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OBJECTIVE: To assess the aetiology, and prognosis of ST-segment elevation (STE) on the exercise electrocardiogram in patients with chest pain without a prior history of myocardial infarction (MI). METHODS: Between January 1998 and December 2005, 14 941 exercise stress tests were performed to assess chest pain in patients without a prior history of MI. Those who developed STE were identified. RESULTS: STE occurred in 0.78% (116/14 941). Coronary angiography was performed in 108 patients. All patients had at least one severe coronary artery stenosis (>70%). The site of STE on exercise ECG was shown to be 95.4% predictive of a severe stenosis in the coronary artery supplying that area. Lateral STE was rare (1/116). Ninety-eight patients underwent revascularisation; 67 patients had percutaneous coronary intervention (PCI) and 31 underwent coronary artery bypass grafting (CABG). Follow-up included recording of death, MI, cerebrovascular event, heart failure and target vessel revascularisation. The projected 7-year event-free survival probability was 62.1% for those undergoing CABG, 77.1% for those who had PCI and 68.6% for those not undergoing revascularisation (no difference between these three groups, log rank p = 0.802). CONCLUSIONS: STE on the exercise ECG is rare but specific for ischaemic heart disease and is predictive of a severe stenosis in the corresponding coronary artery. Prognosis is favourable following revascularisation.

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We prospectively evaluated a rapid-access chest pain clinic in terms of clinical diagnoses, outcomes, morbidity and mortality at 3 months follow-up in patients, and cost-effectiveness. All patients seen at the clinic from February 1999 to December 2000 were assessed. Referring doctors indicated the management they would have provided had the clinic been unavailable, to allow a cost-effectiveness analysis. Overall, 709 patients were referred, 471 (66%) from General Practitioners, 212 (30%) from Accident and Emergency doctors and 26 (4%) from other sources. All had recent onset, or increasing frequency of ischaemic-type chest pain (excluding those with suspected myocardial infarction or rest chest pain angina). Fifty-one (7%) had acute coronary syndromes, 119 (17%) had stable ischaemic heart disease, 144 (20%) had possible ischaemic heart disease, and 395 (56%) were considered to have non-ischaemic symptoms. Some 70% of patients were seen within 24 h. Only 57 patients (8%) were admitted. Had the clinic been unavailable, 160 patients would have been admitted. Out-patient cardiology appointments were arranged for 116 patients (16%), and 429 patients (60%) were discharged directly. Follow-up data at 3 months were obtained from 565/567 eligible patients (99.6%). No major cardiac events (death/myocardial infarction) occurred in those with non-ischaemic chest pain. There were five deaths (including one due to cancer) and three patients had a myocardial infarction (event rate 1%). There were eleven readmissions for angina: six were in patients with acute coronary syndromes, and four of these six were awaiting revascularization. The estimated net saving was pound 58/patient. A rapid-access chest pain clinic offers a prompt, safe and cost-effective service in a challenging group of patients.

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The title compound, C(36)H(30)NP(2)(+).HSO(4)(-).CHCl(3), consists of discrete ions and well separated chloroform solvate molecules. The central feature of the structure is O-H...O hydrogen bonding between two hydrogensulfate ions related by a crystallographic inversion centre. The chloroform solvate molecule takes part in a well defined C-H...O hydrogen bond.

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Previous studies examining the relationship between response rate and reinforcement rate on variable-interval schedules (the variable-interval response function) have confounded elapsed session time with within-session changes in food density. The present experiments attempted to manipulate these factors independently and thus isolate their effects on responding. In Experiment 1, 7 rats pressed a bar for food on a series of four variable-interval schedules (7.5 s, 15 s, 30 s, and 480 s). Elapsed session time was held constant while food density was manipulated via a presession feeding. Changes in food density altered the form of the variable-interval response function, independently of elapsed session time. In Experiment 2, 8 rats responded on the same series of variable-interval schedules as in Experiment 1, but food density was held constant and elapsed session time was manipulated via the use of timeout periods. The results revealed no evidence for an effect of elapsed session time independent of food density. The present results extend a recent analysis of the variable-interval response function by Dougan, Kuh, and Vink (1993) by identifying food density as an important factor determining the form of the function. The present results also help clarify the controversy over the correct empirical form of the variable-interval response function by further defining the variables responsible for differences in the form of that function.

