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PRCIS The iCare HOME tonometer is a useful tool which can be used by patients for fairly accurate and reliable self-measurement of intraocular pressure (IOP). PURPOSE The aim was to compare the accuracy of IOP measurements of trained glaucoma patients using the iCare HOME tonometer before and after a week of self-monitoring at home and study the repeatability of patient measurements done at home. MATERIALS AND METHODS A total of 40 glaucoma patients had IOPs measured using the Goldmann applanation tonometer and the iCare HOME. Patients were trained to use the iCare HOME and measured their IOP twice daily over a loan period of 7 days. Bland-Altman analysis was used to assess agreement between Goldmann applanation tonometer and iCare HOME readings. Intraclass correlation coefficient compared inter-rater reliability of iCare HOME measurements, and test-retest variability for the patient's readings over the 7-day period were analyzed. A 5-point Likert scale questionnaire was used to assess the patient's experience with the device. RESULTS Up to 32 patients (80%) were able to obtain IOP readings within 3 mm Hg of the glaucoma nurse clinician's readings at the preloan visit, and up to 36 patients (90%) at the postloan visit. Good inter-rater reliability was observed between iCare HOME measurements by the glaucoma nurse clinician and patients. At the postloan visit, inter-rater reliability was good for right eye readings and excellent for left eye readings. No distinct trend in test-retest variability was identified over the 7-day period. 65% of patients agreed the device was easy to use and 89% would recommend the device to other glaucoma patients. CONCLUSION Patients trained to use the iCare HOME device can do so with fair accuracy compared with trainers with accuracy improving within 1 week of usage.

Janis Stradins (10.12.1933 – 29.11.2019) was a well-known expert in molecular electrochemistry, ESR spectroscopy and physical organic chemistry, as well as in history of sciences. His main works in electrochemistry were connected with organic molecules single electron reduction and oxidation primary and secondary products studies, these species ESR spectra hyperfine structure investigations, supplying data on various organic molecules groups' reactivity, demonstrating abilities of electrochemical studies for organic compounds reaction prediction. He was ISE member, past president of Latvian Academy of Sciences, full member of European Academy of Sciences and Arts, from 2011 its Honorary Senator.

Arc chutes comprising ferromagnetic splitter plates are common in SF6-insulated medium-voltage switchgears. By splitting and cooling the electric arc, they help to interrupt moderate currents such as the rated current in load break switches or the transfer current in switch–fuse combinations. Between the splitter plates of such an arc chute, the motion of the arc depends on the balance of the attracting magnetic forces from the ferromagnetic plates, the repelling forces between two arc columns at the two sides of a plate, and the viscous forces from the insulating gas. We simulated this motion by calculating the magnetic forces acting on the arc columns after splitting by means of 2-D and 3-D electromagnetic finite-element analyses and by taking the viscous force as drag force into account. This paper describes this calculation method and compares the simulation results with those of laboratory tests.

International audience; Primary angle closure glaucoma (PACG) is a major cause of blindness worldwide. We conducted a genome-wide association study (GWAS) followed by replication in a combined total of 10,503 PACG cases and 29,567 controls drawn from 24 countries across Asia, Australia, Europe, North America, and South America. We observed significant evidence of disease association at five new genetic loci upon meta-analysis of all patient collections. These loci are at EPDR1 rs3816415 (odds ratio (OR) = 1.24, P = 5.94 × 10(-15)), CHAT rs1258267 (OR = 1.22, P = 2.85 × 10(-16)), GLIS3 rs736893 (OR = 1.18, P = 1.43 × 10(-14)), FERMT2 rs7494379 (OR = 1.14, P = 3.43 × 10(-11)), and DPM2-FAM102A rs3739821 (OR = 1.15, P = 8.32 × 10(-12)). We also confirmed significant association at three previously described loci (P < 5 × 10(-8) for each sentinel SNP at PLEKHA7, COL11A1, and PCMTD1-ST18), providing new insights into the biology of PACG.

