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Background Sarcoidosis is a multi-system disorder with an increasing propensity to present in older patients. Diagnostic uncertainty is common and understandable given the higher prevalence of co-morbidities in older patients and broad differential for multi-system clinical presentations. Excluding malignancy and infection with a high degree of certainty is challenging and may require repeated confirmatory investigation where the diagnosis remains in doubt. Summary of main findings There are a paucity of studies examining late-onset sarcoidosis. Female predominance, pulmonary, ocular, skin and systemic symptoms are common, while more classical presentations such as Lofgren’s syndrome are uncommon. Positivity rates of biopsies vary between studies; however, targeted biopsies of accessible sites with organ involvement are the most successful. Therapeutic management is directed at reducing inflammation, and thereby reducing symptom burden, improving quality of life and avoiding progression of organ damage. While most older patients will require corticosteroid therapy, they are also more prone to developing adverse effects. Most older patients will experience a clinical remission; however, the risk of developing chronic sarcoidosis and organ damage is higher compared with younger counterparts. Patients with evidence of pulmonary fibrosis and pulmonary hypertension are at particular risk. Impact on clinical practice Health care providers who care for older adults should be aware of the increasing prevalence of late-onset sarcoidosis and consider the diagnosis in those who present with otherwise unexplained systemic symptoms, thoracic abnormalities on imaging and/or evidence of other organ involvement. Earlier diagnosis and therapeutic intervention to halt the development of pulmonary fibrosis and pulmonary hypertension and monitoring for treatment-related adverse effects will confer a mortality benefit.

In the early twentieth century, bronchiectasis (BE) was not a disease seen in the elderly population as life expectancy was usually

Background Hypernatraemia is associated with morbidity and mortality, particularly in the older person. Last summer, Ireland experienced prolonged periods of excessive heat. The Irish meteorological service defines a heatwave as temperatures exceeding 25°C for five consecutive days. Aim This study sought to compare the frequency of hypernatraemia (sodium (Na+) >145 mmol/l) observed during a modest heatwave with that during average ambient temperature in the temperate Irish climate. Design Retrospective cross-sectional analysis with nested case–control study. Methods The 10-day period from 24 June to 3 July in 2017 and 2018 were chosen as the control and heatwave periods, respectively. Patients aged >65 with at least one Na+ value recorded on the laboratory information system were included. Local meteorological data, age, gender and Na+ levels were evaluated. Results Maximum air temperatures were significantly higher during the heatwave period (mean 27°C vs. 16.8°C, P Conclusion Hypernatraemia was 2.5 times more frequent in samples drawn during the heatwave compared to the control period. In this study, neither age nor gender impacted the profile of patients diagnosed with hypernatraemia. A modest rise in temperatures increases hypernatraemia rates in temperate climates.

Hypernatraemia is associated with high morbidity and mortality and is more common in patients of older age, nursing home residents and those with cognitive impairment and restricted mobility. The most common cause in hospital settings is water dehydration due to reduced intake although other causes should be identified. Once identified, prompt management is necessary to avoid delayed correction as prolonged hypernatremia is associated with increased hospital stay and mortality. Comprehensive history-taking and physical examination, basic investigations and medication review are essential to identify causative and remediable factors in those admitted with hypernatraemia. Accurate calculation of fluid deficit and ongoing losses is essential in order to ensure adequate fluid replacement, The administration of appropriate, usually hypotonic, fluids is also essential to the timely restoration of eunatraemia. Although evidence of definite harm resulting from rapid correction is lacking, a serum sodium reduction rate of