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Two experiments examined the effects of session duration on responding during simple variable-interval schedules. In Experiment 1, rats were exposed to a series of simple variable-interval schedules differing in both session duration (10 min or 30 min) and scheduled reinforcement rate (7.5 s, 15 s, 30 s, and 480 s). The functions relating response rate to reinforcement rate were predominantly monotonic for the short (10-min) sessions but were predominantly bitonic for the long (30-min) sessions, when data from the entire session were considered. Examination of responding within sessions suggested that differences in the whole-session data were produced by a combination of prospective processes (i.e., processes based on events scheduled to occur later in the session) and retrospective processes (i.e., processes based on events that had already occurred in the session). In Experiment 2, rats were exposed to a modified discrimination procedure in which pellet flavor (standard or banana) predicted session duration (10 min or 30 min). All rats came to respond faster during the short (10-min) sessions than during the first 10 min of the long sessions. As in Experiment 1, the results seemed to reflect the simultaneous operation of both prospective and retrospective processes. The results shed light on the recent controversy over the form of the variable-interval response function by identifying one variable (session duration) and two types of processes (prospective and retrospective) that influence responding on these schedules.

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Economic theory predicts an inverse relationship between the quantity of a commodity supplied to the marketplace and the equilibrium market price of that commodity. This prediction was tested in three experiments. Pigeons responded on simple variable-interval schedules, and quantity of reinforcement supplied was varied in a different way in each experiment. In Experiment 1, quantity supplied was varied by manipulating reinforcement rate while keeping session length constant. In Experiment 2, quantity supplied was varied by manipulating reinforcement rate while keeping reinforcers per session constant. In Experiment 3, quantity supplied was varied by manipulating reinforcer magnitude while keeping number of reinforcers constant. As predicted by economic theory, the obtained behavioral cost (responses per reinforcer) increased as supply decreased. The results could not be explained by simple artifacts such as satiation and time available to respond. In addition, the function relating response rate to reinforcement rate was bitonic in 7 of 9 animals in Experiments 1 and 2, which supports economic and regulatory theories over more traditional reinforcement theories.

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In the first experiment, 4 pigeons were each presented with a recurring sequence of four key colors followed by the delivery of grain (block clock). Once the rate of pecking had stabilized, three of the colors were replaced, during different series of sessions, by a darkening of the key. The rate of pecking was reduced within those segments of the interval between deliveries of food during which the key was dark; when the key was dark during the final portion of the interval, rates were reduced throughout the entire interval. In the second experiment, 3 new pigeons were exposed to a different sequence of colors, and the final stimulus was replaced in successive conditions by a novel color, a darkened key, and a restoration of the original color. The data indicated that darkening the key had a more severe, more extensive, and more persistent effect than did a mere change in color. These results suggest that it may be fruitful to conceptualize the autoshaping procedure as a special version of the block clock in which pecking is suppressed throughout the greater part of the interval by darkening the key. In the final condition, the same stimulus appeared in each of the last three portions of the interval. The rate of pecking was lower during the last two portions than when distinctive colors were presented, with the peak rate now appearing in the fifth of seven equal temporal components.

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The purposes of this study were to 1) assess the value of including an expanded business administration unit that would include proprietary practice issues in an entry-level physical therapy curriculum and 2) organize topics by priority that could be included in such a unit. Twenty-seven physical therapists (100%) in private practice in Montana responded to the questionnaire. Ninety-three percent of the respondents stated that such an expansion would be valuable in the entry-level physical therapy curriculum. Topics of greatest priority were 1) Self-analysis of Resources, 2) Reimbursement, and 3) Contracting Services and Referral Sources. Topics of least priority were 1) City and State Tax and Licensure Requirements, 2) Computers and Computer Programs, and 3) Insurance Planning. Further research and development are needed to formulate methods and objectives for such an expansion.

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Male Fischer 344 rats were examined for an age-dependent sensitivity to the anticonflict and central nervous system (CNS) depressant effects of diazepam. A conflict paradigm was used to measure the ability of single intravenous injections of diazepam to attenuate punishment-induced suppression of behavior and to elicit CNS depression in young, mature, and senescent rats. Senescent rats had the lowest behaviorally active threshold dose. However, diazepam at the behaviorally active threshold dose produced a simultaneous increase in punished and unpunished responding in all three age groups. Punished responding was increased more and over a wider dose range in the young and mature rats than in the senescent rats. Sensitivity to the CNS depressant effects of diazepam was over four times greater in the senescent rats than in the other two age groups. In summary, the results indicate that the behavioral effects of diazepam vary with dosage and age of the rat. The male Fischer 344 rat may be a useful animal model for exploring how diazepam elicits age-related behavioral effects in humans.

