Search

The demographic shift to an ageing population in contemporary Western society offers a new cultural frontier, with rapidly shifting contours that demand creative and critical examination. Rather th...

This chapter offers an auto-ethnographic account of my experiences of working as a critical social work educator and trade unionist in contemporary academia. In doing so it provides insight into the increasingly neoliberalised higher education sector, and some of the challenges this context can pose for academics who adopt a critical stance and conceptualise education as having the potential to contribute to a more socially just, equitable and democratic society. The chapter reflects on a managerial system that is wholly implicated in supporting and normalising bullying. The paper seeks to contribute to critical scholarship on higher education by theorising a considered, ethical response to neoliberal managerialism within universities. Critical pedagogy, collective action and collegial solidarity are suggested as practices of agency and resistance.

Continuing to learn is universally accepted and expected by professionals and other stakeholders in professional practice. However, despite changes in undergraduate professional education in response to research findings, most continuing professional development (CPD) practices focus on delivery of content rather than on learning. Professional development still largely consists of brief, didactic episodes, often separated from practice or ongoing support. In exploring reasons for the lack of significant change in support for continuing learning, scant research was found about how professionals experience learning through their working lives. This study explores how allied health professionals learn in the current changing work context. The aim of the study is to enhance understanding about continuing learning so that support for professionals can improve. The findings have implications for learning in health and other professions. Using a phenomenological framework, continuing professional learning (CPL) is conceptualised in this study as part of the professionals’ lived experience of everyday practice. This conceptualisation challenges the problematic way in which much previous research views professional knowledge as a commodity that can be transferred and accumulated, separate from the professionals’ working context. Rich and diverse descriptions of learning were gained from interviews with sixteen therapists, contextualised through worksite visits, network meetings and relevant policy documents. These data were analysed using Giorgi’s empirical phenomenological methodology. A key finding of this study is the identification of significant dissonance between the reality of the professionals’ experiences of learning and the rhetoric of stakeholders’ expectations about professional development. The main focus of previous research, on the implementation and outcomes of CPD activities, fails to acknowledge the complex, diverse, multifaceted and idiosyncratic nature of professional learning experiences. Professional responsibilities with respect to CPD are linked to supervision of standards, monitoring of accountability and promotion of evidencebased practice. As this study clearly reveals, the participants are enthusiastic learners who take these professional responsibilities seriously, but consider that their continuing learning is richer than this narrow CPD interpretation. The findings are reported in two phases. The first describes commonalities across diverse experiences of CPL, in terms of four inter-related constituents: understanding, engagement, interconnection and openness. Within the complexity of descriptions of CPL, tensions are revealed, particularly between the openness and uncertainty of learning, and the constraints and regulation of context. How tensions are resolved depends on each person’s way of being a professional, so that each professional’s learning has a unique quality permeating what is essentially a shared experience. The second phase of the findings draws on phenomenological philosophy to interpret the shared experience of CPL. The key argument of this phase is that the dissonance between rhetoric and reality in CPL is largely hidden from public discourse, being mainly voiced between professionals in supportive environments. It is argued that the hidden nature of this dissonance is one reason for the lack of significant change in CPD practices, in that few professionals publicly question CPD practices or the current context for learning. Within the usual CPD discourse, learning is viewed in epistemological terms as change in professional practice knowledge, with the professional viewed as deficient and in need of developing. In this study, the ontological dimension of CPL is highlighted, in that who the professional is shapes and directs what and how the professional learns. The ontological dimension of learning and the impact of context on learning are overlooked in most CPD practices. It is important that learning providers are cognisant of the complex, diverse nature of CPL so that innovative ways of supporting professionals to learn can be encouraged. Although CPL can’t be controlled, it can be supported, so that professionals can continue to learn in their own authentic way, whilst taking into account the expectations of their working contexts. In seeking a balance between responsibility and agency in CPL, a framework of “Authentic Professional Learning” is proposed as congruent with, and supportive of, professionals’ experiences of learning, yet cognisant of the realities of the workplace with respect to accountability. Constructive strategies are developed from this framework to enable change from the current practice of CPD to that of authenticity in CPL. This study integrates, empirically confirms and extends research in higher education, workplace learning and adult education. The contribution made to understanding and supporting CPL is both theoretical and practical. Furthermore, demonstration of the value of a phenomenological framework as an alternative approach to researching continuing learning makes a methodological contribution to research in this area.

