Increased use of emergency services by older people after health screening

Background: evaluation of the 'Keep Well At Home' (KWAH) Project in West London indicated that a programme of screening persons aged 75 and over had not reduced rates of emergency attendances and admissions to hospital. However, coverage of the target population was incomplete. The present analysis addresses 'efficacy'-whether individuals who completed the screening protocol as intended did subsequently use Accident & Emergency (A&E) services less often. Methods: the target population was divided into five groups, depending on whether an individual had completed none, one or both phases of screening, and whether deviations from the protocol related to incomplete coverage or refusal to participate further. We ascertained use of emergency services before screening and for up to 3 years afterwards by linkage of records from KWAH to those of local A&E Departments. Patterns of emergency care were examined as crude races and, via proportional hazards models, after adjustment for available confounders. Results: there was an increase of 51% (95% CI 22-86%) in the crude rate of emergency admissions in the year after first-phase screening compared with the 12 months before assessment. This was most obvious in individuals deemed at high risk who also underwent the second-phase assessment (adjusted hazard ratio relative to individuals not 'at risk'= 2.33; 95% CI 1.59-3.42). Conclusions: the available data do not allow us to distinguish between several possible explanations for the paradoxical increase in use of emergency services. However, what seem to be sensible policies do not necessarily have their intended effects when implemented in practice.

Development and evaluation of the Clinician Suicide Risk Assessment Checklist

This paper describes the development and evaluation of a new instrument – the Clinician Suicide Risk Assessment Checklist (CSRAC). The instrument assesses the clinician’s competency in three areas: clinical interviewing, assessment of specific suicide risk factors, and formulating a management plan. A draft checklist was constructed by integrating information from 1) literature review 2) expert clinician focus group and 3) consultation with experts. It was utilised in a simulated clinical scenario with clinician trainees and a trained actor in order to test for inter-rater agreement. Agreement was calculated and the checklist was re-drafted with the aim of maximising agreement. A second phase of simulated clinical scenarios was then conducted and inter-rater agreement was calculated for the revised checklist. In the first phase of the study, 18 of 35 items had inadequate inter-rater agreement (60%>), while in the second phase, using the revised version, only 3 of 39 items failed to achieve adequate inter-rater agreement. Further evidence of reliability and validity are required. Continued development of the CSRAC will be necessary before it can be utilised to assess the effectiveness of risk assessment training programs.

Training selective use of a complex categorisation strategy

The present study aims to encourage selective use of a complex categorisation strategy. More specifically, participants will be trained to use a two dimensional strategy in one region of category space and a more complex three-dimensional strategy in another region of category space. In the 2–3 conditions, participants will be presented with stimuli requiring the two-dimensional strategy in the first phase of training and the three-dimensional strategy in the second phase of training. In the 3-2 conditions, participants will be presented with stimuli requiring the three-dimensional strategy in the first phase of training and the two-dimensional strategy in the second phase of training. The main dependent measure will be performance on exceptions to the two-dimensional strategy. If participants learn to selectively use the three-dimensional strategy, then we expect them to correctly classify novel exceptions that occur in the three-dimensional region of the category space and incorrectly classify novel exceptions that occur in the two-dimensional region of the category space.

Caratterizzazione delle Prestazioni di Protezione al Fuoco di Vernici Intumescenti