Background Hypernatraemia is a surrogate marker of morbidity and mortality, particularly in the older person.(1) Met Eireann defines a heatwave as 5 consecutive days >25°C. HSE guidelines outline preventative strategies for community-dwelling adults and inpatients during heatwaves.(2) Our objective was to compare the prevalence of hypernatraemia (Na>145mmol/l), in biochemical samples during the heatwave of 2018 to the same period in 2017 Methods A retrospective cross-sectional study using patient demographics, biochemical data from Laboratory Information System and meteorological data from Met Éireann was performed. A ten-day period from 24thJune to 3rdJuly was assessed in 2017 and 2018. Patients aged >65 with at least one biochemical sample were included. Only the first sample from each patient was included. Predictor variables of age, gender and source of sample were measured. Results Maximum air temperatures were higher in 2018 than 2017 (mean 27 v 16.8°C, p Conclusion Hypernatraemia was 2.5 times more prevalent during the heatwave in 2018 than the previous year in patients aged over 65. Hypernatraemia is more prevalent in GP and inpatients taking into account the usual distribution of samples by source. Current guidelines are either not being adhered to or ineffective, a matter which merits further evaluation.

Background Osteoporosis accounts for more disability-adjusted life years than many non-communicable diseases. Identification and treatment is important to reduce morbidity and mortality associated with further fracture.(1) National Osteoporosis Guideline Group recommends all patients with a fragility fracture should undergo a bone health assessment and commence pharmacological therapy if indicated.(2) Methods Electronic discharge summaries of all patients with a diagnosis of fracture discharged from an off-site rehabilitation unit from 1st January 2018 to 31st December 2018 were reviewed. Patient details, location and mechanism of fracture, bone health assessment and discharge prescription were assessed. Following data collection, an education session directed at NCHDs was performed and a discharge checklist prompting bone health review and consideration of pharmacological therapy was introduced. A re-audit was performed at 4 months to assess change following this intervention. Results 74 patients had a diagnosis of fracture. 4 were excluded as fracture resulted from high impact trauma. 100% had corrected calcium measured. 93%(n=65) had Vitamin D(OH) measured. 91%(n=64) had PTH measured. 55%(n=39) were discharged on calcium/vitamin D(OH) supplementation. 33%(n=23) were discharged on Vitamin D(OH) alone. 66%(n=46) were discharged on antiresorptive therapy: 28%(n=13) bisphosphonate, 67% (n=31) denosumab, 4% others. 33%(n=23) were not prescribed any bone protection on discharge. 4 had advanced chronic kidney disease. 6%(n=4) were discharged without calcium/Vitamin D or antiresorptive therapy. A re-audit from January to April 2019 of 15 patients post NCHD education has shown an increase in antiresorptive therapy prescription 86%(n=13) Conclusion Bone health assessment and prescribing practices of antiresorptive therapy in patients undergoing rehabilitation post fracture is sub-optimal. Education of non-consultant hospital doctors can substantially improve rates of antiresorptive therapy prescription.

Extremes of temperature are likely to increase in frequency associated with climate change. Older patients are particularly vulnerable to the effects of heat with excess mortality well documented in this population. Age-associated neurohormonal changes particularly affecting the renin angiotensin aldosterone system (RAAS), alterations in thermoregulatory mechanisms, changes in renal function and body composition render older persons vulnerable to dehydration, renal failure, heat stroke and increased mortality. Barriers to diagnosis and recognition of dehydration and renal failure include the absence of reliable clinical signs and cost-effective diagnostic tools. Regularly used medications also impact on physiological responses to excess heat as well as interfering with the recognition and management of dehydration during heat waves. In view of the above, anticipatory measures should be instituted ideally prior to the onset of heat waves to minimise morbidity and mortality for older people during periods of excess heat.