Time for reflective thought is constricted in busy academic lives, with available thinking time focused on urgent, analytical inquiry. Paradoxically, time spent in contemplative mindfulness, stepping back from insistent probing into a still, calm space, may allow increased clarity and focus on problems worthy of inquiry, once re-engaged. This paper highlights the dual dimension of reflection captured in the concept of ‘mindful inquiry’ as a dialectic interchange between active critical inquiry and receptive open mindfulness. In the focus on robust critique in contemporary higher education, the value of contemplation is lost. Insights from Western and Eastern philosophy, as well as evidence from empirical research, suggest an integrated approach may allow alternative, creative and intuitive ways of approaching problems to supplement rational, problem solving strategies. The practice of ‘mindful inquiry’ also offers a practical tool, to enhance academic wellbeing as well as help prepare students for partici...

Digital x-ray radiographic systems are desirable as they offer high quality images which can be processed, transferred, and stored without secondary steps. However, current clinical systems are extraordinarily expensive in comparison to film-based systems. Thus, there is a need for an economical digital imaging system for general radiology. The x-ray light valve (XLV) is a novel digital x-ray detector concept with the potential for high image quality and low cost. The XLV is comprised of a photoconductive detector layer and liquid crystal (LC) cell physically coupled in a sandwich structure. Upon exposure to x rays, charge is collected at the surface of the photoconductor, causing a change in the reflective properties of the LC cell. The visible image so formed can subsequently be digitized with an optical scanner. By choosing the properties of the LC cell in combination with the appropriate photoconductor thickness and bias potentials, the XLV can be optimized for various diagnostic imaging tasks. Specifically for chest radiography, we identified three potentially practical reflective cell designs by selecting from those commonly used in LC display technology. The relationship between reflectance and x-ray exposure (i.e., the characteristic curve) was determined for all three cells using a theoretical model. The results indicate that the reflective electrically controlled birefringence (r-ECB) cell is the preferred choice for chest radiography, provided that the characteristic curve can be shifted towards lower exposures. The feasibility of the shift of the characteristic curve is shown experimentally. The experimental results thus demonstrate that an XLV based on the r-ECB cell design exhibits a characteristic curve suitable for chest radiography.

New x-ray radiographic systems based on large-area flat-panel technology have revolutionized our capability to produce digital x-ray images. However, these imagers are extraordinarily expensive compared to the systems they are replacing. Hence, there is a need for a low-cost digital imaging system for general applications in radiology. A novel potentially low-cost radiographic imaging system based on established technologies is proposed-the X-Ray Light Valve (XLV). This is a potentially high-quality digital x-ray detector made of a photoconducting layer and a liquid-crystal cell, physically coupled in a sandwich structure. Upon exposure to x rays, charge is collected on the surface of the photoconductor. This causes a change in the optical properties of the liquid-crystal cell and a visible image is generated. Subsequently, it is digitized by a scanned optical imager. The image formation is based on controlled modulation of light from an external source. The operation and practical implementation of the XLV system are described. The potential performance of the complete system and issues related to sensitivity, spatial resolution, noise, and speed are discussed. The feasibility of clinical use of an XLV device based on amorphous selenium (a-Se) as the photoconductor and a reflective electrically controlled birefringence cell is analyzed. The results of our analysis indicate that the XLV can potentially be adapted to a wide variety of radiographic tasks.

The purpose of this descriptive study is to examine quality of life issues in participants in a behavioral-medicine group (N = 24). Of the sample, 60% indicated current use of complementary therapies. Sexual functioning, a subscale of the quality-of-life measure, was positively correlated with length of time with HIV. CD4+ lymphocyte counts were not significantly correlated with quality of life (QOL). Viral load (VL) was positively correlated with the social-support subscale of the QOL scale. Use of body therapies (massage, acupuncture) was associated with social functioning and use of nutritional therapies was associated with mental health. Results of the study indicate that clinical interventions, including behavioral-medicine interventions and complementary therapies for persons with HIV/AIDS, can result in greater QOL.

In recent years new digital x-ray radiographic and fluoroscopic systems based on large-area flat-panel technology have revolutionized our capability of producing x-ray images. However, such imagers are extraordinarily expensive and their rapid image acquisition capability is not required for many applications such as radiography. Here we report a novel approach to achieve a high-quality digital radiographic system at a cost which is only a small fraction of competitive digital technologies. The results demonstrate that our proposed x-ray light valve system has excellent spatial resolution and adequate sensitivity compared to existing technologies.

