Service user perspectives on social prescribing services for mental health in the UK: a systematic review

AIM

To thematically synthesise adult service users' perspectives on how UK-based social prescribing services support them with their mental health management.

METHODS

Nine databases were systematically searched up to March 2022. Eligible studies were qualitative or mixed methods studies involving participants aged ⩾ 18 years accessing social prescribing services primarily for mental health reasons. Thematic synthesis was applied to qualitative data to create descriptive and analytical themes.

RESULTS

51,965 articles were identified from electronic searches. Six studies were included in the review (n = 220 participants) with good methodological quality. Five studies utilised a link worker referral model, and one study a direct referral model. Modal reasons for referral were social isolation and/or loneliness (n = 4 studies). Two analytical themes were formulated from seven descriptive themes: (1) person-centred care was key to delivery and (2) creating an environment for personal change and development.

CONCLUSIONS

This review provides a synthesis of the qualitative evidence on service users' experiences of accessing and using social prescribing services to support their mental health management. Adherence to principles of person-centred care and addressing the holistic needs of service users (including devoting attention to the quality of the therapeutic environment) are important for design and delivery of social prescribing services. This will optimise service user satisfaction and other outcomes that matter to them.

In Situ Enhancement and Isotopic Labeling of Biogenic Coalbed Methane

Subsurface microbial (biogenic) methane production is an important part of the global carbon cycle that has resulted in natural gas accumulations in many coal beds worldwide. Laboratory studies suggest that complex carbon-containing nutrients (e.g., yeast or algae extract) can stimulate methane production, yet the effectiveness of these nutrients within coal beds is unknown. Here, we use downhole monitoring methods in combination with deuterated water (D₂O) and a 200-liter injection of 0.1% yeast extract (YE) to stimulate and isotopically label newly generated methane. A total dissolved gas pressure sensor enabled real-time gas measurements (641 days preinjection and for 478 days postinjection). Downhole samples, collected with subsurface environmental samplers, indicate that methane increased 132% above preinjection levels based on isotopic labeling from D₂O, 108% based on pressure readings, and 183% based on methane measurements 266 days postinjection. Demonstrating that YE enhances biogenic coalbed methane production in situ using multiple novel measurement methods has immediate implications for other field-scale biogenic methane investigations, including in situ methods to detect and track microbial activities related to the methanogenic turnover of recalcitrant carbon in the subsurface.

Socioeconomic impact of forage-technology adoption by smallholder cattle farmers in Cambodia

In Cambodia, adoption of forage technology is recommended to smallholder cattle farmers as an alternative to the widespread practice of feeding nutritionally inferior rice straw and collected or grazed native grasses. Although field research has demonstrated the nutritional benefits to cattle of smallholders adopting forage technology in Cambodia, we extended these studies by investigating the impacts and financial metrics of forage technology adoption in January 2011 by 120 smallholder participants from the ‘Best practice health and husbandry of cattle Cambodia’ (AH/2005/086) project. Farmers were classified by intervention level (high (HI) or low (LI) intervention) and forage technology adoption (adopter HI, non-adopter HI and non-adopter LI). Information on cattle-feeding practices, including household labour demands of sourcing feed for cattle, plus input costs of forage-plot establishment by adopter HI farmers, was collected and analysed. Results were that while the establishment of forages did not have a significant effect on the use of traditional feed sources such as rice straw, crop bi-products and crop residues, grazing of cattle on native pastures was less common among adopter households. Adopter households also reported a significant (P < 0.05) reduction in daily time spent sourcing feed and reduced involvement of women and children in sourcing feed for cattle compared with non-adopter households. Average total cost of inputs to forage-plot establishment per 100 m2 ranged from US$1.40 to US$16.88, with an average cost of US$5.60. Seed costs were estimated at US$0.50 per 100 m2 for a total input cost of US$6.10 per 100 m2. Partial budget analysis was used to compare the value of forage feeding of the following two scenarios over a 6-month wet-season period: (1) forage-plot establishment and forage feeding across the herd; and (2) forage-plot establishment and target feeding (fattening) of one animal. A net profit of US$139.01 was indicated for Scenario 1 and US$152.94 for Scenario 2 and Monte Carlo simulation indicated similar financial outcomes for both scenarios, namely US$169.09 (95% CI: –17.00, 402.00) and US$172.33 (95% CI: 66.80, 305.80) respectively. We conclude that the reduced labour burden on women and children plus the potential increased household income from forage establishment and forage feeding, support recommendations of forage technology as a strategy to improve the livelihoods of smallholder cattle farmers in Cambodia.

