Psychotropic medications and the transition into care:a national data linkage study

Objectives
To determine whether excessive and often inappropriate or dangerous psychotropic drug dispensing to older adults is unique to care homes or is a continuation of community treatment.

Design
Population-based data-linkage study using prescription drug information.

Setting
Northern Ireland's national prescribing database and care home information from the national inspectorate.

Participants
Two hundred fifty thousand six hundred seventeen individuals aged 65 and older.

Measurements
Prescription information was extracted for all psychotropic drugs included in the British National Formulary (BNF) categories 4.1.1, 4.1.2, and 4.2.2 (hypnotics, anxiolytics, and antipsychotics) dispensed over the study period. Repeated cross-sectional analysis was used to monitor changes in psychotropic drug dispensing over time.

Results
Psychotropic drug use was higher in care homes than the community; 20.3% of those in care homes were dispensed an antipsychotic in January 2009, compared with 1.1% of those in the community. People who entered care had higher use of psychotropic medications before entry than those who did not enter care, but this increased sharply in the month of admission and continued to rise. Antipsychotic drug dispensing increased from 8.2% before entry to 18.6% after entering care (risk ratio (RR) = 2.26, 95% confidence interval (CI)=1.96–2.59) and hypnotic drug dispensing from 14.8% to 26.3% (RR=1.78, 95% CI=1.61–1.96).

Conclusion
A continuation of high use before entry cannot wholly explain the higher dispensing of psychotropic drugs to individuals in care homes. Although drug dispensing is high in older people in the community, it increases dramatically on entry to care. Routine medicine reviews are necessary in older people and are especially important during transitions of care.

The efficacy of SMART Arm training early after stroke for stroke survivors with severe upper limb disability:a protocol for a randomised controlled trial

Recovery of upper limb function after stroke is poor. The acute to subacute phase after stroke is the optimal time window to promote the recovery of upper limb function. The dose and content of training provided conventionally during this phase is however, unlikely to be adequate to drive functional recovery, especially in the presence of severe motor disability. The current study concerns an approach to address this shortcoming, through evaluation of the SMART Arm, a non-robotic device that enables intensive and repetitive practice of reaching by stroke survivors with severe upper limb disability, with the aim of improving upper limb function. The outcomes of SMART Arm training with or without outcome-triggered electrical stimulation (OT-stim) to augment movement and usual therapy will be compared to usual therapy alone.

Physical and dynamical characterisation of low ΔV NEA (190491) 2000 FJ10

Aims: We investigated the physical properties and dynamical evolution of near-Earth asteroid (NEA) (190491) 2000 FJ10 in order to assess the suitability of this accessible NEA as a space mission target. Methods: Photometry and colour determination were carried out with the 1.54 m Kuiper Telescope (Mt Bigelow, USA) and the 10 m Southern African Large Telescope (SALT; Sutherland, South Africa) during the object's recent favourable apparition in 2011-12. During the earlier 2008 apparition, a spectrum of the object in the 6000-9000 Angstrom region was obtained with the 4.2 m William Herschel Telescope (WHT; Canary Islands, Spain). Interpretation of the observational results was aided by numerical simulations of 1000 dynamical clones of 2000 FJ10 up to 106 yr in the past and in the future. Results: The asteroid's spectrum and colours determined by our observations suggest a taxonomic classification within the S-complex although other classifications (V, D, E, M, P) cannot be ruled out. On this evidence, it is unlikely to be a primitive, relatively unaltered remnant from the early history of the solar system and thus a low priority target for robotic sample return. Our photometry placed a lower bound of 2 h to the asteroid's rotation period. Its absolute magnitude was estimated to be 21.54 ± 0.1 which, for a typical S-complex albedo, translates into a diameter of 130 ± 20 m. Our dynamical simulations show that it has likely been an Amor for the past 105 yr. Although currently not Earth-crossing, it will likely become so during the period 50-100 kyr in the future. It may have arrived from the inner or central main belt >1 Myr ago as a former member of a low-inclination S-class asteroid family. Its relatively slow rotation and large size make it a suitable destination for a human mission. We show that ballistic Earth-190491-Earth transfer trajectories with ΔV <2 km s-1 at the asteroid exist between 2052 and 2061. Based on observations made with the Southern African Large Telescope (SALT).