Le pitture intumescenti sono utilizzate come protettivi passivi antincendio nel settore delle costruzioni. In particolare sono utilizzate per aumentare la resistenza al fuoco di elementi in acciaio. Le proprietà termiche di questi rivestimenti sono spesso sconosciute o difficili da stimare per via del fatto che variano notevolmente durante il processo di espansione che subisce l’intumescente quando esposto al calore di un incendio. Per questa ragione la validazione della resistenza al fuoco di un rivestimento presente in commercio si basa su metodi costosi economicamente e come tempi di esecuzione nel quale ciascuna trave e colonna rivestita di protettivo deve essere testata una alla volta attraverso il test di resistenza al fuoco della curva cellulosica. In questo lavoro di tesi adottando invece un approccio basato sulla modellazione termica del rivestimento intumescente si ottiene un aiuto nella semplificazione della procedura di test ed un supporto nella progettazione della resistenza al fuoco delle strutture. Il tratto di unione nei vari passaggi della presente tesi è stata la metodologia di stima del comportamento termico sconosciuto, tale metodologia di stima è la “Inverse Parameter Estimation”. Nella prima fase vi è stata la caratterizzazione chimico fisica della vernice per mezzo di differenti apparecchiature come la DSC, la TGA e l’FT-IR che ci hanno permesso di ottenere la composizione qualitativa e le temperature a cui avvengono i principali processi chimici e fisici che subisce la pittura come anche le entalpie legate a questi eventi. Nella seconda fase si è proceduto alla caratterizzazione termica delle pitture al fine di ottenerne il valore di conduttività termica equivalente. A tale scopo si sono prima utilizzate le temperature dell’acciaio di prove termiche alla fornace con riscaldamento secondo lo standard ISO-834 e successivamente per meglio definire le condizioni al contorno si è presa come fonte di calore un cono calorimetrico in cui la misura della temperatura avveniva direttamente nello spessore del’intumescente. I valori di conduttività ottenuti sono risultati congruenti con la letteratura scientifica e hanno mostrato la dipendenza della stessa dalla temperatura, mentre si è mostrata poco variante rispetto allo spessore di vernice deposto ed alla geometria di campione utilizzato.

Matemática se aprende brincando?! Jogos Eletrônicos como uma possibilidade de Ensino

Esta dissertação tem como objetivo analisar a minha ação docente em aulas de matemática, que implicam a utilização de dois tipos de jogos eletrônicos em ambiente informatizado. Para tanto, foram observadas as ações e reações dos educandos ao utilizarem os jogos eletrônicos, a manifestação do pensamento, do raciocínio e de estratégias para a solução dos problemas encontrados. A metodologia desta pesquisa caracterizou-se pela natureza qualitativa - aos moldes da pesquisa-ação - numa modalidade narrativa, desenvolvendo-se pelas pesquisas bibliográficas e de campo. A coleta dos dados foi realizada por meio de entrevista semi-estruturada aplicada a nove sujeitos pertencentes a duas classes de 5ª série do ensino fundamental, em sua segunda fase. A análise dos resultados e das observações em sala de aula possibilitou concluir que os jogos, de uma maneira geral, e os eletrônicos, de forma específica, podem ser utilizados como ferramentas úteis no ensino da Matemática, proporcionando um aprendizado prazeroso, sob a orientação criteriosa do professor.

The effects of vitamin C supplementation on protein oxidation in healthy volunteers

We have investigated vitamin C supplementation effects on immunoglobulin oxidation (carbonyls) and total plasma protein sulfhydryls in healthy human volunteers. After receiving placebo, plasma ascorbate and oxidation markers were unchanged. Following 5 weeks supplementation with vitamin C (400 mg/day), plasma ascorbate increased but no significant effect on protein oxidation was observed. At 10 and 15 weeks supplementation, carbonyl levels were significantly reduced (P < 0.01) in subjects with low baseline ascorbate (29.51 ± 5.3 μM) but not in those with normal baseline ascorbate (51.81 ± 2.3 μM). To eliminate any effect from seasonal variation in dietary antioxidant intake, a second phase was undertaken. Subjects on vitamin C for 15 weeks were randomly assigned to receive either placebo or vitamin C. No difference in plasma sulfhydryl content was observed. Subjects withdrawn from supplementation showed an increase in immunoglobulin carbonyl content (P < 0.01). This demonstrates that dietary vitamin C supplementation can reduce certain types of oxidative protein damage in subjects with low basal antioxidant. (C) 2000 Academic Press.

Novel formulation strategies for the fabrication of lyophilised orally disintegrating tablets