While the focus of practice-based education (PBE) is on students becoming practising professionals, we contend that professionals inevitably and desirably bring their life experience to their practice, and so PBE curricula should also encompass learning for life. We want professionals to engage with the people and communities they work alongside, to be productive global citizens and to be enriched as people from their work as professionals.

This study used a pretest-posttest pre-experimental design to examine the effect of a 10-week behavioral medicine support group intervention in a sample of persons with HIV Using Solomon's psychoneuroimmunologic framework, the 10-week behavioral medicine program focused on the mind/body interaction, the relaxation response, coping with illness, hardiness, and nutrition. Pearson correlation coefficients and t tests were performed on the pre- and postintervention measures of hardiness, social support, immune function, and perceived health status. Results of the study indicated that hardiness (preintervention) and CD4 counts (pre- and postintervention) were significantly correlated with health status; however, CD4 counts decreased over the course of the behavioral medicine program. Implications for nursing and recommendations for further research are discussed.

Purpose The biopsychosocial model of successful aging is aimed at developing a sense of well-being, high self-assessed quality of life, and a sense of personal fulfillment even in the context of illness and disability. The purpose of this study was to explore key outcomes of a new Successful Aging Mind Body program. We hypothesized the program would increase self-efficacy, which would lead to improved feelings of well-being.

Background Recent changes in clinical guideline recommendations for age of breast cancer screening initiation highlighted the potential psychological ramifications associated with screening. This study examined the feasibility, acceptability, and preliminary efficacy of a brief Relaxation Response training (RRT) to decrease distress among women undergoing breast biopsy. Methods Women scheduled for percutaneous core-needle biopsy were recruited into a single-arm RRT trial, including 3 individual sessions. Psychosocial assessments were completed pre- and postintervention. Results Forty women were enrolled between 6/1/10 and 8/31/11. Among enrollees, 75% completed all 3 RRT sessions, and 75% completed the post-assessment. Participants showed significant reductions in acute distress following each RRT session. Qualitative feedback indicated a positive impact of RRT on clinic care experiences. Conclusions RRT is a portable intervention that was feasible to implement, acceptable to patients and associated with significant decreases in acute emotional distress during the period of diagnostic uncertainty related to percutaneous breast biopsy.

The way that a professional continues to learn is an expression of her way of being a professional, in dynamic interplay with her particular professional context. Conversely, learning shapes that way of being and, therefore, way of dealing with the context. Learning as a professional has an important ontological dimension: what and how a professional learns vary with who she is as a professional.

As this book is based on research into real-life experiences, it opens with the voices of professionals describing situations where they have learnt. The first description was given by a young therapist, Nerida who works full time at a residential setting for adults with intellectual disability. Nerida commented that she often learns as a professional in seemingly incidental situations, with such incidents building upon each other. From the “gum” incident, she described not only learning more about her client but also learning more about communicating with adults with intellectual disability.

“Authentic Professional Learning” is the term I have used to represent the lived experience of continuing to learn as a professional. This term distinguishes the realities of the experience of PL from the rhetoric about PD expectations, whilst raising the notion of authenticity with respect to dealing with dissonance between the two. This chapter outlines a framework based on this notion of APL, proposing constructive possibilities for supporting professionals as they learn in the current context.

From the holistic perspective taken in this research, the descriptions of APL throughout this chapter are imbued with nuances of the professional life-world, but because the focus is on the experience of learning, some life-world details are lightly sketched. To contextualise the phenomenological structure of APL, this chapter begins with a description of the professional life-world drawn from the complete data corpus, with respect to three aspects of the professional context: professional affiliations, employer organisations and local workplaces.

This chapter on methodology begins by reviewing the increasing dissent amongst social researchers about close adherence to research method. I then outline my own position on method in this research, drawing on Mats Alvesson’s argument about the need for “reflexive interpretation” in most empirical research (Alvesson & Skoldberg, 2000; Alvesson, 2002). Following this theoretical and reflexive positioning, issues of quality that influenced the research design and choice of methods are described. The design involves an adapted and extended version of Amedeo Giorgi’s methodology, with some influence from Max van Manen.