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Shakespeare's play The Taming of the Shrew is described in terms of behavior analysis. Changes in the behavior of the character Kate result from her husband Petruchio's manipulation of environmental contingencies. Aspects of behavior analysis found in the play include the identification of target behavior, the establishment of events as reinforcers, the arrangement of contigencies between responses and reinforcers, and the assessment of post-intervention responding. Several aspects of Shakespeare's description are related to current issues in behavior analysis bearing on theory, cultural practices, and public relations.

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Three experiments examined the effects of opportunities for an alternative response (drinking) on positive behavioral contrast of rats' food-reinforced bar pressing. In both Experiments 1 and 2 the baseline multiple variable-interval schedules were rich (variable interval 10-s), and contrast was examined both with and without a water bottle present. In Experiment 1, the rats were not water deprived. When one component of the multiple schedule was changed to extinction, the rate of bar pressing increased in the constant component (positive behavioral contrast). The magnitude of contrast was larger when the bottle was absent than when it was present, as predicted by the matching law. Drinking did not shift from the constant variable-interval component to the extinction component, as might have been expected from competition theory. In Experiment 2, the rats were water deprived. Contrast was larger when the bottle was present than when it was absent, and drinking did shift to the extinction component, as predicted by competition theory. In Experiment 3, water-deprived rats responded on leaner multiple variable-interval schedules (60-s) in the presence of a water bottle. When one component was changed to extinction, contrast did not occur, and drinking did not shift to the extinction component. The present results suggest that there are at least two different sources of behavioral contrast: "competitive" contrast, observed when an alternative response occurs with high probability, and "noncompetitive" contrast, observed when an alternative response occurs with low probability. The results, in conjunction with earlier studies, also suggest that the form of the alternative response and the rate of food reinforcement provided by the multiple schedule combine to determine the amount of contrast.

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The literature was examined to determine how well the generalized matching law (Baum, 1974) describes multiple-schedule responding. In general, it describes the data well, accounting for a median of 91% of the variance. The median size of the undermatching parameter was 0.46; the median bias parameter was 1.00. The size of the undermatching parameter, and the proportion of the variance accounted for by the equation, varied inversely with the number of schedules conducted, with the number of sessions conducted per schedule, and with the time within a component. The undermatching parameter also varied with the operanda used to produce reinforcers and with the reinforcer used. The undermatching parameter did not vary consistently with component duration or with several other variables. Bias was greater when fewer rather than more schedules were conducted, when two rather than one operanda were used, and when White Carneaux rather than homing pigeons served as subjects. These results imply that the generalized matching law may describe both concurrent and multiple-schedule responding, but that the same variables do not always influence the bias and undermatching parameters in the same way for the two types of schedules.

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Positive behavioral contrast has been observed when pigeons press treadles on multiple schedules for high rates of reinforcement, but not for low rates. Negative treadle-press contrast has been observed for low rates of reinforcement. Two experiments showed that differences between response rates emitted during simple and multiple schedules appear and fail to appear under similar conditions. The experiments showed that the rate of pressing during the less favorable component of a multiple schedule was less than the rate of pressing during a comparable simple schedule (negative contrast). The rate of treadle-pressing during the more favorable component was not greater than the rate of pressing during a comparable simple schedule, when the schedules provided a low rate of reinforcement (absence of positive contrast), but it was when the schedules provided a high rate of reinforcement (positive contrast). These results help to clarify the definition of behavioral contrast by showing that simple schedules may be appropriate baselines from which to define and measure contrast.

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Two experiments examined the effects of baseline reinforcement rate and component duration on behavioral contrast and on re-allocation of interim behavior in rats. Positive behavioral contrast occurred during multiple variable-interval 10-second extinction (VI 10 EXT) after a multiple VI 10 VI 10 baseline condition, but not during multiple VI 60 EXT following multiple VI 60 VI 60 baseline. Component duration had no significant effect on contrast. These results differed from those found in studies of pigeons' key pecking. Contrast was accompanied by an increased rate of drinking in the changed component, but drinking in the constant component did not decrease. These results are not consistent with the competition theory of contrast, but are consistent with the predictions based on the matching law. However, no current theory seems to account for all instances of behavioral contrast.

