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Why do some people suffer from becoming a parent, whereas others do not? New parents' actual selves were related to their own hopes for themselves (ideal self) and to their spouse's sense of their responsibilities (ought self). Prebirth actual-ideal discrepancies predicted increased sadness or dejection after birth (especially for couples in longer marriages), whereas prebirth actual-ought discrepancies predicted decreased nervousness or agitation after birth (especially for mothers and couples with a less "easy" child). Becoming a parent introduces new demands that both interfere with attaining one's own hopes (increasing dejection in parents high in ideal [own] discrepancy) and shift attention to the new parenting role (decreasing agitation in parents high in ought [spouse] discrepancy).

Neurotensin (NT) is implicated as a neurohormone in mammals, yet the peptide's neuroendocrine role remains to be determined. NT immunoreactivity has been observed in neurosecretory cells of the arcuate nucleus and paraventricular nucleus, and data suggest that NT release into hypophysial portal blood mediates a component of PRL secretion that is female specific and dependent on ovarian steroids. In the present study, in situ hybridization histochemistry and immunohistochemistry were used to investigate the regulation of NT gene expression in hypothalamic neurosecretory regions of adult rats. In ovariectomized females, estradiol induced expression of messenger RNA (mRNA) encoding NT and neuromedin N (NT/N mRNA) in the dorsomedial division of the arcuate nucleus. In contrast, estradiol did not appreciably alter NT/N mRNA expression in the ventrolateral division of the arcuate nucleus, where labeled cells were numerous, or in the paraventricular nucleus, where labeled cells were virtually absent. Estradiol also increased NT immunoreactivity in the external zone of the median eminence, confirming the neuroendocrine phenotype of NT cells in the dorsomedial division, as well as estrogen-regulated synthesis of NT in this system. In the dorsomedial division of cycling females, NT/N mRNA-expressing cells were significantly more numerous at proestrus than at diestrus, consistent with differences in plasma estradiol levels at these stages. In this same region, NT/N mRNA-expressing cells were significantly more numerous in proestrous females than in gonad-intact males. These results imply that estrogen-regulated release of NT at the median eminence subserves one or more sexually differentiated functions and are consistent with the involvement of tuberoinfundibular NT in estrogen-dependent secretion of PRL or GnRH on the afternoon of proestrus.

Eighty-eight of 143 hospitals in New York State providing psychiatric inpatient treatment responded to a mailed questionnaire designed to determine the size of three subgroups of chemical abusers--alcohol abusers, drug abusers, and polychemical abusers--among inpatients with psychiatric diagnoses, as well as the availability of services for these patients. Data for New York City and its metropolitan area were analyzed separately. In 1987 almost one-third of psychiatric admissions both in and outside the metropolitan area had comorbid chemical abuse disorders. Seventy-five percent of patients in the metropolitan area with comorbid chemical abuse had a drug abuse disorder; in rural areas 88 percent of patients with chemical abuse disorders abused alcohol. Both hospital- and community-based aftercare services, especially in the metropolitan area, were less available to psychiatric patients with chemical abuse than to patients without these disorders.

Neurotensin release from estrogen-responsive neurons in the rostral preoptic area of the female rat may play an important role in triggering preovulatory secretion of gonadotropin-releasing hormone on proestrus. We investigated the possibility of sexually differentiated biosynthesis of neurotensin in the rostral preoptic area, using in situ hybridization histochemistry to detect neurotensin/neuromedin N (NT/N) mRNA in adult male rats and adult female rats at proestrus and the first day of diestrus. In sections through the anteroventral periventricular nucleus (AVPv), the number of labeled cells in proestrous females was four times that in males. Diestrus females exhibited half the number of labeled cells present at proestrus, and there was evidence for a significant correlation between circulating estradiol level and number of labeled cells in the AVPv. In the rostral portion of the medial preoptic nucleus (MPN), two contiguous groups of labeled cells were especially prominent. One group, in the medial half of the MPN, was located closer to the midline in females than in males and displayed greater labeling in males than in females. Furthermore, labeling in the rostral MPN was greater at proestrus than at diestrus. These results indicate that biosynthesis of neurotensin and neuromedin N in the rostral preoptic area may be sexually differentiated and, in the female, may vary across the estrous cycle in parallel with circulating estradiol levels, consistent with the view that neurotensin neurons in this area are involved in the regulation of preovulatory secretion of gonadotropin-releasing hormone. The sex- and region-specific expression of NT/N mRNA in the rostral preoptic area suggests functional heterogeneity of neurotensin neuronal populations in this area and implies complex regulation of NT/N gene expression in the rat brain.