Vogler CM, Menant JC, Sherrington C, Ogle SJ, Lord SR. Evidence of detraining after 12-week home-based exercise programs designed to reduce fall-risk factors in older people recently discharged from hospital. Objective To measure the extent to which improved sensorimotor function and balance resulting from a 12-week exercise intervention were retained 12 weeks after exercise cessation in older adults recently discharged from hospital. Design Randomized controlled trial with reassessment 12 weeks after exercise cessation. Setting Home-based exercises. Participants Adults (N=180) aged 65 years and older recently discharged from hospital (mean length of stay, 12.3±10.6d). Interventions Weight-bearing (WB) exercises (n=60), seated resistance (SR) exercises (n=60), or social visits (n=60). Main Outcome Measures Physiological Profile Assessment (PPA), a composite sensorimotor fall-risk score, and 2 measures of controlled leaning balance assessed at baseline, immediately after the intervention (12wk, 95% assessed), and again 12 weeks later (24wk, 92% assessed). Results After the initial improvements in outcomes found at 12 weeks, both the SR and WB exercise groups showed detraining effects at 24 weeks. The PPA fall-risk scores for both SR and WB groups returned to close to baseline values, and there was no significant difference between groups at 24 weeks when controlling for baseline scores ( P =.924). WB exercise participants lost up to half of the improvement in the maximal balance range and coordinated stability tests. There was no difference between groups for the maximal balance range test at 24 weeks when controlling for baseline scores ( P =.207), but between-group differences were maintained for the coordinated stability test ( P =.017). Conclusions Balance improvements and fall-risk reductions associated with a 12-week home-based exercise program in older adults were partially to totally lost 12 weeks after the cessation of the intervention. These significant detraining effects suggest that sustained adherence to falls prevention exercise programs is required to reduce fall risk.

Movement behavior is a critical process that interacts with landscape structure to affect population connectivity and persistence in fragmented or altered landscapes. The purpose of our study was to test whether different substrates (forest litter, soil, grass, gravel, and asphalt) found in fragmented forested landscapes affected the movement behavior of the Southern Graycheek Salamander (Plethodon metcalfi Brimley, 1912). Latency period of the salamanders was highest on grass substrate and significantly lower only on soil substrate. Sinuosity of the movement path of salamanders was lowest and contained more turns in grass and was significantly higher than only gravel and asphalt substrates. Velocity of the salamanders was highest on asphalt substrate but was not different from gravel substrate. Velocity was higher on asphalt than on grass, forest, or soil, and velocity was higher on gravel than on grass substrate. The results indicated that P. metcalfi reacted differently to natural and anthropogenic substrates, and we suggest that these behavioral differences could have both positive and negative implications for movement success and habitat resistance in forested landscapes fragmented by roads and development.

Aim: To identify Aged Care inpatients potentially suitable for Acute/Post-Acute Care (APAC)-Aged Care, a new service offering community-based acute care as an alternative to hospital admission for frail older people. Methods: Criteria were developed to identify suitable patients for APAC-Aged Care and applied to consecutive Aged Care inpatient admissions at Royal North Shore Hospital, Sydney, Australia, through retrospective chart review. Results: Only 5/90 reviewed patients were potentially suitable for APAC-Aged Care. All five were from Residential Aged Care Facilities. The median age of the 90 patients was 86 years; 30% lived in Residential Aged Care Facilities; 53% of patients were medically stable on presentation; 70% required investigations beyond a standard baseline set; 27% had either no new functional decline on presentation or adequate community support to manage this; 91% had allied health input and 41% had medical/surgical consultation. Conclusion: APAC-Aged Care is a potentially suitable alternative to acute inpatient hospitalisation in a select minority of Aged Care patients.

The Altimetric Bathymetry from Surface Slopes (ABYSS), which is the proposed science payload on the International Space Station (ISS), is a Johns Hopkins University Applied Physics Laboratory-developed flight-proved delay-Doppler phase-monopulse radar altimeter capable of measuring ocean surface slope in the 6-200-km half-wavelength frequency band range with an accuracy of 0.5 mu rad , with autonomous gimbal control to compensate for the ISS structural motions. This measurement allows an improved mapping of the global bathymetry, enabling a wide range of scientific research works and applications. The nonrepeat ISS orbital ground track is ideal for ABYSS. This letter describes a simulation study on the effects of the Earth's gravity field and other errors, including thermal bending of the ISS, on the orbit determination of the altimeter instrument antenna phase center location, fulfilling the science objectives of ABYSS. Our study concluded that the error due to mean gravity field is no longer limiting due primarily to the recent Gravity Recovery and Climate Experiment gravity modeling and that the ABYSS/ISS radial orbit slope error budget in the presence of various force and measurement model errors is estimated at the 0.2-mu rad root-sum-squared (RSS) level, which satisfies the ABYSS orbit accuracy science requirement to provide an improved mapping of global bathymetry.