Investigation of smallholder farmer biosecurity and implications for sustainable foot-and-mouth disease control in Cambodia

In Cambodia, the majority of the population is rural and reliant on subsistence agriculture, with cattle raised by smallholder farmers using traditional practices, resulting in low productivity and vulnerability to foot-and-mouth disease (FMD). As FMD causes deleterious impacts on rural livelihoods, known FMD risk factors were reviewed, using knowledge, attitudes and practice (KAP) surveys of smallholders (n = 240) from four regions. The study aimed to understand current biosecurity threats to smallholder livelihoods and investigate the hypothesis that smallholder farmers practising FMD risk management should be associated with higher incomes from cattle. Descriptive data were examined to demonstrate trends in KAP and a multivariable linear regression model developed to identify cattle income predictors. Results showed that baseline mean knowledge scores were low at 28.4% across all regions and basic biosecurity practices, including quarantine of new cattle, isolation of sick cattle and FMD vaccination, were lacking. As farmers purchase and sell cattle from and to various administration levels (including export), there is high risk of FMD transmission into and from smallholder communities. The final multivariable linear regression model identified significant explanatory parameters for annual cattle income, including region, number of calves born, forage plot size (ha), vaccination of cattle and the number of cattle purchased (F pr. < 0.001, R²  = 29.9). Individual biosecurity practices including FMD vaccination were not significant predictors of income. With the current focus of farmers on treatment of FMD with inappropriate antibiotics leading to potential anti-microbial residue issues, yet receptivity to payment for vaccine in most regions, there is an urgent need for a coordinated national biosecurity and FMD management public awareness campaign. Further, to enhance the association between improved cattle health and rural livelihoods, it is recommended that livestock development programmes implement a systems approach to enhance farmer KAP in biosecurity, nutrition, reproduction and marketing of cattle.

Drivers for animal welfare policies in Asia, the Far East and Oceania

The complex and diverse nature of the World Organisation for Animal Health (OIE) region for Asia, the Far East and Oceania presents both challenges and opportunities in implementing improved approaches to animal welfare. Drivers for improvements include social values, culture, religion, political interest, trade, an increasing global awareness of animal welfare issues, an increasing demand for meat and dairy products, the interest of non-governmental organisations, and the mandate given to the OIE to develop science-based standards for animal welfare. The outcomes-based OIE standards can be amended in the light of new scientific knowledge and implemented by countries in a manner best suited to meet their needs. A number of regional initiatives are described, including a regional strategy, examples of national activities, projects run by the OIE Collaborating Centre for Animal Welfare Science and Bioethical Analysis, and trade measures. Although the overall outlook for improvements in the region looks promising, implementation of standards over the longer-term will require ongoing political commitment, resources and cultural change to ensure sustained improvements.

A brief history of phosphorus: from the philosopher's stone to nutrient recovery and reuse

The element phosphorus has no substitute in sustaining all life and food production on our planet. Yet today's phosphorus use patterns have resulted in both a global environmental epidemic of eutrophication and led to a situation where the future availability of the world's main sources of phosphorus is uncertain. This paper examines the important history of human interference with the phosphorus cycle from initial discovery to present, highlighting key interrelated events and consequences of the Industrial Revolution, Sanitation Revolution and Green Revolution. Whilst these events led to profound advances in technology, public health and food production, they have fundamentally broken the global phosphorus cycle. It is clear a 'Fourth Revolution' is required to resolve this dilemma and ensure humanity can continue to feed itself into the future while protecting environmental and human health.

Joining the dots: devising a supported self-help strategy to help pituitary patients integrate their medical care

Purpose

The lack of integrated medical and psychosocial care limits—and potentially disables—pituitary patients. Providing resources specifically aimed at assisting patients in integrating their own care should lead to improved treatment experiences.