Brunei Darussalam has a mixed population with entirely different cultures and religions. The overall incidence of Hepatitis B virus (HBV) infection is 6%. A racial analysis of the incidence of HBV infection in Brunei shows a significantly higher incidence in Chinese compared to the other races. This is consistent with the incidence in the neighbouring countries.

Colonic polyps are not rare in Brunei Darussalam with an incidence of 13% in 193 colonoscopies performed over the last two years. Majority of the polyps were adenomatous. Incidence was higher in the Malays and had a male preponderance. Commonest age of presentation was above the age of 40 years and the pattern is comparable to the Western pattern. All the polyps were removed by colonoscopic polypectomy.

The purpose of this study was to provide descriptive strength estimates of the major muscle groups of the lower limbs for a group of elite sprinters by comparing both the eccentric and concentric and the agonist and antagonist peak torques. The peak torque values of the flexor and extensor muscle groups of the hip, knee, and ankle joints of the lower extremities were tested in a group of elite male and female sprinters. These values were measured both eccentrically and concentrically for each of the joint movements tested, using a Kin/Com isokinetic dynamometer. The peak torque values for the knee joint were found to be substantially larger than those reported for nonathletes, and comparable to those for other athletic populations. No comparable scores were located for the results of the hip and ankle scores. The flexion and extension ratios for the knee joint, at approximately .60, were similar to others reported, whereas the ratios for the hip joint were larger at .76. The concentric and eccentric ratios varied, depending on the speed of testing and the joint tested.

Legislative mandates for the development of prospective payment methodologies for reimbursing inpatient care have spurred the psychiatric community into its own independent effort, applying both clinical and service research, to develop schemes which are fair to psychiatric patients, their providers and payers. Many of the issues involved in the development of an equitable prospective payment system (PPS) for psychiatric care are not new to the field, namely, problems of limited diagnostic accuracy, a limited knowledge of the outcomes of clearly defined treatment protocols, and a lack of integration, efficiency and efficacy in a highly differentiated service system. The research community needs to respond to these problems in the context of cost containment with an awareness that its response will influence care for psychiatric patients for the remainder of this century. In this paper, we will describe the background issues that have brought the psychiatric community to the present point in its response to PPS, and discuss some of the research problems posed by the need for a PPS with the right incentives for clinical effectiveness and efficiency.

A side benefit of a current systems assessment carried out prior to automation was the development of a systematic picture of the clinical care system as captured in the system flow chart. The results of this assessment provided clinical administrators with a blueprint identifying the current system's strengths and weaknesses, which could be used both to introduce improvements and to measure the effect of such changes totally apart from the initial question of automation.

A study was carried out across 11 psychiatric and mental retardation, and developmental disabilities facilities to investigate the impact of a computerized drug prescription monitoring system on clinicians' prescribing behavior, knowledge of pharmacotherapy, attitudes toward computers, and the relationships between their attitudes and changes in their prescribing practices. The results document that surveillance systems can improve prescribing practices. The tangible feedback provided by the exception report, although in the form of a surveillance mechanism, also increased user acceptance to computer technology. However, the findings also suggest that user acceptance is not necessarily required to see positive effects, which in environments where clinical and fiscal accountability are paramount, may override some clinicians' concerns. Attention to human factors components may help to alleviate some negativism.

