Consultant Surgeons and Vasectomy

In late 1971 410 consultant general surgeons and urologists—74% of a national random sample—responded to a postal survey about vasectomy. Probably about 50,000 vasectomies were performed by surgeons in England and Wales in 1970. The service was largely a private one: 60% of consultants'' hospital vasectomies were not done under the National Health Service, and, in addition, 26% of the consultants who worked in relevant specialties performed vasectomies elsewhere than in hospital (usually in private nursing homes). Based again on consultants'' estimates, probably 6,000 men in 1970 had their requests for vasectomy turned down by surgeons, or more than one turned down for every 10 done. The most common reason was that patients were “too young.”About 90% of the consultants thought vasectomy could normally be performed safely and adequately as an outpatient procedure, yet only 64% said that 90% or more of their hospital vasectomies were done on this basis. While 69% regarded services in their areas as adequate, most were in favour of more special vasectomy clinics.     

Social structure influences extra-pair paternity in socially monogamous mammals

Using the genetic estimates of paternity available for 22 species of socially monogamous mammals, we investigated the impact of the social structure and of the type of pair bonding on the interspecific variations of extra-pair paternity rates. To this purpose, we classified species in three categories of social structure—solitary, pair or family-living species—and in two categories of pair bonding—intermittent or continuous. We show that interspecific variations of extra-pair paternity rates are better explained by the social structure than by the type of pair bonding. Species with intermittent and continuous pair bonding present similar rates of extra-pair paternity, while solitary and family-living species present higher extra-pair paternity rates than pair-living species. This can be explained by both higher male–male competition and higher female mate choice opportunities in solitary and family-living species than in pair-living species.     

Experience in a Maternal Mortality Study in Nova Scotia

Material from a three-year Maternal Mortality Study in the Province of Nova Scotia is presented. Thirty-eight maternal deaths were studied; the chief cause was hemorrhage—either antepartum or postpartum—in 52% of all cases. Seventy-six per cent of the cases were due to practically preventable factors. Inadequate prenatal care in which the family was at fault had existed in 35% of the cases studied. Physician error in judgment and/or technique was present in 65%. Efforts to correct this situation have been described briefly. The need for public education, increased numbers of consultants, continued physician education, critical hospital analysis and improved hospital facilities is stressed.     

Chronic Liver Disease: Differences in Autoimmune Serological Reactions between Australians and Asians

A total of 164 patients from Australia, Ceylon, India, Singapore, and Thailand were studied for the prevalence of autoantibodies associated with “idiopathic” chronic liver disease—namely, antinuclear antibody, smooth muscle antibody, and mitochondrial antibody. The prevalence of these autoantibodies was high among patients from Australia (55%), but was low among patients from Ceylon (14%), India (11%), Singapore (0%), and Thailand (8%). There are variations in types of hepatitis and cirrhosis between races, and this applies particularly to the type associated with autoimmune markers. This may be related to genetic differences that have evolved between peoples of European and Asian descent.     

Variations in Sulfhydryl Concentration During Microsporocyte Meiosis in the Anthers of Lilium and Trillium

Anthers of lily and trillium were followed with respect to variations in protein and soluble sulfhydryls during meiosis and mitosis of the sporogenous tissue. In lily, the meiotic and mitotic cycles are each preceded by a rise in soluble —SH; in trillium there is only one rise which precedes meiosis. During division there is a marked drop in soluble —SH and a rise in soluble disulfides. Protein —SH remains approximately constant until diakinesis or metaphase when it falls briefly.     

Roentgen Examination of Soft Tissues of the Pelvis

With meticulous preparation of the patient and with careful technique, the soft tissues of the pelvis are identifiable in most cases. Search should be made for the traces of abnormal pelvic structures on plain-film studies. Once the normal is recognized, any variations are easily identified. The fundamental differences between various radiologic densities—air, fat, fluid, muscle, calcium, bone and metal—should be observed. Special procedures can be used to enhance the contrasts after adequate evaluation of the simplest and, on many occasions, the invaluable, plain-film study of the soft tissues of the pelvis.     

