Aims and MethodsTo evaluate a new integrated weight management and fitness service for long-stay psychiatric patients who were obese or overweight with physical health risks. Body size and fitness were measured before and after each 10- to 12-week programme.ResultsThe number of patients referred to the programme was 145; 102 were accepted, 95 started a programme and 46 completed it. Analysis was by intention-to-treat. There were significant reductions in weight (P=0.001), body mass index (BMI, P=0.001) and waist size (P=0.001), and considerable improvements in hand strength (left hand, P=0.03; right hand, P=0.015), flexibility (P=0.022), lung function (P=0.001) and aerobic capacity (P=0.001).Clinical ImplicationsAn integrated programme of weight management and fitness is effective in reducing body weight and waist size, and in improving physical fitness in long-stay psychiatric patients. The long-term effect on patient's health and fitness needs to be monitored and strategies are needed to reduce patient withdrawal.

Peer relationships of early adolescents have been examined from a number of pcnpcctives, but no cohaent picturc has yet emerged. This study presents data obtained From 328 first-year students from four high schools in three different socioeconomic areas. The use of a week-long diary record to gather information to supplement the mre triaditional self-report q u c s t i o d n s provided valuable additional data. The major findings w m that s c m from the three self-report questionaairtJ clustered on a single factor. with the diary data loading on thne other factors, labelled Scale, Scope. and Enjoyment with respect to social intcractions. Canonical correlation analysis revealed two dimensions of pecr interaction associated with mcasurcs of self-concept Although the overlap between pecr interactions and selfconcept was modnately high, the amount of variance explained in either direction was moderately low. Boys and girls who scored high on mea~urts of self-concept had low external locus of control scorcs as predicted, although a similar relationship between self-concept and Jociai avoidance was weaker for boys. The predicted relationship between duration of pea contacts and self-concept did not occur. although girls reported stronger. moderate relationships between ratings of enjoyment of interactions & T. Gullona (Eds.). From childhood to adolescence: A trunsition period? (pp. 205-23 1). California: Sage. Hirsch, B.J., & Rapkin, B.D. (1987). The transition to junior high school: A longitudinal study of self esteem, psychological symptomatology. school life and social support. Child Development, 58, 135-1243, Jensen, L.. Olsen. J., & Hughes, C. 71990). Association of country. sex. social class, and life cycle to locus of control in western European counaies. Psychological Reportr. 67. 199-205. Jocsting. J.. & Joesting. R. (1975). Sex differences. egalitarianism. and anxiety in ninth-grade studenu. AdoIescence. 37.59-61. KeltiKangas-Jarvinen. L. (1980). The stability of self-concept during adolesc c n a and early adulthood: A six year follow up study.

potential long-term targets for exploration. Given the declining success rate of global exploration and the increased discovery depth in recent decades there is a requirement for new techniques to detect deposits under cover. These need to be complemented by improved laboratory techniques for the accurate determination of the critical metal abundance and distribution in rocks, ores and waste streams.Given increased future demand it is likely that the minerals industry will turn its attention to more extreme and technically challenging environments. For example, the resource potential of seafloor deposits is largely untested. Fe-Mn crusts and nodules and massive sulphides are known to be enriched in several critical metals which need to be systematically assessed to determine their viability and sustainability relative to land-based deposits.The requirement for major programmes of research to better understand the life cycles of critical metals and to assure their availability is well established. The role of the geoscientist is vital because without geology there can be no exploration and associated expansion of the resource base to supply future generations.

Sixty-five families were enlisted in a study exploring factors associated with distress behavior in 5-year-old children receiving diphtheria-tetanus-pertussis immunizations. At a home visit 1 month before the immunization, the following measures were obtained: (1) the Behavioral Style Questionnaire, a measure of temperament; (2) parental self-reports of medically related attributes (eg, "good patient"); (3) parental attitudes toward pain in children and responsiveness to their child's pain; and (4) parental prediction of distress at upcoming immunization. The child's distress behavior during the immunization was evaluated using a modification of the Procedure Rating Scale-Revised and, after the procedure, the child's assessment of his or her pain was elicited using the Oucher. Children's mean Procedure Rating Scale-Revised score was 2.57 of a possible 11. Thirty-one (48%) had low (≤1) and 7 (11%) had high distress scores (≥2 SD above the mean). Factors positively correlated with distressed behavior included more "difficult child" cluster characteristics, the individual temperamental dimension of adaptability, but few parental attitudes and attributes. Parents' predictions of distress were the strongest correlates. These findings document the variation that children demonstrate in response to pain and offer some insight into associated innate and environmental factors. These results imply that treatment strategies derived from parental knowledge and tailored to individual characteristics of the child may be most effective in alleviating pain-related distress in medical settings.