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In a test of Herrnstein's (1970, 1974) equation for simple schedules, 15 pigeons pecked a key that produced food delivered according to variable-interval schedules. One group of birds was water deprived, and food-reinforced key pecking occurred in the presence of free water. Two other groups were not water deprived; water was present for one and absent for the other. As predicted by Herrnstein, the parameter r(o) was significantly higher in the water-deprived group than in the two nondeprived groups. Contrary to Herrnstein's interpretation of r(o), the rate of drinking varied across schedules. Herrnstein's interpretation can be salvaged by considering r(o) to be an average. However, if r(o) is an average, the equation is not a good explanation of behavior because this average is not valid until all schedules have been sampled. In addition, low percentages of variance accounted for suggest that Herrnstein's equation may be of limited usefulness even as a descriptive model for these situations.

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Between 1976 and 1978, 249 harp seals were sampled from five locations in the Northwest Atlantic and Arctic for heavy metal and selenium residue analyses in tissue. Significant loading was apparent only in blood, brain, kidney, liver and muscle. Samples were analysed for mercury (Hg), selenium (Se), copper (Cu), cadmium (Cd) and lead (Pb). The seals carried higher levels of Cd than of the other metals. Residue levels of Cd were highest in kidney tissue; levels of other metals were highest in liver. Both males and females bioaccumulated Cd, Hg and Se. Cd, Hg, Se and Cu residues were detected in tissue from neonatal seals, indicating that transplacental and transmammary transfer of these elements had occurred. Despite the passage of residues from mother to pup, females bore significantly higher levels of Hg and Cd than males. Conversely, levels of Cu, Se or Pb did not appear to differ significantly between sexes. There was considerable individual variation in residue levels. This, coupled with the extensive annual migration undergone by these animals, made it difficult to arrive at definite conclusions regarding geographic accumulation patterns.

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Between 1976 and 1978, 248 harp seals were sampled from 5 locations in the Northwest Atlantic and Arctic for organochlorine (OC) residue analysis in tissue. Blood, kidney, brain, muscle and blubber samples were analysed for PCB, DDT, dieldrin, hexachlorobenzene (HCB), and heptachlor epoxide. Levels were generally greatest in blubber tissue. Overall, mean levels of DDT and PCB were greater than those of other OC. A barrier prevented OC compounds from accumulating in the brain to the level one might expect in lipid tissues. Positive correlations were found between 1: DDT and PCB, 2: DDT and dieldrin, and 3: PCB and deildrin. Male harp seals bioaccumulated DDT, PCB, heptachlor epoxide and dieldrin with age. As a group, adult males sampled in the Gulf of St. Lawrence carried the highest concentrations of all OC, except that chlordane did not appear to bioaccumulate and levels of hexachlorobenzene were minimal. Females generally ceased exhibiting significant bioaccumulation once breeding age was reached, due to transplacental and transmammary residue transfer of OC from mother to pup. There were some significant differences in OC levels between locations with DDT: Gulf greater than Front; PCB: Gulf greater than Front; dieldrin: Gulf greater than Front; heptachlor epoxide: Front greater than Gulf. No significant differences were found, however, when northern locations (Grise Fiord, Northwest Greenland, Pangnirtung) were compared to southern (Gulf, Front) on a group basis. The latter is not surprising in view of the harp seals extensive cyclical annual migration between the southern breeding grounds and the High Arctic.

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The number of harp seals, Phoca groenlandica (Eodeben 1777) may now range from 2.25 million to 3 million. The total population is divided among three separate breeding stocks in the White Sea, the Greenland Sea, and the Northwest Atlantic. The continued exploitation of the Northwest Atlantic stock has caused controversy, primarily because of public concern for the fate of the newborn "whitecoat." The harp seal's life-cycle is marked by a progression from on-ice birth to in-water mating and subsequent on-ice molt. An extensive migration follows, taking these animals northward to high Arctic summering grounds and southward in an autumnal return migration to the breeding grounds. Harp seals are efficient divers and possess well-developed microsensory perceptions associated with anatomical adaptation to their environment. The relation between our understanding of the basic biology of the species and the confrontation that occurs between these mammals and man is considered with respect to our technological invasion of the North, the regulated commercial kill, and the slow movement toward multispecies management. Sound decisions regarding the exploitation of this species can only be made with a knowledge of its biology.