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Movement disorders associated with exposure to antipsychotic drugs are common and stigmatising but underdiagnosed.
Aims
To develop and evaluate a new clinical procedure, the ScanMove instrument, for the screening of antipsychotic-associated movement disorders for use by mental health nurses.
Method
Item selection and content validity assessment for the ScanMove instrument were conducted by a panel of neurologists, psychiatrists and a mental health nurse, who operationalised a 31-item screening procedure. Interrater reliability was measured on ratings for 30 patients with psychosis from ten mental health nurses evaluating video recordings of the procedure. Criterion and concurrent validity were tested comparing the ScanMove instrument-based rating of 13 mental health nurses for 635 community patients from mental health services with diagnostic judgement of a movement disorder neurologist based on the ScanMove instrument and a reference procedure comprising a selection of commonly used rating scales.
Results
Interreliability analysis showed no systematic difference between raters in their prediction of any antipsychotic-associated movement disorders category. On criterion validity testing, the ScanMove instrument showed good sensitivity for parkinsonism (90%) and hyperkinesia (89%), but not for akathisia (38%), whereas specificity was low for parkinsonism and hyperkinesia, and moderate for akathisia.
Conclusions
The ScanMove instrument demonstrated good feasibility and interrater reliability, and acceptable sensitivity as a mental health nurse-administered screening tool for parkinsonism and hyperkinesia.
Because horsenettle and tall ironweed are difficult to control in cool-season grass pastures, research was conducted in Tennessee and Kentucky in 2010 and 2011 to examine the efficacy of aminocyclopyrachlor on these weeds. Aminocyclopyrachlor was evaluated at 49 and 98 g ai ha−1 alone and in mixtures with 2,4-D amine at 371 and 742 g ae ha−1. Aminopyralid was also included as a comparison treatment at 88 g ai ha−1. Treatments were applied at three POST timings to horsenettle and two POST timings to tall ironweed. By 1 yr after treatment (YAT) horsenettle was controlled 74% with aminocyclopyrachlor plus 2,4-D applied late POST (LPOST) at 98 + 742 g ha−1. By 1 YAT, tall ironweed was controlled ≥ 93% by aminocyclopyrachlor applied early POST (EPOST) or LPOST, at rates as low as 49 g ha−1. Similar control was achieved with aminopyralid applied LPOST. Both aminocyclopyrachlor and aminopyralid were found to reduce horsenettle and tall ironweed biomass the following year. Moreover, all LPOST applications of aminocyclopyrachlor alone or in mixtures with 2,4-D prevented regrowth of tall ironweed at 1 YAT. Based on these studies, a LPOST herbicide application in August or September when soil moisture is adequate is recommended for control of horsenettle and tall ironweed in cool-season grass pastures.
We discuss the stellar halos of massive elliptical galaxies, as revealed by our ambitious integral-field spectroscopic survey MASSIVE. We show that metallicity drops smoothly as a function of radius out to ~ 2.5 Re, while the [α/Fe] abundance ratios stay flat. The stars in the outskirts likely formed rapidly (to explain the high ratio of alpha to Fe) but in a relatively shallow potential (to explain the low metallicities). This is consistent with expectations for a two-phase growth of massive galaxies, in which the second phase involves accretion of small satellites. We also show some preliminary study of the gas content of these most MASSIVE galaxies.
We report data from an observational benchmarking study of adherence to recommended practices for insertion and maintenance of central venous catheters at a heterogeneous group of academic medical centers. These centers demonstrated a need for significant improvement in implementation and documentation of quality performance measures for the prevention of catheter-related bloodstream infections.
Stimulation of dark-adapted rods can shift the hues associated with specific wavelengths throughout the spectrum: Rods exert a green bias (strengthen green relative to red) at longer wavelengths and a blue bias (strengthen blue relative to yellow) at short-to-middle wavelengths. A third rod influence at shorter wavelengths is more complicated because it has been shown to reverse direction with change of stimulus duration. Thus, for 30-ms stimuli, rods exert a green bias like that observed at longer wavelengths. However, for 1-s stimuli, rods exert a red bias that is observed nowhere else in the spectrum. We examined the latency (time course) of rod hue biases by measuring the shifts of the three spectral unique hues under dark-adapted versus bleached (cone plateau) conditions. The rod green bias at unique yellow (mean 10 nm) and, in contrast to some prior studies, the rod blue bias at unique green (mean 21 nm) were not systematically affected by test stimulus duration. A quick rod green bias (mean 5 nm) was shown at unique blue for two of three observers but was dominated by a slower rod red bias (mean 11 nm) after 30–50 ms of rod stimulation. These opposing rod influences may reflect competing effects of rod signals on ML-cone and S-cone pathways.
Debate has proliferated as to the true site of action of opioids when placed in the epidural space. The aim of this study was to compare the analgesic effects of a bolus of diamorphine given by the epidural or intramuscular route.
