Patient recall - strengths and shortcomings of a major information source

Physicians rely on patients for needed information about past medical events, implying a belief that patients are able to understand, recall and verbalize past medical events accurately and reliably. Is this belief valid? This article discusses: 1) whether patients are accurate and reliable reporters of their own health status, medical events and medical history; 2) whether the physician is able to make correct diagnoses and prognoses based upon information provided by patients; and 3) factors that affect recall. In some ways patients are good reporters of their medical history. However, there are numerous factors that affect reporting accuracy and reliability such as: anxiety, mood, severity of illness, type and duration of a procedure, and length of time since the medical episode. Good communication appears to be a key element in eliciting accurate and reliable patient recall. Physician records remain the best source of patient information and many points of information gleaned from patients may be used with confidence. Recognizing that physician records are the repository of the best medical information about individual patients means that more needs to be done to ensure that high priority is placed upon medical record documentation, format, and sharing. It is unlikely that physician records will ever fully replace the role of the patient as a personal medical historian.published_or_final_versio

Distribution of radioactive jackrabbit pellets in the vicinity of the B-C CRIBS, 200 East Area, U.S.A.E.C. Hanford Reservation

During 1972 and 1973 a study was conducted in the B-C Cribs, 200 East Area, to learn the extent to which jackrabbits (Lepus californicus) and their predators had dispersed buried radioactive wastes in their fecal pellets and scats. The specific objective was to gather sufficient data on the pattern of dispersal so that statistically valid sampling strategies could be developed in future programs, depending upon management planning objectives for the area. A secondary objective was to relate these data with parameters, such as topography, wind direction, vegetation types, animal behavior, that might help explain the pattern of dispersal. In 1972, 2625 circular sampling sites were surveyed along 30 transects radiating out 2.4 to 3.2 km from the B-C Cribs. Radioactive contaminated feces, urine, soil and vegetation were distributed in all directions from the cribs, but the area to the south and southwest was more densely and uniformly contaminated. Of the ultimate sampling units surveyed, 278 or 10.6% had activity in excess o f 10,000 counts per minute (cprn) measured with a Geiger-Mueller counter. Of these 278 circular areas, 179 or 64% were found within 0.5 km of the cribs, 23.4% were between 0.5 and 1.0 km, and the remaining 12.2% were further than 1 km from the central point. Although most droppings with a count rate greater than 20,000 cpm were found within 400 meters of the crib, pellets registering in excess of 100,000 cprn were found up to 1.6 km from the cribs. The pellets appeared to be distributed into the prevailing wind directions and contrary to the immediate contours: the only correlation seemed to be with increased vegetation density to the south and southwest, vegetation that is prime jackrabbit habitat. In May-June, 1973, 48 additional transects were run: 7 were parallel to lines established in the B-C Crib Area during 1972; 18 radiated from an abandoned gun battery site 3.2 km east of the cribs; and 23 were run from power lines 5 km south to southwest of the cribs back towards the source of contamination. No contaminated jackrabbit pellets were found at these distances, but one contaminated coyote scat was found near the gun battery site. During 1972 and 1973 field crews walked 106.7 km along 78 radii and recorded observations on 6671 ultimate sampling units of approximately 1.4 m{sup 2}

Shock Temperature of Stainless Steel and a High Pressure - High Temperature Constraint on Thermal Diffusivity of Al_2O_3

Time dependent shock temperatures were measured for stainless steel (SS) films in contact with transparent anvils. The anvil/window material was the same as the driver material so that there would be symmetric heat flow from the sample. Inferred Hugoniot temperatures, T_h , of 5800–7500 K at 232–321 GPa are consistent with previous measurements in SS. Temperatures at the film‐anvil interface (T_i ), which are more directly measured than T_h , indicate that T_i did not decrease measurably during the approximately 250 ns that the shock wave was in Al_2O_3 or LiF anvils. Thus an upper bound is obtained for the thermal diffusivity of Al_2O_3 at the metal/anvil interface at 230 GPa and 6000K of κ≤0.00096 cm_2/s. This is a factor of 17 lower than previously calculated values, resulting in a decrease of the inferred T_h by 730 k. The observed shock temperatures are combined with temperatures calculated from measured Hugoniots and are used to calculate thermal conductivities of Al_2O_3. Also we note that since there was no measurable intensity decrease during the time when the shock wave propagated through the window, we infer from this that Al_2O_3 remained transparent while in the shocked state. Thus sapphire is a good window material to at least 250 GPa for shock temperature measurements for metals

Electronic structure and excited state dynamics in a dicyanovinyl-substituted oligothiophene on Au(111)

Dicyanovinyl (DCV)-substituted oligothiophenes are promising donor materials in vacuum-processed small-molecule organic solar cells. Here, we studied the structural and the electronic properties of DCV-dimethyl-pentathiophene (DCV5T-Me2) adsorbed on Au(111) from submonolayer to multilayer coverages. Using a multi-technique experimental approach (low-temperature scanning tunneling microscopy/spectroscopy (STM/STS), atomic force microscopy (AFM), and two-photon photoemission (2PPE) spectroscopy), we determined the energetic position of several affinity levels as well as ionization potentials originating from the lowest unoccupied molecular orbitals (LUMO) and the highest occupied molecular orbitals (HOMO), evidencing a transport gap of 1.4 eV. Proof of an excitonic state was found to be a spectroscopic feature located at 0.6 eV below the LUMO affinity level. With increasing coverage photoemission from excitonic states gains importance. We were able to track the dynamics of several electronically excited states of multilayers by means of femtosecond time-resolved 2PPE. We resolved an intriguing relaxation dynamics involving four processes, ranging from sub-picosecond (ps) to several hundred ps time spans. These show a tendency to increase with increasing coverage. The present study provides important parameters such as energetic positions of transport levels as well as lifetimes of electronically excited states, which are essential for designing organic-molecule-based optoelectronic devices