Context

The Pituitary Foundation (PF), a UK-based charity with 11,000 members, presents the best opportunity to understand the needs of this patient population. Part of the work of the PF is to respond to patient needs as identified by research and NHS guidelines (NICE Guidelines 2006)

Data sources

In 2005, PF commissioned research to identify the psychosocial needs of pituitary patients which explored their experiences through the process of diagnosis, treatment and ongoing condition management. The analysis identified that current medical care is fragmented and confusing for pituitary patients.

Case description

In response, PF has devised a two-part strategy:

1. Dissemination of research outcomes to the medical community; and

2. Production of a series of self-help booklets designed with the specific aim of enabling patients to negotiate the medical minefield.

Discussion

Changes to medical care take time to implement. Patient involvement in managing the demands of life long conditions is essential if full and individualised integration of care is to be achieved.

Evaluation of a portable blood lead analyzer with occupationally exposed populations

BACKGROUND

This project evaluated a portable electroanalytical instrument that is used to rapidly analyze blood lead levels in individuals, using a fresh whole blood sample (venous).

METHODS

Samples were obtained from 208 lead-exposed employees who donated two 2 ml venous blood samples into "lead-free" evacuated tubes. One blood sample was analyzed onsite using the portable field instrument while the second sample was analyzed using graphite furnace atomic absorption spectrometry (GFAAS).

RESULTS

According to GFAAS results, employee venous blood lead levels ranged from 1 microg/dl to 42 microg/dl. The mean difference between the results from the field instrument and GFAAS was less than 1 microg/dl. Analysis indicates that the results from the field instrument yielded a slight positive bias overall (P value = 0.0213), with less bias for blood lead levels above 10 microg/dl (P value = 0.0738).

CONCLUSIONS

Within the blood range evaluated (1-42 microg/dl), the instrument performed adequately according to Clinical Laboratory Improvements Amendments (CLIA) proficiency requirements. The ability of the instrument to perform rapid analysis makes it potentially valuable to occupational health professionals for medical monitoring or on-site investigations.

Ultrasonic extraction and field-portable anodic stripping voltammetric measurement of lead in dust wipe samples

Dust wipe samples were subjected to ultrasonic extraction (UE) in diluted nitric acid, and then analyzed for lead content using field-portable anodic stripping voltammetry (ASV). Recoveries of lead were determined from wipe materials which were spiked with certified reference materials (CRMs) containing known quantities of lead. Four different wipe materials and four different CRMs were tested, with and without filtration of aliquots of sample extract through 0.45 microm hydrophilic polytetrafluoroethylene filters. The CRMs consisted of paint, soil, particulate, and dust matrices. Wipe materials were chosen from those which have been found to meet the performance aspects of an ASTM standard specification. UE/ASV experiments were carried out in accordance with newly published ASTM procedures for on-site extraction and electroanalysis. Recoveries were found to vary for different wipe materials and CRMs. For several CRMs, quantitative (80--120%) recoveries for UE/ASV were observed for one wipe material whether filtration was used or not, while other wipe materials required filtration for quantitative recovery. In the case of one wipe material which contained detergents, quantitative recoveries could not be achieved whether filtration was used or not. The total analysis time for a sample set of 6--12 samples was 60--90 min, including extraction time and sample manipulation. The results of this work have provided information on the choice of wipe materials that can be used for quantitative lead measurements by UE/ASV in materials that are representative of sources of lead in surface dust.

Field screening test methods: performance criteria and performance characteristics

Field-portable test methods may be quantitative, semi-quantitative, or qualitative and screening methods are often used in the field to determine if the concentration of a toxic substance exceeds regulatory or recommended standards or action levels. For on-site analysis, accurate quantitative tests for field measurements may not be available, depending on the analyte(s) or specific field situation. Thus, in lieu of more definitive test methods, screening tests which are based on qualitative or semi-quantitative methods are often used for making immediate decisions in the field, e.g. for compliance or risk assessment. Also, quantitative methods may be used for screening purposes in many instances. To ensure the quality of these screening tests and the decisions that are made based upon their results, screening methods need to be evaluated with sufficient data and should meet basic performance criteria prior to their being employed for decision-making purposes. Although quantitative, semi-quantitative and qualitative methods demonstrate different characteristics, it is desired that the performance criteria for all three method categories be consistent. If there is consistency, then one can have a sound basis for selecting the most appropriate test(s) for a given application. In order to unify the performance criteria for the different types of methods, a performance function is used to characterise both qualitative and semi-quantitative methods; in turn, this performance function is related to that for quantitative methods. False negative rates, false positive rates, sensitivity and specificity are key characteristics of screening methods that can be determined from the pertinent performance curves. The performance characteristics of each method are related to the uncertainty region that is associated with each method and the applicable uncertainty regions can be gleaned from the performance curves. Also, various options for using multiple test results to improve decisions based on test results are provided.

