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This study examines the co-movement and time-varying integration between equity, exchange rate, and international market volatility indices across different time–frequency domains using - bi-partial wavelet, - supplemented by dynamic conditional correlation-generalised autoregressive conditional heteroskedasticity (DCC-GARCH), - and BEKK GARCH model for selected African countries. First, the findings indicate that the co-movement between equity and exchange rates during the pandemic was exacerbated by global COVID-19 media coverage. The findings indicate that there has been a substantial risk transfer between exchange rates and stock returns during the COVID-19 pandemic, resulting in a decline in domestic stock returns and subsequent capital outflows, which in turn increased the exchange rate. Given the growing difficulties in diversification, specific information on the volatility of financial market connectedness is required to plan hedging strategies. To explore the influence of global market volatility on Africa’s equity and currency markets, it is crucial to analyse the relationship between regional and global market fluctuations, especially given the negative impact of the COVID-19 pandemic. Our empirical research demonstrates that the VIX and OVXCL indices play a significant role in transmitting spillovers to currency and equity markets in Africa. This suggests that the sentiment indicators provided by the VIX and OVXCL can be useful in predicting the behaviour of Africa’s currency and equity markets.

AbstractThis study examines natural disasters’ short-run and long-run effects on economic growth. We analysed insurance’s short-run and long-run role in the natural disaster-economic growth nexus using 48 African countries from 2000 to 2020. Using a two-step system GMM, the study revealed that natural disasters have a short-term detrimental effect and a favourable long-term impact on economic growth. Regarding the role of insurance in the relationship between natural disasters and economic growth, it should be noted that while insurance and those affected have a positive complementary effect on economic growth in the short run, the long-term effects of insurance and natural disasters on economic growth are negligible. Therefore, regulators must enforce periodic high regulatory capital requirements to ensure the financial stability of insurance markets, especially the non-life market in Africa, and to enable insurers to absorb the unforeseen shocks from natural disasters in Africa. Also, regulators should create insurance coverage awareness through insurance education to promote insurance development and help reduce individuals’ and businesses’ financial losses upon the occurrence of natural disasters.

AbstractThis study investigates the effect of pension funds (PF) and institutional quality (IQ) on capital market development in 48 African countries. Using a system GMM regression, the study found that the interaction between PF and IQ significantly negatively affects capital market development. The results of the study suggest that PF in Africa contributes positively to overall financial development, and pension fund managers (PFM) seem to be focusing more on other financial market assets than capital markets. It was concluded that IQ may act as a risk management tool. It is therefore recommended that policies on strong IQ should be put in place to enable fund managers to meet their obligations towards the principal (contributor) during retirement. The study recommends that policymakers should integrate the capital markets by ensuring the cross-listing of some of the national exchanges and cross-border investment and also encourage investments in alternative asset classes.

Abstract Knowledge of Mycobacterium avium subsp. paratuberculosis (MAP) herd infection status is important to plan appropriate control and prevention strategies for Paratuberculosis (PTB); however, in Uganda MAP infection status of most herds is unknown. This study aimed at determining the MAP infection status of cattle herds and the associated risk factors for MAP infection in six western districts of Uganda. The survey covered a total of 93 herds where faecal and blood samples were collected from 1814 cattle. A Recombinase Polymerase Amplification (RPA) and an antibody-based (ELISA) assays were used to test for the presence of MAP DNA in faeces and MAP antibodies in serum, respectively. The apparent cow-level prevalence of MAP infection was 3.2 and 2.7% using ELISA and RPA respectively and the true cow-level prevalence using ELISA and RPA was 4.9 and 3% respectively. A herd-level prevalence of 43% (ELISA) and 40.8% (RPA) and a within-herd prevalence of 3.8 ± 2.1% based on ELISA were obtained. Among the risk factors investigated, long dry spells were significantly associated with high MAP infection (p

Describes adult educational policy, organization, and administration in Thailand and its six categories of programs: functional literacy, academic and general education, vocational, reading skills promotion, public education, and radio/television nonformal education. Closely related to the formal educational system, Thailand's adult education system incorporates nonformal education into the formal system. (MF)

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings.Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI).Results Of 1159 children across 181 hospitals in 51 countries, 523 (45·1%) children were from high HDI, 397 (34·2%) from middle HDI and 239 (20·6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12·8% (51/397) in middle HDI and 24·7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI.Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.

