults (x ± SD age: 34.6 ± 7.1 y) who were initially recruited by random selection from the federal electoral rolls in Melbourne in 1999. Subjects completed a detailed respiratory questionnaire, a validated semiquantitative food-frequency questionnaire, skin-prick testing, and lung function tests, including a methacholine challenge test for bronchial hyperreactivity (BHR). A total of 25 nutrients and 47 food groups were analyzed by using multiple logistic regression with alternate definitions of asthma and atopy as the outcomes. Results: Whole milk appeared to protect against current asthma (odds ratio: 0.66; 95% CI: 0.46, 0.97), doctor-diagnosed asthma (0.73; 0.54, 0.99), BHR (0.68; 0.48, 0.92), and atopy (0.71; 0.54, 0.94). Conversely, soy beverage was associated with an increased risk of current asthma (2.05; 1.19, 3.53), doctor-diagnosed asthma (1.69; 1.04, 2.77), and BHR (1.65; 1.00, 2.71). Apples and pears appeared to protect against current asthma (0.83; 0.71, 0.98), asthma (0.88; 0.78, 1.00), and BHR (0.88; 0.77, 1.00). Conclusions: The consumption of dairy products, soy beverages, and apples and pears, but not of nutrients per se, was associated with a range of asthma definitions. Dietary modification after diagnosis is one possible explanation for this finding. Intervention studies using whole foods are required to ascertain whether such modifications of food intake could be beneficial in the prevention or amelioration of asthma. Am J Clin Nutr 2003;78:414‐21.

Objective To identify and summarize rigorous evaluations of psychosocial and educational interventions aimed at the primary prevention of alcohol misuse by young people aged up to 25 years, especially over the longer term (>3 years). Methods Cochrane Collaboration Systematic Review. Data sources A comprehensive search of 22 databases and recursive checking of bibliographies for randomized and non-randomized controlled trials and interrupted time-series studies. Main outcome measures Objective or self-report measures of alcohol use and misuse. Results Fifty-six studies were selected for inclusion in the systematic review. Twenty of the 56 studies showed evidence of ineffectiveness. No firm conclusions about the effectiveness of prevention interventions in the short- and medium term were possible. Over the longer term (>3 years), the Strengthening Families Programme (SFP) showed promise as an effective prevention intervention. The Number Needed to Treat (NNT) for the SFP over 4 years for three alcohol initiation behaviours (alcohol use, alcohol use without permission and first drunkenness) was 9 (for all three behaviours). One study also highlighted the potential value of culturally focused skills training over the longer-term (NNT = 17 over 3.5 years for 4+ drinks in the last week) Conclusions (1) Research into important outcome variables needs to be undertaken; (2) the methodology of evaluations needs to be improved; (3) the SFP needs to be evaluated on a larger scale and in different settings; (4) culturally focused interventions require further development and rigorous evaluation; and (5) an international register of alcohol and drug misuse prevention interventions should be established and criteria agreed for rating prevention interventions in terms of safety, efficacy and effectiveness.

New results are reported from a measurement of π^{0} electroproduction near threshold using the p(e,e^{'}p)π^{0} reaction. The experiment was designed to determine precisely the energy dependence of s- and p-wave electromagnetic multipoles as a stringent test of the predictions of chiral perturbation theory (ChPT). The data were taken with an electron beam energy of 1192 MeV using a two-spectrometer setup in Hall A at Jefferson Lab. For the first time, complete coverage of the ϕ_{π}^{*} and θ_{π}^{*} angles in the pπ^{0} center of mass was obtained for invariant energies above threshold from 0.5 up to 15 MeV. The 4-momentum transfer Q^{2} coverage ranges from 0.05 to 0.155 (GeV/c)^{2} in fine steps. A simple phenomenological analysis of our data shows strong disagreement with p-wave predictions from ChPT for Q^{2}0.07 (GeV/c)^{2}, while the s-wave predictions are in reasonable agreement.

The increasingly interconnected world is setting new demands on test and measurement suppliers. The authors outline how the industry is rising to the challenge. Instrument manufacturers must always be at the leading edge of the technologies they are involved in, why they play a critical role in establishing new communication standards and protocols. Just about any device that is subject to test and measurement is likely to be connected to some form of network. Testing these networked elements presents a whole new set of problems for the test and measurement engineer, especially for those individuals unfamiliar with modern communications technology. Looking ahead, most test and measurement instruments will be connected to a network. This represents a natural progression for design engineers, both in the way they use instruments and in the way they access data acquired or analysed by an instrument. In future, an engineer will no longer have to move from an office to a lab environment just to check the execution of a test suite-the check will be performed over a network. Similarly, access to an instrument won't be restricted to a single engineer in one location-the whole engineering team will concurrently view the instrument set-up and acquired data, regardless of the physical location of the individual team members or system under test.

