Cognitive skills underlying driving in patients discharged following self-poisoning with central nervous system depressant drugs

Background: Central nervous system-depressant (CNS-Ds) drugs can impair cognitive functions and driving. They are also the most common drugs taken in overdose in hospital-treated episodes of self-poisoning. In Australia most of these patients are discharged within 48?h, while they still have possible subclinical drug effects. We aimed to determine whether patients treated for self-poisoning with CNS-Ds are impaired in the Trail-Making Test (TMT, parts A and B), a neuropsychological test that is known to correlate with driving performance. Methods: This study was a conducted from November 2008 to April 2011 in a referral center for poisonings in New South Wales, Australia. One hundred seven patients discharged from the clinical toxicology unit following treatment for self-poisoning of CNS-Ds (benzodiazepines, atypical antipsychotics, or opioids) and a control group of 68 discharged following self-poisoning of non-CNS-depressant drugs (acetaminophen or nonsedating antidepressants) were tested with the TMT (parts A and B). Due to the known association of impaired TMT with driving impairment and increased risk of traffic accidents, performance less than the 10th percentile for age was defined as significant impairment in each part of the TMT. The odds ratio (OR) for impairment in each part was calculated in multivariate logistic regression (MLR) models adjusted for gender, education, IQ, and the presence of a major psychiatric illness. A secondary MLR analysis was conducted only for those patients (78 CNS-D and 54 control group participants) who were directly discharged home, after excluding those who were transferred for further psychiatric care. Results: The odds of impairment in the CNS-D group was 2.8?times that of the control group on the TMT-A (38 [35.5%] vs. 11 [16.2%]: adjusted OR = 2.76, 95% confidence interval [CI]: 1.28-5.97), and 4.6?times on the TMT-B (67 [62.6%] vs. 22 [32.4%]: adjusted OR = 4.63, 95% CI: 2.06-10.42). The results were similar in the subgroup of patients discharged home, and the odds of impairment in the CNS-D group was 3.3?times that of the control group on the TMT-A (25 [32.1%] vs. 7 [13.0%]: adjusted OR = 3.30, 95% CI: 1.28-8.52), and 3.6?times on the TMT-B (46 [59.0%] vs. 17 [31.5%]: adjusted OR = 3.64, 95% CI: 1.44-9.20). TMT-B impairment in the CNS-D group remained significant even after adjusting for TMT-A performance. Conclusions: Patients with CNS-D overdose may have significant impairment in cognitive skills underlying driving at the time of discharge from hospitals. Clinicians should warn these patients that their driving skills might still be impaired, even if they are considered clinically recovered and advise them not to drive during the first 1 to 2?days following discharge.     

A moderated mediation test of personality,coping, and health among deployed soldiers

Our study examines how personality and coping influence soldiers' psychological health among 648 US Army personnel who were at that time deployed in Iraq at the height of an insurgency. Conscientiousness, neuroticism, and extraversion were associated with different coping behaviors, and these were in turn related to psychological distress. Conscientiousness was positively associated with problem‐focused coping and negatively with avoidance coping, whereas neuroticism was most positively associated with avoidance coping. Extraversion was positively related to both seeking social support and avoidance coping. As expected, avoidance coping was positively associated with psychological distress. Coping style explained more variance in the relationship between personality and distress among soldiers who perceived higher levels of threat, thus supporting a moderated mediation hypothesis. We discuss implications for facilitating the stress coping of workers who face acute and potentially traumatic stress exposures. Copyright © 2011 John Wiley & Sons, Ltd.     

