The role of temperature and larval crowding in morph determination in a tropical beetle, Callosobruchus subinnotatus.

Many insect species can produce individuals of more than one form or morph. Different morphs of the same species may differ in their physiology, morphology and in behaviour. Understanding the factors and mechanisms involved in determining the production of different morphs of insect species is of major importance in understanding the evolution of specific life-history strategies. In this paper, we studied the importance of temperature as an environmental factor involved in morph determination of the tropical beetle, Callosobruchus subinnotatus. Adults occur as relatively sedentary, highly fecund, 'normal' morphs or as an 'active' morph adapted to dispersal. Larval crowding, seed density and external temperature were independently manipulated in a series of controlled experiments and the proportions of 'active' and 'normal' adult morphs among the emergent adult populations were quantified and compared. Development in crowded conditions was found to be associated with the production of a significantly higher proportion of 'active' adults than development in isolation, and was also responsible for a predictable rise in the localised temperature of infested heaps of seeds of between 4 and 8 degrees C above ambient (27 degrees C). This rise in temperature is subsequently shown to be directly and quantitatively associated with the proportion of 'active' adults among emerging adults, both in the presence of larval crowding and independently from it. Thus, it is suggested that in the crowded environment representative of an infested seed store, it is rising temperature, occurring at a specific point in insect development which is the proximate cue for 'active' morph induction in C. subinnotatus. The results are compared to the strategies used by other polymorphic insects to survive in heterogeneous environments.

A detailed study of loss of heterozygosity on chromosome 17 in tumours from Li-Fraumeni patients carrying a mutation to the TP53 gene.

We have studied a total of 36 tumours from 28 patients with germline mutations to the TP53 gene for loss of heterozygosity at TP53 using techniques of both direct sequencing and restriction fragment length polymorphism analysis. All patients were from families conforming to the definition of classical Li-Fraumeni syndrome (LFS) or were Li-Fraumeni-like (LFL). The data we have obtained show that loss of the wild-type TP53 gene is observed in under half (44%) of all tumours, and that the pattern of LOH at TP53 may be mutation specific. LOH has been observed in premalignant as well as invasive tumours. Two tumours (6%) show loss of the mutant allele and retention of the wild-type. To confirm that TP53 is indeed the target for LOH events on chromosome 17, we have used additional microsatellite repeats to examine patterns of allelic imbalance along the length of chromosome 17. Data from this analysis indicate that TP53 is the target of loss, but reveal some other interesting patterns of allelic imbalance at other loci on chromosome 17.

Sexual dimorphism of the pelvic girdle from 3D images of a living Spanish sample from Castilla-La Mancha.

The aim of our study is to provide data regarding the morphology of the pelvic girdle from a living Spanish sample. The material used comprises radiographic images (CT scans) from 74 adult individuals (39 ♂ and 35 ♀) in DICOM format. The variables recorded were the bi-iliac width and the antero-posterior and transverse diameters of the three anatomical planes of the birth canal, with the exception of the transverse diameter of the outlet. Indices of the inlet and mid-plane were also calculated. Statistical analysis of the data (Student's t-test and principal component analysis) revealed that the variables which display sexual differences are the transverse diameter of the inlet, the antero-posterior and transverse diameters of the mid-plane and the mid-plane index. In particular, Spanish women have significantly higher values in the transverse diameter of the inlet and the antero-posterior and transverse diameter of the mid-plane than men; and Spanish men have significantly higher values in the mid-plane index than women. The results of this study are in accordance with those obtained in previous studies based on dry bone, which suggest considerable populational variability in pelvic and birth canal geometry. This kind of CT-based study of living populations may significantly enhance our understanding of population variation of pelvic morphology. This information can be useful to better understand the birth mechanism in Homo sapiens and the appearance of rotative birth in the Homo lineage through comparison with the other primates, living or fossil.

An inhibition enzyme immunoassay for myelin basic protein.

An improved Enzyme Immunoassay for Myelin Basic Protein is described. Myelin Basic Protein covalently attached to glass balls, and Myelin Basic Protein in samples compete with each other for binding of a peroxidase conjugated anti Myelin Basic Protein antibody. The peroxidase activity on the balls is then inversely proportional to the amount of Myelin Basic Protein in the sample. A detection limit of 0.6 ng/ml is demonstrated for diluent or spinal fluid. For plasma a dilution step increases this to 1.8 ng/ml. Both the coated balls and the peroxidase conjugate are stable for long periods. The assay requires no expensive equipment. Although the assay appears to be valid for subcellular fractions spinal fluid and plasma, successful detection of Myelin Basic Protection peptides in clinical samples may require careful selection of suitable antisera. The assay would be very suitable for eventual use with an appropriate monoclonal antibody.

Management of the abnormal Papanicolaou smear.

Screening for cervical neoplasia has been effective in decreasing invasive cervical cancer. As the understanding of the association of HPV with cervical neoplasia increases, new screening interventions may be developed. Classification of cytologic abnormalities and the management of abnormal smears continue to evolve. Ancillary screening techniques such as HPV typing and cervicography may be useful but need further study.

