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The article discusses the negative effects of prolonged bedrest and immobility on the musculoskeletal and immune systems, skin and self-perception. Prolonged bedrest affects the physical self, the achieving self, the social self and the private self.

Background: Previous studies indicate that religiousness is associated with lower levels of substance use among adolescents, but less is known about the relationship between spirituality and substance use. The objective [...]

Objective: To determine the accuracy of the CRAFFT substance abuse screening test. Design: Criterion standard validation study comparing the score on the 6-item CRAFFT test with screening categories determined by a concurrently administered substance-use problem scale and a structured psychiatric diagnostic interview. Screening categories were 'any problem' (ie, problem use, abuse, or dependence), 'any disorder' (ie, abuse or dependence), and 'dependence.' Setting: A large, hospital-based adolescent clinic. Participants: Patients aged 14 to 18 years arriving for routine health care. Main Outcome Measures: The CRAFFT receiver operating characteristic curve, sensitivity, specificity, positive predictive value, and negative predictive value. Results: Of the 538 participants, 68.4% were female, and 75.8% were from racial and ethnic minority groups. Diagnostic classifications for substance use during the past 12 months were no use (49.6%), occasional use (23.6%), problem use (10.6%), abuse (9.5%), and dependence (6.7%). Classifications were strongly correlated with the CRAFFT score (Spearman [rho], 0.72; P Conclusion: The CRAFFT test is a valid means of screening adolescents for substance-related problems and disorders, which may be common in some general clinic populations.

The article discusses the impact of long periods of bed rest on the gastrointestinal, endocrine, renal, reproductive and nervous systems and other processes in the body. Such form of confinement results in constipation, reduction in the metabolic rate, glucose intolerance, urinary tract infections and anxiety, confusion and depression.

The article discusses the physiological effects of bedrest and its impact on the cardiovascular, respiratory and haematological systems. The negative psychological effects of bedrest on the mental makeup of patients such as depression, anxiety, forgetfulness and confusion are highlighted.

The outcomes of cardiac surgery in Indigenous Australians with respect to baseline characteristics, operative events and late mortality are examined using a prospective study. Data reveal that Indigenous Australians undergo cardiac surgery almost 20 years earlier than non-Indigenous Australians and also experience comparatively higher age-graded operative and late mortality.

The complications that develop with the cardiovascular system as a result of the process of ageing are discussed. Senior patients are advised to maintain regular exercise to maintain optimum cardiovascular function.

The final portion of a four-part series explains common diseases and disorders that affect the functioning of the lymphatic system.

The role of the lymphatic system in immunity by preventing foreign particles and presenting it to leukocytes of the immune system is discussed. The most common routes of infection and how they can be tackled by the lymphatic system are observed.

The lymphatic system is composed of the lymph and the lymphatic vessels, and the lymphoid glands and organs. The article discusses the three major functions that include tissue drainage, fat transportation, and immune function.

Insulin-mediated glucose transport is sensitive to the level of GLUT4 protein in insulin-responsive tissues. Thus, increasing expression of GLUT4 is a potential therapy to improve insulin resistant glucose homeostasis. To [...]

Objective: To determine the teaching methods, materials currently used, and unmet needs for teaching developmental-behavioral pediatrics (DBP) at pediatric training programs in the United States. Design: Cross-sectional survey of US pediatric residency training programs. The survey questionnaire consisted of 3 instruments: a program director survey, a developmental-behavioral pediatrics survey, and an adolescent medicine survey. Participants: Survey packets were mailed in January 1997 to 211 programs identified by mailing labels from the Association of Pediatric Program Directors. Results: Data from 148 programs (70%) completing both the DBP survey and program director survey were analyzed. Ninety-five percent of programs reported a block rotation, and 95% of those stated that the rotation was mandatory. Eighty-seven percent had a formal curriculum. Most programs reported using articles, lecture outlines, and precepting for teaching DBP. Few programs used standardized case-based or computerized materials. Most programs, however, indicated a desire for these materials. Few programs felt that 4 topics were covered adequately: adoption (12%), violence (24%), substance use (28%), and conduct problems (41%). Programs that perceived that they covered these topics adequately were more likely to use written cases as part of their curriculum (Mann-Whitney test, 1373.5; P = .04). Barriers to teaching included lack of adequate faculty, time, money, and curricular resources. Conclusions: Pediatric residency programs have made significant gains in mandatory DBP training. However, many programs report a lack of adequate faculty, teaching materials, and methods. Responding programs indicated an interest in case-based materials. This approach may represent an alternative and underutilized resource for teaching DBP. Arch Pediatr Adolesc Med. 1999;153:1190-1194, Many pediatric residency programs do not adequately train residents in developmental-behavioral pediatrics (DBP). About 15% to 20% of all children are taken to a pediatrician for behavioral or developmental problems at some time during childhood. Of 148 US pediatric residency programs surveyed, 87% had a formal curriculum in DBP, but many program directors felt that adoption, violence, substance abuse, and conduct problems were not covered adequately. Many directors noted a lack of qualified faculty, time, money, and instructional resources.

