A radioimmunoassay procedure for tallysomycin S10b in human plasma and urine.

A simple and sensitive radioimmunoassay (RIA) procedure was developed and validated for the analysis of tallysomycin S10b in human plasma and urine. The assay utilized antisera developed in rabbits, 125I-tallysomycin as the radioligand, and dextran-coated charcoal to separate free and bound antigen. The antibody was specific in that it did not cross-react with either tallysomycin A or bleomycin. The lower limit of quantification was 5 ng per ml plasma or urine, and the linear range of the assay was 5-320 ng tallysomycin S10b base per ml plasma or urine. The within-day assay variability (%RSD) for plasma and urine was 11% at a concentration of 50 ng per ml, and 3% and 7% for plasma and urine, respectively at 200 ng per ml. Within-day accuracy ranged from 100% to 108% of the theoretical value. Tallysomycin S10b was stable in human plasma and urine at concentrations of 20 and 160 ng per ml for at least 7 months when stored at -20 degrees C. The method was applied to the analysis of plasma and urine samples from a patient given tallysomycin S10b as part of a phase I study.

Attitudes of the public to medical care: Part 8, "Non-Medical" Practitioners.

A random sample of respondents in Dunedin and Auckland was surveyed to obtain details of utilisation of various aspects of health services and also opinions and knowledge of these services: a section of the survey dealt with "non-medical doctors". A miniority of respondents or their families had made use of such services (13.2 percent) in the previous five years, compared to 47.1 percent utilising medical specialist services and almost 100 percent utilising general practitioner services in the same period. The number of items of services for one patient with one consulting cause was high. The mean being just under eight and in one fifth of cases was 15 or more. Most respondents considered that the services of non-medical practitioners could sometimes be useful and one-third would consider consulting such practitioners themselves, although most would consult an orthodox doctor first. Only one-fifth of respondents were willing to see Government financial support for non-medical practitioners.

Attitudes of the public to medical care: Part 7. Specialist services.

A sample of the adult population in Auckland and Dunedin was surveyed with regard to their utilisation of an opinions about private specialist services. Generally the utilisation of such services was high: almost half the respondents had either had a member of their family utilise the services of a specialist or had utilised such services themselves in the previous five years. The number of services for one patient for one consulting cause showed "specialists" were acting as such rather than as consultants. Not all such services were initiated through a general practitioner. Slightly more respondents would choose a private specialist rather than a hosptial specialist if their general practitioner considered a specialist opinion necessary and about one quarter of respondents had no preference: the reason for such a choice being made are described. There was considerable misinformation and lack of knowledge concerning the financing of such services.

Attitudes of the public to medical care: Part 5-Para-medical services.

A sample of the population of Auckland and Dunedin was asked a series of six questions concerning their attitude to para-medical services as provided by a Plunket nurse; a public health or school nurse; a district nurse; a medico-social worker from a hospital and the ambulance service. Analysis of the replies shows some differences in utilisation of specific services comparing one city to the other. Respondents' opinions on the methods of financing these services show a general vote for preservation of the status quo but with some increased Government support. These are indications that the public is unaware of current methods of financing such services. Public acceptance of the idea of employment of trained nurses and social workers in general practice was high and when the question was made more specific by referring to the respondent's own family doctor the acceptance was much higher. Reasons for non-acceptance do not indicate any major difficulties in the employment of such staff in general practice, at least as far as the patients are concerned.

Attitudes of the public to medical care: part 6. Pharmaceutical benefits.

People's attitudes in Dunedin and Auckland were surveyed regarding prescribing. A significant proportion favoured a prescription charge. With a choice between a free doctor and free medicine, there was preference for the former. No great dissatisfaction with the present system of prescription medicine was found.

Attitudes of the public to medical care: Part 4. Generalpractitioner services.

A number of questions were asked concerning general practitioner services. These questions dealt with utilisation, financial arrangements and satisfaction with various aspects of the service, and also with possible changes in the financing of general practitioner services. Nineteen out of 20 respondents had a doctor they recognised as their personal or family doctor and generally members of the same family attended the same doctor. A change of address of doctor or patient was the most common reason for a change of doctor. There appears to be some differences in the pattern of practice between Auckland and Dunedin, house calls being less in Auckland although the total number of patient-doctor contacts in the two cities is much the same. There are some interesting age differences in the distribution of consultations at surgery and at home. There is little enthusiasm for major changes in the financing of the general practitioner services except for some extension of special groups who should receive extra financial assistance from the government. Satisfaction with general practitioners' service is high but there are some specific aspects which could, from the patient's viewpoint, be improved. Reference has already been made to the research philosophy and the survey design (Dixon and others, 1974). In the section of the survey dealing with general practitioner services a total of 20 questions were asked. Five dealt with utilisation of general practitioner services by the respondent and the respondent's household; 12 questions dealt with financing of general practitioner services and three questions with satisfaction with various aspects of general practitioner services.