Comprehensive clinical drug information service: first year's experience.

A comprehensive clinical drug information service, established in the Northern Region in May 1975, is manned by eight doctors--all clinical pharmacologists--and is available 24 hours a day. In the first year of operation 451 inquiries were received, 354 (78-5%) of which were "consultative." Though junior hospital doctors used the service most, almost half of the inquiries about adverse reactions to drugs came from consultants.     

The regional drug information service: a factor in health care?

Most regional health authorities throughout the United Kingdom have established drug information units to provide health service staff with a wide range of information about drugs and drug use. The units, which are staffed by drug information pharmacists, provide their service mainly by answering inquiries, although some disseminate information more positively through lectures and bulletins.An analysis of inquiries received by regional information units during 1976 showed that most were submitted by hospital doctors or pharmacists; comparatively few were received from general practitioners. Topics of inquiry included adverse effects of drugs, source of supply and identification, current treatment, dosage, route, precautions, and pharmaceutical problems such as stability or formulation of drug preparations. A more detailed analysis of the inquiries received by the North-western Regional Drug Information Service at Manchester over three years showed that the number of inquiries gradually increased and that more were received from general practitioners after a programme of lectures had been introduced to tell them about the service. The North-western service also received more requests from hospital pharmacists than other units, though many originated from clinicians.The regional drug information units consulted widely with clinical and other specialists in answering questions, but about a quarter of all inquiries were pharmaceutical, relating to stability and incompatibility. A multidisciplinary approach therefore seems necessary to provide a comprehensive and advisory drug information service.     

Analysis of pregnancy-related calls to an occupational hazard hot line.

Since 1980 the Hazard Evaluation System and Information Service has responded to over 11,000 inquiries regarding workplace health hazards. Of 2,424 inquiries in 1986, 593 (24%) concerned hazards to pregnancy. This represents a 17-fold increase since 1981. Most pregnancy-related inquiries were from employees (70%) and health care providers (23%). Referral sources for the employees calls were almost exclusively individual health care providers or institutions that provide health care or health counseling, or both. These data suggest that pregnant employees seek information on their own or from health care providers instead of from employers. Of the inquiries, 80% were for general pregnancy hazard information; 20% involved symptomatic pregnant employees. Most inquiries concerned employment in the services (58%) and manufacturing (26%) sectors. Organic solvents, pesticides, acrylic nail-grooming products, lead, and video display terminals were among the agents about which callers inquired most frequently.     

Inquiry into homicides by psychiatric patients: systematic audit should replace mandatory inquiries.

Inquiries into homicides committed by psychiatric patients are currently mandatory under Department of Health guidance. They are often broadly defined in their terms of reference and almost always address not only the cause of the incident but also professional skill, practice, and culpability. Concurrent pursuit of both purposes is unlikely to maximise "learning from experience." Also, since inquiries can set their own thresholds for culpability, doctors can potentially be judged to a higher standard than would be required by the General Medical Council or negligence law. Lack of strict legal process increases the inherent potential unfairness to doctors. Investigation of cause and culpability should be separated and inquiries restricted to the former. There should also be a standing secretariat for inquiries to set terms of reference and to collate and distribute findings of inquiries. Widespread mandatory systematic audit of professional practice and service efficiency concerning risk assessment and management should largely replace costly ad hoc mandatory inquiries after homicides.     

Deaths of two hospital inpatients poisoned by pilocarpine.

Two inpatients of one hospital ward died. Pilocarpine poisoning was suspected and subsequently confirmed by analysis of urine. The circumstantial evidence strongly suggested that the food given to the patients in the ward had been adulterated. Police inquiries failed to elicit any further information, and open verdicts were returned at the inquest. Precautions taken subsequently to prevent a similar event--sealing food containers and trolleys--entailed a capital cost of 43,000 pounds. In addition, food stores were kept locked and tighter control kept on drugs stored in ward pharmacies.     

RNA-triggered gene silencing.

Double-stranded RNA (dsRNA) has recently been shown to trigger sequence-specific gene silencing in a wide variety of organisms, including nematodes, plants, trypanosomes, fruit flies and planaria; meanwhile an as yet uncharacterized RNA trigger has been shown to induce DNA methylation in several different plant systems. In addition to providing a surprisingly effective set of tools to interfere selectively with gene function, these observations are spurring new inquiries to understand RNA-triggered genetic-control mechanisms and their biological roles.     