Objective: To measure the prevalence of alcohol-related problems among pediatric trainees. Methods: An alcoholism screening test was administered anonymously to participants at a mandatory substance abuse education and prevention program. Setting: A large urban pediatric residency training program. Subjects: One hundred fifteen pediatric residents attended the program during 3 consecutive years (1996-1998). Eighty-five (74%) screening tests were returned and 81 (70%) were analyzed Main Outcome Measure: The 25-item Michigan Alcoholism Screening Test (MAST). Differential MAST cut-points have been established to 'suggest' or 'indicate' a lifetime diagnosis of alcoholism. Results: Twelve residents (15%) had scores suggestive and 6 (7%) indicative of alcoholism. Twenty-eight (35%) admitted to having alcohol-associated amnesia (blackouts), 13 (16%) to 'feeling bad' about their drinking, 9 (11%) to drinking before noon, 6 (7%) to getting into fights when drunk, and 2 (2%) to alcohol-related marital problems. However, only 1 (1%) had gone to anyone for help and none admitted to alcohol-related problems at work. Conclusions: These screening data suggest that alcohol abuse and related problems exist among pediatric trainees at troubling rates. While more than one third of the trainees had experienced a serious consequence from heavy drinking, only 1 had gone for help and problems were not apparent at work. Greater emphasis should be placed on alcohol prevention and early intervention programs as a routine part of pediatric training. Arch Pediatr Adolesc Med. 1999;153:1181-1183, Many residents are at risk for alcohol abuse. Of 81 pediatric residents who took the Michigan Alcoholism Screening Test, 22% had scores indicating they had problems with alcohol. Thirty-five percent admitted drinking so heavily they blacked out but only 1 resident had sought help for the problem. None of the residents believed their drinking affected their job performance.

Objective: To develop a brief alcohol and other drug (AOD) screening test for adolescents. Methods: A 9-item test was constructed by combining and modifying items from several AOD assessments, and administered concurrently with the Personal Involvement With Chemicals Scale (PICS), the criterion standard. Setting: A hospital-based adolescent clinic. Subjects: Fourteen- to 18-year-old patients consecutively arriving for routine medical care who were known to have used AOD. Measures: Internal consistency of the 9 items was calculated using the Cronbach [Alpha]. The relationship between the brief screen and PICS raw score was determined by stepwise linear regression analysis. The PICS T score has been shown to correctly classify substance abuse treatment need as no treatment (T [is less than] 35), brief office intervention (T = 35-40), outpatient or short-term treatment (T = 41-54), and inpatient or long-term treatment (T [is greater than or equal to] 55). Sensitivity and specificity rates for predicting a PICS T score of 55 or higher were calculated from 2 x 2 tables. Results: Ninety-nine adolescents were tested (70.7% female, 36.4% black, 32.3% white, 19.2% Hispanic, mean age, 16.3 years). The 9 items had good internal consistency (Cronbach [Alpha] =.79). Stepwise linear regression analysis identified 6 items whose total combined score was highly correlated with PICS (Pearson r= 0.84, P [is less than] .01). This model correctly classified 86% of subjects according to the PICS criteria. Two or more yes answers had a sensitivity of 92.3% and specificity of 82.1% for intensive AOD treatment need. The 6 items were arranged into a mnemonic (CRAFFT). Conclusions: Further research must confirm the test's psychometric properties in a general clinic population. However, CRAFFT seems promising as a brief AOD screening test. Arch Pediatr Adolesc Med. 1999;153:591-596, A nine-item brief screening test for substance abuse accurately identifies teenagers who may require drug and alcohol abuse treatment. Researchers administered the brief test, plus the standard Personal Involvement with Chemicals Scale (PICS) to 99 teenagers. The brief screen classified 86% of the teenagers appropriately, using the PICS results as the standard. The CRAFFT brief screen questions teenagers about desires to cut down on drinking, drinking to relax, family and friends' drinking habits, and trouble resulting from alcohol use.

A [(CA).sub.n] dinucleotide repeat sequence -2.1 kb upstream of the transcription start site of the aldose reductase gene has been found to be strongly associated with human diabetic nephropathy and [...]

Rab proteins are small GTP-binding proteins of the Pas superfamilty that function in the regulation of vesicle transport processes. The Rab4 isoform has been implicated in the insulin-dependent translocation of [...]

The effects of chronological ageing on the skin are highlighted. The process of overall ageing of the human body can be minimized through consumption of foods rich in fiber and antioxidants, particularly from sources like fresh fruit and vegetables.

The article discusses the different physiological changes that an individual undergoes with ageing. The different changes that take place in the immune system of an individual, as they grow older are highlighted.

The article explores the physiological changes that take place in the digestive system among older adults. This causes a slowing in the body metabolism resulting in loss of muscle mass.

The article discusses the location and functions of the spleen and the thymus, both organs of the lymphatic system.

This edition of the Southern Medical Journal includes a special section on spirituality and alcoholism and in a related scientific article, Knight and colleagues report on the importance of forgiveness [...]

The recent release of the Australian Kidney Fdtn.'s first national epidemiological survey of kidney and urinary tract diseases reveals the diseases are common in Australia and that they can have substantial morbidity, mortality and healthcare implications. There are serious gaps in understanding of the epidemiology of the diseases. Key findings of the national epidemiological survey are listed and include costs, numbers affected, causes, and demographic data.

Testing is a deterrent that works. Addiction is a pediatric-onset disease that needs a public health response. In much the same way that school tuberculosis tests identify children who are [...]

I think we can agree on a couple of points. For starters, adolescent alcohol and drug use is a serious health problem in this country, and I do believe all [...]

Discusses the health impact of parental drinking problem on children. Number of children in the United States who are living in a household with an alcoholic adult; Risks of parental drinking; Why pediatricians should address parental problems; National agencies or organizations that offers help or information regarding drinking problems. INSETS: Monique's story: Part 1;Monique's story: Part 2;Getting assistance or further information.