A wide diversity of literature exists that is relevant to examining PD and understanding PL, making such investigation an interdisciplinary area of inquiry. This inquiry is located at the intersection of a number of areas of research and of policy. Research into the continuing learning of professionals can be informed by the literature from higher education and continuing professional education, workplace and informal learning, adult and community education and organisational learning and human resource management. Until recently, research from these areas was rarely integrated, let alone focused towards the particular concerns of the continuing learning of working professionals.

Besides enhancing understanding about the experience of APL, this research reveals concerns about the current focus of PD. As described in Section III, APL is shaped through continuing interplay between who the professional is and the opportunities for and constraints on learning within her professional context. To support learning, opportunities need to be enhanced and problematic issues addressed. This chapter questions the current professional context for learning, whilst being cognizant that the impact of context on learning varies with each professional.

In choosing and using a research perspective, conceptual congruence and clarity are vital. Thus the research purpose should be congruent with the research approach and methods chosen; the assumptions underpinning the research approach should be clear and consistent in their use throughout the research. This chapter highlights conceptual underpinnings in outlining the phenomenological perspective taken in this book. For readers unfamiliar with phenomenology, an overview of key concepts is presented; for others cognizant of the complexity of phenomenology, the philosophical assumptions of the particular approach I have used are clarified.

BACKGROUND. This pilot randomized controlled trial (RCT) examined the clinical effects of 2 complementary (CAM) therapies, relaxation response therapy (RRT) and Reiki therapy, in men being treated with external beam radiotherapy (EBRx) for prostate cancer. METHODS. Study participants were randomly assigned to weekly RRT, Reiki therapy twice weekly, or wait-list control. Well-validated instruments measured anxiety (STAI), depression (CES-D), and quality of life in cancer patients (FACT-G) at randomization and 3 subsequent time points. RESULTS. Fifty-four men were randomized, and 16 of 18 (89%) of RRT and 15 of 18 (83%) of Reiki patients completed the intervention protocol. No statistically significant difference was found between the RRT, Reiki, and control groups on total scores for the STAI, CES-D, or FACT-G instruments at any time point. However, at the end of the intervention, significant improvement was found on the emotional well-being subscale of the FACT-G quality of life scale in the RRT group compared with the Reiki and control groups (P ¼ .01). In participants who were classified as ‘‘anxious’’ at baseline, statistically significant improvement occurred in the RRT group (P ¼ .02), and a positive trend was found in the Reiki group (P ¼ .10). CONCLUSIONS. This pilot study documented the feasibility of conducting a RCT of CAM therapies in men undergoing EBRx for prostate cancer. Relaxation response therapy improved emotional well being and eased anxiety in participants. Reiki therapy also had a positive effect in anxious patients. A larger study to verify and better define the benefits of these therapies in men with prostate cancer is warranted. Cancer 2010;00:000–000. V C 2010 American Cancer Society .

Digital x-ray radiographic systems are desirable as they offer high quality images which can be processed, transferred, and stored without secondary steps. However, current clinical systems are extraordinarily expensive in comparison to film-based systems. Thus, there is a need for an economical digital imaging system for general radiology. The x-ray light valve (XLV) is a novel digital x-ray detector concept with the potential for high image quality and low cost. The XLV is comprised of a photoconductive detector layer and liquid crystal (LC) cell physically coupled in a sandwich structure. Upon exposure to x rays, charge is collected at the surface of the photoconductor, causing a change in the reflective properties of the LC cell. The visible image so formed can subsequently be digitized with an optical scanner. By choosing the properties of the LC cell in combination with the appropriate photoconductor thickness and bias potentials, the XLV can be optimized for various diagnostic imaging tasks. Specifically for chest radiography, we identified three potentially practical reflective cell designs by selecting from those commonly used in LC display technology. The relationship between reflectance and x-ray exposure (i.e., the characteristic curve) was determined for all three cells using a theoretical model. The results indicate that the reflective electrically controlled birefringence (r-ECB) cell is the preferred choice for chest radiography, provided that the characteristic curve can be shifted towards lower exposures. The feasibility of the shift of the characteristic curve is shown experimentally. The experimental results thus demonstrate that an XLV based on the r-ECB cell design exhibits a characteristic curve suitable for chest radiography.