BACUP--the first two years: evaluation of a national cancer information service.

The cancer information service of the British Association of Cancer United Patients (BACUP) was launched in October 1985 as a national service to patients and their relatives, the public, and health professionals. Information is provided by telephone and letter by seven nurses trained in oncology. In the first two years over 30,000 inquiries were received: 23,527 (80%) were from women; 9445 (32%) were from cancer patients 11,574 (39%) from relatives of patients, and 2869 (10%) from health professionals. Inquiries came from all over the United Kingdom and from all sections of society but users were predominantly middle class, aged between 30 and 49, and living in south east England. Information about specific cancer sites, treatment, and how to cope was most commonly sought. Nearly a third of all inquiries were related to breast cancer. Though the service is used more by particular groups focusing on particular diseases, clearly there is a need for a cancer information service in the UK.     

Use of woody plants by locals in Mare aux Hippopotames Biosphere Reserve in western Burkina Faso

The central area of the Mare aux Hippopotames Biosphere Reserve is located in the western part of Burkina Faso. Local populations have a close relationship with the reserve, from which they get much of their needs in food products, medicine, energy, arts and crafts. The use of resources has consequences for the biodiversity, ecosystem and environment of the reserve. The discussions held during ethnobotanical inquiries have permitted us to establish the main uses of woody plants and to pick out the repercussions of this usage. From this it emerges that the reserve has an important floristic richness and a biodiversity unknown to both locals and authorities.     

Molecular signaling in feather morphogenesis

The development and regeneration of feathers have gained much attention recently because of progress in the following areas. First, pattern formation. The exquisite spatial arrangement provides a simple model for decoding the rules of morphogenesis. Second, stem cell biology. In every molting, a few stem cells have to rebuild the entire epithelial organ, providing much to learn on how to regenerate an organ physiologically. Third, evolution and development ('Evo-Devo'). The discovery of feathered dinosaur fossils in China prompted enthusiastic inquiries about the origin and evolution of feathers. Progress has been made in elucidating feather morphogenesis in five successive phases: macro-patterning, micro-patterning, intra-bud morphogenesis, follicle morphogenesis and regenerative cycling.     

Consanguinity, fertility of couples and mortality of children in the high Atlas population (commons of Anougal and Azgour, Marrakesh, Morroco)

This study analyses the relationship between consanguinity, fertility and child mortality in a rural population of two moroccan High-Atlas valleys. Among this very endogamous population, we have reconstituted, by inquiries, for each family, the totality of its reproductive life as well as the genealogic relationships that exist between the spouses on several generations. The analysis carried out on the group of families with women who are over 40 years old (438 families) has shown that the population was very strong related (28% of marriages are consanguineaous). A positive association between levels of fertility, infant mortality and consanguinity was observed.     

Human behavioral ecology: I

New fields of inquiry rarely spring fully grown from the forehead of a single genius, and in addition, it is often difficult to decide when a related set of inquiries has coalesced sufficiently to define a field. As measured by the solicitation and publication of review articles, human behavioral ecology has recently become a self-conscious field, for this is the third essay to review it^1,2 and a book-length survey will appear later this year.³ In this two-part article, I will try to give readers a sense of the field by outlining its theoretical and methodological principles and key issues and by summarizing representative studies and unresolved questions in three main topical areas: subsistence strategies (Part I) and reproductive strategies and social interactions (Part II).     

A survey of biomedical scientists and consultant pathologists involved in the cervical screening programme

The past decade has seen a transformation in the National Health Service Cervical Screening Programme (NHSCSP) largely driven by responses to various screening scandals. Independent inquiries into these laboratory failures have identified a number of contributing factors. The aim of this postal survey was to determine how widespread these factors are throughout screening laboratories in England. The results indicate that issues around recruitment and retention of staff, the training of pathologists and low morale appear to be widespread. However, the results do not indicate a widespread breakdown in working relationships between consultants and biomedical scientists, although there is room for improvement in their relationships with hospital management. Finally, there seem to be mixed messages about the commitment of consultants to the screening programme.     

