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Using microcatheter blood pressure telemetry, the pressure-lowering effect of prindolol (Visken), a beta-blocking drug, was tested at a dose of 10 mg three time daily by mouth in eight patients with essential hypertension (WHO stage II) and low to normal plasma-renin activities. After about ten days of treatment, the hypertensive reaction to everyday physical exercise (walking, climbing stairs, bicycle ergometry) was especially favourably affected. The average blood-pressure reduction at rest was 18.6/12.1 (systolic/diastolic), on stair climbing 41.5/17.2 mm Hg.

The use of primes, contingent attention, and training sessions to assess a child's engagement and skill in six large motor activities was examined using a combination reversal and multiple-baseline design. Assessment was based on four levels: proximity to equipment, touching equipment, unskilled participation, and skilled participation. Before training, priming (suggestion to the child) was more effective than contingent attention for increasing the subject's engagement (but not skill) in five activities and for increasing skilled participation in one activity. Training of four activities in the natural environment effectively increased the subject's skill level in five activities. Thus, training appeared to generalize to one of these five activities in this setting and also to skillfully executed stair climbing in an adjoining setting. After training, primes and contingent attention were sufficient to maintain both the subject's skill level and engagement in all activities. Postchecks in the same setting the following semester with different teachers revealed only slight increases in participation, as compared to previous baselines, but all participation was at the skilled level. Social interaction, which was not experimentally manipulated, did not systematically vary in relation to changes in experimental conditions.

* Accepted for publication by Arnold Gesell of the Editorial Board, and received in the Editorial Office on June 9, 1938.

Continuous monitoring of the heart beats during work and sleep was performed on 12 housewives selected from a group whose daily activities had already been studied by a diary technique (Grievo 1967). Means of the heart rate in work and sleep wore recorded by a Socially Acceptable Monitoring Instrument, SAMI (Baker et al. 1967). Six of the subjects wore an electromechanical counter attached to the SAMI during the day to give a profile of the changes in heart rate during work. Additional information was collected on the housewife's heaviest activities such as shopping, walking and stair climbing.

Proximal tibial osteotomy for degenerative genu varus and valgus has an excellent success rate with proper patient selection and technical proficiency. The following are some infrequently recognized pitfalls. Excessive bone loss prevents two plateau weight-bearing after osteotomy, introduces a "teeter effect," and is therefore a contraindication. Patellofemoral arthritis may produce symptoms, particularly on stair climbing and necessitate secondary surgery. Varus and planning indicates postoperative articular surface obliquity in excess of 10 to 15 degrees another type of reconstruction is indicated. Secure fixation, closing wedge osteotomy, and non-displacement of the d-stal fragment prevent loss of correction. Peroneal nerve palsy may be avoided by careful surgical technique and postoperative dressings. Cracking the apical cortex and visualization of the plateau fragment will usually prevent fracture.

An investigation of the mechanical efficiencies of stair climbing by a group of below-knee amputees fitted with p.t.b. prostheses and another group of lower-limb amputees using crutches was made, and the values were compared with the mechanical efficiency of a group of normal individuals performing the same exercise. The mechanical efficiencies of the first and second group of rehabilitees were, respectively, 20·5% and 48·5% lower than those of normal persons. An attempted comparison of mechanical efficiencies between the p.t.b.-fitted below-knee amputees and normal persons in the performance of a step test failed to reveal any significent differences. The measurement of mechanical efficiency requires a careful choice of the test activity, but shows promise of providing an objective basis for assessments of functional rehabilitation of amputees fitted with different types of prostheses.

A study was undertaken to evaluate the performance of an amputee-prosthesis system in a group of ten below-knee amputees fitted with patellar tendon-bearing prostheses. The subjects had fulfilled the necessary clinical and prosthetic criteria for their discharge from the care of the Rehabilitation Centre to resume their domestic and occupational activities. Pulmonary ventilation, oxygen consumption, energy expenditure and peak heart rate were measured during the rehabilitees' performance of four types of standard physical activities and one standard exercise tolerance test. Similar data were collected from a group of sixteen normal subjects while performing the same series of tests. Statistical tests for difference between the two groups of subjects showed significant differences in the above parameters for the walking on the level and stair climbing activities. From the data it was concluded that although the degree of rehabilitation was satisfactory in the amputees, there is a definite necessity for inc...

