Aspects of audit. 3: Audit in British general practice.

Compared with hospitals, general practice has many handicaps in developing medical audit. This is especially true with regard to defining objectives and outcomes of care. Many methods have been proposed to overcome these problems, and several audit studies that have been published are presented here. Further work should concentrate on evaluating the effectiveness of audit in bringing about change rather than on generating information.     

Involvement of a midbrain vocal nucleus in the production of both the acoustic and postural components of crowing behavior in Japanese quail

Many bird species produce vocalizations which are accompanied by distinctive postural displays, but the neural mechanisms that allow such integrated production of vocal and postural motor patterns are not understood. In the crowing behavior of Japanese quail, a characteristic vocal pattern is accompanied by and coordinated with a postural display that consists of a sequence of rapid, patterned head movements. The purpose of the present study was to investigate the role of a midbrain vocal nucleus, the nucleus intercollicularis, in the production of the acoustic and postural components of crowing in quail. Brief electrical stimuli were applied to the nucleus intercollicularis during spontaneously emitted crows in quail with chronically implanted electrodes, to determine if perturbing neural activity in the nucleus intercollicularis resulted in a disruption of ongoing crowing behavior. The most common effect of such stimuli was a concurrent, premature termination of both the acoustic and head movement components of the crow. These results imply that the nucleus intercollicularis plays a role in the production of both the acoustic and postural components of crowing in quail.     

Biological activity of Burkholderia (Pseudomonas) cepacia lipopolysaccharide

Abstract Burkholderia cepacia has emerged as an important multiresistant pathogen in cystic fibrosis (CF), associated in 20% of colonised patients with a rapid and fatal decline in lung function. Although knowledge of B. cepacia epidemiology has improved, the mechanisms involved in pathogenesis remain obscure. In this study, B. cepacia lipopolysaccharide (LPS) was assessed for endotoxic potential and the capacity to induce tumour necrosis factor (TNF). LPS preparations from clinical and environmental isolates of B. cepacia and from the closely related species Burkholderia gladioli exhibited a higher endotoxic activity and more pronounced cytokine response in vitro compared to preparations from the major CF pathogen Pseudomonas aeruginosa . This study may help to explain the vicious host immune response observed during pulmonary exacerbations in CF patients colonised by B. cepacia and lead to therapeutic advances in clinical management.     

The destruction of spores of Bacillus subtilis by the combined effects of hydrogen peroxide and ultraviolet light

Ultraviolet light irradiation of bacterial spores in the presence of hydrogen peroxide has been shown to produce synergistic kills when compared with ultraviolet light (u.v.) and hydrogen peroxide used sequentially. This use in combination has been patented for the commercial sterilization of packaging before filling with UHT-processed products. Previous results have shown that lamps producing u.v. light with a maximum output at about 254 nm were extremely effective. Results obtained using a Synchrotron radiation source to produce a narrow band of irradiation now shows that the greatest kill of spores of Bacillus subtilis in the presence of hydrogen peroxide is obtained with radiation at ˜270 nm. Such results suggest that the action of the u.v. light is not directly on the spore DNA but may be related to the production of free hydroxyl radicals from hydrogen peroxide.     

PRODUCTIVITY AND PRODUCTION EFFICIENCY OF AN UPPER SONORAN DESERT EPHEMERAL COMMUNITY

During years with good winter rainfall, ephemeral plants can contribute considerably to primary production in the upper Sonoran Desert. This study was designed to compare ephemeral community productivity and production efficiency within the different microhabitats created by trees, shrubs and open spaces in a Sonoran Desert ecosystem. Ephemerals were periodically harvested in the different habitats and dried for biomass and caloric determinations. The caloric data were compared to total solar input into the different microhabitats in order to determine production efficiencies of each stand. Productivity rates were also determined for the total community for the sample period, winters of 1972-74. Both productivity and production efficiency were highest under the shade of Cercidium. The highest production efficiency occurring in the shaded sites was 5.03% which approaches the theoretical maximum photosynthetic efficiency level. The production efficiency of the entire ephemeral community for the whole growing season was only 0.17% during an optimal year, demonstrating the influence of the environment in the interspaces on productivity and solar conversion in the desert.