ABC of one to seven. Services for children: primary care

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ABC of one to seven. Audit in primary care paediatrics

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Histological studies on the development of retinotectal projections from nasoventral quarter-eyes in Xenopus laevis

In Xenopus larvae, the size and location of the retinotectal projection of nasoventral quarter-eyes was analyzed in early stages (43–47), midlarval stages (50 and 53) and metamorphic stages (56 and 60), by labelling the optic nerve with the cobalt-lysine complex or with horseradish-peroxidase (HRP). For direct comparison, both fragment and normal eye projections were determined simultaneously in the same specimen in brain whole mounts. During early stages (up to stage 47), the projection fields of normal eyes and quarter-eyes are confined to the rostral part of the tectum. The extension of the projection in rostrocaudal direction of eye fragments does not differ from that of normal eyes. During later development up to metamorphosis, normal eyes expand their projection over the newly formed tectal surface in a caudal direction, whereas the fiber terminations of nasoventral quarter-eyes still remain in the rostral part of the tectum. Quantitative studies revealed that there is no difference in the size of both halves of the tectum. At least for quarter-eyes, however, a strict correlation between eye size and extension of the contralateral projection field could be established. According to our results, it is unlikely that during development local tectal markers are involved in determining the location of the projection field and the retinotopic ordering of the optic fibers. Instead we suggest that the optic fibers separate in accordance with their retinal specificity.

In defense of genuine ignorance: supporting vitality and relevance in graduate curricula

Genuine ignorance, defined by John Dewey as curiosity and openmindedness in opposition to repetition of catch phrases and familiar propositions, is nurtured in graduate nursing curricula in which the educational process is congruent with course content. Preparation for advanced practice in the mental health environment of the foreseeable future required abandonment of the familiar medical model in favor of conceptual models consistent with current thinking in psychiatric nursing and exposure to current problems (homelessness, family violence, AIDS) and current problem solving strategies (brief treatment, family preservation). Involvement in practice-based research and operationalizing new perspectives on familiar clinical problems, are suggested as strategies for developing the advanced practitioner. Two of the authors, former graduate students, describe the impact of changed perspectives and research activity on their own practice.

Practice activity analysis: collaboration between general practitioners and a family practitioner committee

The Brent and Harrow family practitioner committee has supported a scheme to enable general practitioners to collect data relating to their practice activity. This paper reports on the operation of the scheme involving 76 general practitioners from 22 practices and the findings. Practice nurse activity was also included. The family practitioner committee undertook an analysis of the data and provided each participating general practitioner with a print-out of his or her consultation rates over a range of activity, enabling general practitioners to make comparisons both with their partners and with the averages for all the practices participating in the scheme. The essential aim is to provide structured information which enables general practitioners to look more objectively at their activity. The family practitioner committee gave an assurance that the figures would not be used to criticize individuals.

ABC of 1 to 7 (revised). Services for children: primary care

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[Necrotizing circumscribed scleroderma after cupping therapy in arterial occlusion]

A 50-year-old man suffering from arterial occlusion developed deep ulcerations after cupping therapy of circumscribed scleroderma on his right thigh.

Mucormycotic infection in mice following prolonged incubation of spores in vivo and the role of spore agglutinating antibodies on spore germination

Following intranasal inoculation of mice, Rhizomucor pusillus spores are gradually cleared from the lung, with the clearance complete at 30 days. Incubation of R. pusillus spores in vivo for up to 14 days after intranasal inoculation resulted in pulmonary mucormycosis when the mice were then treated with cortisone. Spore-agglutinating IgM antibodies were detected in normal adult mice and R. pusillus-inoculated but not cortisone-treated mice. There was no correlation between antispore antibody titers and spore germination in vitro. The absence of germinated R. pusillus in inoculated but non-cortisone-treated mice appears to be due to a reversible inhibition of spore germination rather than destruction of spores by the host. The factor(s) that restrict spore germination are reversible and do not appear to be spore agglutinating antibodies.

ABC of 1 to 7: services for children: primary care

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