What are the indications and outcomes of home visits and assessments by geriatricians? Home visits were mainly conducted when older people would not or could not attend a clinic. Many visits occurred to socially isolated people living in poor circumstances in deprived rural areas. Home visits by geriatricians remain a valuable option for selected older people. The value of the home (domiciliary) visit (HV) by geriatricians at the request of general practitioners has been questioned. We analysed HVs conducted by geriatricians in a west of Ireland hospital over a 14-year period. From 2002 to 2016, a systematic record was maintained of all HVs conducted by a geriatrician. Consent to publication was obtained for 114 (81%) of 141 visits performed. A HV was requested in 47 (41%) cases because the person would not attend a clinic, most having a long history of refusing care, and in 40 (35%) cases because the person was severely immobile or too unwell to leave home. In 27 (24%) cases, assessment was best conducted in the home for other reasons including squalor. Of the referrals, only 40 (35%) sought specific medical advice and 15 (13%) sought advice regarding end-of-life planning. In many cases, general advice regarding management of self-neglect, unexplained decline, poor home circumstances and undue risk taking was sought. The commonest decision [45 (39%) participants] was that no major intervention would be appropriate or achievable in the person’s circumstances and having regard to his or her own preferences. Twenty-three (20%) participants were persuaded to accept a major intervention they had previously declined. In 14 (12%) cases, a palliative care approach in the home was agreed. An application to court to determine what care the person should receive occurred in five (5%) cases. Many medications were stopped. Home visits by geriatricians remain a valuable option for selected older people.

In December 2019, in Wuhan, China, the novel coronavirus ‘severe acute respiratory syndrome 2’ (SARS-CoV-2) was discovered as the cause of a pneumonia-like illness and subsequently named coronavirus disease 2019 (COVID-19). COVID-19 spread and is now a global pandemic. With few exceptions, countries in the Northern hemisphere have higher mortality rates from COVID-19. This may be due to an increased prevalence of older people in Northern Europe at higher risk of having cardio-pulmonary and metabolic comorbidities as well as hypovitaminosis D. With increasing age, immunosenescence and ‘inflammaging’ lead to impaired and maladaptive immune responses to SARS-CoV-2 infections, contributing to the enhanced prevalence of severe COVID-19 in older patients. The association of ageing with increased vitamin D deficiency, which is associated with cardiovascular risk factors and disease and worse prognosis in COVID-19 infection, is discussed. Considerable experimental evidence demonstrates the immuno-modulatory properties of vitamin D, in particular, its role in regulating and suppressing the inflammatory cytokine response to viral respiratory infections links the importance of vitamin D sufficiency as a potential protective factor in COVID-19. There is an urgent need for prospective randomised studies to examine whether hypovitaminosis D correlates with severity of COVID-19 disease and the actual benefit of repletion. Moreover, given what has been described as a ‘pandemic of vitamin D deficiency’, especially in Europe, and in the context of the SARS-CoV-2 contagion, the authors support the call for public health doctors and physicians, with support from Governments, to prioritise and strengthen recommendations on vitamin D intake and supplementation.

Background Hypernatraemia arises commonly in acute general medical admissions. Affected patients have a guarded prognosis with high rates of morbidity and mortality. Age-related physiology and physical/cognitive barriers to accessing water predispose older patients to developing hypernatraemia. This study sought to perform a descriptive retrospective review of hypernatraemic patients admitted under acute general medicine teams. Methods A retrospective cross-sectional study of a sample of acute medical in-patients with serum[sodium]>145 mmol/L was conducted. Patients were exclusively older(>69 years) and admitted from Nursing homes (NH)(41%) and non-NH pathways(59%). A comparison of management of NH /non-NH patients including clinical presentation, comorbidities, laboratory values, [sodium] monitoring, intravenous fluid regimes and patient outcomes was performed. Results In total, 102 consecutive patients (males, n=69(67.6%)) were included. Dementia and reduced mobility were more common in NH residents and admission serum [Sodium] higher (148 vs 142 mmol/L/p=0.003). Monitoring was inadequate: no routine bloods within the first 12h in >80% of patients in both groups. No patient had calculated free water deficit documented. More NH patients received correct fluid management (60% vs 33%/p%0.015). Incorrect fluid regimes occurred in both groups (38% vs 58%/p=0.070). Length of stay in discharged patients was lower in NH, (8(4-20) vs 20.5(9.8-49.3 days)/p=0.003). Time to death for NH residents was shorter (9(5.5-11.5) vs 16 (10.25-23.5) days/p=0.011). Conclusion This study highlights suboptimal management of hypernatraemia. Implementation of hypernatraemia guidelines for general medical older inpatients are clearly required with mechanisms to confirm adherence. Health care workers require further education on diagnostic challenges of dehydration in older people and the importance of maintaining adequate hydration.

