The purpose of this study was to compare directly the physiological consequences of 5% hypohydration or euhydration during exercise in both temperate (23 degrees C) and hot (33 degrees C) environments. The subjects were eight male volunteers. Each performed four 1-h exercise bouts at 60% maximum oxygen uptake, one in each of the following conditions: hot-hypohydrated, hot-euhydrated, temperate-hypohydrated, and temperate-euhydrated. Heart rate (HR), rectal temperature (Tre), forearm blood flow, and oxygen uptake were measured after 20, 40, and 60 min exercise. Whole-body sweat rate was also determined for each exercise bout. Hypohydration increased Tre significantly (P<0.05) more in the hot environment (0.16 degrees C per 1% decrease in body mass) than in the temperate environment (0.08 degrees C per 1% hypohydration). Furthermore, compared with euhydration, hypohydration decreased forearm blood flow and whole-body sweat rate significantly more during exercise in the hot than in the temperate environment. The reductions in forearm blood flow and whole-body sweat rate appear to have decreased heat loss, thus accounting for the increase in Tre during exercise in the heat while hypohydrated. In conclusion, this study illustrates that the physiological consequences of hypohydration during exercise are exacerbated in the heat.

In this comparative study, 86 patients with type 2 diabetes and visual impairment were evaluated on their preference for, and ability to operate, three different insulin delivery systems -InnoLet® (NovoNordisk), Humulin® NPH Pen (Eli Lilly) and vial and syringe (Becton Dickinson). Patients found the clocklike dose scale on InnoLet® significantly easier to read than that of the other systems (92% were able to read four doses, versus 45% and 61% with Humulin® Pen and syringe respectively, both p < 0.001), and showed greater ability to set and dispense a 20 unit dose without instruction. After reading the packaging information leaflet and brief verbal instruction, 99% of patients were able to correctly set and dispense three consecutive insulin doses with InnoLet® compared with 85% with Humulin® Pen and 64% with syringe (p = 0.001 and p < 0.001, respectively). Ability to set and deliver insulin was not however clearly related to visual acuity. On questionnaire, 87% of patients expressed an overall preference for InnoLet®, and 13% for Humulin® Pen (p < 0.001); no patients preferred the syringe. In conclusion, insulin delivery systems designed to simplify accurate, reliable insulin delivery for people with visual impairment can improve the ability of such patients to repeatedly set and deliver the correct insulin dose. O R I G I N A L A R T I C L EInsulin delivery devices in the visually impared devices; the syringe had a pre-attached Micro-Fine + 8 mm needle. The study was conducted in accordance with good clinical practice.

A common focus in many modern theories of literature is a reassessment of the traditional view of the character in a narrative text. The position that this article defends is that a revised conception is necessary for an understanding of the means by which dialogism is said to function in novelistic discourse. Revising the notion does not, however, involve discarding it outright as recent theories of the subject would have us do. Nor can we simply void it of all "psychological" content as suggested by many structuralist proposals. To retain Bakhtin's concept of the notion of character, we must understand the term "psychological" in the context of his early book on Freud. In artificially combining Bakhtin's isolated remarks on the literary character, we arrive at a view which postulates textualized voice-sources in the novel. In such a schema, maximum variability and freedom is afforded to each separate source. Yet we must use the term "separate" with extreme caution, for in Bakhtin's writings all those beings which we might wish to view as separate entities are in fact intricately intertwined and inseparable. Viewing something as absolutely separate implies knowing intimately all of its boundaries and possibilities. This is surely a capacity which Bakhtin would deny us when it comes to human figures in texts.

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