A test battery designed to evaluate intellectual, verbal, motor, perceptual-motor, and perceptual task performance levels of preschool psychotic children is outlined in some detail. Also presented to illustrate the battery's application is an experimental comparison of psychotic (11 early schizophrenic, 19 primary autistic, and 35 secondary autistic) and non-psychotic subnormalN=29) children, whose CA group means ranged from 56.1 to 71.8 months. The comparison involved selected adaptive (nonverbal intellectual and perceptualmotor), verbal, and motor tasks, all also performed by 3 normal children. Subnormal children were significantly more advanced than the schizophrenic in 2 motor tasks, and than the primary autistic, in all excepting the Seguin formboard and stair climbing. Primary autistic children were better at stair climbing than the schizophrenic whose motor performance profiles proved similar to those of lower functioning autistic. The discussion is focused on etiological implications of results.

Maximum power output during the performance of a standing jump of two feet from a force platform and stair climbing has been studied in 47 male subjects aged 20-50 years and 8 female subjects aged 18-27 years in relation to body composition. During the standing jump, power output mean values of 5·23 hp for men and 3·15 hp for women wore recorded. These figures are amongst the highest over recorded in man; they ore some four times higher than the corresponding values for the stair climb and fifteen times those achieved during maximum aerobic work on a stationary bicycle ergometer. Maximum power output in the two forms of activity were dependent on ago and sex, size, stature and, to a lesser extent, body composition of the subject. In young men and women the power output values were related to estimates (from soft tissue radiographs) of thigh muscle and loan body mass. However, in older subjects these relationships disappeared. Power output values during stair climbing could be accounted for in ter...

Dyspnea from muscular exercise results when the increased respiratory demands can no longer be met without effort. In the present series of experiments the ability to meet these demands was artificially restricted by having a normal individual (A. W. H.) breathe through small apertures. For this purpose two perforated corks were used, the diameters of the bores being 8 mm. and 6 mm. respectively. The first of these caused no effort so long as the subject of the experiments was at rest. It caused moderate respiratory effort when stairs were climbed at the rate of approximately 80 per minute. The second caused slight effort at rest and considerable distress during stair climbing. The latter culminated in discontinuance of the exercise after two or three minutes.During rest, the respiratory rate was not influenced by the milder obstruction but in some experiments was somewhat slowed by the more marked obstruction. During exercise, the respiratory rate was definitely slowed by each, average figures being: wit...

In the summer of 1923, the Sunset Camp Service League of Chicago, a philanthropic organization which maintains a camp ordinarily used for the recreation of Jewish working girls, organized a plan to use the camp during September for the care of a group of girls with chronic heart disease. The project was rather experimental in nature, the object being to determine, if possible, the value of such an experience to the patients treated. The camp used is situated on the shore of a small lake sixty miles northwest of Chicago. It covers five acres of dry and wooded ground which is about from fifteen to twenty feet above the lake level. The buildings include the main house, which has a large porch, living room. dining room, kitchen and lavatories on the first floor and dormitories on the second and third floors; also a smaller cottage with additional sleeping quarters. There

To the Editor: —Concerning the need of elevators in the public schools of New York, I am glad that Dr. Goldberger (The Journal, October 30) does not defend the lack of elevators on medical grounds, but rather as an official of the board of education of New York. I am also glad that Dr. Goldberger does not deny that not one of the 605 elementary schools in Greater New York has an elevator. It is a reflection on the city that the public schools are the only public buildings without elevators, and the majority of these are four and five stories high. In the consensus of medical opinion, stair climbing has a harmful effect on the hearts of children. This opinion is corroborated by numerous letters from the principals in the various schools, from which I can extract the following: The climbing of stairs in buildings of four or five