In recent years new digital x-ray radiographic and fluoroscopic systems based on large-area flat-panel technology have revolutionized our capability of producing x-ray images. However, such imagers are extraordinarily expensive and their rapid image acquisition capability is not required for many applications such as radiography. Here we report a novel approach to achieve a high-quality digital radiographic system at a cost which is only a small fraction of competitive digital technologies. The results demonstrate that our proposed x-ray light valve system has excellent spatial resolution and adequate sensitivity compared to existing technologies.

In recent years, new x-ray radiographic systems based on large area flat panel technology have revolutionized our capability to produce digital x-ray radiographic images. However, these active matrix flat panel imagers (AMFPIs) are extraordinarily expensive compared to the systems they are replacing. Thus there is a need for a low cost digital imaging system for general applications in radiology. Different approaches have been considered to make lower cost, integrated x-ray imaging devices for digital radiography, including: scanned projection x-ray, an integrated approach based on computed radiography technology and optically demagnified x-ray screen/CCD systems. These approaches suffer from either high cost or high mechanical complexity and do not have the image quality of AMFPIs. We have identified a new approach - the X-ray Light Valve (XLV). The XLV has the potential to achieve the immediate readout in an integrated system with image quality comparable to AMFPIs. The XLV concept combines three well-established and hence lowcost technologies: an amorphous selenium ( a -Se) layer to convert x-rays to image charge, a liquid crystal (LC) cell as an analog display, and an optical scanner for image digitization. Here we investigate the spatial resolution possible with XLV systems. Both a -Se and LC cells have both been shown separately to have inherently very high spatial resolution. Due to the close electrostatic coupling in the XLV, it can be expected that the spatial resolution of this system will also be very high. A prototype XLV was made and a typical office scanner was used for image digitization. The Modulation Transfer Function was measured and the limiting factor was seen to be the optical scanner. However, even with this limitation the XLV system is able to meet or exceed the resolution requirements for chest radiography.

In recent years, new x-ray radiographic systems based on large area flat panel technology have revolutionized our capability to produce digital x-ray radiographic images. However, these active matrix flat panel imagers (AMFPI) are extraordinarily expensive compared to the systems they are replacing. Thus there is a clear need for a low cost digital imaging system for general applications in radiology. Different approaches have been considered to make lower cost xray imaging devices for digital radiography, including: reducing the cost of existing flat panel systems, scanned projection x-ray, an approach based on computed radiography (CR) technology, and optically demagnified x-ray screen/camera systems. All of these approaches are quite expensive and none have the image quality of AMFPIs. We have identified a new approach - the X-ray Light Valve (XLV). It combines three well-established technologies: an a- Se layer to convert x-rays to image charge, a liquid crystal (LC) cell, and a scanned digital readout. This device achieves our goal of immediate readout with image quality comparable to an AMFPI, while keeping costs low. The XLV system has been shown to have all the properties required for general radiography.

Purpose To compare the effectiveness of three image subtraction algorithms designed to improve arterial conspicuity in first-pass contrast-enhanced magnetic resonance (MR) angiography. Materials and Methods Three subtraction methods were analyzed through computer simulations, phantom studies, and clinical studies. These algorithms were: complex subtraction, magnitude subtraction, and maximum intensity projection subtraction. Results In high resolution three-dimensional imaging, maximum intensity projection subtraction generally yields the best background suppression. Complex subtraction is effective in reducing partial volume effects in low resolution imaging. Magnitude subtraction works better in high resolution, low contrast concentration protocols. Conclusion Choosing the appropriate subtraction method according to the protocol is helpful in optimizing image quality. J. Magn. Reson. Imaging 2002;15:541–550. © 2002 Wiley-Liss, Inc.

The purpose of this study was to examine the relationship between social support and quality of life in individuals with HIV. Using a descriptive, correlational design, data were collected from 50 HIV-positive individuals who were: (a) participants in support groups at a behavioral medicine unit, (b) inpatient or respite care patients with HIV, or (c) respondents to advertisements at AIDS service organizations. Instruments used for data collection were the Personal Resource Questionnaire 85-Part 2 (Weinert, 1987), measuring perceived social support, and the Quality of Life Index (QLI) (Ferrans & Powers, 1985), measuring the sense of well-being in life including the satisfaction with and importance of life domains with four subscales: health and functioning, socioeconomic, psychological/spiritual, and family. The results of the study indicated that social support was significantly correlated with quality of life (r = 0.81, p < 0.0001). Further, HIV status (a symptomatic HIV symptomatic HIV, AIDS) was significantly related to quality of life (p < 0.01). However, HIV status was not significantly related to social support. No significant relationship was found between CD4 counts and HIV status, CD4 counts and social support, or CD4 counts and perceived health status. However, CD4 counts were significantly correlated with scores on the QLI. The findings of the study indicate that social support and quality of life are significantly intercorrelated and that higher CD4 counts are related to quality of life in this sample of persons living with HIV. Further areas for research include evaluation of quality of life over the span of HIV disease and interventions aimed at enhancing or maintaining quality of life in persons across the spectrum of HIV disease.

