Social association predicts immunological similarity in rewilded mice.

Environmental influences on immune phenotypes are well-documented, but our understanding of which elements of the environment affect immune systems, and how, remains vague. Behaviors, including socializing with others, are central to an individual's interaction with its environment. We tracked behavior of rewilded laboratory mice of three inbred strains in outdoor enclosures and examined contributions of behavior, including social associations, to immune phenotypes. We found that the more associated two individuals were, the more similar their immune phenotypes were. Social association was particularly predictive of similar memory T and B cell profiles and was more influential than sibling relationships or worm infection status. These results highlight the importance of social networks for immune phenotype and reveal important immunological correlates of social life.

Physical activity and exercise training prescriptions for patients.

The dominant outcome from exercise prescription is an increase in various markers of exercise capacity. A very large group of studies have demonstrated that the VO2max is increased in response to exercise performed according to well-accepted principles of exercise prescription. Other markers of exercise capacity, such as the VT, also improve substantially following exercise training. Finally, improvement in exercise capacity is generally related to improved quality of life, particularly in patients with exercise capacity limited by various disease processes. Beyond the specific physiologic gains from training, exercise contributes to a better overall clinical outcome. Although there are few data conclusively demonstrating that exercise independently causes favorable changes in other risk factors, it should be recognized that exercise can contribute indirectly to modulation of other risk factors. Exercise represents positive health advice. Since most of our other recommendations to patients are in the nature of negative advice (e.g., don't smoke, don't eat high-fat foods), and since people are infamous for ignoring negative advice, the value of using a positive recommendation that may indirectly lead the patient to discontinue bad behaviors can hardly be overstated.

Reaching the goals of "Healthy People 2000" regarding breastfeeding.

The Healthy People 2000 objectives for breastfeeding were to move the breastfeeding initiation rate to 75% from 54% and the breastfeeding continuation rate to 50% at age 6 months from the 1988 baseline of 21%. The 1996 data indicated that the goal will not be met either for initiation or duration in spite of governmental strategic planning and coalition building, the acknowledgement of the benefits of breastfeeding by professional associations, the implementation of the Baby-Friendly Hospital Initiative, or the efforts of individual health professionals. Clearly, there is still work to be done. The Baby-Friendly Hospital Initiative was organized within Baby-Friendly USA too late in the decade to have had any impact on the 1996 data. It may take an additional decade before sufficient hospitals and birthing centers are engaged in the process to make a measurable difference in duration. Work protection legislation was not introduced until 1998. A national breastfeeding committee was not formed until 1998. National breastfeeding promotion programs were still either in the planning stage or in early stages of implementation in 1996. There is no paid maternity leave guaranteed by legislation for women in the United States. The International Code on Marketing has not been addressed, except to propose ways of examining the issue. The blueprints developed by the Surgeon General's Workshop on Breastfeeding and the Call for Action workshop enumerated strategies that will be carried over to the 2010 objectives. New blueprints will be developed to meet the 2010 goals, but it is not enough to strategize and plan. The substantive advantages of breastfeeding make accomplishment of the goals imperative if we are to achieve "health for all."

Using the quality improvement process to affect breastfeeding protocols in United States hospitals.

Engaging in the Quality Improvement Process represents an opportunity for lactation consultants and breastfeeding advocates to examine and reevaluate hospital breastfeeding policies and procedures. Cause and effect diagrams that explore the problem of an 8-hour-old baby who has not yet breastfed are presented as examples of a quality tool.

The metabolic effects of hemodialysis with and without glucose in the dialysate.

The present study compares some of the metabolic effects of hemodialysis of fasting patients with and without glucose in the dialysate bath. Unlike glucose dialysis, glucose-free dialysis caused marked decreases in blood levels of glucose, insulin, lactate, and pyruvate along with profound increases in acetoacetate and beta-hydroxybutyrate. It is concluded that oxidation of fatty acids increases to meet energy demands and that the combined processes of glycogenolysis and gluconeogenesis serve to prevent critical hypoglycemia during glucose-free dialysis.