Growth and metastatic spread of invasive carcinoma depends on angiogenesis, the formation of new blood vessels. Platelet-derived endothelial cell growth factor (PD-ECGF) is an angiogenic growth factor for a number of solid tumors, including lung, bladder, colorectal, and renal cell cancer. Cervical intraepithelial neoplasia (CIN) is the precursor to squamous cell cervical carcinoma (SCC). Mean vessel density (MVD) increases from normal cervical tissue, through low- and high-grade CIN to SCC. We evaluated PD-ECGF immunoreactivity and correlated its expression with MVD in normal, premalignant, and malignant cervical tissue. PD-ECGF expression was assessed visually within the epithelial tissues and scored on the extent and intensity of staining. MVD was calculated by counting the number of vessels positive for von Willebrand factor per unit area subtending normal or CIN epithelium or within tumor hotspots for SCC. Cytoplasmic and/or nuclear PD-ECGF immunoreactivity was seen in normal epithelium. PD-ECGF expression significantly increased with histologic grade from normal, through low- and high-grade CIN, to SCC (P < .02). A progressive significant increase in the microvessel density was also seen, ranging from a mean of 28 vessels for normal tissue to 57 for SCC (P < .0005). No correlation was found between PD-ECGF expression and MVD (P = .45). We conclude that PD-ECGF expression and MVD increase as the cervix transforms from a normal to a malignant phenotype. PD-ECGF is thymidine phosphorylase, a key enzyme in the activation of fluoropyrimidines, including 5-fluorouracil. Evaluation of PD-ECGF thymidine phosphorylase expression may be important in designing future chemotherapeutic trials in cervical cancer.

Migration-time reproducibility is essential in the use of capillary electrophoresis to identify components in mixtures. Two methods based on the migration time of either one or two reference markers are proposed for improving migration time reproducibility. These methods were evaluated to determine the migration time reproducibility for phenylthiohydantoin-amino acids, fluorescein thiohydantoin-amino acids, and tetramethylrhodamine labeled oligosaccharides. In the best case, the relative standard deviation of the migration time was reduced from >3% without correction to

The aim of this audit was to determine if inadequate cervical smears are associated with significant cervical pathology. Case records for 52 women with three consecutive inadequate smears referred for colposcopy to the Leicester Royal Infirmary (LRI) were retrieved. Sixteen women underwent large loop excision of the transformation zone (LLETZ) and cervical intraepithelial neoplasia (CIN) was identified in six cases. There were no cases of inadequate smears initiating the diagnosis in 100 consecutive women with invasive cervical cancer. Inadequate smears are associated with high rates of treatment for a low yield of CIN. To reduce morbidity associated with colposcopy it may be acceptable to repeat an inadequate smear after 6 months rather than arranging immediate recall.

We present the case of a 48-year-old woman with pelvic mass, ascites, and an elevated CA125 mimicking advanced-stage ovarian cancer. She underwent laparotomy, drainage of ascites, total abdominal hysterectomy, bilateral salpingo-oophorectomy, and infracolic omentectomy. Histology confirmed this to be mesovarian hemangioma, a benign condition.

The levonorgestrel-releasing intrauterine system (LNG-IUS), commonly referred to as mirena, is an effective form of contraception, which is widely used as an intrauterine device. It has a 32-mm long-shaped plastic frame that holds a reservoir (on the vertical stem) of 52 mg of levonorgestrel mixed with polydimethylsiloxane to allow a steady release of 20 μg of levonorgestrel per day within the endometrial cavity through a rate-limiting surface membrane. Apart from contraceptive purpose, it is also now commonly used in the management of heavy menstrual blood loss. This study included a 36-year old woman who developed endometrial cancer following the insertion of the LNG-IUS. Her main presentation was irregular vaginal bleeding, which is a common finding in women using this form of contraception. Although we would advice caution in investigating such women, the LNG-IUS remains a relatively safe method of contraception.

