Distinguishing Mild from Moderate Dementia Using the Clock Drawing Test

Introduction: The Clock Drawing Test (CDT) is popular amongst professionals such as neuropsychologists and neurologists working with dementia patients as well as among a wider range of physicians, including general practitioners. The purpose of this study is to investigate the capacity of CDT to distinguish mild from moderate dementia and to determine relevant cut-off thresholds for three popular scoring systems. Material and methods: Forty-six patients with Alzheimer's disease were included. They were tested using MMSE and CDT. The latter was scored according to the systems proposed by Sunderland, Shulman and Lam. T-test and ROC analysis were performed. Results: According to MMSE, patients were classified as having mild or moderate dementia. Significant differences between the CDT scores of the two groups were found for the Sunderland and Lam methods (p 4 (Shulman), and> 6 (Lam). Discussion: Determining the severity of dementia is important not only for understanding the extent to which the patient is dependent on care, but also for determining the appropriate treatment. The availability of short neuropsychological instruments with good sensitivity and specificity, such as CDT, enables specialists to be more flexible in their practice

Michael P. O\u27Connor, an individual, Plaintiff and Appellant, v. Gary W. Burningham, Jeanna Burningham, Sandy Phillips, Ruby Ray, Drew Downs, Curt Parke, Julie Parke, Mike Powell, Barbara Powell, Steve Davis, Jan Davis, Todd Kirkpatrick, Sue Chandler, Dallie Haderlie, Wendy Haderlie, Sheldon Worthington, John C. Rogers, Kenny Norris, Robyn Norris, Will Sunderland, Darlene Durrant, Blair Swenson, Robert T. Price, Kim M. Price, Kent Beckstead, Suzanne Beckstead, Lisa Gray, John Jex, Jessica Jensen, Jeff Burningham and John Does 1-50, Defendants and Appellees : Brief of Appellant

MICHAEL P. O\u27CONNOR, an individual, Plaintiff and Appellant, v. GARY W. BURNINGHAM. JEANNA BURNINGHAM. SANDY PHILLIPS. RUBY RAY. DREW DOWNS. CURT PARKE. JULIE PARKE. MIKE POWELL. BARBARA POWELL. STEVE DAVIS. JAN DAVIS. TODD KIRKPATRICK. SUE CHANDLER. DALLIE HADERLIE. WENDY HADERLIE. SHELDON WORTHINGTON, JOHN C. ROGERS. KENNY NORRIS. RQBYN NORRIS. WILL SUNDERLAND. DARLENE DURRANT. BLAIR SWENSON, PAULA SWENSON, ROBERT T. PRICE. KIM M. PRICE. KENT BECKSTEAD. SUZANNE BECKSTEAD. LISA GRAY. JOHN JEX. JESSICA JOHNSEN. JEFF BURNINGHAM. and JOHN DOES 1-50, j Defendants and Appellees. | APPELLANT BRIEF Case No. 20060090 Subject to reassignment to the Court of Appeal

Integrated electronic prescribing and robotic dispensing: a case study

INTRODUCTION: To quantify the benefits of electronic prescribing directly linked to a robotic dispensing machine. CASE DESCRIPTION: Quantitative case study analysis is used on a single case. Hospital A (1,000 beds) has used an integrated electronic prescribing system for 10 years, and in 2009 linked two robotic dispensing machines to the system. The impact on dispensing error rates (quality) and efficiency (costs) were assessed. EVALUATION AND DISCUSSION: The implementation delivered staff efficiencies above expectation. For the out-patient department, this was 16% more than the business case had suggested. For the in-patients dispensary, four staff were released for re-deployment. Additionally, £500,000 in stockholding efficiency above that suggested by the business case was identified. Overall dispensing error rates were not adversely affected and products dispensed by the electronic prescribing - robot system produced zero dispensing errors. The speed of dispensing increased also, as the electronic prescribing - robot combination permitted almost instantaneous dispensing from the point of a doctor entering a prescription. CONCLUSION: It was significant that the combination of electronic prescribing and a robot eliminated dispensing errors. Any errors that did occur were not as a result of the electronic prescribing - robotic system (i.e. the product was not stocked within the robot). The direct linking of electronic prescribing and robots as a dispensing system together produces efficiencies and improves the quality of the dispensing process

Neck-cooling improves repeated sprint performance in the heat

The present study evaluated the effect of neck-cooling during exercise on repeated sprint ability in a hot environment. Seven team-sport playing males completed two experimental trials involving repeated sprint exercise (5 × 6 s) before and after two 45 min bouts of a football specific intermittent treadmill protocol in the heat (33.0 ± 0.2°C; 53 ± 2% relative humidity). Participants wore a neck-cooling collar in one of the trials (CC). Mean power output and peak power output declined over time in both trials but were higher in CC (540 ± 99 v 507 ± 122 W, d = 0.32; 719 ± 158 v 680 ± 182 W, d = 0.24 respectively). The improved power output was particularly pronounced (d = 0.51–0.88) after the 2nd 45 min bout but the CC had no effect on % fatigue. The collar lowered neck temperature and the thermal sensation of the neck (P 0.05). There were no trial differences but interaction effects were demonstrated for prolactin concentration and rating of perceived exertion (RPE). Prolactin concentration was initially higher in the collar cold trial and then was lower from 45 min onwards (interaction trial × time P = 0.04). RPE was lower during the football intermittent treadmill protocol in the collar cold trial (interaction trial × time P = 0.01). Neck-cooling during exercise improves repeated sprint performance in a hot environment without altering physiological or neuroendocrinological responses. RPE is reduced and may partially explain the performance improvement

Spiders in the agricultural landscape

Spiders in agroecosystems play a role in natural pest suppression and contribute to biodiversity. In this thesis I have investigated if and when spiders recolonise cereal fields in spring when they have the potential to suppress establishing pest aphid populations. Furthermore, the influence of different environmental factors on spiders has been investigated to understand how it might be possible to provide suitable conditions for enhancement of their populations. Linyphiid spiders recolonised fields after being negatively affected by sowing in spring, while lycosid spiders were unaffected. Conversely, lycosids showed a recolonisation in winter cereals after overwintering, but not linyphiids. But linyphiid migratory patterns also differed over time, because they were positively influenced by landscape heterogeneity in the beginning of spring but not at the end. Diversity of lycosid and linyphiid spiders was positively influenced by perennial crops and forest in the surrounding landscape. Field margins were found to be a key habitat for the diversity of both spider families. Lycosid abundance was affected on the habitat scale and linyphiid abundance on the larger landscape scale, which can be explained by the families' different modes of dispersal. Farming systems, conventional or organic, contained different compositions of lycosid and linyphiid species. The dominant lycosid and linyphiid species were more abundant at organic sites. Body condition of Pardosa (Lycosidae) turned out to be superior in landscapes dominated by large fields with annual crops, irrespective of farming system, perhaps because of less competition for available resources. This thesis provides evidence that spiders are present in crop fields early in spring when they have the opportunity to suppress establishing aphid pests. Different spider species were associated with different farming systems, but the abundances of the most common species were enhanced by organic management. A diverse landscape with easy access to perennial crops and field margins will augment both number of species and individuals of spiders