What do hospital consultants value about their jobs? A discrete choice experiment

Objective To examine the strength of hospital consultants'' preferences for various aspects of their work.Design Questionnaire survey including a discrete choice experiment.Setting NHS Scotland.Participants 2923 hospital consultants in Scotland.Main outcome measures Monetary valuations or prices for each job characteristic, based on consultants'' willingness to pay and willingness to accept extra income for a change in each job characteristic, calculated from regression coefficients.Results The response rate was 61% (1793 resspondents). Being on call was the most important attribute, as consultants would need to be compensated up to £18 000 (30% of their average net income) (P < 0.001) for a high on-call workload. Compensation of up to £9700 (16% of their net income) (P < 0.001) would be required for consultants to forgo opportunities to undertake non-NHS work. Consultants would be willing to accept £7000 (12% of net income) (P < 0.001) in compensation for fair rather than good working relationships with staff, and £6500 (11% of net income) (P < 0.001) to compensate them for a shortage of staff. The least important characteristic was hours of work, with £562 per year (0.9% of their net income) (P < 0.001) required to induce consultants to work one extra hour per week. These preferences also varied among specific subgroups of consultants.Conclusions Important information on consultants'' strength of preferences for characteristics of their job should be used to help to address recruitment and retention problems. Consultants would require increased payment to cover more intensive on-call commitments. Other aspects of working conditions would require smaller increases.     

Characteristics of consultants who hold distinction awards in England and Wales: database analysis with particular reference to sex and ethnicity

Objective To determine whether women, ethnic minorities, and particular specialties are discriminated against in the receipt of NHS distinction awards.Design Analysis of database of consultants eligible for distinction awards.Setting England and Wales, 2002.Main outcome measures Holding of B, A, and Aplus distinction awards, analysed for all awards, irrespective of when made, and for awards made in the last five years studied.Results Women and doctors from ethnic minorities were substantially under-represented among award holders when no account was taken of potential confounding factors. Differences diminished after multivariate analysis, but some remained significant. For example, the adjusted odds ratio of women holding awards compared with men was 0.69 (95% confidence interval 0.59 to 0.82) for any award and 1.37 (0.86 to 2.20) for Aplus awards; the odds ratio for any award for non-white doctors trained abroad compared with white doctors trained in the United Kingdom was 0.45 (0.37 to 0.56). In the last five years studied the adjusted ratio of women to men was 0.94 (0.79 to 1.10) for B awards and 1.54 (0.85 to 2.83) for Aplus awards. The adjusted ratio for non-white British trained consultants was 0.86 (0.62 to 1.17) for B awards and 1.20 (0.37 to 3.87) for Aplus awards; for non-white consultants trained abroad it was 0.68 (0.54 to 0.85) for B awards and 0.69 (0.15 to 3.10) for Aplus awards; and for white consultants trained abroad it was 0.70 (0.54 to 0.91) for B awards and 0.90 (0.38 to 2.15) for Aplus awards.Conclusion Historical under-representation in award holding by women and doctors from ethnic minorities was partly explained by time spent as a consultant. Recent awards showed no under-representation of women and no appreciable under-representation of ethnic minorities overall. However, doctors who trained abroad—both white and non-white—remained under-represented for B awards.     

Recollection-Based Retrieval Is Influenced by Contextual Variation at Encoding but Not at Retrieval

In this article, we investigated the effects of variations at encoding and retrieval on recollection. We argue that recollection is more likely to be affected by the processing that information undergoes at encoding than at retrieval. To date, manipulations shown to affect recollection were typically carried out at encoding. Therefore, an open question is whether these same manipulations would also affect recollection when carried out at retrieval, or whether there is an inherent connection between their effects on recollection and the encoding stage. We therefore manipulated, at either encoding or retrieval, fluency of processing (Experiment 1)—typically found not to affect recollection—and the amount of attentional resources available for processing (Experiments 2 and 3)—typically reported to affect recollection. We found that regardless of the type of manipulation, recollection was affected more by manipulations carried out at encoding and was essentially unaffected when these manipulations were carried out at retrieval. These findings suggest an inherent dependency between recollection-based retrieval and the encoding stage. It seems that because recollection is a contextual-based retrieval process, it is determined by the processing information undergoes at encoding—at the time when context is bound with the items—but not at retrieval—when context is only recovered.     

Rational choice,neuroeconomy and mixed emotions

Experimental psychology has shown differences between predictions of theory of decision and human choices. Emotions like regret can partly explain these differences. Neuroimagery used in combination with behavioural economics (neuroeconomics) has been used in order to try to disentangle the different emotional and rational factors (regret, rejoicing, reward, costs, uncertainty, trade-off between positive and negative aspects of different options). Emotions then appear as much more complex and mixed affective states than usually assumed. Not only might we feel a positive affect in punishing unfair partners, but mixed emotions can, for example, combine transmutation of previous anxiety into relief and elation by comparison with another less exciting option (elating relief). At the level of complexity of these mixed emotions—which we formally represent by comparisons between ‘unexpected utilities’ and expected ones—the main biases that Kahnemann and Tversky have shown can be explained. In spite of the complexity of these mixed emotions, some of these hypotheses might be partially tested by brain imagery.     