This document describes the technical layout and the expected performance of the Straw Tube Tracker (STT), the main tracking detector of the $\bar{P}$ANDA target spectrometer. The STT encloses a Micro-Vertex-Detector (MVD) for the inner tracking and is followed in beam direction by a set of GEM stations. The tasks of the STT are the measurement of the particle momentum from the reconstructed trajectory and the measurement of the specific energy loss for a particle identification. Dedicated simulations with full analysis studies of certain proton-antiproton reactions, identified as being benchmark tests for the whole $\bar{P}$ANDA scientific program, have been performed to test the STT layout and performance. The results are presented, and the time lines to construct the STT are described.

Cosmic-ray muons are highly penetrative charged particles that are observed at sea level with a flux of approximately one per square centimetre per minute. They interact with matter primarily through Coulomb scattering, which is exploited in the field of muon tomography to image shielded objects in a wide range of applications. In this paper, simulation studies are presented that assess the feasibility of a scintillating-fibre tracker system for use in the identification and characterisation of nuclear materials stored within industrial legacy waste containers. A system consisting of a pair of tracking modules above and a pair below the volume to be assayed is simulated within the GEANT4 framework using a range of potential fibre pitches and module separations. Each module comprises two orthogonal planes of fibres that allow the reconstruction of the initial and Coulomb-scattered muon trajectories. A likelihood-based image reconstruction algorithm has been developed that allows the container content to be determined with respect to the atomic number Z of the scattering material. Images reconstructed from this simulation are presented for a range of anticipated scenarios that highlight the expected image resolution and the potential of this system for the identification of high-Z materials within a shielded, concrete-filled container. First results from a constructed prototype system are presented in comparison with those from a detailed simulation. Excellent agreement between experimental data and simulation is observed showing clear discrimination between the different materials assayed throughout., Comment: 11 pages, 14 figures

Measuring high-speed signals on high-speed serial data buses such as fibre channel, SONET, gigabit Ethernet and infiniband, or of microprocessor systems incorporating bus architectures, such as DDR II and rapid I/O can be very difficult. Determining the accuracy of this measurement type is no trivial task, especially given how highly interdependent it is on the signal under test. To ensure accurate measurements, a thorough understanding is required of the different types of delta-time measurements and the various sources of errors that affect the ability to make precise measurements. Sources of measurement inaccuracy come from the digital oscilloscope and its connection to the test component.

When acetone-2,4-dinitrophenylhydrazone is dissolved in pure acetonitrile and analyzed by micellar electrokinetic capillary chromatography, peak splitting is observed. As the amount of acetonitrile is reduced in the sample solution, the peaks converge and a single, narrow peak is observed. Peak splitting due to geometric isomerism has previously been observed in gas and liquid chromatographic analyses of dinitrophenylhydrazine derivatives of aldehydes and asymmetrical ketones, but the acetone derivative has no such isomerism. Peak splitting is thought to be a result of the interaction of acetonitrile with the micelles in the separation buffer. This artifact may occur whenever analytes are prepared in a buffer containing a large concentration of organic phase; decreasing the concentration of organic phase should produce simpler electropherograms.

The Buddhist Path to Awakening. A Study of the Bodhi-Pakkhiya Dhamma. R.M.L. Gethin. E.J. Brill, Leiden 1992. xii, 382 pp. $111.50.

The European Food Information Resource (EuroFIR) Network of Excellence (http://www.eurofir.eu) aims to provide validated food composition data (FCD) from European food composition databanks. However, the network covers 27 countries with different languages and food cultures, making comparisons difficult. Moreover, in 2005, only 25% of the databases included international food classification or food description. To overcome some of the challenges, it was decided to use the LanguaL thesaurus (http://www.langual.org) to index (systematically describe) and link the foods in European food composition databases (FCDBs). To facilitate food indexing, LanguaL Food Product Indexer software was introduced and several short (1-2 days) food indexing courses for FCD compilers from all participating countries were organised. Feedback between the LanguaL Technical Committee and the FCD compilers allowed the latter to improve their food indexing skills. In turn, the compilers proposed new descriptors and translations for the thesaurus. The result was a set of more than 26,000 foods in national databases and 2360 foods in specialised data sets that were LanguaL indexed and thus able to be linked to the EuroFIR network. Both the EuroFIR network and the individual FCD compilers benefit from standardised food description, allowing foods to be linked and compared across borders and language barriers. The LanguaL thesaurus has, in turn, benefited from the expertise of the FCDB compilers from different cultures.