Comparison of three sampling and analytical methods for the determination of airborne hexavalent chromium

A field study was conducted with the goal of comparing the performance of three recently developed or modified sampling and analytical methods for the determination of airborne hexavalent chromium (Cr(VI)). The study was carried out in a hard chrome electroplating facility and in a jet engine manufacturing facility where airborne Cr(VI) was expected to be present. The analytical methods evaluated included two laboratory-based procedures (OSHA Method ID-215 and NIOSH Method 7605) and a field-portable method (NIOSH Method 7703). These three methods employ an identical sampling methodology: collection of Cr(VI)-containing aerosol on a polyvinyl chloride (PVC) filter housed in a sampling cassette, which is connected to a personal sampling pump calibrated at an appropriate flow rate. The basis of the analytical methods for all three methods involves extraction of the PVC filter in alkaline buffer solution, chemical isolation of the Cr(VI) ion, complexation of the Cr(VI) ion with 1,5-diphenylcarbazide, and spectrometric measurement of the violet chromium diphenylcarbazone complex at 540 nm. However, there are notable specific differences within the sample preparation procedures used in three methods. To assess the comparability of the three measurement protocols, a total of 20 side-by-side air samples were collected, equally divided between a chromic acid electroplating operation and a spray paint operation where water soluble forms of Cr(VI) were used. A range of Cr(VI) concentrations from 0.6 to 960 microg m(-3), with Cr(VI) mass loadings ranging from 0.4 to 32 microg, was measured at the two operations. The equivalence of the means of the log-transformed Cr(VI) concentrations obtained from the different analytical methods was compared. Based on analysis of variance (ANOVA) results, no statistically significant differences were observed between mean values measured using each of the three methods. Small but statistically significant differences were observed between results obtained from performance evaluation samples for the NIOSH field method and the OSHA laboratory method.

Ultrasonic extraction and portable anodic stripping voltammetric measurement of lead in paint, dust wipes, soil, and air: an interlaboratory evaluation

Recent studies have demonstrated the utility of ultrasonic extraction (UE), followed by portable anodic stripping voltammetry (ASV), for the on-site determination of lead in environmental and industrial hygiene samples. The aim of this work was to conduct an interlaboratory evaluation of the UE-ASV procedure, with a goal of establishing estimates of method performance based on results from collaborative interlaboratory analysis. In this investigation, performance evaluation materials (PEMs) with characterized lead concentrations were used for interlaboratory testing of the UE-ASV procedure. The UE-ASV protocol examined has been promulgated in the form of two separate national voluntary consensus standards (one for UE and another for electroanalysis, which includes ASV). The PEMs consisted of characterized and homogenized paints, soils, and dusts (the last of which were spiked onto wipes meeting national voluntary consensus standard specifications), and air filter samples (mixed cellulose ester membrane) generated using characterized paints within an aerosol chamber. The lead concentrations within the PEMs were chosen so as to bracket pertinent action levels for lead in the various sample matrices. The interlaboratory evaluation was conducted so as to comply with an applicable national voluntary consensus standard that can be used to estimate the interlaboratory precision of a given analytical test method. Based on the analytical results reported by the participating laboratories, relative standard deviations (RSDs) for repeatability and reproducibility were computed for three different lead contents of the four PEMs. RSDs for repeatability were 0.019-0.100 for paints; 0.030-0.151 for soils; 0.085-0.134 for dust wipes; and 0.095-0.137 for air filters. RSDs for reproducibility were 0.127-0.213 for paints; 0.062-0.162 for soils; 0.085-0.134 for dust wipes; and 0.114-0.220 for air filters. With the exception of one of the air filter samples and one of the paint samples, the precision estimates were within the +/- 20% precision requirement specified in the US Environmental Protection Agency National Lead Laboratory Accreditation Program (NLLAP). The results of this investigation illustrate that the UE-ASV procedure is an effective method for the quantitative measurement of lead in the matrices evaluated in this study.

