Ups and downs at unit level.

The status of the unit administrator is quite often fourth or fifth in line because under the present structure administrators cannot take important decisions without consultation with other colleagues in different disciplines says the Royal Commission. Author looks at the work of one unit administrator at Tooting Bec Hospital.

Bottom line on the top people--by Speakman.

The Speakman review, that long-awaited probe into top posts in the NHS, is about to burst upon an impatient world. Alison Hyde has been taking a look at its contents. Speakman proposes 24 steps in appraising top jobs.

Hospital life: a downgraded system?

Author takes a two-stage tour of the labyrinths of hospital regrading. Stage one this week shines a torch into some of the dark corners of a system that can keep a person waiting for a year or more on its decision to upgrade or not and, if he or she is lucky, another two or three months for the result of an appeal. The machinery creaks and a whole range of people are impatient with it.

The kindly kidnappers.

If to the average child in the street going into hospital is like being kidnapped, as a doctor recently put it, then to the child who lives in Birmingham 'operation baby snatch' may not be such a bad thing. For the children's hospital there strives to be more like a home from home.

Mecca and the unbelievers.

Wallingford Community Hospital was an experiment by the then Oxford Regional Hospital Board to make available to general practitioners the facilities and skills which a community hospital could provide. It included many additional responsibilities for the GP.

A special kind of patient care.

The community hospital is seen as a bridge between the district general hospital and primary care, but is not yet wholly accepted by GPs.

Industrial relations: does Whitley work or whitewash . .?

The incomprehensible web of committees and councils that constitute the General Whitley Council and the attitudes of both staff and management to the 1976 Lord McCarthy report on the Whitley Council are discussed.

[Uptake of tryptophan and tyrosine in some cases of manic depressive psychosis and schizophrenia (author's transl)].

The uptake of tryptophan and tyrosine by the brain has been studied in 6 manic-depressive patients and in 8 schizophrenics. In an attempt to saturate the blood-brain transport mechanisms, this uptake has been evaluated by measuring the arteriovenous differences (arterial plasma-internal jugular plasma) of these two amino acids before and after perfusion with L-dopa and L-5-HTP. Considering a positive difference as an uptake and a negative one as an outflow, results show (1) in melancholia an uptake of tryptophan and an outflow of tyrosine; (2) in mania an uptake of tyrosine and an outflow of tryptophan, and (3) in schizophrenia an outflow of tryptophan accompanied with either an uptake or an outflow of tyrosine.