Toxic epidermal necrolysis and Staphylococcal scalded skin syndrome (SSSS) are potentially life-threatening dermatological emergencies that present in a similar clinical fashion. Toxic epidermal necrolysis is typically triggered by anticonvulsant and other neurological medications and reports clindamycin inducing the disease is exceedingly rare. SSSS seldomly occurs in adult patients. We present the case of a 60-year-old male presenting with dermatological rash covering >80% his body surface. Diagnosis and therapy involved multidisciplinary contribution from medical physicians, dermatologists, microbiologists and histopathologists to provide a favourable outcome.

Extreme weather events including recently experienced prolonged heatwaves are predicted to increase in frequency and intensity as a result of climate change. Vulnerable groups, and particularly older persons, are at increased risk of heat-related illness and mortality. Multimodal interventions that incorporate community, primary and secondary care programmes are required. Social programmes such as early warning systems, regional heat plans and community-led initiatives that specifically target the isolated, dependent older person are protective. Establishing clear and effective communication on health promotion and preventative measures is the key. Energy-efficient building design and eco-city planning are vital to reduce the impact of heatwaves at both a population and individual level. Anticipatory strategies should be adopted to ensure ample access to fluids, target barriers to increase oral intake and allow early identification of intercurrent illness, along with regular medication reviews. Prompt management of risk factors for the development of heat-related illness and treatment of complications such as heat stroke and cardiovascular events are keys to reducing the negative health impact of extreme heat in at-risk populations. Morbidity and mortality in heatwaves should be preventable. Evidence-based interventions are available to mitigate and prevent the negative health impact of extreme heat and should be implemented in all residential settings.

This case describes a 103-year-old lady who presented from home with an incidental diagnosis of a left femoral fracture. She had no history of trauma and denied pain. She had a known diagnosis of osteoporosis, and sustained a fracture of the contralateral femur aged 93 which was managed conservatively. She was bed-bound with fixed contractures, poor oral intake and was non-compliant with prescribed calcium/vitamin D supplementation. Clinical biochemical measurements showed severe vitamin D deficiency and mild hypocalcaemia. Secondary hyperparathyroidism in the setting of an inappropriately normal phosphate suggested concurrent renal bone disease. Biomarkers of bone turnover were also consistent with bone remodelling. The history of prior fragility fractures, severe vitamin D deficiency and immobility supports a diagnosis of osteoporotic fracture, however other causes of spontaneous fracture were also considered. This case highlights the complexity of interpreting clinical biochemistry results in the setting of multi-morbidity and addresses the challenges of bone health management in the frail older person.

Accessible summary: The government and other organisations say that improving health care is important for people with learning disabilities. We asked people with learning disabilities and the people who look after them what it was like for them when they went to the dentist. Those we asked said that when they went to the dentist, they knew that those they saw knew about looking after their teeth. Some of those we talked to though said that certain things needed to be better. Background: The government alongside other health and social care organisation have identified the need to improve the care provided for people with learning disabilities. Materials and Methods: This service evaluation aimed to explore the experiences of people with learning disabilities and their carers who accessed community dental services using a qualitative research design. Adults with learning disabilities (n = 4) and their carers (n = 6) took part in one to one, face to face semi structured interviews. Results and Discussion: Generally, participants were satisfied with community dental services and in particular valued the skills and the competence of practitioners. However, when dissatisfaction was expressed this was generally as a result of poor communication and the transition from child to adult dental services. Conclusions: A number of recommendations are identified and discussed in relation to engagement with adults with learning disabilities and their carers in the development and delivery of community dental services. © 2017 John Wiley & Sons Ltd.

