Informal knowledge transfer in the period before formal health education programmes: case studies of mass media coverage of HIV and SIDS in England and Wales

Background: How advances in knowledge lead via behaviour change to better health is not well understood. Here we report two case studies: a rapid reduction in HIV transmission in homosexual men and a decline in Sudden Infant Death Syndrome ( SIDS) that took place in the period before the relevant national education programmes commenced, respectively, in 1986 and 1991. The role of newspapers in transferring knowledge relevant to reducing the risk of AIDS and SIDS is assessed. Methods: HIV. Searches were made of The Times (1981-1985), Gay News (1981-1984) and, for the key period of April to June 1983, of eight newspapers with the highest readership. Information on transmission route and educational messages were abstracted and analysed.SIDS Searches were made of The Times and the Guardian (1985-1991), The Sun ( selected periods only, 1988-1991) and selected nursing journals published in England and Wales. Information on sleeping position and educational messages were abstracted and analysed.Results: HIV Forty-five out of 50 articles identified in newspapers described homosexuals as an at risk group. Sexual transmission of AIDS was, however, covered poorly, with only 7 (14%) articles referring explicitly to sexual transmission. Only seven articles (14%) associated risk with promiscuity. None of the articles were specific about changes in behaviour that could be expected to reduce risk. Gay periodicals did not include specific advice on reducing the number of partners until early 1984.SIDS Out of 165 relevant articles in The Times and 84 in the Guardian, 7 were published before 1991 and associated risk with sleeping position. The reviewed nursing journals reflected a pervasive sense of uncertainty about the link between SIDS and sleeping position. Conclusion: Presumptively receptive audiences responded rapidly to new knowledge on how changes in personal behaviour might reduce risk, even though the 'signals' were not strong and were transmitted, at least partly, through informal and 'horizontal' channels. Advances in knowledge with the potential to prevent disease by behaviour change may thus yield substantial health benefits even without the mediation of formal education campaigns ('interventions'). Formal campaigns, when they came, did make important additional contributions, especially in the case of SIDS

Spontaneous regression of human acute myeloid leukaemia xenografts and phenotypic evidence for maturation.

A population of human AML cells which have a characteristic karyotypic marker was cryopreserved and then grown in short-term liquid culture for 2 weeks, during which time the cells increased about 7-fold in number and progressively acquired characteristics of macrophages. 10(7) cells obtained after 1 day in culture, when they were almost devoid of Fc receptors (Fc-), on inoculation into immune-deprived mice gave rise to tumours in more than 90% of the animals. However, after 13 days of culture, when almost all the cells had Fc receptors (Fc+), a similar inoculum did not grow as tumours. After 7 days in culture the cells were heterogeneous, and divided about equally into Fc+ and Fc- cells, both of which were replicating. The Fc- population was capable of producing tumours, whereas the Fc+ was not. Of 23 assessable xenograft tumours produced by the AML cells, 14 regressed completely, 4 grew progressively and 5 grew progressively after initial regression. Progressive tumours could be further transplanted. The regression may arise as a result of maturation in vivo similar to that seen in vitro

P19-53 LB. Priming with recombinant BCG expressing HIV-1 Gag or RT and boosting with recombinant MVA induces an effective immune response in mice

Mycobacterium bovis BCG (BCG) has a number of characteristics that give it great potential to act as a vehicle for the delivery of recombinant vaccines. However, its success depends on overcoming the challenges of poor antigen expression levels and genetic instability. Our studies using an optimized mycobacterial shuttle vector which utilizes the Mycobacterium tuberculosis mtrA promoter, induced upon infection of macrophages, and the M. tuberculosis 19 kDa signal sequence may overcome these issues. We have used this system to generate a recombinant BCG (rBCG) expressing HIV-1 subtype C full length Gag or reverse transcriptase (RT)

Further evidence of response by leukaemia patients in remission to antigen(s) related to acute myelogenous leukaemia.

Fifteen patients with acute myelogenous leukaemia were studied to determine if their remission blood leucocytes could be stimulated into taking up [3H] thymidine after in vitro culture with their own cryo-preserved irradiated AML leukaemia cells. In 6/15 patients it was possible to show autologous recognition and equal recognition of their stored leukaemia cells, even when they had previously been maintained in in vitro proliferative cultures in liquid suspension and undergoing myeloid maturation for one week. After in vitro proliferative culture, 4 populations of leukaemia cells produced material in the supernatant media between 3 and 7 days capable of inducing [3H] thymidine uptake in autologous (2 pts, 5 supernatants) and allogeneic (2 pts, 2 supernatants) AML remission lymphocytes, but not in normal donor lymphocytes. The relevance of these observations to tumour-associated AML antigen is discussed

Bi-directional light transmission properties assessment for venetian blinds : Computer simulations compared to photogoniometer measurements

An accurate evaluation of daylight distribution through advanced fenestration systems (complex glazing, solar shading systems) requires the knowledge of their Bi-directional light Transmission Distribution Function (BTDF). An innovative equipment for the experimental assessment of these bi-directional functions has been developed, based on a digital imaging detection system. An extensive set of BTDF measurements was performed with this photogoniometer on venetian blinds presenting curved slats with a mirror coating on the upper side. In this paper, the measured data are compared with ray-tracing results achieved with a virtual copy of the device, that was constructed with a commercial ray-tracing software. The model of the blind was created by implementing the measured reflection properties of the slats coatings in the ray-tracing calculations. These comparisons represent an original and objective validation methodology for detailed bi-directional properties for a complex system; the good agreement between the two methods, yet presenting very different parameters and assessment methodologies, places reliance both on the digital-imaging detection system and calibration, and on the potentiality of a flexible calculation method combining ray-tracing simulations with simple components measurements

A randomised trial comparing combination chemotherapy using mitomycin C, mitozantrone and methotrexate (3M) with vincristine, anthracycline and cyclophosphamide (VAC) in advanced breast cancer.

This paper describes a randomised clinical trial in patients with advanced breast cancer, comparing the regimen 3M, mitomycin C 7-8 mg m-2 (day 1), mitozantrone 7-8 mg m-2 (day 1 and 21), methotrexate 35 mg m-2 (day 1 and 21) given on a 42 day cycle with a standard anthracycline containing regimen, VAC, vincristine 1.4 mg m-2 (day 1), anthracycline (adriamycin or epirubicin) 30 mg m-2 (day 1), cyclophosphamide 400 mg m-2 (day 1) given on a 21 day cycle. Of a total of 217 patients, 107 were randomised to 3M and 110 to VAC and a mean of 5.5 courses was given per patient. The overall response rate (complete and partial) was 53% (95% Confidence Limits (CL): 43-62%) for 3M and 49% (CL; 39-58%) for VAC. The response according to sites of metastases was the same for both treatment groups. Symptomatic toxicity including alopecia, neuropathy, vomiting (P less than 0.001) and nausea (P less than 0.01) were significantly less for 3M. Myelosuppression including leucopenia (P less than 0.001) and thrombocytopenia (P less than 0.001) was significantly greater with 3M at day 21, although there was no difference in nadir counts in patients at special risk of myelosuppression and there was no evidence of an increase in infective or bleeding complications. There was no significant difference in the duration of response to 3M (10 months, CL 6-15) and VAC (11 months, CL 7-12), nor in survival (3M, 8 months, CL 6-12; VAC, 10 months, CL 8-12). These results indicate that 3M is as effective as, but has significantly less symptomatic toxicity than, an anthracycline containing regimen for the treatment of advanced breast cancer