Background: Peripheral neuropathy can affect balance and increase fall risk. Tai Chi is known to activate neuromuscular systems and may help improve balance and postural control. We conducted a scoping review of clinical studies that evaluated the impact of Tai Chi on balance and related neurobiological outcomes among individuals with peripheral neuropathy., Methods: We systematically searched three databases from inception to December 19, 2023 and identified 11 eligible clinical studies. We extracted trial information from each study and performed a qualitative study features analysis to summarize the clinical evidence and neurobiological mechanisms of Tai Chi in regulating balance among people with peripheral neuropathy., Results: We found that among 508 participants with clinical peripheral neuropathy, Tai Chi significantly improved single leg stance, 6-min walk, timed up-and-go tests, and gait speed when measured pre- and post-exercise. However, the differences between Tai Chi and sham exercise control that involved active calisthenics and stretching exercises were not statistically significant. Studies that used quantitative sensory testing showed that Tai Chi was associated with significant increases in plantar vibration and tactile sensitivity. The effect of Tai Chi on postural control varied depending on plantar sensory loss status, and results on muscle strength remained mixed. Other neurobiological effects involve strengthening muscle performance and proprioception and consolidating cognitive awareness of walking strategy and practical behavioral techniques., Conclusions: The findings indicated that Tai Chi may enhance balance, postural control, and gait speed in patients with peripheral neuropathy, possibly through sensory restoration, although further research is needed to confirm this. Whether Tai Chi improves muscle strength or other gait health parameters is inconclusive. Rigorous randomized clinical trials should be conducted to determine the effect of Tai Chi on balance in this population by measuring functional balance and quantitative sensory outcomes., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Ting Bao reports a relationship with Eisai Inc that includes: consulting or advisory. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Purpose: While there are many benefits to radiation oncology services, there can be emotional burdens in the care of patients with advanced cancer. Burnout is a prevalent problem in oncology. Existing literature suggests refocusing attention on providers' sense of purpose to protect against burnout. "Sacred moments" are moments of deep interconnection between people with accompanying spiritual emotions such as awe, joy, and gratitude. These moments naturally occur in health care settings, offering potential benefits to both patient and provider. Little is known about the prevalence and impact of sacred moments among health care workers in a radiation oncology setting., Methods and Materials: We conducted an exploratory qualitative study of 13 semi-structured interviews among physicians, registered nurses, and advanced practice providers of a radiation oncology consult service at a large National Cancer Institute-designated cancer center between March and May 2023. Interviews were recorded, transcribed, and analyzed to identify key themes. Data were systematically coded and analyzed in NVivo software and organized into a codebook organized by domains and themes., Results: Of the 13 health care workers interviewed, 12 interviewees reported experiencing at least one sacred moment during their clinical careers. None of the interviewees were initially familiar with the term; however, all understood the concept once explained. Interview findings were organized into four domains: (1) common elements, (2) impact, (3) barriers, and (4) provider reactions. Common elements included a moment of deep interconnection between provider and patient, often involving end-of-life patients. The impact of these moments was most commonly described as an increased sense of purpose in their role. Lack of time with patients was the most common barrier., Conclusions: Sacred moments are commonly experienced by health care workers in a radiation oncology consult service. They helped to humanize the patient, buffer against provider burnout, and increase a sense of purpose and job satisfaction., (© 2024 The Authors.)

Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating side effect of neurotoxic chemotherapy. Exercise activates neuromuscular function and may improve CIPN. We examined the association between exercise and CIPN symptoms in breast cancer survivors., Methods: In a retrospective cross-sectional study, we included patients completing a survey assessing exercise exposure and neuropathy symptoms in a tertiary cancer center survivorship clinic. We evaluated exercise duration and intensity using a standardized questionnaire quantified in metabolic equivalent tasks (MET-h/wk). We defined exercisers as patients meeting the National Physical Activity Guidelines' criteria. We used multivariable logistic regressions to examine the relationship between exercise and CIPN and if this differed as a function of chemotherapy regimen adjusting for age, gender, and race., Results: We identified 5444 breast cancer survivors post-chemotherapy (median age 62 years (interquartile range [IQR]: 55, 71); median 4.7 years post-chemotherapy (IQR: 3.3, 7.6)) from 2017 to 2022. CIPN overall prevalence was 34% (95% confidence interval [CI]: 33%, 36%), 33% for non-taxane, and 37% for taxane-based chemotherapy. CIPN prevalence was 28% (95% CI: 26%, 30%) among exercisers and 38% (95% CI: 37%, 40%) among non-exercisers (difference 11%; 95% CI: 8%, 13%; p < 0.001). Compared to patients with low (<6 MET-h/wk) levels of exercise (42%), 11% fewer patients with moderate (6-20.24 MET-h/wk) to high (>20.25 MET-h/wk) levels of exercise reported CIPN. Exercise was associated with reduced prevalence of all CIPN symptoms regardless of chemotherapy type., Conclusion: CIPN may persist several years following chemotherapy among patients with breast cancer but is significantly reduced by exercise in a dose-dependent manner., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Yoga interventions need fidelity monitoring to standardize the trial process and ensure adherence. We examined fidelity measures of current yoga trials and developed a fidelity assurance process in a phase III randomized clinical trial addressing chemotherapy-induced peripheral neuropathy among cancer survivors., Methods: We qualitatively analyzed the fidelity monitoring components in published clinical trials on yoga therapy for chemotherapy-induced peripheral neuropathy through a literature search in PubMed from inception to February 2023. Leveraging fidelity measures for community-based, complex interventions and yoga therapy reporting guidelines, we developed an instructor/participant-oriented fidelity checking approach in an ongoing phase III trial evaluating yoga for improving chemotherapy-induced peripheral neuropathy in cancer survivors. Two researchers independently assessed 4 of 8 video recordings of yoga instructor-led training sessions (50%) and participant-kept home practice logs using a developed fidelity checklist., Results: None of the 4 eligible yoga trials specifically have intervention fidelity measures. We prospectively incorporated yoga instructor training, virtual delivery, and participant engagement strategies in the phase III trial protocol following guidelines. All trial yoga instructors were trained under study protocol to ensure compliance and participant engagement. There was high intervention fidelity in all instructor-led virtual sessions: an average of 100% adherence to class structure and three-thirds on specific skills. Assessment of participant adherence to the established home yoga protocol was 63%., Conclusion: Yoga trials for chemotherapy-induced peripheral neuropathy need adequate fidelity measures. Our study provides a feasible fidelity-monitoring approach to ensure trial intervention delivery and protocol adherence by instructors and participants in oncological settings., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Ting Bao reports a consultation role in Eisai Inc. The authors do not report any patents, copyrights, or royalties relevant to the submitted work. The authors do not report other relationships or activities that could have influenced the content of the submitted work.

Purpose: The aim of this systematic review and meta-analysis is to evaluate the effect of mindfulness-based interventions (MBIs) on post-surgical pain in patients undergoing a total hip replacement (THR) or total knee replacement (TKR)., Methods: We performed a systematic review and meta-analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A search of multiple databases, including PubMed and EMBASE, was performed for studies from database inception through March 2nd, 2022. Data were extracted, and pooled estimates of standardized mean differences in pain scores were calculated using a random effects model and inverse probability weighting., Results: Two randomized control trials were eligible for inclusion (299 patients). The average ages of participants in each study were similar at 65.5 and 64.8 years, and both studies were predominantly female at 72.4% and 61.9%. The mindfulness intervention ranged from an eight-week program to a 20-minute session. Both individual studies reported statistically significant reductions in postoperative pain for MBI groups. The pooled standardized mean difference in pain scores for the MBI groups compared to the control groups was -1.94 (-3.39; -0.48)., Conclusions: There exists preliminary evidence for the beneficial effect of MBIs on reducing the postoperative pain experience in this patient population. Given the significant consequences of postoperative pain and the necessity for non-opioid forms of analgesia, this topic represents a promising area of research that warrants future randomized control trials to better understand the role of MBIs for postoperative analgesia., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Barton et al.)

