Background: Psychological therapy services are often required to demonstrate their effectiveness and are implementing systematic monitoring of patient progress. A system for measuring patient progress might usefully ‘inform supervision’ and help patients who are not progressing in therapy. Aims: To examine if continuous monitoring of patient progress through the supervision process was more effective in improving patient outcomes compared with giving feedback to therapists alone in routine NHS psychological therapy. Method: Using a stepped wedge randomized controlled design, continuous feedback on patient progress during therapy was given either to the therapist and supervisor to be discussed in clinical supervison (MeMOS condition) or only given to the therapist (S-Sup condition). If a patient failed to progress in the MeMOS condition, an alert was triggered and sent to both the therapist and supervisor. Outcome measures were completed at beginning of therapy, end of therapy and at 6-month follow-up and session-by-session ratings. Results: No differences in clinical outcomes of patients were found between MeMOS and S-Sup conditions. Patients in the MeMOS condition were rated as improving less, and more ill. They received fewer therapy sessions. Conclusions: Most patients failed to improve in therapy at some point. Patients’ recovery was not affected by feeding back outcomes into the supervision process. Therapists rated patients in the S-Sup condition as improving more and being less ill than patients in MeMOS. Those patients in MeMOS had more complex problems.

A series of panels at the ASA meeting in November 1989 focused on sources and methods for the study of law in colonial Africa. At an informal discussion held afterwards, participants agreed that court records are potentially very valuable sources for historians, anthropologists, and other scholars of Africa but that they have not been used as widely as they might be. In an effort to alert Africanists to the existence of such documents and to encourage their use, those of us who had used court records in our research were asked to provide descriptions of them. This paper is a collection of the responses.

Courts were established in the African housing quarters in what was then Usumbura in 1938 as part of a broad reorganization by the colonial administration of the conditions of African residence in the city, one in the quartier of Buyenzi and the other in that of Beige (today Bwiza). These tribunals, which are still in existence, were granted jurisdiction over civil and minor criminal cases between Africans; each court had its own officials, advisors, and clerks, prominent residents of the quartier appointed by the colonial administration. Buyenzi's population was predominantly Muslim, and its court officials were men knowledgeable about Islamic law. Beige, in contrast, was a more heterogeneous community, and its court tended to be staffed by residents who had risen in the African ranks of the civil service.

Men and women of both housing quarters resorted frequently to the courts, with the Buyenzi court hearing approximately 9,000 cases and Beige almost twice that many in the years between their establishment in 1938 and independence in 1962. Their complaints covered a wide range of matters: debts, business ventures, bridewealth disputes, divorces, child rights, property transfers, and various quarrels between friends, neighbors, and family members. Procedure was relatively simple. A man or woman who wished to present a complaint went before the court and was given an appointment for the case to be heard. At the time the court considered the complaint, both accuser and defendant were present. Although the parties might bring with them supporters and witnesses, there were no intermediary personnel such as lawyers. Each individual argued his own case and answered questions put by the judges. A judgment was usually handed down immediately, and it was based on customary rather than European practice. As these courts were originally established, their autonomy was very great: in principle, unless the decisions violated colonial law, they could not be overruled by Belgian officials.

Immunocytochemistry and retrograde labeling were used to define the thalamic projections of calbindin- and parvalbumin-containing cells in superficial layers of the rat's superior colliculus (SC). Quantitative analysis revealed that 90.8 ± 2.2% (mean ± standard deviation) of the calbindin-immunoreactive neurons in the stratum griseum superficiale (SGS) projected to the dorsal lateral geniculate nucleus (LGNd) and that 91.3 ± 4.3% of calbindin-immunoreactive neurons in the stratum opticum (SO) projected to the lateral posterior nucleus (LP). In contrast, only 17.3 ± 2.5% of parvalbumin-immunoreactive neurons in the SGS were found to project to the LGNd and 16.5 ± 3.1% of the parvalbumin-immunoreactive SO cells were retrogradely labeled after LP injections. Few of the parvalbumin-immunoreactive neurons in either the SGS (7.2 ± 2.5%) or the SO (9.2 ± 2.5%) were GABA positive. The retrograde-labeling results suggest that parvalbumin-immunoreactive neurons in the rat's SO and SGS may either be primarily interneurons or have descending projections, while calbindin-containing cells are primarily thalamic projection neurons. These results are consistent with data from other rodents, but almost exactly the opposite of data that have been reported for the cat for these same populations of SC projection neurons. Such interspecies differences raise questions regarding the functional importance of expressing one calcium-binding protein versus another in a specific neuronal population.

Over a 7-year period (1978-1984) the authors studied the rates of nosocomial bloodstream infections in acute-care hospitals participating in a statewide surveillance network in Virginia. A total of 4,617 hospital-acquired bloodstream infections were documented among 1,807,989 patients at risk for an overall rate of 25.5 cases per 10,000 patient admissions/discharges (annual range = 22.1 to 30.7). Compliance of reporting for Virginia hospitals averaged 58% (1 to 5 monthly reports in a study year), and 39% (≥6 monthly reports annually). Significant changes in bloodstream infection rates (cases per 10,000 patient admissions/discharges) due to specific pathogens included the following: coagulase-negative staphylococci increased from a rate of 1.3 to 4.5 (P=.0003), and those due to all gram-positive cocci increased from a rate of 7.5 to 11.4 (P=.03). Candida species increased from a rate of 0.1 to 1.5 (P=.005). The data show a continuing rise of nosocomial Candida BSI and clearly document the re-emergence of gram-positive cocci as major nosocomial bloodstream pathogens.

Do women drink excessively for the same reasons as men? A growing body of opinion suggests not. Beckman's (1975) views are representative— “Alcoholism and heavy drinking in women appear more likely to be linked to psychological stress and a specific precipitating circumstance or situation than is alcoholism or heavy drinking in men”.