A CQUIRED immune deficiency syndrome (AIDS) is currently the most serious public health problem in the United States. As of September 1992, over 230,000 cases of AIDS have been reported by the Centers for Disease Control (CDC), with over 150,000 deaths since the syndrome was identified (CDC, 1992). Approximately 1. million to 1.5 million Americans are estimated to be seropositive for the human immunodeficiency virus (HIV). Because of the length of time between HIV infection and progression of illness, as well as the variability of disease progression, researchers are seeking answers to why some individuals rapidly succumb to HIV whereas others maintain longterm survival. Several authors have suggested the existence of personality variables such as hardiness and other physical and social factors that may impact on health status in individuals with HIV (Solomon & Temoshok, 1987; Solomon, Temoshok, O'Leary, & Zich, 1987). Kiecolt-Glaser and Glaser (1988) suggested the importance of psychosocial or behavioral variables as cofactors that may influence HIV infection and disease progression. Among the psychosocial and behavioral variables that may impair immunity are bereavement (Schleifer, Keller, Camerino, Thornton, & Stein, 1983), caregiving burden (Kiecolt-Glaser, Glaser, Dyer, Shuttlewoth, Ogrocki, & Speicher, 1987), and personality type (Solomon, 1987). As the number of persons affected by HIV increases, strategies aimed at maintaining health become increasingly important. Kobasa (1979) introduced the personality variable of hardiness as a construct that may moderate the stress-illness relationship. Kobasa's early studies indicated that male executives with high levels of stressful life events but fewer illnesses scored higher on the hardiness characteristic as measured by the Hardiness Inventory (Kobasa, 1979; Kobasa, Maddi, & Kahn, 1982). Pollock (1986) subsequently developed the Health-Related Hardiness Scale (HRHS) to measure the hardiness construct in the health-related domain. Studies using the HRHS have supported the relationship between hardiness and other variables, including adaptation to chronic illness (Pollock, 1986); health promotion activities, use of social resources, and perceived health (Pollock, 1989); and self-care practices and perceived health (Nicholas, in press). Psychometric evaluation of the HRHS indicated the presence of a two-factor scale comprised of the three dimensions of commitment, control, and challenge (challenge/commitment and control). The dimensions of challenge and commitment overlapped to form one factor with control as the second factor. Support groups for persons with HIV are frequently used as a strategy to address the psychosocial issues of these individuals across the disease spectrum. Studies examining the effectiveness of support groups for persons with HIV/AIDS suggest that participation in a support group may help these individuals to better cope with their illness (DiPasquale, 1990; Donlou, Wolcott, Gottlieb, & Landsverk, 1985; Flaskerud, 1987; Kendall, 1992; Newmark, 1984; Ribble, 1989). DiPasquale (1990) found that participation in a support group decreased the level of anxiety and hopelessness in HIV-positive individuals. Flaskerud (1987) suggests that support groups may provide a vehicle for problem solving regarding psychosocial issues including grief, loss, hopelessness, and despair. In a study examining wellness in HIV support groups, Kendall (1992) identified four major themes: (a) intimacy, (b) group process, (c) group structure