Objectives: Peer support programs are effective in improving outcomes among low-resource populations. Prior studies suggest that shared experiences improve peer partnerships. We hypothesized that participants in a peer coaching program who then became coaches might bring insight into their coaching role. We explored the motivations of coaches in a diabetes self-management coaching program who became coaches after completing the program as participants., Methods: Between June 2016 and April 2017 we conducted semi-structured interviews with eight participants-turned-coaches and four of their peer partners in a six-month peer coaching program for patients with poor glycemic control at the Detroit VA. The interviews were transcribed, reviewed and coded by two researchers in an iterative process until consensus was reached. Key themes were identified and analyzed., Results: Participants-turned-coaches reported the importance of their own peer coach in their decision to become a coach. Participants-turned-coaches described commitment to their partners, providing realistic encouragement, and fostering a reciprocal partnership. Participants-turned-coaches shared their own difficulties to motivate their partners and create a sense of commonality., Discussion: Encouraging participants who complete diabetes peer coach interventions to become coaches appears to be a useful strategy for developing peer coaches who bring sensitivity, commitment, and reciprocity to their role.

The estimation of myocardial blood flow (MBF) in dynamic PET can be biased by many different processes. A major source of error, particularly in clinical applications, is patient motion. Patient motion, or gross motion, creates displacements between different PET frames as well as between the PET frames and the CT-derived attenuation map, leading to errors in MBF calculation from voxel time series. Motion correction techniques are challenging to evaluate quantitatively and the impact on MBF reliability is not fully understood. Most metrics, such as signal-to-noise ratio (SNR), are characteristic of static images, and are not specific to motion correction in dynamic data. This study presents a new approach of estimating motion correction quality in dynamic cardiac PET imaging. It relies on calculating a MBF surrogate, K 1 , along with the uncertainty on the parameter. This technique exploits a Bayesian framework, representing the kinetic parameters as a probability distribution, from which the uncertainty measures can be extracted. If the uncertainty extracted is high, the parameter studied is considered to have high variability - or low confidence - and vice versa. The robustness of the framework is evaluated on simulated time activity curves to ensure that the uncertainties are consistently estimated at the multiple levels of noise. Our framework is applied on 40 patient datasets, divided in 4 motion magnitude categories. Experienced observers manually realigned clinical datasets with 3D translations to correct for motion. K 1 uncertainties were compared before and after correction. A reduction of uncertainty after motion correction of up to 60% demonstrates the benefit of motion correction in dynamic PET and as well as provides evidence of the usefulness of the new method presented.

