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Clinical improvement is demonstrated in a group of 41 day patients of mixed diagnosis by changes in measures of depression, self-esteem, loquacity and sociability over a period of six weeks. Staff predictions of success, made after 2 weeks, correlated positively (Spearman's rho = 0.53) with an overall assessment of success after 6 weeks, which itself was positively correlated with improvements in scores on depression (rho = 0.58) and sociability (rho = 0.66 and 0.60). The patients for whom staff predicted least success were in 6 cases out of 7 men aged 20-51.

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Clinical and radiographic assessment of the spine was carried out in 75 patients with osteoarthrosis (OA) of the hip and in 75 controls without hip disease. Radiographic degenerative changes in the spine were more frequent in the patients with OA hips, occurring in both the dorsal and lumbar spine. Moderate or severe changes were found in the dorsal spine in 29 patients with OA hips (compared with 12 controls), and in the lumbar spine in 32 patients with OA hips (compared with 10 controls).

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Suicide mortality in the area now administered by the Greater London Council was assessed for three five-year periods 1949-1953, 1959-63, and 1969-73. For each of the periods the standard mortality ratio (SMR) for suicide in various boroughs was calculated for men and women separately. The boroughs with high SMRs for men were constant. There was a pronounced change in the geographical distribution of high mortality among women. These findings support the hypothesis that the determinants of suicide differ between the sexes.

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We have assessed the effect of house-cleaning procedures on changes in airborne dust and bacteria counts and correlated these with respiratory function tests in 14 children with bronchial asthma who were known to have developed attacks at home, and who had positive skin tests to house dust and the house-dust mite. We have demonstrated that after cleaning procedures a positive and statistically significant correlation exists between the increase in the numbers of small particles, 2 mum. and less in diameter, in the environment, and reduction in mean peak flow. This indicates that particles of this size penetrate the bronchial tree and are the causative factor in the genesis of bronchospasm.

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Gas concentrations and ventilation levels have been measured within a conventional Magill circuit when conscious volunteers breathed a non-narcotic gas mixture at varying fresh gas flows. When evidence of rebreathing of alveolar gas was detected, the fresh gas flow was kept constant until a steady state developed. All subjects showed evidence of rebreathing when the fresh gas flow approached the predicted alveolar ventilation levels. A variety of subject-circuit interactions was seen and shown to be precipitated by naturally occurring breath-to-breath variations in ventilation. A single large breath could perturb the system. This could have a temporary effect, when the fresh gas flow was sufficient to wash the increased aliquot of expired carbon dioxide from the circuit. At other times a progressive response occurred as ventilatory stimulation as a result of the increased inspired carbon dioxide concentrations caused alveolar gas to reach the reservoir bag and converted the system behaviour from that of a simple added deadspace to that of a total mixing device. Whilst marked changes occurred commonly in both ventilation and inspired gas concentrations, only slight changes in end-tidal gas concentrations occurred.

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An evaluation of the IMI oxygen analyser is described. The accuracy was found to be adequate for clinical purposes though it was considered that this could be improved if the meter was read with greater discrimination than the existing calibrations and if the zero could be adjusted.

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Simple methods are described for computing the variables derived from the Siggaard-Andersen nomogram, where the in vitro buffer line is either established by direct measurement or calculated from measurements of pH, Pco2 and haemoglobin. Calculations are performed using the equation of the pH-log Pco2 buffer line, the Henderson-Hasselbalch equation, and the polynomials: BE=-38.402+1.8970 (SB)-0.013342 (SB)-2 m-equiv/litre; SL=-69.046+17.377 (pH40)-1.1121 (pH40)-2; SH=-123.30+31.357 (pH40)-2.0143 (pH40)-2. Then haemoglobin=7.5 (1+(S-SL)/(SH-SL)) G/100 ml, where S is the slope of the buffer line. Results are sufficiently accurate for clinical purposes.

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Development of computer-assisted patient monitoring began at Westminster Hospital in early 1971. The system handles fluid balance measurements from data input to the system by keyboards, and automatically monitors cardiovascular measurements made by standard bedside monitors. Various graphical outputs are available on visual displays at the bedside to assist in the care of the patients, and as hard copy to replace the "traditional" nurses charts. The system was designed to assist the nurses in their daily tasks, and much of its initial success is believed to be due to the "user oriented" design philosophy.

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