The patterns of disease caused by five common viruses which infect the respiratory tract are described. The viruses were strains of rhinovirus types 2, 9, and 14, a strain of coronavirus type 229E and of respiratory syncytial virus. Volunteers were given nasal drops containing a low infectious dose of one of the viruses, quarantined from 2 days before to 5 days after inoculation, and examined daily by a clinician using a standard checklist of respiratory signs and symptoms. Only subjects who developed clinical illness accompanied by viral shedding and/or specific antibody production were analysed [n = 116]. The results confirm indication from earlier studies that the main difference between colds induced by different viruses is in duration of the incubation period. Patterns of symptom development were not substantially different with different viruses. Analyses of signs and symptoms in different categories, e.g. nasal symptoms v. coughing, justify treatment with different drugs either successively or simultaneously.

SUMMARY The aim of this study was to explore how the level of shiftwork exposure during an individual’s working life might be related to subjectively reported sleep quality and timing during retirement. Telephone interviews regarding past employment and sleep timing and quality (among other variables) were conducted using a pseudo-random age-targeted sampling process. Subjective sleep quality was assessed using a telephone version of the Pittsburgh Sleep Quality Index. Timing of reported habitual bedtimes and rise-times were assessed using the Sleep Timing Questionnaire. Questions measuring morningness and subjective health were also given. Retired seniors (aged 65 years+, n=1113) were studied. Analysis was by analysis of variance, with shiftwork exposure in three bins [0 (n=387), 1–15 (n=371) and >15 years (n=355)], gender (n=634 male, 479 female) and former occupation [in two broad categories, ‘managerial’ (n=437) versus ‘other’ (n=676)] as factors. In retired shiftworkers, relative to retired day workers, past exposure to shiftwork was associated with higher (worse) PSQI scores by 0.96 units (1–15 years) and 0.61 units (>15 years) (main effect P=0.005). There were also main effects of gender and former occupation (males and managerials reporting better sleep), but neither variable interacted with shiftwork exposure. The timing of current mean habitual bedtimes and rise-times (and also the variance around them) were very similar for the three shiftwork exposure groups. The shiftwork exposure effect did not appear to be mediated by either morningness or current health. Prior exposure to shiftwork would appear to be related to currently reported sleep problems during retirement.

Blood was collected from 684 healthy volunteers and examined for total and differential white blood cell (WBC) counts. A subgroup also was tested for numbers of T cells, B cells, and CD4 and CD8 subsets. Smoking status and alcohol consumption were determined by means of questionnaire, and smoking status was verified with serum cotinine concentration. High smoking rate was associated with increases in all counts. Former smokers abstinent less than 5 years still demonstrated elevated counts, whereas those abstinent more than 5 years had WBC counts comparable to It has been reported for some time that smoking influences the peripheral blood leukocyte count. Studies in both the United Kingdom 1 and France 2 found that mean total white blood cell (WBC) count was 30% higher in smokers than in nonsmokers. Leukocyte counts in ex-smokers, however, were similar to those in nonsmokers. The French study also found that those who inhaled had higher counts than those who smoked similar amounts without inhaling. Other studies have shown that, although smoking was associated with a higher WBC count, consumption of up to three alcoholic drinks a day was not.3 Nevertheless, there has been much interest in the effect of alcohol excess on WBC count and function, because alcoholic those in persons who were never smokers. Compared with levels in those who had never smoked, total WBC counts were 27% higher in current smokers and 14% higher in former smokers who were abstinent for less than 5 years. Lymphocyte counts were 9% higher in those consuming more than one alcoholic drink per day than in those consuming less alcohol, but drinking was not associated with other cell populations. ( Impaired WBC function has been recorded in alcoholic patients 5 ; however, data on WBC count in persons who regularly consume modest amounts of alcohol are few. Furthermore, recent evidence indicates that for nonsmokers (but not smokers), temperate drinking is associated with increased resistance to experimentally induced upper respiratory tract infections. 6 We studied the peripheral WBC count in 684 healthy volunteers and related it to the amount they smoked and drank. We confirmed earlier findings, and extend this work by providing data on how long smoking-associated elevation in cell count persists after persons stop smoking. We also provide data on the potential role of social drinking on WBC count, differential counts, and lymphocyte subsets. MATERIALS AND METHODS SubjectsTwo hundred eighty-three men and 401 women volunteered to take part in studies at the Common Cold Unit, Salisbury, England. They were screened by means of medical history, routine clinical examination, and laboratory tests as part of the regular admission procedures of the Unit.7 Pregnant women were excluded from the study. Mean age of the study subjects was 33 years (±10.4 SD). All studies were approved by the Harrow District Ethical Committee.

In retired seniors, a morning-type orientation and regularity in bedtimes and rise-times appear to be correlated with improved subjective sleep quality and with less time spent in bed.

The systematic study of dying is an important endeavor that deserves attention from sophisticated researchers in many disciplines. It would be especially useful to bring dying into the mainstream of stress research. Although much information is available regarding the demographic aspects of death, it is remarkable that there is so little generalizable empirical data about the process of dying and the experiences of dying persons. Most of the available data are either methodologically flawed, limited in scope, or based on small and non-representative samples. This article reviews the literature on terminal patients and the nature of their experiences during the time before their death. The discussion is divided into four parts. First, we examine the magnitude of the problem by identifying the number of individuals each year who must confront their own death. Second, we discuss the emotional responses of dying patients to their impending death. The third section deals with interventions for the dying patient, and the fourth identifies areas for future research.