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.     

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.     

The effects of salinity,temperature and sediment on the toxicity of copper to juvenile Hediste (Nereis) diversicolor (O. F. Muller)

Without sediment, increasing salinity (7.3 to 29.2) and increasing temperature (12 to 22 °C) reduced the toxicity of copper to juvenile Hediste diversicolor. The LC₅₀ values ranged from 357 gL^-1 in 7.3 to 513 g L^-1 in 29.2 at 12°C and from 247 to 500 g L^-1 at 22°C. In deionized water all the juvenile were dead in all solutions to which copper was added (100 to 600 g L^-1). Dead worms were swollen and everted their pharynxs. In higher doses of copper (500 to 600 g L^-1) the worms were abnormal in behaviour in all salinities (0 to 29.2). The ability to swim or crawl was disturbed.With sediments increasing temperature and increasing salinity increased the toxicity of copper to the worms. The LC₅₀ values ranged from 3200 to 4100 g L^-1 at 22°C. The response of the juvenile to copper was antagonistic to increasing temperature and salinity and synergistic to increasing salinity and increasing temperature without and with the sediment respectively.     

An environmental stress information system

This paper reports on the development of an environmental stress information system (ESIS) for the purpose of storing, updating and analysing environmental stress data related to noise, heat, improper illumination and air contaminants. The information system (ESIS) consists of a set of programs as well as a set of data base files for the purpose of efficient data processing. The system is user-friendly and, once started, guides the user with the help of menu-driven options. All data related to noise, heat, illumination and air contaminants can be entered, updated, displayed or printed in certain specified formats. Finally, the use of the ESIS in evaluating air contaminants such as total suspended particles, certain specified metals and inorganic gases in the Jeddah Industrial estate is also reported.     

The effect of temperature and salinity on copper body-burden and copper toxicity to Hediste (Nereis) diversicolor

Temperature from 12 to 22°C and salinity from 30.5 to 7.6 increased accumulation of copper in Hediste diversicolor. Copper accumulated ranged from 85.83 to 217.14 g g^-1. Sediments reduced accumulation of copper under temperature-salinity combinations. Accumulated copper ranged from 90.19 to 153.26 g g^-1.However, mortality of the worms was not solely dependent upon copper body-burden. It ranged from 34 to 45% and from 38 to 80% in the presence of sediment. A combination of osmoregulatory and thermal stresses increased the toxic effect of copper to the worms.     

Interspecific and intraspecific identification of Dendrobium based on the psbAtrnH intergenic region sequences and the 5S rRNA gene spacer sequences北大核心CSCD

This research aimed to investigate the interspecific and intraspecific identification of Dendrobium by using the multi-locus method so as to provide a molecular basis for Dendrobium identification through the combination of chloroplast psbA-trnH intergenic region sequences and ribosome 5S rRNA gene spacer sequences. PCR direct sequencing was applied to detect the chloroplast psbA-trnH intergenic region sequences as well as the ribosome 5S rRNA gene spacer sequences of 12 Dendrobium species, while the psbA-trnH intergenic region sequences of Dendrobium denneanum dq-2 variety and dq- 5line were cloned and sequenced for single nucleotide polymorphism (SNP) analyzing. The sequences were analyzed by the software Sequencher4.14, Bioedit7.0, MEGA5.2 and Dansp5.0; the interspecific and intraspecific Kimara-2-Parameter(K2P) distances were also calculated. The phylogenetic tree (using Neighbor joining method) was constructed with Bulbophyllum odoratissimum and Bletilla striata as outgroup. The results showed an average length of chloroplast psbA-trnH gene sequences in Dendrobium as 742.3 bp, with 72 variable sites, including 33 information sites; the average length of the ribosome 5S rRNA gene spacer sequences in Dendrobium was 336.4 bp, with 213 variable sites including 139 information sites. Using psbAtrnH intergenic region sequences in combination with ribosome 5S rRNA gene spacer sequences can not only identify D. denneanum, D. hancockil, D. thysiflorum, D. devonianum, D. moniliforme, D. chrysotoxum, D. officinale, D. heterocarpum and D. nobile, but also differentiate D. officinale from different geographical populations, and distinguish the dq-2 variety and dq 5line with SNP in the multi locus of D. denneanum.     

Effects of initial decomposing leaf litter of Cinnamomum camphora on the growth and physiology of Impatiens balsamina北大核心CSCD

A pot experiment was conducted to study the allelopathic effects of initial decomposing leaf litter of Cinnamomum camphora on growth and physiology of Impatiens balsamina. Three leaf litter treatments included 20, 40 and 80 g of C. camphora leaf litter mixed with 8 kg of soil, namely T1, T2, and T3, respectively. In order to test the effect of leaf litter addition on the permeability and ventilation of soil simultaneously, a parallel trial with steamed leaf litter was conducted with the three treatments of the leaf litter. The leaf litter was steamed for 2 d to remove the secondary metabolites as much as possible, dried, and then mixed with 8 kg of soil, namely Z1, Z2, and Z3, respectively. No leaf litter was added in control (CK). The growth parameters of I. balsamina were determined at the 20 d, 60 d, 100 d and 120 d after sowing and the main physiology indicators were determined at the 60 d. The results indicated that: (1) The ground surface diameter and height of I. balsamina were inhibited significantly at 60 d (P < 0.05). Photosynthetic pigments and gas exchange parameters of I. balsamina were inhibited significantly at 60 d, and the inhibition effect was stronger with increased amount of leaf litter addition. The chlorophyll content, Pn and Ls decreased significantly with increased amount of leaf litter (P < 0.05). The activity of superoxide dismutase (SOD) and peroxidase (POD) in leaves of I. balsamina decreased with the increase of leaf litter addition. The content of MDA in treatments T1, T2 and T3 were all higher than that in CK, which indicated that I. balsamina suffered oxidative damage in a certain degree. The content of free proline (Pro) and soluble sugar (SS) in leaves of I. balsamina decreased significantly with the increase of the leaf litter (P < 0.05), while the content of soluble protein (SP) increased. (2) In the parallel trial, 60 d after sowing, no obvious difference was observed between CK and any steamed leaf litter treatment in terms of the morphological and physiological features stated above (P > 0.05). It indicated that the soil physical properties were not greatly influenced by leaf litter addition in the dose interval designed, or that the release of secondary metabolites from decomposing leaf litter was probably a better reason to explain the inhibition of leaf litter treatment to I. balsamina growth. (3)The compound effect (CE) of leaf litter decomposition on I. balsamina was enhanced with increase of the leaf litter, to 0.169, 0.354, and 0.497, respectively, in treatments of T1, T2 and T3. The study indicated that initial decomposition of C. camphora leaf litter in soil reduces the content of photosynthetic pigments, inhibits photosynthetic capacity and resistance physiology of I. balsamina, weakens its adaptability to the environment, and restrains growth of the plant. © 2015, Science Press. All rights reserved.