These studies examined how pharmacological stimulation and blockade of alpha receptors would affect active motor behavior in rats. In experiment I, alpha-2 receptor antagonists (piperoxane, yohimbine) and agonists [clonidine, norepinephrine (NE)] were infused into various locations in the ventricular system of the brain, including the locus coeruleus region, and motor activity was measured. Activity was measured principally in a swim test but spontaneous (ambulatory) activity was also recorded while drugs were being infused. When infused into the locus coeruleus region, small doses of the antagonists piperoxane and yohimbine depressed activity in the swim test while infusion of the agonists clonidine and NE had the opposite effect of stimulating activity. These effects were highly specific to the region of the locus coeruleus, since infusions of these drugs into other nearby locations in the ventricular system or use of larger doses had different, often opposite effects. This was especially true of clonidine and NE which profoundly depressed activity when infused posterior to the locus coeruleus, particularly over the dorsal vagal complex. Infusion of small doses of these drugs into the lateral ventricle had effects similar to infusion into the locus coeruleus region, though less pronounced. Changes in spontaneous motor activity were also observed, but this measure differentiated the groups less well than did the swim test. In experiment II, the predominantly postsynaptic receptor agonists isoproterenol (beta agonist) and phenylephrine (alpha-1 agonist) were infused into the ventricular system. Since infusions of piperoxane and yohimbine into the locus coeruleus that decreased activity in experiment I increase the release of NE by blocking alpha-2 inhibitory receptors on cell bodies and dendrites of the locus coeruleus, experiment II tested whether ventricular infusion of predominantly postsynaptic receptor agonists would also decrease activity in the swim test. Both isoproterenol and phenylephrine produced this effect, but did so selectively with respect to dose and location of infusion in the ventricular system. These findings are consistent with recent results relating to the mechanism that underlies stress-induced depression of active behavior.

Summary Radioactive phosphorus inoculated extra-allantoically into the yolk sac of 7-day-old embryos has been traced throughout the components of the embryonated egg for 14 days. The labeled phosphorus left the yolk sac at an essentially constant rate and became dispersed within a few days throughout all components of the embryonated egg in varying degrees with the exception of the shell and the albumin. The embryo utilized more P32 than any of the other components under consideration with the allantoic membrane and the allantoic fluid acquiring the next larger portions of P32.

Behavioral depression produced by exposing animals to a Stressor that they cannot control (uncontrollable shock) was reversed by infusion of the monoamine oxidase (MAO) inhibitor pargyline into the locus coeruleus (LC) region of the brain stem. Following exposure to uncontrollable shock, rats were infused through bilateral cannulas implanted in the LC region with either pargyline or vehicle. At 110 min after infusion, animals were tested for behavioral activity in a swim tank. Immediately following the behavioral test, animals were sacrificed for determination of the monoamines [norepinephrine (NE), dopamine (DA), serotonin (5-HT)], as well as 5-hydroxy-indoleacetic acid (5-HIAA) in various brain regions. The results showed that animals exposed to uncontrollable shock and then infused with vehicle exhibited significantly less activity in the swim test than animals not exposed to shock and similarly infused with vehicle; thus, the usual behavioral depression following exposure to uncontrollable shock was observed. On the other hand, shocked animals infused with pargyline did not show reduced activity in the swim test. Unshocked animals infused with pargyline showed no more activity than did shocked animals infused with pargyline or unshocked animals infused with vehicle, which demonstrated that the infusion of pargyline into shocked animals did not eliminate the shock-induced depression of activity simply by generally stimulating motor activity. Measurement of the concentration of NE, DA, 5-HT, and 5-HIAA present in seven brain regions at the conclusion of the swim test showed that pargyline infusion into the LC eliminated the large depletion of NE in the LC that is normally observed after exposure to uncontrollable shock while having no effect on NE levels in the other brain regions examined. The level of 5-HT in the LC was also raised by infusion of pargyline into the LC, but again, there was no effect of pargyline infusion on 5-HT levels in any of the other brain regions. In conclusion, infusion of pargyline into the LC region of the brain eliminated both the large depletion of NE in the LC region and the behavioral depression that otherwise results from exposure of animals to uncontrollable shock.

To determine whether age affected the attitudes of patients to intensive care, we administered a questionnaire to 57 patients who had been hospitalized in our ICU or coronary care unit (CCU). The 28 men and 29 women ranged in age from 20 to 92 yr (mean 58.4). Nineteen patients were greater than or equal to 70 yr and nine were greater than or equal to 80 yr. The "intensity" and "severity" of the treatments were similar in the older and younger patients, both men and women, in the ICU and CCU. The great majority of the patients, both old and young, were satisfied with their treatment and outcome, and expressed willingness to undergo similar treatment(s) in the future, if needed. Only five patients were dissatisfied with their treatment: two were greater than 70 yr, the other three were 27, 62, and 65 yr. We did not interview a large number of patients and thus, cannot draw far-reaching conclusions without additional study. Nevertheless, although we expected that older patients would be particularly distressed about their treatments and hence, say they would decline them in the future, in this study both the older and the younger patients were highly accepting of the treatment they received.