Motorcycle crashes are associated with a high incidence of head injuries and fatalities. Helmets have been shown to decrease the risk and occurrence of both head injuries and fatalities in motorcycle crashes, along with a decrease in hospitalizations and healthcare costs. Many states have laws in place requiring all motorcyclists to wear helmets and have shown that laws directly affect these outcomes. Wisconsin is a state in which there is a law regarding helmet use; however, there are contingents. It is required only in those who are younger than 18 years and those with an instructional permit. Language: en

Objectives: To develop, implement, and evaluate a pharmacist-led multidisciplinary intervention in a hospital setting that would optimize antithrombotic use in elderly atrial fibrillation patients. The hypothesis that there would be an increase in the proportion of patients receiving antithrombotic therapy at discharge was tested. Design: Evidence-based algorithms were developed to define the criteria (stroke risk vs contraindications) by which an elderly patient's requirement for antithrombotic therapy was assessed. Setting: A major Sydney teaching hospital. Participants: Two hundred eighteen consecutively admitted elderly patients (mean age 85.2) were recruited over a 6-month period. Intervention: A pharmacist-coordinated multidisciplinary review process was implemented to coordinate risk assessments and subsequently recommend appropriate antithrombotic therapy, as per the algorithms. Measurements: The proportion of patients receiving antithrombotic therapy was assessed on admission (preintervention), at discharge (postintervention), and postdischarge (follow-up at 3 and 6 months). Results: As a result of the intervention, 78 patients (35.8%) required changes to their existing antithrombotic therapy. Of these changes, 60 (76.9%) were “upgrades” to more-effective treatment options (e.g., from no therapy to any agent or from aspirin to warfarin). The remaining 18 (23.1%) changes were “downgrades” to less-effective, albeit safer, options. Despite a significant increase in anti thrombotic use overall (59.6% vs 81.2%, P

A series of low-toxicity gelcasting systems has been developed. The reagents used in these systems have very low acute toxicity. The new systems perform at least as well as, and in some cases better than, the original acrylamide-based system. The development of these systems is described herein, including the search for new gel compositions, the study of suspensions made with the new gel precursor solutions, and pyrolysis of the dried gels and gelcast parts. Applications of the new gelcasting systems include complex silicon nitride parts, large-diameter rings, rapid prototyping by green machining, and metal-powder gel casting.

Past studies from our laboratory have shown that whole immature, or mature sliced, zygotic embryos are a very good starting explant for coconut somatic embryogenesis. The highest rate of somatic embryogenesis was obtained when certain polyamines were added into the culture medium as well as activated charcoal (AC) to absorb unwanted phenolics. These past studies also showed that the development and maturation of the somatic embryos produced could be improved by the addition of abscisic acid (ABA), alone or with one of several osmotically active agents, into the culture medium. In the present study this well characterised somatic embryogenic system for zygotic tissues is being modified and applied to somatic tissues. This recent approach should be a better method for the rapid production of clonal, true-to-type coconut palms. The present research approach is focused on young leaf section explants which have been found to be very responsive to callus production. Young leaf sections produced optimum callus when cultured on media containing 2,4-D (150 μM) and the amount produced could be increased by soaking the sections in sterile water (15 to 60 minutes) or ascorbic acid (15 to 30 minutes) prior to culturing. Further improvement in callus production, as well as a reduction in the time taken for callogenesis was obtained when casein hydrolysate and/or certain polyamines were added to the callus induction medium. The development of the somatic embryos was improved by using ABA and polyethylene glycol (PEG) in the maturation medium. Despite these initial successes in improving coconut somatic embryogenesis, further studies are now being considered to shorten the time to achieve somatic embryogenesis, to better germinate somatic embryos and to improve the rate of somatic seedling conversion into plantlets.

The rust fungus Puccinia abrupta var. partheniicola, a potential biological control agent of parthenium weed (Parthenium hysterophorus), was evaluated under controlled environmental conditions. A range of spore germination temperatures as well as dew period durations and temperatures were investigated to determine some of the environmental requirements for disease establishment and disease progress. Plants were inoculated with urediniospores and exposed to dew periods between 3 to 12 h at temperatures of 10, 15, or 20 degrees C. For disease expression, the inoculated plants were then grown in a glasshouse at one of two temperature regimes (30/26 degrees C or 18/13 degrees C; day/night). Urediniospores germinated best at 12 +/- 1 degrees C, with lower germination rates at 5 degrees C or above 20 degrees C. No infection occurred when the plants were exposed to dew periods of less than or equal to 3 h, regardless of the incubation temperature. The disease progressed most rapidly when plants were inoculated and incubated for a dew period of at least 12 h at a temperature of 15 +/- 1 degrees C. The disease progressed most slowly following inoculation at dew periods of 6 h or less. Disease progress was more rapid when the plants were exposed to a cool-temperature regime (18/13 degrees C) than when exposed to a warm-temperature regime (30/26 degrees C). This suggests that good infection of parthenium weed could be obtained when the urediniospores arrive on the plants during the afternoon in the cooler months of the central Queensland autumn when relatively long dew periods are expected. (C) 1999 Academic Press.