Evaluation of a portable X-ray fluorescence instrument for the determination of lead in workplace air samples

Occupational Safety and Health Administration (OSHA) regulations for worker exposure to lead specify worker protection levels based upon airborne concentrations of lead dust. The rapid, on-site determination of lead in air filter samples using a portable x-ray fluorescence (XRF) instrument with an attachment to hold the filter would expedite the exposure assessment process and facilitate compliance with the OSHA standards. A total of 65 lead in air filter samples were collected at bridge blasting lead-abatement projects using closed-faced, 37-mm cassettes with pre-loaded 0.8 micron pore size mixed cellulose ester membrane filters. The lead loading range of the data set was 0.1-1514.6 micrograms (micrograms) of lead/sample. Samples were initially analyzed with a field portable XRF (NITON 700) using an experimental non-destructive XRF method. Samples were subsequently analyzed using National Institute for Occupational Safety and Health (NIOSH) Method 7105 (Graphite Furnace AA) as a reference analytical method. The paired data were not normally distributed; therefore, the non-parametric Wilcoxon signed rank test was used for statistical analysis. There was no statistically significant difference between data from the field portable XRF method and the NIOSH method (p-value = 0.72). Linear regression of the data resulted in a slope of 0.959, a y-intercept of 5.20 micrograms, and an r2 of 0.985. The XRF limit of detection and limit of quantitation were determined to be 6.2 and 17 micrograms of lead/sample, respectively. The XRF method accuracy was +/- 16.4% (7.1%-27%, 90% confidence interval). The data presented in this study indicate that field-portable XRF can be used for the analysis of lead air filter samples over the range of 17 to 1500 micrograms of lead/sample. The practicing industrial hygienist can use field-portable XRF to produce a rapid, on-site determination of lead exposure that can immediately be communicated to workers and help identify appropriate levels of personal protection. As the method is non-destructive, samples can subsequently be sent to a laboratory for confirmation. Confirmation would be recommended when greater than 16.4 percent accuracy from an analytical method is required. This study provided data of suitable quality for the development of NIOSH Method 7702, "Lead by Field Portable XRF."

An evaluation of worker lead exposures and cleaning effectiveness during removal of deteriorated lead-based paint

We evaluated worker lead exposures and cleaning effectiveness during initial cleanup of 19th-century buildings with highly deteriorated lead-based paint. Eighteen rooms of similar size and condition in two university-owned buildings were selected for a pilot project to compare three methods for removing loose paint, paint chips, and dust. The methods used were: dry scraping followed by dry sweeping (no engineering or work practice controls); wet scraping and high-efficiency particulate air (HEPA) vacuuming; and the latter method with the addition of a portable HEPA-filtered exhaust fan in the room providing about 40 air changes per hour. The final step for all methods was wet-mopping once with tri-sodium phosphate solution. During a single day 18 rooms were cleaned; each of three two-person work crews cleaned six rooms, two with each method. Air and surface samples were collected before, during, and after cleaning. All of the methods were potentially hazardous to workers: 44 percent of the method-based exposures (range: 5.0-360 micrograms/m3) and one of five full-shift exposures exceeded the OSHA PEL (range 9.4-110 micrograms/m3). Lowest worker exposures were during the wet scraping and vacuuming method (mean: 24 micrograms/m3). Providing general ventilation in rooms did not reduce worker exposures and appeared to increase them (mean: 73 micrograms/m3). Overall, the mean floor surface lead levels were reduced 50 percent after cleaning (from 2,600 to 1,300 micrograms/ft2), but the effectiveness of the three methods in reducing floor lead levels did not differ significantly. Overall, the method, mean paint lead concentration, pre-cleaning surface lead concentration, and work crew were significantly associated with the mean worker exposures during cleaning (p = 0.023), but not with the post-cleaning surface lead concentrations (p = 0.13).