This article reports the experience of the Victorian Department of Health in seeking clinician engagement in the testing of 11 quality-of-care indicators in 20 health services in Victoria. The Department previously developed a suite of 18 core indicators and seven subindicators known as the AusPSI set. We used routinely collected administrative data from the Victorian Admitted Episodes Dataset to produce variable life-adjusted display (VLAD) control charts for 11 selected indicators. The Department recognises that clinicians are responsible for the safety and quality of the care they provide, and therefore the necessity of engaging clinicians in the process of investigating apparent variation in patient care. Although using readily available and inexpensive routinely collected administrative data to measure clinical performance has a certain appeal, the use of administrative data and VLADs to identify apparent variations has posed significant challenges due to concerns about the quality of the data and resource requirements. When clinicians at a major Melbourne hospital were engaged, it resulted in an improvement in clinical practice. Investigating apparent variation in patient care provides an ideal opportunity for emerging clinical leaders to take local ownership and develop expertise in investigating apparent variation in processes of care and implementing change as required.

We report a violation of the CHSH inequality for ghost-images. This is achieved by using two spatially separated phase modulators within the context of a two-photon parametric down-conversion experiment. We obtain edge enhanced images as a direct consequence of the quantum correlations in the orbital angular momentum (OAM) of the down-converted photon pairs. For phase objects, with differently orientated edges, we show a violation of the CHSH Bell-type inequality for an OAM subspace, thereby unambiguously revealing the quantum nature of our ghost-imaging arrangement.

The surgical approach to intrinsic lesions within the brain stem is undertaken by the surgeon knowing the potential for significant operative morbidity. We report the use of real-time intraoperative ultrasound and electrophysiological mapping techniques to aid in the localization and resection of an intrinsic brain-stem tumor in a child. These techniques permitted an aggressive surgical approach without encountering adverse postoperative neurological sequelae.

Nutritional status and growth play an important part in determining the prognosis in cystic fibrosis (CF). In South Africa, the median survival of patients with CF is 18 years. Using chart review, we studied the pattern of growth over time of a South African CF population. The percentages of expected weight-for-age, height-for-age and weight-for-height were determined for each patient in 1986 (n = 49) and 1996 (n = 63). Mean indices were the same in the two years. In 1996, mean weight-for-age of children aged 5-10 years was 94.2 per cent (SD 20.4), 14.3 per cent higher (p < 0.05, 95 per cent confidence intervals 3-25 per cent) than children of the same age in 1986. Improved growth of young children with CF has been achieved in a resource-poor country setting the scene for improved prognosis.

Laboratory experiments using prepared seaweed food strips coated with the extracts of two dietary and four nondietary macrophytes provided evidence that the feeding of cold-water hervivorous fish is deterred chemically by at least one brown algal species. Neither polar nor nonpolar extracts of the dietary algae Iridaea splendens (Turn.) Bory and Ulva lobata (Kutz) S. et G. or the nondietary macrophytes Laurencia spectabilis Post. & Rupr., Macrocystis integrifolia Bory and Phyllospadix scouleri Hook applied to the food strips reduced feeding by the stichaeid fish Cebidichthys violaceus (Girard). Only food strips coated with a polar extract of the nondietary fucoid brown alga Fucus gardneri Silv. significantly reduced feeding by C. violaceus . Moreover, the polar extract of F. gardneri but not that of the laminarian brown alga M. integrifolia coated on the dietary alga Ulva lobata reduced the digestibility of this alga when force-fed to C. violaceus . Specifically, the assimilation of N by C. violaceus was significantly reduced. These results partially explain food choice in this herbivorous fish and help explain why fucoid algae are not eaten by north temperate herbivorous fishes.

The relative frequency of causes of cholestatic disorders of infancy in a developing area was established in a prospective study. During a 10-year period, 145 infants with conjugated hyperbilirubinaemia were investigated. Intrahepatic disorders accounted for 68 per cent with no identifiable cause (idiopathic hepatitis) in the majority. Syphilis, urinary tract infection and septicaemia together made up 30 per cent of intrahepatic causes with metabolic disorders accounting for 12 per cent. Outcome in those with idiopathic hepatitis, and those treated for syphilis and UTI was relatively good. Complete recovery from syphilitic hepatitis on average took 11 months. Extrahepatic disorders occurred in 32 per cent and were almost entirely due to biliary atresia. Results of hepatic portoenterostomy for biliary atresia were poor because of late referral in many instances. Compared to developed countries, infantile cholestasis in developing areas is more commonly associated with treatable bacterial infection. Referring agencies should be aware of this fact and the need for early referral of cases with possible biliary atresia.