Physicians use myocardial perfusion imaging to a variable extent in patients presenting with possible coronary artery disease. There are few clinical data on the most cost-effective strategy although computer models predict that routine use of myocardial perfusion imaging is cost-effective.To measure the cost-effectiveness of four diagnostic strategies in patients newly presenting with possible coronary artery disease, and to compare cost-effectiveness in centres that routinely use myocardial perfusion imaging with those that do not.We have studied 396 patients presenting to eight hospitals for the diagnosis of coronary artery disease. The hospitals were regular users or non-users of myocardial perfusion imaging with one of each in four countries (France, Germany, Italy, United Kingdom). Information was gathered retrospectively on presentation, investigations, complications, and clinical management, and patients were followed-up for 2 years in order to assess outcome. Pre- and post-test probabilities of coronary artery disease were computed for diagnostic tests and each test was also assigned as diagnostic or part of management. Diagnostic strategies defined were: 1: Exercise electrocardiogram/coronary angiography, 2: exercise electrocardiogram/myocardial perfusion imaging/coronary angiography, 3: myocardial perfusion imaging/coronary angiography, 4: coronary angiography. Primary outcome measures were the cost and accuracy of diagnosis, the cost of subsequent management, and clinical outcome. Secondary measures included prognostic power, normal angiography rate, and rate of angiography not followed by revascularization.Mean diagnostic costs per patient were: strategy 1: 490 Pounds, 2: 409 Pounds, 3: 460 Pounds, 4: 1253 Pounds (P0.0001). Myocardial perfusion imaging users: 529 Pounds, non-users 667 Pounds (P = 0.006). Mean probability of the presence of coronary artery disease when the final clinical diagnosis was coronary artery disease present were, strategy 1: 0.85, 2: 0.82, 3: 0.97, 4: 1.0 (P0.0001), users 0.93, non-users 0.88 (P = 0.02), and when coronary artery disease was absent, 1: 0.26, 2: 0.22, 3: 0.16, 4: 0.0 (P0.0001), users 0.21, non-users 0.20 (P = ns). Total 2-year costs (coronary artery disease present/absent) were: strategy 1: 4453 Pounds/710 Pounds, 2: 3842 Pounds/478 Pounds, 3: 3768 Pounds/574 Pounds, 4: 5599 Pounds/1475 Pounds (P0.05/0.0001), users: 5563 Pounds/623 Pounds, non-users: 5428 Pounds/916 Pounds (P = ns/0.001). Prognostic power at diagnosis was higher (P0.0001) and normal coronary angiography rate lower (P = 0.07) in the scintigraphic centres and strategies. Numbers of soft and hard cardiac events over 2 years and final symptomatic status did not differ between strategy or centre.Investigative strategies using myocardial perfusion imaging are cheaper and equally effective when compared with strategies that do not use myocardial perfusion imaging, both for cost of diagnosis and for overall 2 year management costs. Two year patient outcome is the same.

To identify Aged Care inpatients potentially suitable for Acute/Post-Acute Care (APAC)-Aged Care, a new service offering community-based acute care as an alternative to hospital admission for frail older people.Criteria were developed to identify suitable patients for APAC-Aged Care and applied to consecutive Aged Care inpatient admissions at Royal North Shore Hospital, Sydney, Australia, through retrospective chart review.Only 5/90 reviewed patients were potentially suitable for APAC-Aged Care. All five were from Residential Aged Care Facilities. The median age of the 90 patients was 86 years; 30% lived in Residential Aged Care Facilities; 53% of patients were medically stable on presentation; 70% required investigations beyond a standard baseline set; 27% had either no new functional decline on presentation or adequate community support to manage this; 91% had allied health input and 41% had medical/surgical consultation.APAC-Aged Care is a potentially suitable alternative to acute inpatient hospitalisation in a select minority of Aged Care patients.

217 consecutive admissions to an acute geriatric care facility in a teaching hospital were prospectively evaluated to assess the prevalence of drug related problems (DRPs) contributing to admission. DRPs were considered to include adverse drug reactions (ADRs), toxic overdose and poor compliance leading to therapeutic failure. The prevalence of DRPs on admission was 22.1% of total patients or 24.0% of those on prescribed medication at the time of admission. DRPs comprised 41 cases (85.4%) of ADRs, 1 case (2.1%) of exacerbated disease due to withdrawal of medication by the prescriber, and 6 cases (12.5%) of patient non-compliance. DRPs were significantly associated with both the total number of immediate pre-admission medications and the presence of a previous history of ADR. No other significant associations were found. The results suggest that prescriber behaviour, as opposed to patient behaviour, is a major contributor to DRPs and accordingly indicate the need for education of doctors about the risks of polypharmacy.