Field method for the determination of hexavalent chromium by ultrasonication and strong anion-exchange solid-phase extraction

A simple, fast, sensitive, and economical field method was developed and evaluated for the determination of hexavalent chromium (CrVI) in environmental and workplace air samples. By means of ultrasonic extraction in combination with a strong anion-exchange solid-phase extraction (SAE-SPE) technique, the filtration, isolation, and determination of CrVI in the presence of trivalent chromium (CrIII) and potential interferents was achieved. The method entails (1) ultrasonication in basic ammonium buffer solution to extract CrVI from environmental matrixes; (2) SAE-SPE to separate CrVI from CrIII and interferences; (3) elution/acidification of the eluate; (4) complexation of chromium with 1,5-diphenylcarbazide; and (5) spectrophotometric determination of the colored chromium-diphenylcarbazone complex. Several critical parameters were optimized in order to effect the extraction of both soluble (K2CrO4) and insoluble (PbCrO4) forms of CrVI without inducing CrIII oxidation or CrVI reduction. The method allowed for the dissolution and purification of CrVI from environmental and workplace air sample matrixes for up to 24 samples simultaneously in less than 90 min (including ultrasonication). The results demonstrated that the method was simple, fast, quantitative, and sufficiently sensitive for the determination of occupational exposures of CrVI. The method is applicable for on-site monitoring of CrVI in environmental and industrial hygiene samples.

Ultrasonic extraction and field-portable anodic stripping voltammetry for the determination of lead in workplace air samples

An on-site, field-portable analytical method for the determination of lead in workplace air samples, based on the use of ultrasonic extraction and anodic stripping voltammetry (ASV), was evaluated. Workplace air samples were obtained using a standard method involving particulate collection onto mixed cellulose ester membrane filters. Samples were collected at work sites where airborne particulates were generated from the abrasive blasting of lead-containing paint on highway bridges. Ultrasonic extraction (UE) of air filter samples in diluted nitric acid, followed by portable ASV, was used for the determination of lead. Also, performance evaluation samples consisting of reference materials of known lead concentration were subjected to the UE-ASV procedure for lead determination. Confirmatory analyses of the air filters and performance evaluation samples subjected to the UE-ASV lead measurement method were conducted by hotplate digestion in concentrated nitric acid and 30% hydrogen peroxide, followed by inductively coupled plasma-atomic emission spectrometric (ICP-AES) determination of lead. Recoveries of lead from performance evaluation materials (when using the UE-ASV method) were found to be quantitative. The performance of the UE-ASV method for lead in air filters was found to be acceptable, as evaluated by comparison with results from hotplate strong acid digestion followed by ICP-AES analysis. Based on the results of this study, the ultrasonic extraction/portable ASV procedure demonstrates potential for the on-site determination of lead in personal breathing zone and area air samples.

Determination of hexavalent chromium in industrial hygiene samples using ultrasonic extraction and flow injection analysis

A simple, fast, and sensitive method was developed for the determination of hexavalent chromium (CrVI) in workplace samples. Ultrasonic extraction in alkaline solutions with 0.05 M (NH4)2SO4-0.05 M NH3 provided good extraction efficiency of CrVI from the sample and allowed the retention of CrVI on an ion-exchange resin (95%). The CrVI in the sample solution was then separated as an anion from trivalent chromium [CrIII] and other cations by elution from the anion-exchange resin with 0.5 M (NH4)2SO4 in 0.1 M NH3 (pH 8) buffer solution. The eluate was then acidified with hydrochloric acid and complexed with 1,5-diphenylcarbazide reagent prior to flow injection analysis. By analyzing samples with and without oxidation of CrIII to CrVI using CeIV, the method can measure CrVI and total Cr. For optimizing the separation and determination procedure, preliminary trials conducted with two certified reference materials (CRMs 013-050 and NIST 1633a) and three spiked samples (ammonia buffer solution, cellulose ester filters and acid washed sand) indicated that the recovery of CrVI was quantitative (> 90%) with this method. The limit of detection for FIA-UV/VIS determination of the Cr-diphenylcarbazone complex was in the sub-nanogram range (0.11 ng). The technique was also applied successfully to a workplace coal fly ash sample that was collected from a power plant and paint chips that were collected from a heating gas pipe and a university building. The principal advantages of this method are its simplicity, sensitivity, speed and potential portability for field analysis.

