Some aspects of the relationship between body weight and sexual behaviour with particular reference to massive obesity and anorexia nervosa

There is some evidence for the existence of a precise weight/fat threshold for puberty. Following puberty, body weight and shape take on important new psycho-social significances for both males and females. Adolescent females usually strive to reduce their 'fatness' even it is not excessive from a biological standpoint. Super-obesity and anorexia nervosa are two human disorders of weight and fatness, more common in women, and importantly related to disturbances of sexual behavior, metabolic, social and experiential. These latter aspects sometimes at least reflect the presence of several factors which have contributed to the development of the disorders. Anorexia nervosa in particular reflects the adaptive psychosocial needs of the person concerned. Attention to this aspect during treatment will often allow the patient to tolerate the major weight gain required for recovery, thereby at the same time providing a paradigm for aspects of the pubertal process which can then be studied. The results of some such investigations together with related studies of the super-obese are reported here.     

Attaching community psychiatric nurses to general practice

A scheme for attachment of psychiatric nurses from hospital to group practice in Oxford is described. One community psychiatric nurse can work satisfactorily with eight general practitioners covering a population of about 18,000. From analysis of a working year, it is concluded that this arrangement improves the care of patients in the community by providing psychiatric help at times when it was previously unavailable or unacceptable.The implications of such a scheme for the workings of the primary health care team and the hospital psychiatric service are considered, and a case is made for a further study involving a comparison between practices with and without the attachment of a community psychiatric nurse.     

Diagnosis and management of colovesical fistulas

Diagnosis and management may present difficult problems in patients with colovesical fistulas. Symptoms in the urinary tract are most common, and cystoscopy, and cystography are the most valuable diagnostic procedures. It may not always be possible to demonstrate the fistula by diagnostic tests, and a high index of suspicion should be maintained in patients with inflammatory or neoplastic disease of the rectosigmoid area or bladder with recurrent cystitis. Definitive treatment should include resection of the fistula and diseased segment of the intestine. Both one stage and multistage procedures have their place in the treatment of this condition. There are specific criteria for success for a one stage procedure.     

Upper extremity replantation: current concepts and patient selection

Dramatic advances in replantation and microsurgery have somewhat altered the criteria we use in selecting patients to be candidates for upper extremity replantation surgery. We suggest that contraindications for such replantation are: presence of associated life-threatening injuries; serious anesthetic risk; preexisting medical or psychiatric problems; previous injury or disease of the amputated part; warm ischemic time greater than 6-8 hours for extremities or greater than 10-12 hours for digits; and single-digit amputations (except thumb, for grasp). Replantation is feasible when: amputated part is properly preserved; injury type is sharp amputation, mild to moderate crush, or selected avulsion, and amputation is proximal to the DIP joint. Careful preservation of the amputated part, not in dry ice, is mandatory. On an individual basis, the decision to attempt replantation rests on the prediction that the patient may have better function with such surgery than with a prosthesis.     

Design approach to low-cost process control

The design of a control package for industrial use on small-scale processes is discussed. A modular system is described, made up of intelligent satellite and peripheral controllers plus various cards to provide communication with the industrial plant itself. The design is intended for operators who have little or no experience of computing. It is based on a language called paracode, an interpretive language structured to provide a number of control sequences which can run independently of each other or in parallel. Two applications of the design—a clean-in-place system and a beer-fermentation controller—are used as illustrations.     

Bilateral femoral neck fractures as a complication of myelography

This paper discusses two cases of bilateral subcapital fracture of the proximal femur as a complication of myelography with Conray 60. The literature is reviewed.     

Dynamic range improvements and measurements in radar systems

The extension of the dynamic range performance of existing radar systems is integral to the requirement for current sensors to see deeper into clutter, that is, to detect weak signals (e.g. small targets) in the presence of strong interference (e.g. urban clutter signals). The rationale behind this requirement is that this additional capability greatly enhances the utility of military and commercial systems. Two approaches to improving the dynamic range of modern radar and surveillance receivers are described: (1) linearisation of intermodulation distortion (IMD) using digital post-distortion algorithms and (2) linearisation of IMD using frequency retranslation mixer (FRM). The experimental results presented illustrate that the digital post-distortion and FRM approaches are effective in providing IMD improvements for the hardware and test scenarios measured. The improvements measured ranged from 15 to 35 dB for narrowband signals to 2-6 dB for frequency-modulated continuous wave (FMCW) wideband signals. The digital post-distortion approach provided the greatest performance improvement when the input signals were between the analogue-to-digital converter full range and 20 dB below that level. The improvements measured for the FRM linearisation approach ranged from 20 to 25 dB for the narrowband two-tone tests and 16-18 dB for the wideband FMCW signal chirps.