The kinetic parameters and pathways of decay of the cation-radicals formed as primary products in the course of electro-oxidation of the esters of 1,2- and 1,4-dihydropyridine have been studied by rotating ring-disk electrode ( rrde ) method in temperature range from +20°C to −30°C. Two ways of the decay of these cation-radicals, ie via loss of H + and via loss of H . operating simultaneously have been proved to be possible. Competition between these two ways depends on the influence of temperature and on electronic effects of the substitutes attached to the dihydropyridine ring. Cation-radicals of 1,2-dihydropyridine derivatives the sufficiently more stable than those of 1,4-dihydropyridines due to a more extended common π-electron system of the latter. 1,2-Dihydropyridine derivatives are oxidized more readly (by 200–250 mV) than the corresponding 1,4-dihydropyridines.

Operational discharges of oil from the stern tube is a common occurrence for ice breakers as propellers are prone to impact from ice causing shafts to flex and seals are unable to maintain a complete barrier to keep seawater out or lubricating oil in the stern tube. Whereas solar radiation generally speeds the break-down of contaminants, the reduced level of sunlight in the Arctic lengthens the degradation process and increases the likelihood that toxic substances in the stern tube lubricating oil will find their way into the food chain. Hence, deemed “biodegradable” lubricants may not be as biodegradable in the Arctic operating environments. However, there exists a proven, viable option for vessels operating in the Arctic to eliminate stern tube oil pollution. This paper outlines the process for converting the sterntube bearings from oil-lubricated white-metal bearings to Thordon COMPAC seawater lubricated bearings, based on recent works on a twin screw ice breaker at a shipyard in Canada.

Warfarin theraphy is underused in the target at-risk elderly population. Clinicians perceive that older patients are reluctant to use this theraphy, however the perspective of patients or their carers has yet to be explored. Objective: To explore in-depth the perspectives of elderly patients and/ or their carers regarding the use of warfarin therapy. Method: A qualitative study, using semi-structured group interviews was undertaken. The audio-taped discussions were transcribed verbatim, then thematically analysed to identify emergent themes. Group discussions were conducted at a major Sydney teaching hospital, over a 2-month period. Individuals aged 65 years or older (and/or their carers) who were using long-term (6 months) warfarin therapy were recruited by voluntary response to study flyers. Results: 17 patients and carers (mean age 77.2 SD=7.5 years) participated in one of two focus groups. Five core themes emerged regarding warfarin therapy: inadequate knowledge and understanding about it, patients/carers variable experience of information provision, cycle of reactions to being on it, issues in its practical management, and the spectrum of experiences with it. Overall, participants were very accepting of the therapy, describing a high level of compliance, despite initial fears and anxieties, and a relative lack of knowledge. Patients felt somewhat abandoned in their management of warfarin due to the lack of ongoing support services in the community, and inadequate information provision. Conclusions: Elderly patients and their carers appear to be quite accepting of warfarin therapy, in contrast to the perceptions of health care professionals. More effort is needed, however, in terms of information provision, particularly in the form of community-based services, to assist patients in the long-term management of warfarin.

Vogler CM, Sherrington C, Ogle SJ, Lord SR. Reducing risk of falling in older people discharged from hospital: a randomized controlled trial comparing seated exercises, weight-bearing exercises, and social visits. Objective To compare the efficacy of seated exercises and weight-bearing (WB) exercises with social visits on fall risk factors in older people recently discharged from hospital. Design Twelve-week randomized, controlled trial. Setting Home-based exercises. Participants Subjects (N=180) aged 65 and older, recently discharged from hospital. Interventions Seated exercises (n=60), WB exercises (n=60), and social visits (n=60). Main Outcome Measures Primary outcome factors were Physiological Profile Assessment (PPA) fall risk score, and balance while standing (Coordinated Stability and Maximal Balance Range tests). Secondary outcomes included the component parts of the PPA and other physical and psychosocial measures. Results Subjects were tested at baseline and at completion of the intervention period. After 12 weeks of interventions, subjects in the WB exercise group had significantly better performance than the social visit group on the following: PPA score ( P =.048), Coordinated Stability ( P P =.019); body sway on floor with eyes closed ( P =.017); and finger-press reaction time ( P =.007) tests. The seated exercise group performed better than the social visit group in PPA score ( P =.019) but for no other outcome factor. The seated exercise group had the highest rate of musculoskeletal soreness. Conclusions In older people recently discharged from the hospital, both exercise programs reduced fall risk score in older people. The WB exercises led to additional beneficial impacts for controlled leaning, reaction time, and caused less musculoskeletal soreness than the seated exercises.