The effect of overtaking behavior on unidirectional pedestrian flow

We present a model of overtaking behavior that can be used to simulate unidirectional pedestrian flow in routine. All pedestrians have the ability to determine whether or not to overtake other pedestrians according to their desired velocity and position. Although existing models such as cellular automata models, lattice gas models, social force models, etc., can be used to predict evacuation performance, most of these models are either computationally inefficient or do not account for some crucial elements of human behavior in a moving crowd. Furthermore, these models use either empirical equations developed from experiments or mechanical system analogies to determine movement decisions. The pedestrian flow patterns simulated by these models may deviate significantly from reality. In reality, pedestrians walk at different velocities and pedestrians with a higher walking velocity are accustomed to overtaking other pedestrians with a lower walking velocity and this paper aims to mimic this behavior as the original social force model developed by Helbing et al. does not reflect this pattern of collective pedestrian behavior. In this paper, we propose modifications of the social force model that reflects how overtaking behavior operates in routine. The comparison of the pedestrian flow pattern between the original social force model and the modified social force models with the real data collected by the camcorder is also performed in order to demonstrate our modified social force model can be used to achieve reasonable simulations of overtaking behavior among pedestrians.     

Comparing the usability and reliability of a generic and a domain-specific medical error taxonomy

Medical error taxonomies are used to report and analyse patient safety incidents. Medical error taxonomies can be generic or domain-specific. In comparing generic and domain-specific medical error taxonomies, the literature compares the information both type of taxonomies classify. There is little evidence the taxonomies have been compared in terms of usability and reliability. Twenty nurses and 21 pharmacists participated in a study comparing the usability and reliability of a generic medical error taxonomy and a medication error taxonomy. The medical error taxonomies utilized were the Patient Safety Event Taxonomy and the NCC MERP Taxonomy of Medication Error. The study found no significant difference in the usability ratings of both taxonomies. The taxonomies required different amount of time to classify patient safety incidents and had significantly different reliability levels. The reliability of the NCC MERP Taxonomy of Medication Error was significantly different when used by nurses and pharmacists. The taxonomy was also preferred by the majority of participants. Some recommendations are made about the design of future medical error taxonomies.     

Overstory mortality as an indicator of forest health in California

The interagency Forest Health Monitoring Program involves a network of about 4200 forest plots on a triangular grid across the United States. We present data on recent mortality of trees 27.9 cm diameter from the first three years of measurements in California (1992–1994). Three plot designs were used to collect data representative of a 1-ha stand at each site; the designs differed primarily in total area sampled (0.067, 0.4 and 1.0 ha). Approximately 50 sites were visited each year yielding a total of about 150. Field tallies showed few cases of recent mortality in the smallest plot size. Cumulative distribution functions of recent dead tree densities in the 0.067-ha plots differed significantly from those generated by tallies from entire 1-ha stands. We conclude that an area of 0.067 ha is unsuitable to assess and monitor overstory mortality in Pacific Coast forests.The U.S. government right to retain a non-exclusive, royalty free licence in and to any copyright is acknowledged.     

Trophic transfer of polybrominated diphenyl ethers and polychlorinated biphenyls in a tidal freshwater marsh

The John Heinz National Wildlife Refuge (NWR) at Tinicum Marsh contains one of the last remaining tidal freshwater marsh communities along the Pennsylvania side of the Delaware River Estuary. The marsh receives a significant load of nutrients and sediment-associated contaminants and is hypothesised to act as an effective trap for these chemicals. The goal of this study was to quantify the levels of polybrominated diphenyl ethers (PBDEs) and polychlorinated biphenyls (PCBs) at various trophic levels at two sites within Tinicum Marsh and assess the factors important in determining their bioaccumulation and trophic transfer. For both PCBs and PBDEs, lipid variation for all species was a large factor in determining contaminant body burden. Also, concentrations in biota increased with increasing trophic level as determined by nitrogen isotope analysis (δ¹⁵N values) at the downstream site within Tinicum Marsh. This trend was less apparent at the upstream site and may be due to differences in feeding behaviours among species between the two sites and/or differences in carbon and nitrogen sources and recycling. These data are valuable in assisting bioaccumulation/trophic transfer studies and serve as benchmarks to which future PCB and PBDE concentrations will be compared.     