Orally disintegrating Tablets (ODTs), also known as fast-disintegrating, fast-melt or fast-dissolving tablets, are a relatively novel dosage technology that involves the rapid disintegration or dissolution of the dosage form into a solution or suspension in the mouth without the need for water. The solution containing the active ingredients is swallowed, and the active ingredients are then absorbed through the gastrointestinal epithelium to reach the target and produce the desired effect. Formulation of ODTs was originally developed to address swallowing difficulties of conventional solid oral dosage forms (tablets and capsules) experienced by wide range of patient population, especially children and elderly. The current work investigates the formulation and development of ODTs prepared by freeze drying. Initial studies focused on formulation parameters that influence the manufacturing process and performance of lyophilised tablets based on excipients used in commercial products (gelatin and saccharides). The second phase of the work was followed up by comprehensive studies to address the essential need to create saccharide free ODTs using naturally accruing amino acids individually or in combinations. Furthermore, a factorial design study was carried out to investigate the feasibility of delivering multiparticulate systems of challenging drugs using a novel formulation that exploited the electrostatic associative interaction between gelatin and carrageenan. Finally, studies aimed to replace gelatin with ethically and morally accepted components to the end users were performed and the selected binder was used in factorial design studies to investigate and optimise ODT formulations that incorporated drugs with varies physicochemical properties. Our results show that formulation of elegant lyophilised ODTs with instant disintegration and adequate mechanical strength requires carful optimisation of gelatin concentration and bloom strength in addition to saccharide type and concentration. Successful formulation of saccharides free lyophilised ODTs requires amino acids that crystallise in the frozen state or display relatively high Tg', interact and integrate completely with the binder and, also, display short wetting time with the disintegrating medium. The use of an optimised mixture of gelatin, carrageenan and alanine was able to create viscous solutions to suspend multiparticulate systems and at the same time provide tablets with short disintegration times and adequate mechanical properties. On the other hand, gum arabic showed an outstanding potential for use as a binder in the formulation of lyophilised ODTs. Compared to gelatin formulations, the use of gum arabic simplified the formulation stages, shortened the freeze drying cycles and produced tablets with superior performance in terms of the disintegration time and mechanical strength. Furthermore, formulation of lyophilised ODTs based on gum arabic showed capability to deliver diverse range of drugs with advantages over commercial products.

Canadian province-building : the state as educator and entrepreneur in Alberta

This study provides an account and analysis of the development of systems of educational provision In capitalist democracies, especially in connection with the social origin and relative autonony of those systems. Using the case study of Athabasca University, a Canadian distance-education institution in the province of Alberta, the study is a critical work of historical sociology, in which the shifting social role of a system of educational provision during two transitions of a regional political economy is analyzed. Comparative observations are made in reference to other systems of educational provision and organizations, in particular the training department of a large Company based In the same region as the Unversity. The study explores the social origin and relative autonomy of systems of educational provision In relation to educational ideologies, which are themselves associated with social ideologies. Pierre Bourdieu's theoretical construction of "fields of power'' allows for a consideration of power as a relational phenomenon in the study. In other words, power is understood as being exercised in a way that simultaneously takes account of the power of other actors and groups. Fields of power also allow for an analysis of power as it is exercised at various levels of organizations and within society. The study is organized in two phases. First, an account is developed of the historical period in which the Unlversity and the Company were created, but especially the period of establishment for the Unlversity, 1970 - 75. Conclusions are offered concerning the causal associations between the historical antecedents that gave rise to the two organlzations. It is argued that both the University and the Company were established In part to enact the AIberta government's efforts to enhance Its powers within the Canadian federation (a process called province-building), The second phase is concerned with a more recent period of three years, 1993 - 95. By this time, province-building was not as significant a concern for policy-makers, and the organizational responses of the University and the Company reflected this shift. A divergence of practice is observed at the University and the Company, with actors at the Company encouraging the development of collectivist values for employees, while at the University no such overt strategy was followed, The study concludes that a consumerist model of education developed by the University in 1970 - 75 and expanded In 1993 - 95 contributed significantly to the institution's social origin and relative autonomy. The model was used as an Ideology in the earlier period and as a strategy In the later one, serving to forestall the institution's closure during both periods of crisis, though Ieading to ambiguous social outcomes. A consumerist model may on the one hand be progressive in that expanded access to educational opportunities is made possible. On the other hand, the consumerist model will tend increasingly to provide educational services to those social segments that already have access to educational opportunities.

The development and optimisation of a fast pyrolysis process for bio-oil production