Abdominal injuries associated with the use of seatbelts.

The mandatory use of seatbelts has become commonplace in Canada, and such legislation was adopted by the province of British Columbia in 1977. This has provided us with an opportunity to study the effects of seatbelt restraints on accident victims, particularly concerning abdominal injuries. Five hundred sixty-two patient charts were reviewed during a 3-year period. Documented use of seatbelts was found in 126 cases. Thirty-six of these patients underwent laparotomy and form the basis of this study. Compared with previously reported figures for blunt abdominal trauma, there was a high incidence of gastrointestinal injuries (67 percent). In addition, associated lumbar spine injuries were found in a large proportion of patients (19 percent, p less than 0.005). We found an increased risk of spinal injury in patients wearing a lap versus a three-point belt.

The application of strong cation exchange high-performance liquid chromatography to drug analysis.

The application of strong cation exchange (SCX) HPLC to the analysis of drugs in plasma, tissue and rodent feed is presented. This approach is shown to give useful separations allowing the separation of physiochemically diverse compounds in a simple isocratic system. The SCX columns are not as robust as standard reversed-phase materials and to ensure maximum column lifetimes the use of a guard column is recommended.

Government funding of the UK National Health Service: what does the historical record reveal?

OBJECTIVES: To examine the historic funding record of the UK National Health Service (NHS) by year (1948-1997), political administration and political party. METHODS: Construction of a deflated expenditure series between 1948 and 1997 from published sources of cash spending for each UK country and by four main NHS budget heads using extrapolated NHS-specific inflation measures for each budget head. Analysis of the resultant real funding record for the UK NHS by year, political administration, political party and pre-general election years. RESULTS: A historical funding record constructed from a number of official sources appears to show noticeable differences in volume levels of government spending on the NHS in the UK between political administrations and between political parties. All administrations (apart from the 1951-1955 Churchill/Eden government) have increased funds to the NHS over and above the level of NHS-specific inflation during their periods of office. Labour administrations have increased average annual real percentage funding by around 3.75% compared with an average increase of 2.33% for Conservative administrations. It does not appear that incumbent governments spend more than the long-run trend in pre-election (or, indeed, election) years. The economic difficulties of the mid 1970s (primarily the oil price shocks) appear to have realigned NHS spending at a lower level compared with spending rates in the 1950s, 1960s and early 1970s. Between 1950 and 1997, NHS cash spending as a percentage of gross domestic product increased by around 0.06% per year, with decreases in this proportion in 25 out of the 48 years examined. A comparatively crude analysis of changes in productive efficiency in the hospital and community health services sector between 1951 and 1991 suggests that there is no significant relationship between financial inputs (adjusted for NHS-specific inflation) and outputs (discharges and deaths). One explanation is that the NHS copes (at unknown cost) in times of financial stringency, but, conversely, does not systematically respond (at least, not in terms of increased output) in times of financial plenty. In policy terms, a very tentative interpretation of these findings would be that improvements in productivity can be brought about by restricting financial inputs and at the same time applying managerial pressure to the NHS to at least maintain (or improve) output levels (through, for example, improvements in medical practice). CONCLUSIONS: As a guide to voting, this analysis may confirm some prejudices. However, judging the performance of political administrations in relation to the NHS is rather more complex than a macro analysis of financial inputs alone suggests. The apparently weak relationship between inputs and outputs and the possible ability of governments to increase productivity by restricting inputs (and hence partially to deflect criticism of their funding policy) perhaps confirms other prejudices about the productive slack of large organisations. Again, however, care should be taken in the interpretation of the macro analysis, since the potential costs (e.g. reduced quality) arising from parsimonious funding are not captured by the global output measure used in this analysis.

Health system goals: life, death and ... football.

OBJECTIVES: Both the World Health Organization (WHO) and the Fédération Internationale de Football Association (FIFA) have developed sophisticated ways of defining and aggregating performance to produce overall, single-number indices. These are used to illustrate some of the problems of measuring, comparing and improving health system performance. METHODS: Possible associations between FIFA football rankings for international 'A' sides for 176 countries and rankings on the WHO overall health system performance index were explored using econometric techniques. RESULTS: There is a significant relationship between a country's FIFA ranking and its ranking by the WHO. Taken at face value, the statistical analysis suggests that, if the national football team does well, the WHO score improves. CONCLUSIONS: The relationship between FIFA and WHO ranks is entirely spurious. However, comparison of the two indices illustrates problems with the WHO exercise, including measurement difficulties, how policy-makers may use the information to improve health system performance, what the public are to make of the data and how different dimensions of overall performance may be subject to trade-offs.

Variation in responses to susceptible and resistant cowpeas among West African populations of Callosobruchus maculatus (Coleoptera: Bruchidae).