Physicochemical properties of non-living water hyacinth (Eichhornia crassipes) and lesser duckweed (Lemna minor) and their influence on the As(V) adsorption processes

Eichhornia crassipes (Ec) and Lemna minor (Lm) are aquatic plants. They are considered as weeds of the water and approach being a scourge in many parts of the world, choking waterways and hindering transport upon them. At the same time they are known to readily remove heavy metal ions from water. This paper considers the use of non-living plants as novel and inexpensive biosorbent for the removal of As(V) from watersheds. In the first place they were conditioned and characterised to determine their physicochemical and surface properties and in the second place their adsorption properties for As(V) from aqueous solution were evaluated considering the toxicity of this metalloid in the environment. It describes the methodology to prepare the non-living biomasses; the physicochemical characterisation by SEM, XRD, FTIR, TGA analyses and surface characterisation of Ec and Lm by specific surface, hydration kinetic, point of zero charge determination by mass titration, active site density and XPS analysis are described. Both studied biomasses were found to be potential bio-sorbents for arsenic ions from aqueous solution. According to their efficiency to remove arsenic, they can be used in a very low cost metalloid ions removal system.     

Efficacy of rapeseed residue and eggshell waste on enzyme activity and soil quality in rice paddy

Addition of plant residue into soils improves soil physiochemical properties and its fertility. Rapeseed residue is an emerging N source to paddy soils via rice-rape double-cropping practice. The objective of this study was to evaluate the effects of rapeseed residue and eggshell waste on chemical changes and enzyme activity in the rice paddy soil. The powdered eggshells at 0, 1, 3, and 5% were applied once to 7.0 kg paddy repacked soils in each pot treated with the rapeseed residue or the conventional N, P, and K fertilisers. Eight rice seedlings (Oriza sativa L. cv. Ilmibyeo) (40 days after sowing) were transplanted to the treated each pot. The contents of total C (TC) and N (TN), and organic matter (OM) were significantly increased in soils treated with the rapeseed residue compared to the N, P, and K fertilisers. With the addition of eggshell containing ～92% CaCO₃, a considerable increase of soil pH was observed in soils treated with the rapeseed residue and the N, P, and K fertilisers, compared to the untreated soil. Activities of β-glucosidase, urease, and arylsulfatase enzymes were higher in soils treated with the rapeseed residue than soils treated with the N, P, and K fertilisers. The eggshell additions at 1, 3, and 5% into soils treated with the rapeseed residue increased enzyme activity mainly resulting from N mineralisation, whereas no change in enzyme activity was observed in the soils treated with the NPK fertiliser. The combined use of the rapeseed residue and the eggshells can be beneficial to improve soil environment.     

Deposition Inputs,Water Quality and Liming Effectiveness

Rainfall quantity and quality, and stream and loch water quality have been monitored throughout the Loch Fleet Project. This has allowed the effects of liming of parts of the catchment to be monitored, and assessments made of the effectiveness and duration of these treatments. Rainfall over 1989–1993 fluctuated around the long-term average of 2100 mm. Over this time, year by year variations in acid or sulphate loading from deposition was evident and quite substantial. There was no trend, however, reflecting reductions in national sulphur emissions. Liming parts of the catchment in 1986 increased stream and loch water pH and calcium concentrations and reduced inorganic aluminium concentrations. Improved stream and loch water quality has been maintained for more than eight years since liming.     

Behaviour of Dioxins,Furans and Metals Associated with Stabilized Msw Combustor Ash in Sea Water

This report presents the results of a research programme designed to examine the engineering and environmental acceptability of stabilizing municipal solid waste (MSW) combustor ash for artificial reef construction. Municipal solid waste combustor ash was combined with Portland cement to form solid blocks using conventional construction block making technology. the resultant stabilized combustor ash (SCA) blocks were used to construct an artificial habitat in Conscience Bay, Long Island Sound, New York and compared to identical concrete blocks, fabricated using natural aggregates. Over a 4.5 year period divers periodically returned to the site to monitor the interaction of SCA blocks with the marine environment and compare the performance of these blocks with the concrete control blocks. Results show that the SCA blocks retain their strength after prolonged sea water exposure. Contaminants of environmental concern, including metals, dioxins and furans, were retained within the cementitious matrix of the SCA blocks after prolonged sea water submersion. in addition, organisms growing on the surfaces of the SCA blocks did not accumulate contaminants from the blocks.