One of the areas of the body which is very often injured by athletes is the lower lack, or the lumbar area of the spine. This problem is of some concern to physical educators, athletic therapists, coaches, athletes, and physicians. The type of injury which occurs in the lumbar spine is dependent on the direction, magnitude, and the point of application of the forces to the spine. This part of the body is susceptible to injury due to the large forces which must be supported, which include the body weight and any external weights, as well as the forces due to very high accelerations of the body parts. Since the lumbar spine is the only connecting column between the upper and lower parts of the body, all the forces must be transmitted via these structures. There are two general techniques of calculating the forces on the lumbar spinal structures, a static approach and a dynamic approach. The static approach may be useful to calculate compression and shear forces on the spine in stationary positions as may be seen in weightlifting. However, the dynamics approach should be used to calculate the effects of the various weights and inertial forces on spinal structures. The most common types of lower back injuries found in athletes were: muscle strains, ligament sprains, lumbar vertebral fractures, disc injuries, and neural arch fractures. The most common serious athletic injury to the lower back was found to be neural arch fractures at the pars interarticularis, or the isthmus between the superior and inferior articular processes. These fractures are known as spondylolysis, or defect in the pars interarticularis of one side of the vertebrae; and spondylolisthesis, a bilateral defect in the pars interarticularis, often accompanied by forward displacement of the vertebral body. The sports in which lower back injuries commonly occurred were also examined, and it was determined that gymnastics, weightlifting and football were the sports in which the lower back is at greatest risk. In order to help to reduce, the high incidence of injuries to this area of the body, athletes should attempt to increase the strength of the abdominal muscles, and to maximize the flexibility of the lower back.

We have recently shown that intracerebroventricular (i.c.v.) infusion of vasoactive intestinal peptide (VIP) in ovariectomized (OVX) rats causes a pronounced inhibition of pulsatile luteinizing hormone (LH) secretion. Since there is increasing evidence for an interaction between VIP- and norepinephrine-secreting systems in the brain, we tested the hypothesis that disruption of central noradrenergic activity would attenuate VIP-induced suppression of pulsatile LH release. Seven days prior to blood sampling, we administered either 6-hydroxydopamine (30 micrograms) or vehicle into the third cerebral ventricle of long-term OVX rats. This treatment reduced hypothalamic norepinephrine concentrations to 36% of control values. On the day of blood sampling, serial 300-microliter blood samples were taken from conscious, unrestrained animals at 5-min intervals for a total of 4 h. Each sample was replaced with an equal volume of a blood replacement mixture. Immediately following a control bleeding period of 2 h, VIP was administered i.c.v. to each animal for 2 h (at a dose of 1.8 nmol/h). The suppression of pulsatile LH secretion caused by VIP infusion was virtually identical in the 6-hydroxydopamine- and vehicle-pretreated groups. These results indicate that a substantial depletion of hypothalamic norepinephrine does not attenuate VIP-induced suppression of pulsatile LH secretion. This provides evidence that centrally administered VIP inhibits pulsatile LH secretion by a mechanism independent of noradrenergic transmission.

This study was conducted to determine some fitness parameters of two elite handball players, including the current world champion, and also to determine some of the time-motion characteristics of the game of hand-ball. The VO2 max values of the two players were found to be similar (53.1 and 55.2 ml/kg/min), while the world champion was substantially higher on the anaerobic power test and in peak ventilation scores. The results of heart rate monitoring of these players indicated that the mean game heart rate was dependent on several external factors, such as the skill level of each player, the fitness level of each player, the length of the rallies, and the player in control of the rally. The mean heart rate for the world champion was 149 beats per minute (bpm) during each game, while that for the other skilled player was 163.6 bpm, which represented 80% and 88% of maximum, respectively. The average length of each rally was 9 seconds, and the mean pause time (between rallies) was 10 seconds, producing a work-to-test ratio of approximately 1:1. The ball was found to be in play for an average of 47.3% of the total mean game time of 17 minutes. Each player was found to take approximately 350 strokes per match, with the world champion, and eventually the winner, taking a greater number of serves. Handball training should consist of interval training at an intensity of at least 80% of maximum heart rate, with a work-to-rest ratio of 1:1 and an emphasis on 10 second intervals.

Twenty-three elite sprinters, 9 females and 14 males, were filmed while performing a maximal sprint. Age, height, weight, and personal best 100 m time were also determined for each sprinter. Several kinematic variables were calculated for each athlete from the filmed sprint, including stride length, stride frequency, horizontal and vertical velocity of the CG, and the angular kinematics of the limbs. A Kin/Com isokinetic dynamometer was used to determine lower limb peak and average torque values. Correlation coefficients were calculated between each of the kinematic variables and each of the strength variables. Stepwise multiple regression analysis was also carried out for each set of kinematic and strength variables, to determine the best predictors of sprinting speed. Significant relationships were noted between sprinting times for the 100 m and peak torque scores (N.m/kg) for males for fast concentric knee extension and slow eccentric dorsiflexion, and for females for concentric dorsiflexion at both speeds, and slow eccentric dorsiflexion.