Evaluation of a chemical spot-test kit for the detection of airborne particulate lead in the workplace

A commercial rhodizonate-based test kit was evaluated for its potential use in the detection of lead in airborne particulate samples at work sites. Over 350 air samples were collected at abrasive blasting lead paint abatement sites using cellulose ester membrane filters and personal sampling pumps. The filter samples were tested with the chemical spot test and then analyzed by graphite furnace atomic absorption spectrophotometry. No positive readings were recorded for lead masses below 1.3 micrograms Pb/filter, and no negative readings were observed for lead amounts above 8.1 micrograms Pb/filter. Experimental data were statistically molded in an effort to estimate the performance parameters of the spot test kit. The identification limit of the kit was found to be approximately 3.6 microgram/filter sample. For lead mass values above approximately 10 micrograms Pb/filter, 95% confidence of a positive reading was found, while 95% confidence of a negative reading was found for lead masses below approximately 0.6 micrograms Pb/filter. Based on the results of this study the rhodizonate-based test kit for lead demonstrates potential for use in field screening for lead in personal breathing zone and area air samples.

Evaluation of wipe sampling materials for lead in surface dust

The suitability of several commercially available wipe sampling materials for the determination of lead in dust on solid surfaces was evaluated. Criteria for the selection of wipe materials appropriate for field use and subsequent laboratory analysis were identified. These included (a) uniform background lead levels in the materials (preferably < 5 micrograms); (b) ease of digestion in nitric acid/hydrogen peroxide or nitric acid/perchloric acid leachate; (c) > or = 80% recoveries of lead from standard reference material spikes; and (d) ease of use in the field. Other candidate wipe materials that were not examined in this study can be evaluated in a similar manner.

A comparison of transcranial Doppler ultrasound (TCD) and radioactive microspheres in determining cerebral perfusion in normal and low flow states

We have previously utilized the technique of transcranial Doppler (TCD) ultrasound to determine cerebral perfusion in patients undergoing cardiopulmonary resuscitation (CPR). In order to assess if TCD can reliably measure alterations in cerebral perfusion under conditions of normal and low cardiac outputs, we compared TCD measured blood flow velocities in the middle cerebral artery (MCA) of six piglets with radioactive microsphere determinations of total cerebral perfusion at baseline normal sinus rhythm (NSR), during CPR, and following return of spontaneous circulation (ROSC). Peak systolic and mean blood flow velocities were compared to the microsphere perfusion results on 15 different occasions; six during NSR, five during CPR, and four following ROSC. Although qualitative alterations in TCD measurements reflected changes in microsphere perfusion, we could not find a statistically significant correlation between either peak systolic or mean MCA blood flow velocities and microsphere perfusion measurements either overall or in any subgroup. The possible reasons which may explain the findings are discussed.

Combined optical second harmonic generation/quartz crystal microbalance study of underpotential deposition processes: copper electrodeposition on polycrystalline gold

Optical second harmonic generation and quartz crystal microbalance techniques are used as in situ probes of copper underpotential deposition on polycrystalline gold surfaces in sulfuric acid electrolyte. The second harmonic signal from a polished bulk gold substrate is observed to decrease by >60% as a result of copper underpotential deposition on gold. Also, the mass of an underpotentially deposited copper adlayer is monitored in situ by an oscillating quartz crystal microbalance, yielding an estimated coverage of ~8.0 x 10(-10) mol cm(-2) and an electrosorption valency of 1.5 for a copper adlayer on the surface of vapor-deposited polycrystalline gold.

A combinatorial method for grouping cases with multiple malformations

A combinatorial method is described for grouping cases with multiple malformations for the purpose of identifying previously undescribed syndromes. This method includes ways of carrying out 'tight' or 'loose' grouping, of allowing for variability of reporting of physical features by different observers, and of minimising the number of 'spurious' groups. Evaluation using a test data set of known dysmorphic syndromes showed that the method provides a feasible and useful means of grouping undiagnosed cases.

ITA, a portable program for the interactive analysis of data from tracer experiments

ITA is a portable program for analysing data from tracer experiments, most of the mathematical and graphical work being carried out by subroutines from the NAG and DASL libraries. The program can be used in batch or interactive mode, commands being typed in an English-like language, in free format. Data can be entered from a terminal keyboard or read from a file, and can be validated by printing or plotting them. Erroneous values can be corrected by appropriate editing. Analysis can involve elementary statistics, multiple-isotope crossover corrections, convolution or deconvolution, polyexponential curve-fitting, spline interpolation and/or compartmental analysis. On those installations with the appropriate hardware, high-resolution graphs can be drawn.