Several neuroimaging techniques now exist that provide ways of studying functional activity in the living brain. Having been widely used in the fields of cognitive and sensory neuroscience, functional neuroimaging has more recently been applied to investigating the way in which psychoactive agents affect brain activity. The non-invasive nature of functional magnetic resonance imaging (fMRI), coupled with its excellent spatial and temporal resolution and proven ability for investigating sensory, motor and cognitive functions in a non-invasive and repeatable way, have made it a particularly attractive technique for drug research, providing an insight into the functional effects of receptor activation in vivo in far greater detail than previously possible. This application of fMRI techniques to neuropharmacology, termed pharmacological MRI or phMRI [1], has been used to successfully demonstrate those regions of the brain that respond to a range of different psychoactive compounds. In addition to providing information concerning the regional specificity of drug action, the time course over which drugs act can also be established, as can the results of interactions between different compounds, and their central effects on cognition can be ascertained. By imaging activity throughout the entire brain, phMRI can determine the duration of druginduced brain activity in all regions of interest with a temporal resolution down to several seconds, without the need for selective regional sampling. Despite its infancy, the use of phMRI has greatly expanded in recent years, having being used to examine the effects of CNS penetrating drugs in both humans and animals. Initial demonstrations that functional neuroimaging was able to detect druginduced changes in brain activity in both humans [2–5] and animals [6–10], highlighted the enormous potential of such techniques for investigating drug action within the CNS. PhMRI is of particular interest to the pharmaceutical industry, with it being seen as having the potential to establish novel surrogate markers in animal disease models and provide early evidence of proof-of-concept for novel compounds, as well as helping characterize brain penetrability, pharmacokinetics, and the regionally specific actions of new drugs. By comparing existing “gold-standard” compounds with the patterns of neuronal activity induced by novel pharmaceutical agents, phMRI may help to establish potential efficacy, side effects, and therapeutic targets early in development. As phMRI is non-invasive and does not involve exposure to ionizing radiation, it can also be incorporated into longitudinal investigations of the neuroadaptive changes that occur during chronic treatment schedules that underlie the actions of many therapeutic agents.

How Buddhism Began. The Conditioned Genesis of the Early Teachings. Richard F. Gombrich. Jordan Lectures 1994. Published by Athlone Press for The School of Oriental and African Studies, London 1996. xi, 180 pp. £25.00. ISBN 0-485-17417-0.

This study was to determine the risk of finding significant cervical pathological abnormality in women referred to the colposcopy clinic primarily because of postcoital bleeding. We evaluated the cervical smear history of such women and correlated this with any colposcopic or pathological abnormality. There were 142 women seen over a period of 12 months. The age range of the study population was 16 - 61 years (mean age of 34.1 years). There was no case of lower genital tract invasive neoplasia. Out of the 142 cases, 56 women (39.4%) had normal findings at colposcopy and 44 (31%) were secondary to cervical ectopy. A total of 27 (19%) had cervical intraepithelial neoplasia (CIN) out of which there were 15 (10.6%) cases of high-grade disease (CIN II and CIN III); and, 20 (74%) out of the 27 women with CIN had a recently negative cervical smear (within the previous 36 months). Seven women (4.9%) had benign cervical polyps that were removed during colposcopy. The frequency of finding invasive lower genital tract neoplasia in women with postcoital bleeding is low. However, a good proportion of them would have a diagnosis of cervical intraepithelial neoplasia even with a recently negative cervical smear. Therefore, postcoital bleeding should remain an indication for referral to the colposcopy clinic for a detailed evaluation of the lower genital tract.

Capillary electrophoresis with laser-induced fluorescence detection (CE-LIF) is a promising new method for the analysis of protein sequencing products. It gives 10 zmol (1 zmol = 10(-21) mol) limits of detection (3 sigma) for fluorescein thiohydantoin (FTH) amino acids. We have developed a separation for the (FTH)-amino acid products generated from 18 of the 20 coded amino acids. The extremely low volume requirement associated with CE-LIF makes it incompatible with commercial sequencers. For this reason, we have also been developing a miniaturized sequencer that can be more easily coupled to our detection system. Both the CE-LIF system and the miniaturized sequencer are described.