The purposes of this study were (1) to determine the relative motions of the upper limb segments during the execution of the softball windmill pitch (2) to attempt to determine the effect of these motions on the performance of the skill. High speed motion picture film was used to calculate the kinematic parameters of the pitching arm segments during the pitch. Four highly-skilled pitchers were used as subjects. Each performed at least ten trials of the pitch, which were recorded by two motion picture cameras. The two trials with the fastest ball velocity for each of the four subjects were analyzed from a sagittal aspect only. The resulting kinematic analysis indicated that there was a definite proximal-to-distal sequence of these motions, with decelerations occurring in the proximal segments prior to release of the ball. It was concluded that one of the critical factors in highly-skilled performance of ballistic skills is the ability to decelerate such segments, which likely require very strong eccentric contractions of antagonistic muscle groups.

The pattern of female sexual behavior shown by aging male and female hamsters was related to exposure to perinatal androgen. Twenty-five female and 37 male hamsters in Experiment 1 was gonadectomized on the day of birth or at 43 days of age. The received 11 tests for receptivity between the ages of 28 and 66 wk. In Experiment 2, 83 females were implanted with a Silastic pellet containing 3, 1, 3 or 9% testosterone (T) or testosterone propionate (TP) by weight from the second to the tenth day of life, and tested approximately every 2 wk from 22 to 58 wk of age. Receptivity was induced by estradiol benzoate and progesterone injected before each 600 sec mating test. Normal females exhibited the highest lordosis scores, followed by minimally androgenized females and males castrated at birth. High doses of exogenous or endogenous perinatal T suppressed receptivity throughout the animal's lifespan, but did not accelerate the rate of decline in female behavior over time. Non-androgenized animals showed the greatest decrease in receptivity with advanced age.

Ovarian steroids act on unidentified neurons to trigger preovulatory secretion of GnRH. In the rat, important steroid target cells reside in the anterior medial preoptic nucleus (AMPN), a sexually dimorphic structure essential for stimulatory effects of ovarian steroids on LH secretion. The AMPN contains neurotensin (NT)-immunoreactive neurons, and immunoneutralization of NT in the preoptic region markedly attenuates steroid-induced LH surges. Using probes derived from the rat gene that encodes NT and neuromedin N (NT/N), we investigated the ability of estrogen to influence NT/N mRNA levels in the AMPN. Ovariectomized rats were treated for 14 days with sham capsules or capsules that produce supraphysiological serum levels of 17 beta-estradiol (250 +/- 20 pg/ml). As determined by in situ hybridization, estradiol markedly altered the distribution of NT/N mRNA in the medial preoptic region, causing a striking increase in NT/N mRNA abundance specifically in the AMPN and adjacent medial preoptic nucleus (MPN). In contrast, estradiol caused no obvious changes in labeling in the lateral septum, diagonal band of Broca, bed nucleus of the stria terminalis, and lateral preoptic area. The distribution of NT/N mRNA in the AMPN of normal male rats closely resembled that in ovariectomized rats, where labeled cells were rarely observed. Microdissection and S1 nuclease protection analysis were used to quantitate the effect of estradiol on NT/N mRNA levels. Supraphysiological estradiol treatment for 14 days caused a 3.4-fold increase (P less than 0.0002) in NT/N mRNA levels in the combined AMPN/MPN, whereas levels in the central amygdaloid nucleus remained constant, providing further evidence of regional specificity. Forty-eight hours of estradiol treatment, at concentrations (60 +/- 1 pg/ml) similar to those observed on the morning of proestrus, caused a 1.8-fold increase (P less than 0.001) in NT/N mRNA levels in the AMPN/MPN, indicating that the time course of NT/N mRNA induction by estrogen is compatible with events of the normal estrous cycle. Together with previous findings, our results strongly suggest that NT neurons mediate, directly or indirectly, stimulatory effects of ovarian steroids on GnRH secretion.