Cell Lineages and the Logic of Proliferative Control

It is widely accepted that the growth and regeneration of tissues and organs is tightly controlled. Although experimental studies are beginning to reveal molecular mechanisms underlying such control, there is still very little known about the control strategies themselves. Here, we consider how secreted negative feedback factors (“chalones”) may be used to control the output of multistage cell lineages, as exemplified by the actions of GDF11 and activin in a self-renewing neural tissue, the mammalian olfactory epithelium (OE). We begin by specifying performance objectives—what, precisely, is being controlled, and to what degree—and go on to calculate how well different types of feedback configurations, feedback sensitivities, and tissue architectures achieve control. Ultimately, we show that many features of the OE—the number of feedback loops, the cellular processes targeted by feedback, even the location of progenitor cells within the tissue—fit with expectations for the best possible control. In so doing, we also show that certain distinctions that are commonly drawn among cells and molecules—such as whether a cell is a stem cell or transit-amplifying cell, or whether a molecule is a growth inhibitor or stimulator—may be the consequences of control, and not a reflection of intrinsic differences in cellular or molecular character.     

Maintenance Hemodialysis in Myeloma Kidney Disease

Maintenance hemodialysis and chemotherapeutic agents were used in the treatment of seven patients with end-stage myeloma kidney disease. Results indicate that with the use of such therapy life can be prolonged substantially. It appears that patients with myeloma—with or without serious extrarenal complications—are suitable candidates for maintenance hemodialysis and should not be denied the treatment even in the face of systemic neoplasm.     

Minimization of Childhood Maltreatment Is Common and Consequential: Results from a Large,Multinational Sample Using the Childhood Trauma Questionnaire

Childhood maltreatment has diverse, lifelong impact on morbidity and mortality. The Childhood Trauma Questionnaire (CTQ) is one of the most commonly used scales to assess and quantify these experiences and their impact. Curiously, despite very widespread use of the CTQ, scores on its Minimization-Denial (MD) subscale—originally designed to assess a positive response bias—are rarely reported. Hence, little is known about this measure. If response biases are either common or consequential, current practices of ignoring the MD scale deserve revision. Therewith, we designed a study to investigate 3 aspects of minimization, as defined by the CTQ’s MD scale: 1) its prevalence; 2) its latent structure; and finally 3) whether minimization moderates the CTQ’s discriminative validity in terms of distinguishing between psychiatric patients and community volunteers. Archival, item-level CTQ data from 24 multinational samples were combined for a total of 19,652 participants. Analyses indicated: 1) minimization is common; 2) minimization functions as a continuous construct; and 3) high MD scores attenuate the ability of the CTQ to distinguish between psychiatric patients and community volunteers. Overall, results suggest that a minimizing response bias—as detected by the MD subscale—has a small but significant moderating effect on the CTQ’s discriminative validity. Results also may suggest that some prior analyses of maltreatment rates or the effects of early maltreatment that have used the CTQ may have underestimated its incidence and impact. We caution researchers and clinicians about the widespread practice of using the CTQ without the MD or collecting MD data but failing to assess and control for its effects on outcomes or dependent variables.     

Locating the Elderly in a General Practice

A preliminary survey undertaken before compiling a geriatric register showed that about 90% of the information on the practice files for patients over 65 was accurate. It is emphasized that such a register—which should be as accurate and up-to-date as possible—is important for the successful organization of a preventive geriatric clinic, or to any project designed to “screen” a defined population.     

Fenoprofen in Treatment of Osteoarthrosis of Hip and Knee

Two studies on 41 patients with osteoarthrosis of the hip or knee have shown fenoprofen—a compound with analgesic and anti-inflammatory properties—to be an effective addition to the drug treatment of these conditions. It was found to be superior to paracetamol but no statistically significant difference was shown in a comparison with phenylbutazone.     

Natural selection and the genetics of adaptation in threespine stickleback

Growing knowledge of the molecular basis of adaptation in wild populations is expanding the study of natural selection. We summarize ongoing efforts to infer three aspects of natural selection—mechanism, form and history—from the genetics of adaptive evolution in threespine stickleback that colonized freshwater after the last ice age. We tested a mechanism of selection for reduced bony armour in freshwater by tracking genotype and allele frequency changes at an underlying major locus (Ectodysplasin) in transplanted stickleback populations. We inferred disruptive selection on genotypes at the same locus in a population polymorphic for bony armour. Finally, we compared the distribution of phenotypic effect sizes of genes underlying changes in body shape with that predicted by models of adaptive peak shifts following colonization of freshwater. Studies of the effects of selection on genes complement efforts to identify the molecular basis of adaptive differences, and improve our understanding of phenotypic evolution.     