A two-tier study is presented in this thesis. The first involves the commissioning of an extant but at the time, unproven bubbling fluidised bed fast pyrolysis unit. The unit was designed for an intended nominal throughput of 300 g/h of biomass. The unit came complete with solids separation, pyrolysis vapour quenching and oil collection systems. Modifications were carried out on various sections of the system including the reactor heating, quenching and liquid collection systems. The modifications allowed for fast pyrolysis experiments to be carried out at the appropriate temperatures. Bio-oil was generated using conventional biomass feedstocks including Willow, beechwood, Pine and Miscanthus. Results from this phase of the research showed however, that although the rig was capable of processing biomass to bio-oil, it was characterised by low mass balance closures and recurrent operational problems. The problems included blockages, poor reactor hydrodynamics and reduced organic liquid yields. The less than optimal performance of individual sections, particularly the feed and reactor systems of the rig, culminated in a poor overall performance of the system. The second phase of this research involved the redesign of two key components of the unit. An alternative feeding system was commissioned for the unit. The feed system included an off the shelf gravimetric system for accurate metering and efficient delivery of biomass. Similarly, a new bubbling fluidised bed reactor with an intended nominal throughput of 500g/h of biomass was designed and constructed. The design leveraged on experience from the initial commissioning phase with proven kinetic and hydrodynamic studies. These units were commissioned as part of the optimisation phase of the study. Also as part of this study, two varieties each, of previously unreported feedstocks namely Jatropha curcas and Moringa olifiera oil seed press cakes were characterised to determine their suitability as feedstocks for liquid fuel production via fast pyrolysis. Consequently, the feedstocks were used for the production of pyrolysis liquids. The quality of the pyrolysis liquids from the feedstocks were then investigated via a number of analytical techniques. The oils from the press cakes showed high levels of stability and reduced pH values. The improvements to the design of the fast pyrolysis unit led to higher mass balance closures and increased organic liquid yields. The maximum liquid yield obtained from the press cakes was from African Jatropha press cake at 66 wt% on a dry basis.

The tribology of linear tape recording systems

This thesis is devoted to the tribology at the head~to~tape interface of linear tape recording systems, OnStream ADRTM system being used as an experimental platform, Combining experimental characterisation with computer modelling, a comprehensive picture of the mechanisms involved in a tape recording system is drawn. The work is designed to isolate the mechanisms responsible for the physical spacing between head and tape with the aim of minimising spacing losses and errors and optimising signal output. Standard heads-used in ADR current products-and prototype heads- DLC and SPL coated and dummy heads built from a AI203-TiC and alternative single-phase ceramics intended to constitute the head tape-bearing surface-are tested in controlled environment for up to 500 hours (exceptionally 1000 hours), Evidences of wear on the standard head are mainly observable as a preferential wear of the TiC phase of the AI203-TiC ceramic, The TiC grains are believed to delaminate due to a fatigue wear mechanism, a hypothesis further confirmed via modelling, locating the maximum von Mises equivalent stress at a depth equivalent to the TiC recession (20 to 30 nm). Debris of TiC delaminated residues is moreover found trapped within the pole-tip recession, assumed therefore to provide three~body abrasive particles, thus increasing the pole-tip recession. Iron rich stain is found over the cycled standard head surface (preferentially over the pole-tip and to a lesser extent over the TiC grains) at any environment condition except high temperature/humidity, where mainly organic stain was apparent, Temperature (locally or globally) affects staining rate and aspect; stain transfer is generally promoted at high temperature. Humidity affects transfer rate and quantity; low humidity produces, thinner stains at higher rate. Stain generally targets preferentially head materials with high electrical conductivity, i.e. Permalloy and TiC. Stains are found to decrease the friction at the head-to-tape interface, delay the TiC recession hollow-out and act as a protective soft coating reducing the pole-tip recession. This is obviously at the expense of an additional spacing at the head-to-tape interface of the order of 20 nm. Two kinds of wear resistant coating are tested: diamond like carbon (DLC) and superprotective layer (SPL), 10 nm and 20 to 40 nm thick, respectively. DLC coating disappears within 100 hours due possibly to abrasive and fatigue wear. SPL coatings are generally more resistant, particularly at high temperature and low humidity, possibly in relation with stain transfer. 20 nm coatings are found to rely on the substrate wear behaviour whereas 40 nm coatings are found to rely on the adhesive strength at the coating/substrate interface. These observations seem to locate the wear-driving forces 40 nm below the surface, hence indicate that for coatings in the 10 nm thickness range-· i,e. compatible with high-density recording-the substrate resistance must be taken into account. Single-phase ceramic as candidate for wear-resistant tape-bearing surface are tested in form of full-contour dummy-heads. The absence of a second phase eliminates the preferential wear observed at the AI203-TiC surface; very low wear rates and no evidence of brittle fracture are observed.