(1990). Improvement of Vision in Macular Degeneration Associated with Intravenous Zinc and Selenium Therapy: Two Cases. Journal of Nutritional Medicine: Vol. 1, No. 2, pp. 133-138.

To explore the barriers to warfarin use from the perspective of nurses working in aged care.A qualitative study, involving a semi-structured group interview, during March-April 2001.Eleven nurses, employed within the catchment of the Northern Sydney Area Health Service, who were involved in the care of elderly warfarinised patients.Identification, via thematic analysis, of the main themes underpinning the nursing perspective on warfarin use in this setting, with regard to their perceived role/s, experiences with patients, and potential strategies for managing the therapy.Five main themes were identified: perceived patient attitude toward warfarin; barriers to the use of warfarin; expressed lack of confidence in the processes involved; nurses' role in warfarin use; and strategies to improve warfarin use. Nurses were concerned about warfarin use in the elderly, but felt they had a limited capacity to intervene.Nurses are potentially underutilised as a resource and support for both patients and prescribers, in the management of warfarin therapy.

Objective: To identify the views of health professionals, patients and their carers on strategies to improve the use and management of warfarin in older patients with atrial fibrillation. Design: Qualitative study based on analysis of group interviews. Setting: A major metropolitan teaching hospital, from 1 March to 30 April 2003. Participants: 14 patients (≥ 65 years) with established atrial fibrillation and taking warfarin, three carers, 12 specialists, eight general practitioners, six community pharmacists, nine hospital pharmacists, and 11 nurses volunteered in response to flyers promoting the study. Results: Suggested strategies to improve warfarin management targeted support services for GPs and patients. Hospital-based clinicians felt that dissemination of trial evidence to GPs to support treatment recommendations is required, and that GPs need to enlist allied health professionals in the management of patients taking warfarin. GPs preferred access to practical advice from expert colleagues on the day-to-day management. Patients requested more information about warfarin therapy, as access to information is inadequate, particularly from primary sources (GPs, community pharmacists). Verbal and written information are equally important, but a single counselling session or supply of a booklet was viewed as inadequate. Participants identified various interventions for all levels of warfarin management; from the collective input, a framework for management strategies was developed. Conclusions: Health professionals and patients require more customised information to support warfarin use and management.

The goal of the Test Readiness Program is to transition to a 24 month test readiness posture and if approved move to an 18-month posture. One of the key components of the Test Readiness Program necessary to meet this goal is the reconstitution of the important diagnostics. Since the end of nuclear testing, the ability to field diagnostics on a nuclear test has deteriorated. Reconstitution of diagnostics before those who had experience in nuclear testing either retire or leave is essential to achieving a shorter test readiness posture. Also, the data recording systems have not been used since the end of testing. This report documents the reconstitution of one vital diagnostic: the low bandwidth reaction history diagnostic for FY04. Reaction history is one of the major diagnostics that has been used on all LLNL and LANL tests since the early days of nuclear testing. Reaction history refers to measuring the time history of the gamma and neutron output from a nuclear test. This gives direct information on the nuclear reactions taking place in the device. The reaction history measurements are one of the prime measurements the nuclear weapon scientists use to validate their models of device performance. All tests currentlymore » under consideration require the reaction history diagnostic. Thus moving to a shorter test readiness posture requires the reconstitution of the ability to make reaction history measurements. Reconstitution of reaction history was planned to be in two steps. Reaction history measurements that have been used in the past can be broadly placed into two categories. The most common type of reaction history and the one that has been performed on virtually all nuclear tests is termed low bandwidth reaction history. This measurement has a time response that is limited by the bandpass of kilometer length coaxial cables. When higher bandwidth has been required for specific measurements, fiber optic techniques have been used. This is referred to as high-bandwidth reaction history. The first step in the reconstitution of reaction history was thus naturally the reconstitution of the low-bandwidth capability in FY04. This will be followed in FY06 by the reconstitution of the high bandwidth capability. The reconstitution of the low-bandwidth reaction history measurement was done in several phases. First the status of legacy equipment has been ascertained. Existing detectors, cables, and recording systems have been inventoried, characterized and, for the most part, satisfied the specifications of the test program and are still useable. The ability to obtain replacement equipment is now available. Modern low-bandwidth fiber optic recording equipment which was similar to systems used on the old tests, has been evaluated. The ability to characterize and calibrate detectors and other components has been reestablished. New scientists and engineers have been working with designated mentors. These mentors participated on numerous shots during the old test program. Finally as a proof test, two hypothetical test scenarios were proposed: one each from LLNL and LANL. The LANL event was called ALPHA and the LLNL event was called POPOUT. The reaction history diagnostics for these two hypothetical underground tests were completely laid out and analyzed to make sure that the diagnostic could be successfully fielded within a 24 month time frame. In addition as part of a training exercise a reaction history trailer was reconstituted. This system was configured using a combination of new and experienced technical personnel and data analysts in collaboration with LLNL and LANL event physicists.« less