The objectives of this study were: (1) to examine Composite International Diagnostic Interview (CIDI) period prevalence and comorbidity for depression and anxiety disorder in a cohort of women assessed during the first 6-8 months postpartum and (2) to examine the benefits of combining the Edinburgh Postnatal Depression Scale (EPDS) with a simple "interval symptom" question to optimize screening postpartum. Women aged over 18 (N = 1,549) were assessed during late pregnancy and reviewed at approximately 2, 4, and 6-8 months postpartum using the EPDS and an "interval symptom" question. The latter asked about any depressive symptoms in the interval since the last EPDS. Women who scored >12 on the EPDS and/or positive on the "interval symptom" question were then administered the CIDI. A further 65 randomly selected women that screened negative were also administered the CIDI. Loss to postnatal follow-up was very significant, and returns rates were inconsistent across the three postnatal time points. Almost 25% of those who screened positive did not complete a CIDI. For screen-positive status, a total of 314 (24.4%) of those that returned questionnaires (N = 1,289) screened positive at least once across the 6- to 8-month interval. Of these, 79 were lost to follow-up; thus, 235 (74.8%) completed a CIDI. In this group, 34.7% had been positive both on the EPDS and the "interval" question, 15.9% on the EPDS alone, and 49.4% on the "interval" question alone. For the CIDI diagnosis and estimated 6- to 8-month period CIDI prevalence, among those 235 women who screened positive and completed a CIDI, 67.2% met the criteria for a CIDI diagnosis, as did 16.9% of those who screened negative. The breakdown in CIDI diagnoses in the 235 women was 32.8% major depression (± anxiety disorder); 26.4% minor depression alone; and 8.1% with a primary anxiety disorder (approximately half with minor depression). Put another way, 20.4% of these women had an anxiety disorder (approximately two thirds with comorbid depression) and 37.7% of women with a major depressive episode (MDE) had a comorbid anxiety disorder. The estimated 6- to 8-month prevalence rate for a CIDI diagnosis of anxiety or depression (major or minor) was 29.2% (95% CI 26.7%-31.7%). The use of the "interval symptom" question alone was 1.7 times more likely to identify positive CIDI cases than the EPDS alone. Almost 40% of postnatal women with a diagnosis of MDE have a comorbid diagnosis of anxiety disorder. The estimated 6- to 8-month period prevalence for CIDI cases of anxiety and depression was 29.2%. Screening for anxiety and depression using the EPDS alone was associated with a lesser capacity to identify CIDI caseness than a simple "interval symptom" question (for the 2 months prior) which almost doubled the yield. This paper demonstrates that combining the EPDS with the "interval symptom" question improves detection of CIDI caseness.

There is increasing evidence that sensitization of the androgen receptor (AR) signaling pathway contributes to the failure of androgen ablation therapy for prostate cancer, and that direct targeting of the AR may be a useful therapeutic approach. To better understand how AR function could be abrogated in prostate cancer cells, we have developed a series of putative dominant-negative variants of the human AR, containing deletions or mutations in activation functions AF-1, AF-5, and/or AF-2. One construct, AR inhibitor (ARi)-410, containing a deletion of AF-1 and part of AF-5 of the AR, had no intrinsic transactivation activity but inhibited wild-type AR (wtAR) in a ligand-dependent manner by at least 95% when transfected at a 4:1 molar ratio. ARi-410 was an equally potent inhibitor of gain-of-function AR variants. Ectopic expression of ARi-410 inhibited the proliferation of AR-positive LNCaP cells, but not AR-negative PC-3 cells. Whereas ARi-410 also marginally inhibited progesterone receptor activity, this was far less pronounced than the effect on AR (50% vs. 95% maximal inhibition, respectively), and there was no inhibition of either vitamin D or estrogen receptor activity. In the presence of ligand, ARi-410 interacted with wtAR, and both receptors translocated into the nucleus. Whereas the amino-carboxy terminal interaction was not necessary for optimal dominant-negative activity, disruption of dimerization through the ligand binding domain reduced the efficacy of ARi-410. In addition, although inhibition of AR function by ARi-410 was not dependent on DNA binding, the DNA binding domain was required for dominant-negative activity. Taken together, our results suggest that interaction between ARi-410 and the endogenous AR in prostate cancer cells, potentially through the DNA binding and ligand binding domains, results in a functionally significant reduction in AR signaling and AR-dependent cell growth.

