Application of STOPP and START criteria: interrater reliability among pharmacists

BACKGROUND: Inappropriate prescribing is a well-documented problem in older people. The new screening tools, STOPP (Screening Tool of Older Peoples' Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment) have been formulated to identify potentially inappropriate medications (PIMs) and potential errors of omissions (PEOs) in older patients. Consistent, reliable application of STOPP and START is essential for the screening tools to be used effectively by pharmacists. OBJECTIVE: To determine the interrater reliability among a group of clinical pharmacists in applying the STOPP and START criteria to elderly patients' records. METHODS: Ten pharmacists (5 hospital pharmacists, 5 community pharmacists) were given 20 patient profiles containing details including the patients' age and sex, current medications, current diagnoses, relevant medical histories, biochemical data, and estimated glomerular filtration rate. Each pharmacist applied the STOPP and START criteria to each patient record. The PIMs and PEOs identified by each pharmacist were compared with those of 2 academic pharmacists who were highly familiar with the application of STOPP and START. An interrater reliability analysis using the k statistic (chance corrected measure of agreement) was performed to determine consistency between pharmacists. RESULTS: The median ? coefficients for hospital pharmacists and community pharmacists compared with the academic pharmacists for STOPP were 0.89 and 0.88, respectively, while those for START were 0.91 and 0.90, respectively. CONCLUSIONS: Interrater reliability of STOPP and START tools between pharmacists working in different sectors is good. Pharmacists working in both hospitals and in the community can use STOPP and START reliably during their everyday practice to identify PIMs and PEOs in older patients.

The role of visual landmarks in the avian familiar area map - Commentary

The question of whether homing pigeons use visual landmarks for orientation from distant, familiar sites is an unresolved issue in the field of avian navigation. Where evidence has been found, the question still remains as to whether the landmarks are used independent of the map and compass mechanism for orientation that is so important to birds. Recent research has challenged the extent to which experiments that do not directly manipulate the visual sense can be used as evidence for compass-independent orientation. However, it is proposed that extending a new technique for research on vision in homing to include manipulation of the compasses used by birds might be able to resolve this issue. The effect of the structure of the visual sense of the homing pigeon on its use of visual landmarks is also considered.

Further evidence for visual landmark involvement in the pigeon's familiar area map

In previous experiments suggesting that previewing visual landscapes speeds homing from familiar release sites, restricted access to olfactory cues may have artefactually encouraged homing pigeons, Calumba livia, to resort to visual landmark orientation. Since evidence for the role of visual landmarks in wide-ranging avian orientation is still equivocal, Braithwaite & Guilford's (1991, Proc. R. Sec. Lond. Ser. B, 245, 183-186) 'previewing' experiments were replicated: birds were allowed or denied visual access to a familiar site prior to release, but allowed ample access to olfactory cues. In experiment 1, allowing birds to preview familiar sites for 5 min prior to release enhanced homing speeds by about 12%. In experiment 2, modified to reduce between-day effects on variation, previewing enhanced homing speeds by about 16%. These experiments support the conclusion that visual landmarks remote from sight of the loft are an important component of the familiar area map, although the nature of the landmarks and how they are encoded remain to be determined. (C) 1997 The Association for the Study of Animal Behaviour.

Tracking clock-shifted homing pigeons from familiar release sites

Clock-shifted homing pigeons were tracked from familiar sites 17.1km and 23.5 km from the home loft in Pisa, Italy, using an on-board route recorder. At the first release site, north of home, the majority of clock-shifted birds had relatively straight tracks comparable with those of control birds, At the second release site, south of home, the clock-shifted birds deflected in the direction predicted for the degree of clock shift, with many birds travelling some distance in the wrong direction before correcting their course. The possible role of large-scale terrain features in homing pigeon navigation is discussed.

Observation of ion temperatures exceeding background electron temperatures in petawatt laser-solid experiments

Neutron time of flight signals have been observed with a high resolution neutron spectrometer using the petawatt arm of the Vulcan laser facility at Rutherford Appleton Laboratory from plastic sandwich targets containing a deuterated layer. The neutron spectra have two elements: a high-energy component generated by beam-fusion reactions and a thermal component around 2.45 MeV. The ion temperatures calculated from the neutron signal width clearly demonstrate a dependence on the front layer thickness and are significantly higher than electron temperatures measured under similar conditions. The ion heating process is intensity dependent and is not observed with laser intensities on target below 10(20) W cm(-2). The measurements are consistent with an ion instability driven by electron perturbations.

Quantification of DNA damage by PFGE: development of an analytical approach to correct for the background distribution

Purpose: To analyse the currently existing methods to infer the extent of cellular DNA damage induced by ionizing radiation when the pulsed field gel electrophoresis (PFGE) technique is used.

Detection of a novel porcine boca-like virus in the background of porcine circovirus type 2 induced postweaning multisystemic wasting syndrome

Porcine circovirus type 2 (PCV-2) has been found to be the causative agent of postweaning multisystemic wasting syndrome (PMWS). However, PCV-2 is a ubiquitous virus in the swine population and a majority of pigs infected with PCV-2 do not develop the disease. Different factors such as age, maintenance, the genetics of PCV-2, other pathogens, etc. have been suggested to contribute to the development of PMWS. However, so far no proven connection between any of these factors and the disease development has been found. In this study we explored the possible presence of other so far unknown DNA containing infectious agents in lymph nodes collected from Swedish pigs with confirmed PMWS through random amplification and high-throughput sequencing. Although the vast majority of the amplified genetic sequences belonged to PCV-2, we also found genome sequences of Torque Teno virus (TTV) and of a novel parvovirus. The detection of TTV was expected since like PCV-2, TTV has been found to have high prevalence in pigs around the world. We were able to amplify a longer region of the parvovirus genome, consisting of the entire NP1 and partial VP1/2. By comparative analysis of the nucleotide sequences and phylogenetic studies we propose that this is a novel porcine parvovirus, with genetic relationship to bocaviruses.

Magneto-optical trapping and background-free imaging for atoms near nanostructured surfaces

We demonstrate a combined magneto-optical trap and imaging system that is suitable for the investigation of cold atoms near surfaces. In particular, we are able to trap atoms close to optically scattering surfaces and to image them with an excellent signal-to-noise ratio. We also demonstrate a simple magneto-optical atom cloud launching method. We anticipate that this system will be useful for a range of experimental studies of novel atom-surface interactions and atom trap miniaturization.

Regularized Online Mixture of Gaussians for Background Subtraction

Mixture of Gaussians (MoG) modelling [13] is a popular approach to background subtraction in video sequences. Although the algorithm shows good empirical performance, it lacks theoretical justification. In this paper, we give a justification for it from an online stochastic expectation maximization (EM) viewpoint and extend it to a general framework of regularized online classification EM for MoG with guaranteed convergence. By choosing a special regularization function, l1 norm, we derived a new set of updating equations for l1 regularized online MoG. It is shown empirically that l1 regularized online MoG converge faster than the original online MoG .

Gaussian mixture background modelling optimisation for micro-controllers

This paper proposes an optimisation of the adaptive Gaussian mixture background model that allows the deployment of the method on processors with low memory capacity. The effect of the granularity of the Gaussian mean-value and variance in an integer-based implementation is investigated and novel updating rules of the mixture weights are described. Based on the proposed framework, an implementation for a very low power consumption micro-controller is presented. Results show that the proposed method operates in real time on the micro-controller and has similar performance to the original model. © 2012 Springer-Verlag.