Methods
Sixty patients having elective primary total knee replacements were recruited and randomized to receive epidural or intramuscular diamorphine. A lumbar epidural catheter was sited and 10 mL of bupivacaine 0.5% wt vol−1 was injected. Patients subsequently received diamorphine 5 mg into the epidural space or as an intramuscular injection. Patient-controlled analgesia with intravenous morphine was used for postoperative analgesia. The primary outcome measures included time to first patient-controlled analgesia use and total morphine consumption in 24 h. Secondary end-points considered possible treatment complications.
Results
All primary end-points showed significant differences in favour of epidural diamorphine. Medians for times to first patient-controlled analgesia use and total 24 h morphine requirements were significantly different (P < 0.001) at 418 vs. 198 min and 11 vs. 39 mg, respectively. There were no significant differences in secondary end-points.
Conclusions
This study has shown the superior analgesic efficacy of epidural diamorphine when compared to intramuscular injection.
The Full-sky Astrometric Mapping Explorer (FAME) is designed to perform an all-sky, astrometric survey with unprecedented accuracy. It will create a rigid astrometric catalog of 4 × 107 stars with 5 < mV < 15. For bright stars, 5 < mV < 9, FAME will determine positions and parallaxes accurate to < 50 μas, with proper motion errors < 50 μas/yr. For fainter stars, 9 < mV < 15, FAME will determine positions and parallaxes accurate to < 500 μas, with proper motion errors < 500 μas/yr. It will also collect photometric data on these 4 × 107 stars in four Sloan Digital Sky Survey colors. NASA selected FAME to be one of five MIDEX missions funded for a concept study. In October 1999, NASA selected FAME for launch in 2004 as the MIDEX-4 mission in its Explorer program.
The surface properties of symmetric microphase separated diblock copolymers of polystyrene (PS) and polymethylmethacrylate (PMMA) were investigated using X-ray photoelectron spectroscopy (XPS), the specular reflectivity of neutrons and secondary ion mass spectrometry (SIMS). PS, the lower surface energy component, exhibited a preferential affinity for the free surface. For copolymers that are far from the bulk microphase separation transition (MST), the surface consists of a layer of pure PS. When the system is close to the MST the surface is a mixture of PS and PMMA. The PS surface excess can be described bya N-1/2 dependence, where N is the number of segments that comprise the copolymer chain. It is shown that the surface undergoes an ordering transition at a temperature T2 that is above that of the bulk MST. The ordering of the bulk lamellar morphology is induced by an ordering at the surface. This is analogous to the ferromagnetic order observed in systems such as Gd at temperatures above the bulk Curie temperature. The results here are discussed in light of previous work on copolymer surfaces and in light of mean field theory.
Pt/ri low resistance non-alloyed ohmic contacts to p-InP-based contact layers in photonic devices, which were formed by rapid thermal processing (RTP), were studied. E-gun evaporated Pt/Ti metallization deposited onto 1.5· 1019 cm−3 Zn doped In0.53Ga0.47 As yielded the best electrical performance. These contacts were ohmic as deposited with a specific contact resistance value of 3.0 · 10−4 Ωcm2. RTP at higher temperatures led to decrease of the specific contact resistance to 3.4 · 10−8 Ωcm2 (0.08Ωmm) as a result of heating at 450°C for 30 sec. This heat treatment caused only a limited interfacial reaction (about 20 nm thick) between the Ti and the InGaAs, resulted in a thermally stable contact and induced tensile stress of 5.6 · 109 dyne · cm−2 at the metal layer but without degrading the adhesion. Heating at temperatures higher than 500°C resulted in an extensive interaction and degradation of the contact.
The method of Ion Beam Enhanced Deposition, (IBED), was used to produce hard films of i-BN, i-SixNy and i-TixNy. The friction, hardness, adhesion, and wear behavior of these nitride coalings were examined using a ball-ondisc Friction/wear tester. The friction and wear results were sensitive to stoichiometry and the presence of impurities (e.g., hydrogen) in the film as well as the choice of ball material (400C stainless steel or silicon nitride).
Thin carbon films of ˜ 600 Å have been deposited on Si <111> wafers by striking an RF discharge in gas mixtures of hydrogen and methane. The deposition rate increased with increasing methane fraction. The peak rate was ˜ 1 Å/sec at an applied power density of 0.4 W cm−2. The films, with an average density of 2.54 gm cm−3, are amorphous in nature but exhibit broad diffraction maxima corresponding to interatcidc spacings of 2.05Å and 1. 15Å. Measurements of hydrogen concentration in the films showed that the hydrogen at. % [H/(H+C)] increased from 30 to 40% as the hydrogen fraction in the feed gas increased. By using a D2-CH4, we were also able to deduce that hydrogen molecules can be a large source of hydrogen trapped in the films.
The small oval burial mound at Alfriston, East Sussex, being one of only twelve certain burial structures of the 3rd millennium bc in Sussex, was totally excavated in 1974 prior to its final obliteration by ploughing. The barrow was found to consist of a simple dump mound derived from material out of flanking ditches. It covered a single burial pit containing the crouched skeleton of a young female. Information concerning the post-Neolithic land use of Alfriston Down was obtained from the ditch silts and expanded by an intensive field survey.
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