Aims: To assess whether links exist between maternal trait anxiety (STAI), perceived life event (LE) stress and depression (Edinburgh scale) and infant temperament., Study Design and Subjects: Women in the third trimester of pregnancy returned psychological self-report questionnaires; infant temperament was evaluated at 4 and 6 months by maternal and paternal report, while depression (concurrent Edinburgh scale) was also assessed at four and six months. As data were returned inconsistently at 4 and 6 months, we combined these two time points for simplicity of reporting and optimisation of numbers., Results: Univariate logistic regressions on 970 subjects indicated that the pregnancy STAI (>40) scores were associated with 2.56- and 1.57-fold increases (maternal and paternal, respectively), in the odds of "difficult" infant temperament at 4 or 6 months. Concurrent Edinburgh scores (OR of 3.06 and 2.64 for maternal reports, respectively) were also predictive of infant temperament. Age, education, income, marital status, obstetric complications, infant gender and prematurity were not predictive of infant temperament. In stepwise multiple logistic regression analyses, the antenatal trait STAI (odds ratio 1.96) significantly predicted maternal reports of "difficult" temperament at 4 or 6 months independent of both antenatal and postnatal depression scores. There were similar trends for paternal reports of "difficult" temperament but these were not significant. Antenatal depression and perceived LE stress were not predictive of temperament. Finally, women (N=14) reporting domestic violence (DV) in pregnancy had highly significant increased Edinburgh and STAI scores., Conclusions: Maternal trait anxiety was predictive of "difficult" infant temperament, independent of "concurrent" depression and key sociodemographic and obstetric risk factors. These findings, while needing replication using objective measures of infant temperament, suggest that antenatal psychological interventions aimed at minimising anxiety may optimize infant temperament outcomes. There may be some benefit in shaping specific interventions to women reporting specific risk factors such as DV or past abuse.

Community health nursing is a complex practice that encompasses nurses working in many diverse settings. This article discusses the development of a project which focused on better preparation of students for potential employment in community settings. The formation of the working team and the development of the curriculum is outlined. A focus is given to the linking of primary health care principles in the teaching and facilitation of students within hospital and community settings. Comprehensive conclusions cannot be made yet from the project's preliminary findings. However, the process of collaboration has demonstrated several issues. These will have an impact on everyone who has been part of this project, and the issues are discussed in this article. The article provides an overview of the first year of collaboration of a 4-year project.

Phylogenetic reconstruction in molecular systematics has largely been achieved using mitochondrial gene sequences and less frequently sequences of nuclear ribosomal RNA genes. At present few other nuclear genes have been identified that could be used to test these phylogenies. C-mos, a single-copy nuclear oncogene, has been identified as a candidate nuclear marker. Data are presented on the usefulness of c-mos sequences in the phylogenetic analysis of squamate reptile families. We obtained partial sequences of c-mos from 13 squamate reptile families and outgroup representatives from the orders Rhynchocephalia, Chelonia, and Crocodylia. Phylogenetic analysis reveals a high degree of phylogenetic information contained within the sequence for both the synonymous and nonsynonymous substitutions. Phylogenetic resolution was present at both the deepest and shallower divergences but relationships among the major squamate lineages were not resolved, possibly because rapid cladogenesis may have led to the diversification of these lineages., (Copyright 1998 Academic Press.)

1. Anipamil, a long acting analogue of verapamil, was tested for its actions against arrhythmias induced by ischaemia and reperfusion in conscious and anaesthetized rats, as well as for effects on epicardial intracellular action potentials. 2. When given 15 min or 4 h before coronary occlusion, 1 and 5 mg kg-1 anipamil reduced ischaemia-induced arrhythmias in conscious rats. The same doses also reduced arrhythmias when given 15 min before occlusion in acutely-prepared anaesthetized rats. ED50 values were between 1 and 5 mg kg-1. 3. The incidence of reperfusion arrhythmias depended upon the period of regional ischaemia prior to reperfusion such that the peak incidence occurred after 5-7 min of ischaemia. Anipamil (2.5 mg kg-1, i.v.) selectively abolished the reperfusion arrhythmias induced by short periods of ischaemia, although some antiarrhythmic effects were seen for all periods of ischaemia. 4. Anipamil slowed the rate of development of R-wave increases and S-T segment elevations induced by ischaemia, but did not reduce the maximum values they attained. 5. Anipamil (2.5 mg kg-1 i.v.) lacked Class I or III electrophysiological actions on intracellular action potentials recorded in vivo from the epicardium of rat hearts. 6. In conclusion, the antiarrhythmic actions of anipamil appeared to depend upon calcium antagonism which may have reduced arrhythmias by a combination of anti-ischaemic and direct anti-arrhythmic actions. Presumed anti-ischaemic actions changed the relationship between the duration of preceding ischaemia and resulting reperfusion arrhythmias.