Aim of study: To investigate the use of antithrombotic therapy in elderly patients with atrial fibrillation (AF). Methods: Data were collected retrospectively from the medical records of 262 AF patients >65 years, who were admitted to a Sydney teaching hospital over a 12-month period. Results: Overall, 202 (79%) patients were discharged on some antithrombotic therapy. Patients 80 years were 5.46 times more likely to receive aspirin in preference to warfarin than their younger counterparts (P

Potato leafhopper is a predominant biotic stress in alfalfa production, whereas drought and flooding are frequent abiotic stresses. Controlled environment studies were conducted to examine the interaction between flooding or drought stress and potato leafhopper (PLH, Empoasca fabae [Harris]) feeding damage on seedlings of two cultivars of alfalfa (Medicago sativa L): one susceptible to PLH, one resistant to PLH. Flooding treatments reduced shoot dry matter accumulation approximately 50% in the absence of PLH in both cultivars and significantly reduced root dry matter in one cultivar. Drought stress significantly reduced shoot dry matter and increased root dry matter. PLH feeding combined with either flooding or drought stress reduced root dry matter accumulation but not shoot dry matter. Flooding injury and PLH feeding injury showed an additive negative response for root dry matter accumulation. Flooded and non-stressed plants accumulated less root total non-structural carbohydrates (TNC) when subjected to PLH feeding. Responses of the two cultivars were similar across all biotic and abiotic treatments. The results clearly show that the most damaging physiological response of seedling alfalfa to PLH feeding is a sharp decline in root growth and TNC accumulation. This suggests that seedlings that have experienced even minor root waterlogging damage may be especially susceptible to damage by PLH feeding. Accepted for publication 23 April 2002. Published 2 May 2002.

This study measured the prevalence of difficulty experienced by elderly inpatients in opening and removing tablets from a range of common commercial medication packagings and in breaking a bar-scored tablet in half. One hundred and twenty elderly patients admitted to a teaching hospital acute geriatric service were tested for their ability to open the container and remove a tablet from it. They were rated as 'able' or 'unable' to do so. In all, 94 patients (78.3%) were unable to break a tablet or open one or more of the containers. Of the 111 patients taking medication at the time of their admission, 46 (41.4%) were unable to perform one or more tasks necessary to gain access to medications in their own treatment regimen. The factors that were significantly and independently associated with inability to open containers were poor vision, impaired general cognitive function, and female sex. Many of the drug packagings in common use significantly impede access by elderly patients to their medications. Language: en

During 1990 all present and retired china clay workers in the United Kingdom were invited to take part in a chest health survey. A total of 4401 china clay workers participated representing over 70% of current employees and 17% of pensioners. The survey consisted of a chest x ray film, lung function measurements, and a questionnaire on respiratory symptoms and smoking habits. The chest x ray films were read by three readers to the International Labour Office (ILO) 1980 classification. Full details of occupational history for each participant were available and for each employee an estimate of total exposure to china clay dust was derived from representative dust concentrations for each location and job. These were based on measured dust concentrations after 1978 and on estimates before 1978. Analyses of the data were carried out to investigate the relations between exposure, x ray film category, lung function, and respiratory symptoms. The percentage of people with small opacities greater than major x ray film category 1 was 0.8% (lower than in previous studies). Dust concentrations have been reduced in recent years, averaging 1.7 mg m-3 for dryers in 1990 compared with 3.5 mg m-3 in 1978. The lower effect of exposure after 1971, compared with earlier exposure, was confirmed by the analyses. After 1971 the milling of dried china clay (Atritor mills) was found to be the occupation with the highest effect on x ray film category. The relation between total exposure to china clay dust and x ray film category is such that a typical non-smoker worker employed in the most dusty of current occupations may expect to reach the lower limit of category 1 after about 42 years continuous employment in that job at current exposures. Both forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were found (as in other studies) to decline with age, more rapidly for smokers than non-smokers at the rates for FVC of 0.035 l/y and 0.033 l/y, whereas for FEV1 the rates are 0.039 l/y for smokers and 0.034 l/y for non-smokers. Changes in x ray film category are also related to lung function , a change of one major category being equivalent to about six years of aging in its effect on FEV1.