Spontaneous insufficiency fractures are caused by normal or physiological stress on weakened bone. The leading cause of insufficiency fractures is osteoporosis which has a propensity to affect older patients. Other causes or associated factors are disorders which affect bone metabolism, collagen formation, bone remodelling and medications such as bisphosphonates and glucocorticoids. Pathological fractures and abuse are important causes of unexplained fractures which warrant careful consideration. Spontaneous fractures of the long bones affect on average 1% of nursing home residents per year and tend to occur in patients who are bed-bound with joint contractures. Preventative measures for spontaneous insufficiency fractures include optimising nutrition to include an adequate intake of protein, calcium and vitamin D, maintaining mobility and preventing long periods of bed-rest and treatment of underlying pre-disposing conditions.

The value of the home (domiciliary) visit (HV) by geriatricians at the request of general practitioners has been questioned. We analysed HVs conducted by geriatricians in a west of Ireland hospital over a 14-year period.From 2002 to 2016, a systematic record was maintained of all HVs conducted by a geriatrician.Consent to publication was obtained for 114 (81%) of 141 visits performed. A HV was requested in 47 (41%) cases because the person would not attend a clinic, most having a long history of refusing care, and in 40 (35%) cases because the person was severely immobile or too unwell to leave home. In 27 (24%) cases, assessment was best conducted in the home for other reasons including squalor. Of the referrals, only 40 (35%) sought specific medical advice and 15 (13%) sought advice regarding end-of-life planning. In many cases, general advice regarding management of self-neglect, unexplained decline, poor home circumstances and undue risk taking was sought. The commonest decision [45 (39%) participants] was that no major intervention would be appropriate or achievable in the person's circumstances and having regard to his or her own preferences. Twenty-three (20%) participants were persuaded to accept a major intervention they had previously declined. In 14 (12%) cases, a palliative care approach in the home was agreed. An application to court to determine what care the person should receive occurred in five (5%) cases. Many medications were stopped.Home visits by geriatricians remain a valuable option for selected older people.

For some people, interaction preference settings like large fonts or speech output are essential for technology access. We demonstrate a 'First Discovery Tool' intended as an easy and accessible way for people to discover and set preferences to address major access barriers. The tool is designed to support people who have limited technology experience or confidence. Testing in educational and senior settings found that most participants were able to understand the preferences offered, and some discovered helpful options they were previously not aware of.

The decapeptide LVV-hemorphin-7 binds with high affinity to the angiotensin IV (Ang IV) receptor (AT(4) receptor), eliciting a number of physiological effects, including cellular proliferation and memory enhancement. We have recently shown that the AT(4) receptor is identical to insulin-regulated aminopeptidase (IRAP) and that both LVV-hemorphin-7 and Ang IV inhibit the catalytic activity of IRAP. In the current study, a series of alanine-substituted and N- or C-terminally modified analogs of LVV-hemorphin-7 were evaluated for their abilities to compete for (125)I-Ang IV binding in sheep adrenal and cerebellar membranes. Selected analogs were also analyzed for binding to recombinant human IRAP and inhibition of IRAP aminopeptidase activity. C-Terminal deletions of LVV-hemorphin-7 resulted in modest changes in affinity for IRAP, whereas deletion of the first three N-terminal residues abolished binding. Monosubstitutions of Tyr(4) and Trp(6) with alanine resulted in a 10-fold reduction in affinity. Competition binding studies using recombinant human IRAP demonstrated the same rank order of affinity as obtained for the ovine tissues. All LVV-hemorphin-7 analogs tested, except for Leu-Val-Val-Tyr, inhibit the cleavage of the synthetic substrate, leucine beta-naphthylamide, by IRAP, with K(i) values between 56 and 620 nM. We find that the Val(3) residue is crucial for LVV-hemorphin-7 binding to IRAP, whereas the C-terminal domain seems to play a minor role. The current study highlights the minimal residues necessary for binding and inhibition of IRAP and provides a basis to design peptidomimetic analogs for experimental and potentially clinical use.