Robot and insect navigation by polarized skylight

A study of a large number of published experiments on the behaviour of insects navigating by skylight has led to the design of a system for navigation in lightly clouded skies, suitable for a robot or drone. The design is based on the measurement of the directions in the sky at which the polarization angle, i.e. the angle χ between the polarized E-vector and the meridian, equals ±π/4 or ±(π/4 + π/3) or ±(π/4 - π/3). For any one of these three options, at any given elevation, there are usually 4 such directions and these directions can give the azimuth of the sun accurately in a few short steps, as an insect can do. A simulation shows that this compass is accurate as well as simple and well suited for an insect or robot. A major advantage of this design is that it is close to being invariant to variable cloud cover. Also if at least two of these 12 directions are observed the solar azimuth can still be found by a robot, and possibly by an insect.

Solar phase functions of cometary nuclei

Relatively few measurements of the solar phase function of cometary nuclei exist, despite the importance of this parameter in determining accurate sizes and its use in modeling surface properties. We make use of robotic telescopes and servicemode observing to monitor cometary nuclei over months at a time, combining intensive observations at a single epoch with regular short light-curve segments to efficiently account for brightness changes due to both nucleus rotation and changing solar phase angle. We present our latest results on comets 8P/Tuttle, 14P/Wolf, 67P/Churyumov- Gerasimenko and 110P/Hartley 3.

Bacteria microarrays as sensitive tools for exploring pathogen surface epitopes and recognition by host receptors

We describe a protocol for the generation and validation of bacteria microarrays and their application to the study of specific features of the pathogen's surface and interactions with host receptors. Bacteria were directly printed on nitrocellulose-coated glass slides, using either manual or robotic arrayers, and printing quality, immobilization efficiency and stability of the arrays were rigorously controlled by incorporating a fluorescent dye into the bacteria. A panel of wild type and mutant strains of the human pathogen Klebsiella pneumoniae, responsible for nosocomial and community-acquired infections, was selected as model bacteria, and SYTO-13 was used as dye. Fluorescence signals of the printed bacteria were found to exhibit a linear concentration-dependence in the range of 1 x 10(8) to 1 x 10(9) bacteria per ml. Similar results were obtained with Pseudomonas aeruginosa and Acinetobacter baumannii, two other human pathogens. Successful validation of the quality and applicability of the established microarrays was accomplished by testing the capacity of the bacteria array to detect recognition by anti-Klebsiella antibodies and by the complement subcomponent C1q, which binds K. pneumoniae in an antibody-independent manner. The biotin/AlexaFluor-647-streptavidin system was used for monitoring binding, yielding strain-and dose-dependent signals, distinctive for each protein. Furthermore, the potential of the bacteria microarray for investigating specific features, e.g. glycosylation patterns, of the cell surface was confirmed by examining the binding behaviour of a panel of plant lectins with diverse carbohydrate-binding specificities. This and other possible applications of the newly developed arrays, as e.g. screening/evaluation of compounds to identify inhibitors of host-pathogen interactions, make bacteria microarrays a useful and sensitive tool for both basic and applied research in microbiology, biomedicine and biotechnology.

Factors associated with spectacle-wear compliance in school-aged Mexican children.

PURPOSE: To study the prevalence and determinants of compliance with spectacle wear among school-age children in Oaxaca, Mexico, who were provided spectacles free of charge. METHODS: A cohort of 493 children aged 5 to 18 years chosen by random cluster sampling from primary and secondary schools in Oaxaca, Mexico, all of whom had received free spectacles through a local program, underwent unannounced, direct examination to determine compliance with spectacle wear within 18 months after initial provision of spectacles. Potential determinants of spectacle wear including age, gender, urban versus rural residence, presenting visual acuity, refractive error, and time since dispensing of the spectacles were examined in univariate and multivariate regression models. Children not currently wearing their spectacles were asked to select the reason from a list of possibilities, and reasons for noncompliance were analyzed within different demographic groups. RESULTS: Among this sample of children with a mean age of 10.4 +/- 2.6 years, the majority (74.5%) of whom were myopic (spherical equivalent [SE] < or = -0.50 D), 13.4% (66/493) were wearing their spectacles at the time of examination. An additional 34% (169/493) had the spectacles with them but were not wearing them. In regression models, the odds of spectacle wear were significantly higher among younger (OR = 1.19 per year of age; 95% CI, 1.05-1.33) rural (OR = 10.6; 95% CI, 5.3-21.0) children and those with myopia < or = -1.25 D (OR = 3.97; 95% CI, 1.98-7.94). The oldest children and children in urban-suburban areas were significantly more likely to list concerns about the appearance of the glasses or about being teased than were younger, rurally resident children. CONCLUSIONS: Compliance with spectacle wear may be very low, even when spectacles are provided free of charge, particularly among older, urban children, who have been shown in many populations to have the highest prevalence of myopia. As screening programs for refractive error become increasingly common throughout the world, new strategies are needed to improve compliance if program resources are to be maximized.