Computer aided design and manufacture for three dimensional milling

Advances in both computer technology and the necessary mathematical models capable of capturing the geometry of arbitarily shaped objects has led to the development in this thesis of a surface generation package called 'IBSCURF' aimed at providing a more economically viable solution to free-form surface manufacture. A suit of computer programs written in FORTRAN 77 has been developed to provide computer aids for every aspect of work in designing and machining free-form surfaces. A vector-valued parametric method was used for shape description and a lofting technique employed for the construction of the surface. The development of the package 'IBSCURF' consists of two phases. The first deals with CAD. The design process commences in defining the cross-sections which are represented by uniform B-spline curves as approximations to give polygons. The order of the curve and the position and number of the polygon vertices can be used as parameters for the modification to achieve the required curves. When the definitions of the sectional curves is complete, the surface is interpolated over them by cubic cardinal splines. To use the CAD function of the package to design a mould for a plastic handle, a mathematical model was developed. To facilitate the integration of design and machining using the mathematical representation of the surface, the second phase of the package is concerned with CAM which enables the generation of tool offset positions for ball-nosed cutters and a general post-processor has been developed which automatically generates NC tape programs for any CNC milling machine. The two phases of these programs have been successfully implemented, as a CAD/CAM package for free-form surfaces on the VAX 11/750 super-minicomputer with graphics facilities for displaying drawings interactively on the terminal screen. The development of this package has been beneficial in all aspects of design and machining of free form surfaces.

Computer integrated system for form-roll manufacture

Computer integrated manufacture has brought about great advances in manufacturing technology and its recognition is world wide. Cold roll forming of thin-walled sections, and in particular the design and manufacture of form-rolls, the special tooling used in the cold roll forming process, is but one such area where computer integrated manufacture can make a positive contribution. The work reported in this thesis, concerned with the development of an integrated manufacturing system for assisting the design and manufacture of form-rolls, was undertaken in collaboration with a leading manufacturer of thin-walled sections. A suit of computer programs, written in FORTRAN 77, have been developed to provide computer aids for every aspect of work in form-roll design and manufacture including cost estimation and stock control aids. The first phase of the development programme dealt with the establishment of CAD facilities for form-roll design, comprising the design of the finished section, the flower pattern, the roll design and the interactive roll editor program. Concerning the CAM facilities, dealt with in the second phase, an expert system roll machining processor and a general post-processor have been developed for considering the roll geometry and automatically generating NC tape programs for any required CNC lathe system. These programs have been successfully implemented, as an integrated manufacturing software system, on the VAX 11/750 super-minicomputer with graphics facilities for displaying drawings interactively on the terminal screen. The development of the integrated system has been found beneficial in all aspects of form-roll design and manufacture. Design and manufacturing lead times have been reduced by several weeks, quality has improved considerably and productivity has increased. The work has also demonstrated the promising nature of the expert systems approach to computer integrated manufacture.

Planning and implementing safety management systems

This thesis describes a study of the content and applicability of BS8800:1996 Guide to occupational health and safety management systems. The research is presented chronologically, with literature review and content analysis of SMS related guides and standards interwoven with two elements of qualitative empirical work. The first of these was carried out shortly after publication of BS8800 in 1996, a 'before-the-event' investigation of how organisations were intending to approach SMS implementation. The challenges faced by these organisations are reviewed against standard management theory, suggesting that the initial motivation for SMS implementation governs the approach organisations will adopt to guidance such as BS8800. The second phase of empirical work was undertaken in the context of OHSAS 18001, an auditable protocol based on BS8800, which allows organisations to certify their safety management systems. A discussion of the evolution of certifiable safety management system is presented, highlighting the similarities and differences between this, BS8800, SMS and wider management system standards. A case study then reviews the experiences of a catering company that implemented 18001, motivated by the opportunity for certification as a business benefit. The empirical work is used to comment on the guidance provided by BS8800, within its evolved role as guidance organisations may use for implementation of a SMS to be certified according to the specifications of OHSAS 18001. It is suggested that optimal implementation is facilitated by initial status review, continual improvement and the use of annexes, where there are used to make changes to the existing safety management system. This thesis concludes with a discussion of these elements, highlighting pertinent areas within BS8800 where revision or amendment may be appropriate.

