Numerous studies have shown that ingesting carbohydrate in the form of a drink can improve exercise performance by maintaining blood glucose levels and sparing endogenous glycogen stores. The effectiveness of carbohydrate gels or jellybeans in improving endurance performance has not been examined. On 4 separate days and 1-2 hr after a standardized meal, 16 male (8; 35.8 +/- 2.5 yr) and female (8; 32.4 +/- 2.4 yr) athletes cycled at 75% VO(2peak) for 80 min followed by a 10-km time trial. Participants consumed isocaloric (0.6 g of carbohydrate per kg per hour) amounts of randomly assigned sports beans, sports drink, gel, or water only, before, during, and after exercise. Blood glucose concentrations were similar at rest between treatments and decreased significantly during exercise with the water trial only. Blood glucose concentrations for all carbohydrate supplements were significantly, p < .05, higher than water during the 80-min exercise bout and during the time trial (5.7 +/- 0.2 mmol/L for sports beans, 5.6 +/- 0.2 mmol/L for sports drink, 5.7 +/- 0.3 mmol/L for gel, and 4.6 +/- 0.3 mmol/L for water). There were no significant differences in blood glucose between carbohydrate treatments. The 10-km time trials using all 3 carbohydrate treatments were significantly faster (17.2 +/- 0.6 min for sports beans, 17.3 +/- 0.6 min for sports drink, and 17.3 +/- 0.6 min for gel) than water (17.8 +/- 0.7 min). All carbohydrate-supplement types were equally effective in maintaining blood glucose levels during exercise and improving exercise performance compared with water only.

Objective: To determine the effects of teaching medical Spanish to eight PGYl emergency medicine residents on their subsequent interactions with Spanish-speaking patients.Methods: Eight PGY 1 residents completed a 45-hour medical Spanish course administered during their first residency month. Thirty-four subsequent physician-patient interactions by these residents were audiotaped over a six-month period at a suburban teaching ED. The tapes were transcribed and analyzed for errors by a professional medical Spanish interpreter and a native Spanish speaker. Results:Minor errors (e.g., technically incorrect grammar or vocabulary with generally appropriate patient understanding) were found in more than half of the interactions and major errors (e.g., misunderstanding duration of symptoms, misunderstanding of vocabulary) were found in 14% of the interactions. In addition, although the course was designed to supplement, not replace, professional interpreters, the residents called for an interpreter only 46% of the time. Conclusion:Although medical language courses may be a useful adjunct to interpreters, they are not designed to replace them. Significant errors may occur when participants in such courses assume their knowledge is sufficient to obtain a good history, give patient release instructions, and provide medical care in general without an interpreter present.Acad. Emerg. Med. 1995; 2:32-37.I Data from the 1990 U.S. Census indicate that the Hispanic population has grown rapidly over the past ten years and currently represents 9.0% of the U.S. population.' In certain Southwestern states, such as California, the Hispanic population comprises over 25% of the total population and is expected to increase to 30% by the year 2000.* A significant number of Hispanics speak little or no English. Preliminary work at Stanford University Hospital's E D showed that 12% of the patients were monolingual Spanish speakers who required an interpreter to communicate with medical personnel. In light of this information, we studied the effects of teaching a limited amount of medically oriented Spanish to eight PGYl residents during their first month of orientation in the Stanford University/Kaiser Emergency Medicine (EM) Residency program. We sought to determine whether such a course would be beneficial to patients and residents by improving patient rapport, increasing communication, and avoiding errors inherent in bilingual interactions.

The purpose of this paper is to present a case study of the costs to feed replacement beef heifers through the winter. A comparison between heifers fed in a commercial feedlot (Group A) and heifers raised by the owners (Group B) will be made. The effects of the feeding programs on pregnancy rate will then be evaluated. The feeding study was performed by Deseret Ranches, Ltd. of Alberta, Canada, and their computerized results were used for this project. All heifers were examined rectally for pregnancy determination by E.G. Prince, D.V.M. The two major goals of reproductive management are: increase the number of females cycling early in the breeding season, and improve conception rates. It is the first of these goals that is most affected by heifer replacement management programs. The remainder of the discussion, therefore, will center on the ability of the two feeding programs to increase the number of replacement heifers cycling early in the breeding season. The conception rate is assumed to be equal in the two groups since all bulls servicing the two groups successfully passed breeding soundness evaluations and were then randomly distributed between the two groups. The bull:heifer ratio was the same for the two groups (1:30), as were the environmental and management conditions. Both groups were maintained on the same ranch except during the winter when Group A was moved to the feedlot located approximately 20 miles from the ranch. With all other factors being equal, the success of the two feeding programs to increase the number of heifers cycling early in the breeding season, while minimizing cost, is demonstrated by the pregnancy rate. In order to discuss the results of these feeding trials, a description of the two programs must be given. This will be followed by a summary of the performance of each group during the feeding trial and during the breeding season. The cost of the respective programs will then be discussed and the determined pregnancy rates presented.

The purpose of this paper is to present a case study of the economic importance of reproductive management in a beef herd. Deseret Ranches, Ltd., of Alberta, Canada, have provided their computerized records for use in this project. Unlike the dairyman, the beef breeder derives most of his income from calves born into the herd, making fertility the most important trait. A recent economic study showed that fertility was five times more important than growth rate and ten times more important than carcass quality. The two major goals of reproductive management are: Increase the number of females in estrus early in the breeding season, and improve conception rates. In order to address these goals, a brief description of the physical ranch management practices must be given. This will be followed by a description and comparison of the reproductive management practices before (Program 1) and after (Program 2) the implementation of a veterinary supervised reproductive herd health program. The comparison will deal specifically with the economic efficiency of each program in striving to attain the two stated major goals.