The association between refractive cutoffs for spectacle provision and visual improvement among school-aged children in South Africa.

OBJECTIVES: To evaluate different refractive cutoffs for spectacle provision with regards to their impact on visual improvement and spectacle compliance. DESIGN: Prospective study of visual improvement and spectacle compliance. PARTICIPANTS: South African school children aged 6-19 years receiving free spectacles in a programme supported by Helen Keller International. METHODS: Refractive error, age, gender, urban versus rural residence, presenting and best-corrected vision were recorded for participants. Spectacle wear was observed directly at an unannounced follow-up examination 4-11 months after initial provision of spectacles. The association between five proposed refractive cutoff protocols and visual improvement and spectacle compliance were examined in separate multivariate models. MAIN OUTCOMES: Refractive cutoffs for spectacle distribution which would effectively identify children with improved vision, and those more likely to comply with spectacle wear. RESULTS: Among 8520 children screened, 810 (9.5%) received spectacles, of whom 636 (79%) were aged 10-14 years, 530 (65%) were girls, 324 (40%) had vision improvement > or = 3 lines, and 483 (60%) were examined 6.4+/-1.5 (range 4.6 to 10.9) months after spectacle dispensing. Among examined children, 149 (31%) were wearing or carrying their glasses. Children meeting cutoffs < or = -0.75 D of myopia, > or = +1.00 D of hyperopia and > or = +0.75 D of astigmatism had significantly greater improvement in vision than children failing to meet these criteria, when adjusting for age, gender and urban versus rural residence. None of the proposed refractive protocols discriminated between children wearing and not wearing spectacles. Presenting vision and improvement in vision were unassociated with subsequent spectacle wear, but girls (p < or = 0.0006 for all models) were more likely to be wearing glasses than were boys. CONCLUSIONS: To the best of our knowledge, this is the first suggested refractive cutoff for glasses dispensing validated with respect to key programme outcomes. The lack of association between spectacle retention and either refractive error or vision may have been due to the relatively modest degree of refractive error in this African population.

Laughter Research: A Review of the ILHAIRE Project

Laughter is everywhere. So much so that we often do not even notice it. First, laughter has a strong connection with humour. Most of us seek out laughter and people who make us laugh, and it is what we do when we gather together as groups relaxing and having a good time. But laughter also plays an important role in making sure we interact with each other smoothly. It provides social bonding signals that allow our conversations to flow seamlessly between topics; to help us repair conversations that are breaking down; and to end our conversations on a positive note.

A Structured Approach to Simulate Manufacturing System In Virtual Environment

Nowadays, the realization of the Virtual Factory (VF) is the strategic goal of many manufacturing enterprises for the coming years. The industrial scenario is characterized by the dynamics of innovations increment and the product life cycle became shorter. Furthermore products and the corresponding manufacturing processes get more and more complex. Therefore, companies need new methods for the planning of manufacturing systems.
To date, the efforts have focused on the creation of an integrated environment to design and manage the manufacturing process of a new product. The future goal is to integrate Virtual Reality (VR) tools into the Product Lifecycle Management of the manufacturing industries.
In order to realize this goal the authors have conducted a study to perform VF simulation steps for a supplier of Industrial Automation Systems and have provided a structured approach focusing on interaction between simulation software and VR hardware tools in order to simulate both robotic and
manual work cells.
The first results of the study in progress have been carried out in the VR Laboratory of the Competence Regional Centre for the qualification of the Transportation Systems that has been founded by Campania Region.