The Trade-Off between Spatial and Temporal Variabilities in Reciprocal Upper-Limb Aiming Movements of Different Durations

The spatial and temporal aspects of movement variability have typically been studied separately. As a result the relationship between spatial and temporal variabilities remains largely unknown. In two experiments we examined the evolution and covariation of spatial and temporal variabilities over variations in the duration of reciprocal aiming movements. Experiments differed in settings: In Experiment 1 participants moved unperturbed whereas in Experiment 2 they were confronted with an elastic force field. Different movement durations—for a constant inter-target distance—were either evoked by imposing spatial accuracy constraints while requiring participants to move as fast as possible, or prescribed by means of an auditory metronome while requiring participants to maximize spatial accuracy. Analyses focused on absolute and relative variabilities, respectively captured by the standard deviation (SD) and the coefficient of variation (CV = SD/mean). Spatial variability (both SDspace and CVspace) decreased with movement duration, while temporal variability (both SDtime and CVtime) increased with movement duration. We found strong negative correlations between spatial and temporal variabilities over variations in movement duration, whether the variability examined was absolute or relative. These findings observed at the level of the full movement contrasted with the findings observed at the level of the separate acceleration and deceleration phases of movement. During the separate acceleration and deceleration phases both spatial and temporal variabilities (SD and CV) were found to increase with their respective durations, leading to positive correlations between them. Moreover, variability was generally larger at the level of the constituent movement phases than at the level of the full movement. The general pattern of results was robust, as it emerged in both tasks in each of the two experiments. We conclude that feedback mechanisms operating to maximize task performance are subjected to a form of competition between spatial and temporal variabilities.     

Information use and resource competition: an integrative framework

Organisms may reduce uncertainty regarding how best to exploit their environment by collecting information about resource distribution. We develop a model to demonstrate how competition can facilitate or constrain an individual''s ability to use information when acquiring resources. As resource distribution underpins both selection on information use and the strength and nature of competition between individuals, we demonstrate interdependencies between the two that should be common in nature. Individuals in our model can search for resources either personally or by using social information. We explore selection on social information use across a comprehensive range of ecological conditions, generalizing the producer–scrounger framework to a wide diversity of taxa and resources. We show that resource ecology—defined by scarcity, depletion rate and monopolizability—determines patterns of individual differences in social information use. These differences suggest coevolutionary processes linking dominance systems and social information use, with implications for the evolutionary demography of populations.     

Characterizing the Evolutionary Path(s) to Early Homo

Numerous studies suggest that the transition from Australopithecus to Homo was characterized by evolutionary innovation, resulting in the emergence and coexistence of a diversity of forms. However, the evolutionary processes necessary to drive such a transition have not been examined. Here, we apply statistical tests developed from quantitative evolutionary theory to assess whether morphological differences among late australopith and early Homo species in Africa have been shaped by natural selection. Where selection is demonstrated, we identify aspects of morphology that were most likely under selective pressure, and determine the nature (type, rate) of that selection. Results demonstrate that selection must be invoked to explain an Au. africanus—Au. sediba—Homo transition, while transitions from late australopiths to various early Homo species that exclude Au. sediba can be achieved through drift alone. Rate tests indicate that selection is largely directional, acting to rapidly differentiate these taxa. Reconstructions of patterns of directional selection needed to drive the Au. africanus—Au. sediba—Homo transition suggest that selection would have affected all regions of the skull. These results may indicate that an evolutionary path to Homo without Au. sediba is the simpler path and/or provide evidence that this pathway involved more reliance on cultural adaptations to cope with environmental change.     

Food or just a free ride? A meta-analysis reveals the global diversity of the Plastisphere

It is now indisputable that plastics are ubiquitous and problematic in ecosystems globally. Many suggestions have been made about the role that biofilms colonizing plastics in the environment—termed the “Plastisphere”—may play in the transportation and ecological impact of these plastics. By collecting and re-analyzing all raw 16S rRNA gene sequencing and metadata from 2,229 samples within 35 studies, we have performed the first meta-analysis of the Plastisphere in marine, freshwater, other aquatic (e.g., brackish or aquaculture) and terrestrial environments. We show that random forest models can be trained to differentiate between groupings of environmental factors as well as aspects of study design, but—crucially—also between plastics when compared with control biofilms and between different plastic types and community successional stages. Our meta-analysis confirms that potentially biodegrading Plastisphere members, the hydrocarbonoclastic Oceanospirillales and Alteromonadales are consistently more abundant in plastic than control biofilm samples across multiple studies and environments. This indicates the predilection of these organisms for plastics and confirms the urgent need for their ability to biodegrade plastics to be comprehensively tested. We also identified key knowledge gaps that should be addressed by future studies.Subject terms: Microbial ecology, Soil microbiology, Water microbiology, Microbial ecology, Microbiome