Out-of-hours visits in a group practice.

In one year 1644 out-of-hours calls were undertaken by a partnership of eight doctors working in a deprived inner urban area and a deprived large council housing estate; of these calls 332 were performed between the hours of 11 pm and 7 am. The number of calls required in the housing estate, 1077, was about twice as many as in the inner urban area, although the same doctors were using the same criteria for a visit. The rate of visits of 107 per 1000 patients in the housing estate was much higher than in other published series. The reasons for this difference appeared to be related to the comparative youth of parents and the number of young children.     

Relative costs of specialist services in a family practice population

The frequency and cost of referrals to specialists in March 1984 for 8980 rostered patients attending a family practice clinic located in a teaching hospital were analysed. The patients made 1891 visits to specialists. In all age groups and for all specialties female patients were more likely to be seen. The total direct provider costs were higher for female patients than for male patients. However, costs per patient seen were higher for male patients, except for psychiatry and medicine. Visits to surgeons had the highest total cost, while visits to psychiatrists had the highest cost per patient seen. Of the direct provider costs 61% was for specialist services. The family physician, in the “gatekeeper” role, has an opportunity to control some of the costs of the health care system by ensuring that the best and most efficient use is made of the referral network.     

Effect on prescribing of the limited list in a computerised group practice.

The prescribing of drugs in the therapeutic classes that are affected by the government''s limited list was investigated in a computerised group practice of just over 3,000 patients. Prescribable drugs in categories that are affected by the list were identified for two consecutive six month periods before and one six month period after the introduction of the list. A significant decrease in the prescribing of cough and cold remedies, vitamins, and antacids occurred after the list was introduced, whereas no change occurred in the prescribing of laxatives, benzodiazepines, or analgesics. The prescribing of iron and penicillin increased significantly after the list was introduced, whereas the use of H2 antagonists and non-steroidal anti-inflammatory drugs showed no significant change.     

Unacceptable face of private practice: prescription of controlled drugs to addicts.

Self administered questionnaires completed by 69 out of 100 consecutive drug addicts attending two drug dependence clinics suggested that some private general practitioners were easily persuaded to prescribe controlled drugs. These drugs were usually methadone, dipipanone-cyclizine (Diconal), and methylphenidate (Ritalin). Numbers of new narcotic addicts notified to the Home Office confirmed the practice, which may lead to a severe spread of addiction, as occurred in the 1960s with heroin and cocaine. If the General Medical Council or a tribunal set up in accordance with the Misuse of Drugs Act 1971 cannot stop the practice, then the present licensing system should be extended to include all controlled drugs.     

Characterization of transfer regions within the HII incompatibility group plasmid pHH1508a.

A circular map of the 208-kilobase IncHII plasmid pHH1508a was constructed by using the restriction endonucleases XbaI, XhoI, and NotI. Tn5 insertion mutagenesis showed that transfer genes were distributed widely over the plasmid map. Analysis of the deletion mutant pDT1178 indicated that genes required for conjugative pilus production are located in a 96.0-kilobase region of the plasmid.     

Behavioral and energetic costs of group membership in a coral reef fish

Animals in social aggregations often spend more time foraging than solitary conspecifics. This may be a product of the relative safety afforded by aggregations: group members can devote more time to foraging and less time to antipredator behaviors than solitary animals (the “risk reduction” effect). All else being equal, risk reduction should result in higher food intake for grouped animals. However, intragroup competition may force group members to spend more time foraging in order to obtain the same food ration as solitary individuals (the “resource competition” effect). We compared these opposing explanations of foraging time allocation in a coral reef fish, bluehead wrasse (Thalassoma bifasciatum). Aggregations of juvenile bluehead wrasse experience safety-in-numbers, and preliminary observations suggested that juveniles in aggregations spent more time foraging for copepods in the water column than solitary juveniles. However, the risk reduction and resource competition hypotheses are indistinguishable on the basis of behavioral observations alone. Therefore, we collected behavioral, dietary, and growth data (using otolith growth rings) for bluehead wrasse at multiple reefs around a Caribbean island. Despite spending more time foraging in the water column, grouped fish did not capture more prey items and had slower growth rates than solitary fish. Thus, the increased foraging time of grouped fish appears to reflect resource competition, not risk reduction. This competition may limit the size and frequency of aggregations among juvenile bluehead wrasse, which have been shown to experience reduced mortality rates in larger groups. Bluehead wrasse recruits also spent less time foraging but grew faster at sites where planktonic copepod prey were more abundant. This suggests the possibility that large-scale spatiotemporal variability in the abundance of planktonic copepods over coral reefs may produce corresponding variability in the dynamics of reef fish populations. Electronic supplementary material The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Social behaviors within a group of captive female Hippopotamus amphibius

Grouping is known to occur in many species of mammals, and the structure of groups can range along a continuum from basic aggregations to complex social systems. Any social patterns that may occur within the group must be determined in order to understand the adaptive nature of the group. Female Hippopotamus amphibius are known to aggregate in the wild, but their social behaviors are still not understood. Our objective was to determine if captive female hippos display social structure within an aggregation by examining their interactions, and if kinship, familiarity, and dominance influence these interactions. Behavioral data, using continuous focal animal sampling and scan sampling, were collected on a group of captive female hippos housed at Disney’s Animal Kingdom and were used to analyze their interactions, association patterns based on kinship and familiarity, and a dominance hierarchy. Our results support the hypothesis that hippos exhibit social patterns due to the attraction to particular individuals. There were more associations between kin than non-kin and also between individuals that were more familiar. Dominance patterns were also found among these hippos. These results may aid in the general understanding of hippopotamus behavior and provide a framework for future research.