Preliminary survey of polychlorinated biphenyls (PCBs) in aquatic habitats and Great Blue Herons on the Hanford Site. [Ardea herodias]

Polychlorinated biphenyls (PCBs), constituents of insulating fluids used in electrical transformers and capacitors, were identified during a preliminary survey of waters, sediments, and fish from five locations on the Hanford Site in southeastern Washington State: Gable Mountain Pond, B Pond, West Pond, White Bluffs Slough on the Columbia River, and a pond on the Wahluke Slope. These aquatic areas are all within the foraging range of great blue herons (Ardea herodias) that nest on the Hanford Site. Of those waters that contained PCBs, concentrations were found to be somewhat over 1 ng/L, but less than 20 ng/L, and equal to or less than concentrations reported for other freshwater regions of the United States. The PCBs in sediments and fish closely resembled the chromatographic profile of Aroclor 1260, a commercial PCB mixture produced in the United States by the Monsanto Company. Concentrations of PCBs detected in the sediments were 10 to 100 times lower than those found in soils and sediments from other areas of the nation. Concentrations of PCBs in fat from Hanford great blue herons ranged from 3.6 to 10.6 ppM, while PCB concentrations in herons from other areas of the Pacific Northwest ranged from 0.6 to 15.6 ppM. Great blue herons at Hanford contained PCB isomer distributions closely matching that of Aroclor 1260; great blue herons from other locations contained isomer distributions indicating the presence of a mixture of aroclors. 21 refs., 13 figs., 8 tabs

Ecological survey of M-Field, Edgewood Area Aberdeen Proving Ground, Maryland

An ecological survey was conducted on M-Field, at the Edgewood Area, Aberdeen Proving Ground, Maryland. M-Field is used routinely to test army smokes and obscurants, including brass flakes, carbon fibers, and fog oils. The field has been used for testing purposes for the past 40 years, but little documented history is available. Under current environmental regulations, the test field must be assessed periodically to document the presence or potential use of the area by threatened and endangered species. The M-Field area is approximately 370 acres and is part of the US Army's Edgewood Area at Aberdeen Proving Ground in Harford County, Maryland. The grass-covered field is primarily lowlands with elevations from about 1.0 to 8 m above sea level, and several buildings and structures are present on the field. The ecological assessment of M-Field was conducted in three stages, beginning with a preliminary site visit in May to assess sampling requirements. Two field site visits were made June 3--7, and August 12--15, 1991, to identify the biota existing on the site. Data were gathered on vegetation, small mammals, invertebrates, birds, large mammals, amphibians, and reptiles

Effects of daily porcine somatotropin administration on tile performance and carcass characteristics of finishing swine

One hundred forty-four pigs (72 barrows and 72 gilts) were utilized in six treatments with six pens each to evaluate four levels of daily porcine somatotropin (pST) injections (0, 1, 3, or 5 mg/d) in combination with diets containing 13 or 16% crude protein (CP). One randomly selected pig from each pen was slaughtered when it reached a weight between 230 and 240 lb. Daily feed intake (ADFI), tenth rib backfat, and estimated percentage of lean pork were reduced in pigs fed the 13% CP diet and injected with 3 mg/d pST compared to pigs fed the same diet and injected daily with a placebo. Feed intake was reduced in pigs fed the 16% CP diet and injected daily with 3 and 5 mg/d pST. Improvement in feed conversion (F/G), tenth rib backfat, and estimated percentage lean pork occurred when pigs fed the 16% CP diet were injected with 1 mg/d, with greater improvements occurring at the 3 and 5 mg/d levels of pST. The improvement in F/G and the greater magnitude of response observed in pigs fed 16% CP diets compared to the response of pigs fed the 13% CP diet indicate that both the performance and carcass characteristics of pigs injected with pST are dependent on the dietary CP content.; Swine Day, Manhattan, KS, November 16, 198

Ecological baseline study of the Yakima Firing Center proposed land acquisition: A Preliminary Report

A baseline census was conducted from October 1987 to Janurary 1988 on the property identified for possible expansion of the Yakima Firing Center. These studies provide general descriptions of the major plant communities presentand animal inhabitants during the late fall and winter study period. A vegetation map derived from a combination of onsite surveillance and remotely sensed imagery is also provided as part of this report. Through January 1988, 13 wildlife species of special interest to state and federal agencies, in addition to ducks and geese, were observed on the proposed expansion area. Then raptorial bird species were observed in the area, including bald eagles, golden eagles, and prairie falcons. Upland game bird species, such as sage grouse, California quail, chuckars, and gray (Hungarian) partridge were present. Loggerhead shrikes, a species of special interest, were also observed on the site. Estimates of waterfowl abundance are included for the Priest Rapids Pool of the Columbia River, which includes the proposed river crossing sites. The number of waterfowl on the proposed crossing areas were comparatively low during the winter of 1986 to 1987 and high in 1987 to 1988. Bald eagles ad common loons were observed on the crossing areas. Six small mammal species were captured during this study period;one, the sagebrush vole, is a species of special interest. Two large animal species, mule deer and elk, were noted on the site. Beaver were the only furbearig animals noted to date. Rainbow trout were the only fish species collected within the proposed northern expansion area. The distribution of fall chinook salmon spawning areas was documented within the proposed river crossing areas. 3 refs., 7 figs., 3 tabs