This paper highlights the research for year one of the Preferences for Global Access (PGA) project whose long term goal is to define a cross-platform preference acquisition system to acquire a user’s needs and preferences for accessing Information and Communication Technology (ICT) as part of a cloud-based Global Public Inclusive Infrastructure (GPII).

With the rapid growth of sensor platforms for imagery collection, from micro-unmanned aerial systems (UAS) to smart phones, an ability to geo-register image data is a fundamental need for many downstream applications. Approaches to georegistration for sensor imagery have deep roots in photogrammetry, and more recently with the integration of computer vision techniques. Georegistration solutions are increasingly sought for inexpensive and non-metric quality sensors and/or those that may lack the metadata needed to support rigorous coordinate transfer with error estimation. This indicates a range of solution quality, with situational awareness at one end, and rigorous accuracy at the other. There are a variety of correspondence and transformation models from which to select, with tradeoffs among simplicity, accuracy, and error estimation. The continually expanding vernacular of terms and methods can lead to confusion of application among the broader community of users. A sorting of representative terminology, processes, and techniques, is proposed as a framework. The goal is to motivate discussion for application guidelines.

This paper examines community efforts to enhance usability of motion imagery to support Geospatial Intelligence (GEOINT) production and analysis. Beginning with a snapshot of "where we are now," the paper will describe potential technologies for integration into baseline systems. The efforts cover PED chains for both wide area and narrow field of view sensors, with strong emphasis on workflow and process automation. While automation is key and critical to slowing down the spiraling problem of data overload, it is recognized that all intelligence problems are not "machine solvable" and therefore a delicate balance between human and machine must be designed and maintained, in order to meet critical timelines, achieve desired throughput, and get the most value out of the massive amounts of data collected. The community continues to seek innovative ways to package and deliver enhanced analytic capability.

The Video National Imagery Interpretability Rating Standard (V-NIIRS) consists of a ranked set of subjective criteria to assist analysts in assigning an interpretability quality level to a motion imagery clip. The V-NIIRS rating standard is needed to support the tasking, retrieval, and exploitation of motion imagery. A criteria survey was conducted to yield individual pair-wise criteria rankings and scores. Statistical analysis shows good agreement with expectations across the 9-levels of interpretability, for each of the 7 content domains.

A perceptual evaluation compared tracking performance when using color versus panchromatic synthetic imagery at low frame rates. Frame rate was found to have an effect on tracking performance for the panchromatic motion imagery. Color was found to be associated with improved tracking performance at 2 frames per second (FPS), but not at 6 FPS or greater. A self estimate of task confidence given by the respondents was found to be correlated to the measured tracking performance, which supports the use of task confidence as a proxy for task performance in the future development and validation of a motion imagery rating scale.

The motion imagery community would benefit from the availability of standard measures for assessing image interpretability. The National Imagery Interpretability Rating Scale (NIIRS) has served as a community standard for still imagery, but no comparable scale exists for motion imagery. Previous studies have explored the factors affecting the perceived interpretability of motion imagery and the ability to perform various image exploitation tasks. More recently, a study demonstrated an approach for adapting the standard NIIRS development methodology to motion imagery. This paper presents the first step in implementing this methodology, namely the construction of the perceived interpretability continuum for motion imagery. We conducted an evaluation in which imagery analysts rated the interpretability of a large number of motion imagery clips. Analysis of these ratings indicates that analysts rate the imagery consistently, perceived interpretability is unidimensional, and that interpretability varies linearly with log(GSD). This paper presents the design of the evaluation, the analysis and findings, and implications for scale development.