16013 Background: Chemotherapy IR are the dose limiting factor for many agents and have clinical consequences ranging from patient symptom burden to death. No work has been done to describe the provider burden of chemotherapy IR. The purpose of this analysis was to describe the clinical interventions associated with mild and severe IR and estimate the associated HR costs. Methods: Staff from a single, free standing, community oncology practice were surveyed regarding involvement in the management of mild and severe chemotherapy IR using a modified time and motion survey to identify tasks required to manage CIR and the HR time required. Mild and severe chemotherapy IR HR events were created. Salary averages for each type of staff were used to estimate HR costs. Results: 39 staff participated in the survey and were 85% (n = 33) female, average age 44, with M = 7.6 years experience. 21 distinct tasks (e.g. initial assessment, patient monitoring, infusion stopped, notify physician) were identified representing the management of the mild and severe chemotherapy IR. 11 types of staff indicated routine participation in ≥ 1 IR related task. Total HR time was 188 and 194 minutes for mild and severe IR respectively, resulting in HR cost of $124 and $187. Conclusions: The above methodology will be used in an expanded analysis of 20 outpatient practices. Recent changes in cancer treatment reimbursement have resulted increased interest in practice efficiency and provider cost. Definitions for quality care should consider minimization of unnecessary direct and indirect costs and maximization of practice efficiency. Models such as the one described are needed to understand provider costs. Clinical processes and chemotherapy agents that reduce rates and severity of CIR should reduce HR burden related to CIR. [Table: see text] [Table: see text]

Elderly patients may be more susceptible to acute severe hepatitis than younger patients (Woodhouse and James 1990: Wynne, Cope and James 1989). aAPPT: activated partial thromboplastin time

Pathotypes of Cochliobolus sativus have been reported overseas but variation in the Australian population has not been investigated nor have the optimum conditions for the identification of variation been established. Preliminary experiments showed that maximum separation of infection responses of seedlings to infection by C. sativus conidia was obtained at 21°C using inocula containing 104 conidia/mL and a dew period of 40 h. Under these conditions, the existence of pathotypes in the Australian population of C. sativus was demonstrated. Using 20 lines, six pathotypes were identified among 34 isolates of the fungus. A differential set consisting of 12 barley cultivars is proposed.

OBJECTIVE To assess the use of patient-held medication record cards and their acceptability to patients and doctors. DESIGN Prospective 12-month study with data collection at baseline and on three subsequent occasions at four-monthly intervals. PATIENTS AND SETTING 187 patients with a mean age of 78.4 years (range, 60-101) were taking a mean of 5.8 medications each (range, 1-18). They lived on Sydney's lower north shore and were able to care for themselves. MAIN OUTCOME MEASURES Availability of card on request, frequency of use, status of recorders and accuracy of records (checked by inspection of medications at home). RESULTS Most patients retained their cards, but the proportion who presented it to their doctor fell from 61% to 23% over the 12 months (P < 0.0001), and the proportion with accurately recorded drug regimens ranged from 20% down to 16%. Of the 75 regimens written exclusively by general practitioners in the 12 months, only 19 (25%) were consistent with what the patients were actually taking. CONCLUSION Medication record cards introduced into the doctor-patient relationship by a "third-party" are unlikely to result in better quality use of medicines.

Variation in the concentration of virus in different parts of the plant has implications for virus-indexing programs. To allow more reliable detection of Sugarcane mosaic virus (SCMV), the distribution of the virus in sugarcane plants after artificial inoculation was studied using a reverse transcription polymerase chain reaction (RT-PCR) assay. Leaves of susceptible and moderately resistant sugarcane were mechanically inoculated with SCMV 6 weeks after planting. Weekly for 8 weeks after inoculation, plants were examined for mosaic symptoms and samples of leaves, roots and tillers were tested by RT-PCR to detect virus. SCMV moved from the point of inoculation to younger leaves, roots and tillers and eventually to leaves that emerged prior to inoculation. The pattern of SCMV distribution in moderately resistant and susceptible cultivars was not substantially different. However, the virus moved more slowly in the moderately resistant than in the susceptible cultivar. Young leaves proved to be the most suitable tissue for testing.