The cowpea seed beetle, sometimes also known as the cowpea weevil, Callosobruchus maculatus (F.), is a major pest of stored cowpeas (Vigna unguiculata Walpers) in West Africa. Control methods have included development of 'resistant' varieties as an environmentally benign alternative to insecticides, but there is concern over their effectiveness because of population variation among the insects and the possibility of adaptation overcoming seed resistance. Populations of C. maculatus from Nigeria, Ghana, Benin, and Niger, were used to examine variation in response to resistant and susceptible cowpea varieties at two geographical scales. Among seven Nigerian populations, there were significant differences in development times, the pattern of adult emergence, adult weights, and female fecundity when reared under identical conditions. Development in the resistant variety was retarded, produced higher mortality and lower adult weights. Significant interactions between variety and population were evident in terms of their effects on adult weight and development time; development times in the resistant variety were longer and emergences occurred over a longer period in some populations than in others. Population responses to resistant seeds were therefore unpredictable, but there was no evidence to suggest adaptation to overcome seed resistance within three generations. On a larger geographical scale, variation in performance was much greater and therefore, even less predictable. Mortality in resistant seeds was also higher among populations collected from outside Nigeria and may be explained by significant adaptation among Nigerian populations to previous release of resistant varieties. The findings are discussed in relation to understanding the extent of intraspecific variation in C. maculatus and its implications for future pest management.

Cross sectional study of reporting of epileptic seizures to general practitioners.

OBJECTIVE: Comparison of reporting of recent epileptic seizures by patients to a doctor and anonymously. DESIGN: Cross sectional study of patients with epilepsy by comparison of paired questionnaires. SETTING: Rural and urban general practices in Norfolk. PARTICIPANTS: 122 patients aged over 16 years and able to self complete a questionnaire who were recruited by 31 general practitioners when attending for review of their epilepsy. MAIN OUTCOME MEASURE: The difference in reported occurrence of seizure to general practitioners and in a linked anonymous questionnaire. RESULTS: 18 patients failed to report a seizure in the past year to their general practitioner (uncontrolled epilepsy). 40% (24/60) of people with epilepsy who anonymously reported a seizure in the past year held a driving licence, but only six revealed this to their general practitioner. The unemployment rate was 34%, substantially higher than the 9% in the general population. Measures of anxiety, depression, and stigmatization were higher in patients with uncontrolled epilepsy. CONCLUSIONS: A significant proportion of patients with epilepsy under-report their seizures. Recognition of underreporting is important if patients are to benefit from adequate and appropriate treatment. General practitioners' ability to treat epilepsy is hampered by their role in regulating the rights of epileptic patients to hold a driving licence or access certain occupations.

Management costs. Cut and run.

Government claims that the NHS will have saved 1 bn Pounds on management costs by the end of this financial year are exaggerated. Published figures on savings since 1997-98 vary considerably. The question of what level of management costs the NHS should be expected to bear to run efficiently needs to be addressed.

Health promotion. Feelgood factors.

Half the targets in The Health of the Nation have already been, or are set to be, achieved by the specified date. Deaths from strokes, smoking, fat consumption, and accidents among elderly people are all falling-but not fast enough to meet targets. Obesity, drinking, skin cancer and smoking among 11 to 15-year-olds are all increasing.

Health and efficiency.

Measuring efficiency is essential but purchasers and providers should treat the perverse incentives of the efficiency index with caution, warn John Appleby and Val Little.

Measuring performance. Green with envy?

The traffic-light system proposed in the NHS plan attempts to measure performance in absolute and relative terms. Using methodology likely to be employed by the Department of Health, it has been possible to draw up a league table of health authorities. The table appears to show a North-South divide. There is an argument for adjusting rankings to reflect the relative difficulties HAs face.

NHS activity. Short measure.

Despite a large increase in NHS funding, the rate of activity has slowed and may be decreasing. Elective activity has fallen at times when more money is going in. Growth in elective activity has tended to be in planned admissions, which have no direct impact on waiting lists. Unless money is redirected into activity-generating areas that impact on waiting times, the NHS will struggle to deliver on waiting-time targets.

Health spending. Extra time.

The government is committed to raise spending on healthcare in the UK up to the European average by 2006. There is debate about the exact target figure, but agreement that the key consideration is how the extra money will be spent. If the UK is to achieve the EU average, it will probably have to increase private as well as public spending. To match German levels of staffing, the UK would need an extra 100,000 doctors and 300,000 nurses. There has been little analysis of how the extra expenditure will improve outcomes.

Freedom of information. Quietly does it.

The forthcoming legislation on freedom of information is likely to be far less radical than originally envisaged. Decisions over what information to release will rest with civil servants. The legislation is likely to require primary care groups to respond to requests for information about allocation of resources between services. Access to the workings of government and the evidence underlying policy decisions would enable people to become active citizens. It would also stimulate sympathy for managers' and clinicians' rationing dilemmas. Current restrictions are at odds with government policy to modernize the NHS.

Run for your money.

The DoH's efficiency index is criticised for being crude, biased and inaccurate. John Appleby, Trevor Sheldon and Aileen Clarke discuss NAHAT's consultation and suggest some improvements.