A fundamental problem in image processing is finding objective metrics that parallel human perception of image quality. In this study, several metrics were examined to quantify compression algorithms in terms of perceived loss of image quality. In addition, we sought to describe the relationship of image quality as a function of bit rate. The compression schemes used were JPEG2000, MPEG2, and H.264. The frame size was fixed at 848x480 and the encoding varied from 6000 k bps to 200 k bps. The metrics examined were peak signal to noise ratio (PSNR), structural similarity (SSIM), edge localization metrics, and a blur metric. To varying degrees, the metrics displayed desirable properties, namely they were monotonic in the bit rate, the group of pictures (GOP) structure could be inferred, and they tended to agree with human perception of quality degradations. Additional work is being conducted to quantify the sensitivity of these measures with respect to our Motion Imagery Quality Scale.

Motion imagery will play a critical role in future intelligence and military missions. The ability to provide a real time, dynamic view and persistent surveillance makes motion imagery a valuable source of information. The ability to collect, process, transmit, and exploit this rich source of information depends on the sensor capabilities, the available communications channels, and the availability of suitable exploitation tools. While sensor technology has progressed dramatically and various exploitation tools exist or are under development, the bandwidth required for transmitting motion imagery data remains a significant challenge. This paper presents a user-oriented evaluation of several methods for compression of motion imagery. We explore various codecs and bitrates for both inter- and intra-frame encoding. The analysis quantifies the effects of compression in terms of the interpretability of motion imagery, i.e., the ability of imagery analysts to perform common image exploitation tasks. The findings have implications for sensor system design, systems architecture, and mission planning.

The motion imagery community would benefit from the availability of standard measures for assessing image interpretability. The National Imagery Interpretability Rating Scale (NIIRS) has served as a community standard for still imagery, but no comparable scale exists for motion imagery. Several considerations unique to motion imagery indicate that the standard methodology employed in the past for NIIRS development may not be applicable or, at a minimum, requires modifications. The dynamic nature of motion imagery introduces a number of factors that do not affect the perceived interpretability of still imagery - namely target motion and camera motion. A set of studies sponsored by the National Geospatial-Intelligence Agency (NGA) have been conducted to understand and quantify the effects of critical factors. This study discusses the development and validation of a methodology that has been proposed for the development of a NIIRS-like scale for motion imagery. The methodology adapts the standard NIIRS development procedures to the softcopy exploitation environment and focuses on image interpretation tasks that target the dynamic nature of motion imagery. This paper describes the proposed methodology, presents the findings from a methodology assessment evaluation, and offers recommendations for the full development of a scale for motion imagery.

The development of a motion imagery (MI) quality scale, akin to the National Image Interpretibility Rating Scale (NIIRS) for still imagery, would have great value to designers and users of surveillance and other MI systems. A multiphase study has adopted a perceptual approach to identifying the main MI attributes that affect interpretibility. The current perceptual study measured frame rate effects for simple motion imagery interpretation tasks of detecting and identifying a known target. By using synthetic imagery, there was full control of the contrast and speed of moving objects, motion complexity, the number of confusers, and the noise structure. To explore the detectibility threshold, the contrast between the darker moving objects and the background was set at 5%, 2%, and 1%. Nine viewers were to detect or identify a moving synthetic "bug" in each of 288 10-second clip. We found that frame rate, contrast, and confusers had a statistically significant effect on image interpretibility (at the 95% level), while the speed and background showed no significant effect. Generally, there was a significant loss in correct detection and identification for frame rates below 10 F/s. Increasing the contrast improved detection and at high contrast, confusers did not affect detection. Confusers reduced detection of higher speed objects. Higher speed improved detection, but complicated identification, although this effect was small. Higher speed made detection harder at 1 Frame/s, but improved detection at 30 F/s. The low loss of quality at moderately lower frame rates may have implications for bandwidth limited systems. A study is underway to confirm, with live action imagery, the results reported here with synthetic.