Human Rights,Dual Loyalties,and Clinical Independence

Although Australia has comparatively few individuals seeking asylum, it has had a mandatory detention policy in place since 1992. This policy has been maintained by successive governments despite the overwhelmingly negative impact mandatory detention has on mental health. For mental health professionals working in this environment, a number of moral, ethical, and human rights issues are raised. These issues are discussed here, with a focus on dual loyalty conflicts and drawing on personal experience, the bioethics and human rights literature, and recent parliamentary inquiries. For those who continue to work in this environment, future directions are also discussed.     

The laboratory animal management system--an animal housing management data-processing system]

The Laboratory Animal Management System (LAMS) is a flexible, multi-purpose animal house management tool. It has a decentralized structure and was developed using UNIFACE and Oracle-database software. The multiuser LAMS system runs on a Micro-Vax computer and can be accessed from several workstations. LAMS has been designed to manage the following functions: animal study details; animal procurement; book keeping and follow-up; amendments; update of data; inquiries; statistics and numerous additional tasks. LAMS is a user-friendly interactive system which does not allow input of incorrect data and can be operated by staff with very little computer experience. The system fully complies with German legal requirements and is becoming an increasingly important tool for routine management of animal house facilities and animal experimentation.     

Over 50,000 Metagenomically Assembled Draft Genomes for the Human Oral Microbiome Reveal New Taxa

The oral cavity of each person is home to hundreds of bacterial species. While taxa for oral diseases have been studied using culture-based characterization as well as amplicon sequencing,metagenomic and genomic information remains scarce compared to the fecal microbiome. Here,using metagenomic shotgun data for 3346 oral metagenomic samples together with 808 published samples, we obtain 56,213 metagenome-assembled genomes(MAGs), and more than 64% of the3589 species-level genome bins(SGBs) contai...     

Brain–computer interfaces for dissecting cognitive processes underlying sensorimotor control

Sensorimotor control engages cognitive processes such as prediction, learning, and multisensory integration. Understanding the neural mechanisms underlying these cognitive processes with arm reaching is challenging because we currently record only a fraction of the relevant neurons, the arm has nonlinear dynamics, and multiple modalities of sensory feedback contribute to control. A brain–computer interface (BCI) is a well-defined sensorimotor loop with key simplifying advantages that address each of these challenges, while engaging similar cognitive processes. As a result, BCI is becoming recognized as a powerful tool for basic scientific studies of sensorimotor control. Here, we describe the benefits of BCI for basic scientific inquiries and review recent BCI studies that have uncovered new insights into the neural mechanisms underlying sensorimotor control.     

Human error on the flight deck

Despite terrorist bombs and structural failures, human error on the flight deck continues to account for the majority of aircraft accidents. The Royal Air Force (RAF) Institute of Aviation Medicine (IAM) has investigated the psychology of such error since the early 1970s, and to this end has used two principal techniques. The first has involved assisting in the official inquiries into both RAF and civil flying accidents, and the second has involved setting up a reporting system that permits any commercial pilot to report his own everyday errors, in complete confidence, to the RAF IAM. The latter system possesses the clear benefit of gathering error data untainted by considerations of culpability, and sometimes permits system rectification before the occurrence of accidents. This paper examines selected examples of errors associated with the design of equipment and with the social psychology of crews, and suggests that some consideration of the psychology of organizations may be necessary to ensure that the problems of human error are given the degree of consideration they require.     

Assembling chromatin: The long and winding road

It has been over 35years since the acceptance of the "chromatin subunit" hypothesis, and the recognition that nucleosomes are the fundamental repeating units of chromatin fibers. Major subjects of inquiry in the intervening years have included the steps involved in chromatin assembly, and the chaperones that escort histones to DNA. The following commentary offers an historical perspective on inquiries into the processes by which nucleosomes are assembled on replicating and nonreplicating chromatin. This article is part of a Special Issue entitled: Histone chaperones and Chromatin assembly.     

Results of the anthropologic studies of school children in Jena between 1880 and 1985

The present report is based on the results from anthropological examinations on schoolchildren, which have been carried out in Jena since 1880. The introduction to the paper gives a survey on the goals of these inquiries, followed by remarks on secular changes in selected measurements of the body (body height, body weight, chest circumference). Besides the extent of the changes in these features, the anticipation of the pubertal growth period and--by means of the relation of body height to chest circumference--a becoming slimmer of today's population of schoolchildren is documented. The comparison of the findings of 1975 and 1985 shows that, regarding the features mentioned, the acceleration in the Jena probands (although in part with reduced intensity) has lasted up to the present time.