The creep behaviour of pressure diecast zinc-aluminium based alloys

The creep behaviour of three pressure diecast commercial zinc-aluminium based alloys: Mazak 3, corresponding to BS 1004A, and the new alloys ZA.8 and ZA.27 with a series of alloys with compositions ranging from 0% to 30% aluminium was investigated. The total creep elongation of commercial alloys was shown to be well correlated using an empirical equation. Based on this a parametrical relationship was derived which allowed the total creep extension to be related to the applied stress, the temperature and the time of test, so that a quantitative assessment of creep of the alloys could be made under different conditions. Deviation from the normal creep kinetics occurred in alloys ZA.8 and ZA.27 at very low stresses, 150°C, due to structural coarsening combined with partial transformation of ε -phase into T' phase. The extent of primary creep was found to increase with aluminium content, but secondary creep rates decreased in the order Mazak 3, ZA.8 and ZA.27. Thus, based on the above equation, ZA.8 was found to have a substantially better total creep resistance than ZA.27, which in turn was marginally better than Mazak 3 for strains higher than 0.5%, but inferior for smaller strains, due to its higher primary creep extension. The superior creep resistance of ZA.8 was found to be due to the presence of strictly-orientated, thin plate-like precipitates of ε(CuZn4) phase in the zinc matrix of the eutectic and the lamellarly decomposed β phase, in which the precipitation morphology and orientation of ε in the zinc matrix was determined. Over broad ranges of temperature and stresses, the stress exponents and activation energies for creep were found to be consistent with some proposed creep rate mechanisms; i.e. viscous glide for Mazak 3, dislocation climb over second phase particles for ZA.8 and dislocation climb for ZA.27, controlled by diffusion in the zinc-rich phase. The morphology of aluminium and copper-rich precipitates formed from the solid solution of zinc was clearly revealed. The former were found to further increase the creep rate of inherently low creep resistant zinc, but the latter contributed significantly to the creep resistance. Excess copper in the composition, however, was not beneficial in improving the creep resistance. Decomposition of β in copper-containing alloys was found to be through a metastable Zn-Al phase which is strongly stabilised by copper, and the final products of the decomposition had a profound effect on the creep strength of the alloys. The poor creep resistance of alloy ZA.27 was due to the presence of particulate products derived from decomposed β-phase and a large volume of fine, equiaxed products of continuously decomposed α-dendrites.

The role of cytoskeletal proteins in the mechanism of insulin release

This thesis is concerned with the role of /3-cell cytoskeletal proteins in the mechanism of insulin release from islets of experimental animals, the Aston obese diabetic hyperglycaemic (ob/ob) mouse and their lean littermates and the cultural insulin secreting /?-cell lines, HIT-TT5 and RINm5F. Investigations were carried out into the glucose induced insulin response of the lean and obese mouse islets and HIT-TI5 cells and the D-glyceraldehyde response of RINm5F cells using a static incubation system. Colchicine was found to inhibit insulin release from both lean and obese mouse islets more significantly than cultured TTT-TI5 and RINm5F cells. (Colchicine pre-treatment also inhibited the second phase of insulin release from perifused lean mouse islets and HIT-TI5 cells). Cytocha-lasin B, used to investigate the role of the microfilamentous system in the mechanism of insulin release enhanced insulin release from both lean and obese mouse islets to a significantly greater degree than that from cultured HIT-TI5 and RINm5F cells. Pre-treatment of isolated lean and obese mouse islets and cultured /?-cells with a combination of colchicine and cytochalasin B significantly reduced the insulin response of the HIT-TI5 and RINm5F cells compared with the control values suggesting that intact microtubules are more important for the sustained release of insulin than the microfilamentous system. However, the response was not so clearly defined with the lean and obese mouse islets. Tubulin was separated from the extracts of lean mouse islets and the HIT-TI5 and RINm5F cells and actin was separated from all of the cell types including the obese mouse islets by SDS- polyacrylamide electrophoresis. A tubulin radioimmunoassay and a colchicine binding assay were developed to measure the tubulin content of lean and obese mouse islets, and the shift between the proportions of tubulin dimers and polymerized tubulin under stimulatory and non-stimulatory conditions. The assay methods developed were not prone to be accurate, sensitive and precise but gave some indication of the shift from unpolymerised to polymerised tubulin during glucose stimulated insulin release. These studies show that microtubules do play a fundamental role in the mechanism of insulin release from both islets and cultured HIT-TI5 and RINm5F cells.