Addressing long-term physical healthcare needs in a forensic mental health inpatient population using the UK primary care Quality and Outcomes Framework (QOF): an audit

Objectives This audit aims to evaluate the effectiveness of delivering an equivalent primary care service to a long-term forensic psychiatric inpatient population, using the UK primary care national Quality and Outcomes Framework (QOF).Method The audit compares the targets met by the general practitioner with special interest (GPwSI) service, using local and national QOF benchmarks (2005-2006), and determines the prevalence of chronic disease in a long-term inpatient forensic psychiatry population.Results The audit results show that the UK national QOF is a useful tool for assessment and evaluation of physical healthcare needs in a non-community based population. It shows an increased prevalence of all QOF-assessed long-term physical conditions when compared to the local East London population and national UK population, confirming previously reported elevated levels of physical healthcare need in psychiatric populations.Conclusions This audit shows that the UK General Practice QOF can be used as a standardised instrument for commissioning and monitoring the delivery of physical health services to in-patient psychiatric populations, and for the evaluation of the effectiveness of clinical interventions in long-term physical conditions. The audit also demonstrates the effectiveness of using a GPwSI in healthcare delivery in non-community based settings. We suggest that the findings may be generalisable to other long-term inpatient psychiatric and prison populations in order to further the objective of delivering an equivalent primary care service to all populations.The QOF is a set of national primary care audit standards and is freely available on the British Medical Association website or the UK Department of Health website. We suggest that primary care workers in health economies who have not yet developed their own national primary care standards can access and adapt these standards in order to improve the clinical standards of care given to the primary care populations that they serve.     

Vestiges of an ancestral host plant: preference and performance in the butterfly Polygonia faunus and its sister species P. c‐album

1. In the study of the evolution of insect–host plant interactions, important information is provided by host ranking correspondences among female preference, offspring preference, and offspring performance. Here, we contrast such patterns in two polyphagous sister species in the butterfly family Nymphalidae, the Nearctic Polygonia faunus, and the Palearctic P. c‐album. 2. These two species have similar host ranges, but according to the literature P. faunus does not use the ancestral host plant clade – the ‘urticalean rosids’. Comparisons of the species can thus test the effects of a change in insect–plant associations over a long time scale. Cage experiments confirmed that P. faunus females avoid laying eggs on Urtica dioica (the preferred host of P. c‐album), instead preferring Salix, Betula, and Ribes. 3. However, newly hatched larvae of both species readily accept and grow well on U. dioica, supporting the general theory that evolutionary changes in host range are initiated through shifts in female host preferences, whereas larvae are more conservative and also can retain the capacity to perform well on ancestral hosts over long time spans. 4. Similar rankings of host plants among female preference, offspring preference, and offspring performance were observed in P. c‐album but not in P. faunus. This is probably a result of vestiges of larval adaptations to the lost ancestral host taxon in the latter species. 5. Female and larval preferences seem to be largely free to evolve independently, and consequently larval preferences warrant more attention.     

Effects of potassium and gibberellic acid on stem growth of whole sunflower plants

Abstract The effects of gibberellic acid (GA₃) on whole sunflower (Helianthus annuus L.) plants grown at three potassium (K) levels (0.0, 0.5 and 5.0 mM) were studied. A tenfold increase in the length of the first internode was observed when plants grown without K were treated with GA₃. The uneven K distribution along the plant (higher K content in the higher internodes) was enhanced by GA₃ treatment. Gibberellic acid increased the content of reducing sugars, especially in K-deficient plants. An increase in the K level in the nutrient solution resulted in a decrease of the osmotic potential of stem segments. Osmotic potential differences within the elongating first internode were increased by GA₃ treatment.     

A taxonomic revision of the Hilara maura-group (Diptera: Empididae) in Europe

Abstract. The European species of the Hilara maura-group are revised. Three species are described as new to science, namely, H.nitidorella sp.n., H.discalis sp.n. (both temperate Central and Western Europe) and H.mauroides sp.n. (Caucasus, male only). A further five species, H.hybrida Collin, H.femorella Zetterstedt, H.sulcitarsis Strobl, H.tyrolensis Strobl and H.bartaki Straka are redescribed, and H.eumera Loew, 1873 becomes a new synonym of H.nitidula Zetterstedt, 1838. Seven lectotypes are designated. All IS European species are keyed, the main differential characters are illustrated, and additional data on biology and distribution are given. The Hilara maura-group is recognized as a monophyletic group within the genus, characterized by a set of apomorphous characters, and the hypothetical phylogenetic relationships of the species, classified into four natural complexes, are demonstrated.