Recent studies implicate vasoactive intestinal polypeptide (VIP) as a neurotransmitter or neuromodulator, and several observations suggest that VIP, originating within the brain, may alter the secretion of GnRH. We have tested the hypothesis that VIP acts as a central nervous system regulator of pulsatile GnRH secretion, as reflected in pulsatile LH release, by assessing the effect of intraventricularly administered VIP on several parameters of LH secretion in ovariectomized (OVX) rats. To examine the possibility that centrally administered VIP alters pituitary responsiveness to GnRH, we challenged OVX rats with GnRH and compared the LH response in VIP-treated animals with that in control animals. Finally, we tested the hypothesis that exposure of the animal to gonadal steroids alters VIP's effect on LH secretion by assessing LH release during central administration of VIP in OVX rats pretreated with estrogen and progesterone. Unanesthetized rats with external jugular cannulae were bled at 5-min intervals for 2 h before infusion and for 2 h during continuous intraventricular infusion of either VIP (1.8 nmol/h) or saline. Blood samples (300 or 400 microliter) were replaced with an equal volume of a blood replacement mixture. VIP infusion significantly reduced LH pulse frequency by 80% (P less than 0.002) and mean LH levels by 60% (P less than 0.002), but did not significantly affect LH pulse amplitude. In contrast, saline infusion produced no significant change in any of these parameters. The plasma LH response to 2 ng GnRH, iv, in VIP-treated animals did not differ significantly from that in control animals. Finally, VIP infusion had no discernible effect on LH secretion in OVX rats pretreated with estradiol benzoate (50 micrograms) and progesterone (25 mg). These results demonstrate that VIP can profoundly inhibit pulsatile LH secretion in the OVX rat and provide evidence to suggest that this effect is not due to diminished pituitary responsiveness to GnRH. Based upon these observations, we argue that VIP, originating within the brain, may be an important inhibitory regulator of pulsatile GnRH secretion.

The purpose of this study was to examine the results of the two major methods of treatment of complete acromioclavicular separation: surgery and nonsurgical techniques. Twenty male patients with complete acromioclavicular separation within the preceding 13 months were retrospectively examined and tested for recovery of shoulder strength and function. Comparisons were conducted between 10 of the patients who had been treated nonsurgically (Group 1), and 10 who had been treated surgically (Group 2). An additional group of 10 uninjured male subjects as controls was also tested for comparison of strength between dominant and nondominant limbs (Group 3). All of the patients were tested for strength of both shoulders using the Kin-Com isokinetic dynamometer, for shoulder flexibility using the Leighton flexometer, and for grip strength using a standard grip dynamometer. A questionnaire concerning patient evaluation of the injury was also administered to all of the subjects. The majority of strength and flexibility tests showed no significant differences between the nonsurgical and surgical groups. The nonsurgical group was statistically superior to the surgical group in the following test scores: eccentric abduction (fast speeds), concentric external rotation (slow speeds), eccentric external rotation (fast), eccentric abduction (slow), and flexibility in external rotation. These findings generally indicated that the nonsurgical treatment of a third-degree acromioclavicular separation is superior in restoring normal shoulder function in the 1st year following injury.

Neurotensin (NT) has been implicated in the central regulation of LH and PRL secretion in the rat. We investigated the importance of NT release to the neural events that trigger the preovulatory LH surge and coincident PRL surge, using as our animal model ovariectomized (OVX) rats treated with estrogen and progesterone to induce reliable and robust surges. To interfere with the action of endogenous NT in the basal forebrain, we administered a NT antiserum (NTAS) in a series of bilateral microinjections aimed at the anterior border of the medial preoptic area. One week after OVX, rats bearing cerebral guide cannulae received Silastic capsules (3 x 15 mm; sc) containing 17 beta-estradiol. Two days later, beginning at 0830 h, conscious rats were administered either NTAS or control serum bilaterally in a series of four 100-nl injections spaced at 30-min intervals. After an initial blood sample, rats received progesterone (4 mg, sc) at 1200 h; blood samples were then taken at 1-h intervals from 1400-2100 h. Blood samples were obtained from conscious, freely moving rats via a chronic atrial catheter implanted previously. Plasma levels of LH and PRL were measured by RIA, and the location of microinjection sites was verified histologically. Administration of NTAS caused a 66% reduction in the magnitude of the LH surge without altering its timing, whereas the PRL surge was unaffected. These results provide strong evidence that NT in the basal forebrain participates in the steroid-induced LH surge and suggest that NT plays a role in the preovulatory LH surge.