Development and Validation of Written Exam Items for the Agricultural Hazardous Occupations Orders (AgHOs) Certification Training Program.

Research was conducted to develop and validate a pool of exam items that can be used to test the readiness of youth, ages 14-15 years, to be certified under the current federally mandated Agricultural Hazardous Occupations Orders (AgHOs). The AgHOs require training prior to employment in agricultural workplaces that the Secretary of Labor has determined are especially hazardous for youth within the prescribed age range. Under the current provisions of the AgHOs certification process, non-exempt youth seeking employment in agriculture are required to pass a written exam concentrating on safe work practices as partial satisfaction to receive certification of eligibility for employment to perform certain tasks. However, the regulations provide little guidance concerning the format of the exam, subject matter to be covered, degree of difficulty, or minimum passing score. As part of the USDA-sponsored Hazardous Occupations Safety Training in Agriculture (HOSTA) initiative, efforts have been made to develop consistent and evidence-based testing methods for disseminating the test protocols to instructors. The goal was to expand, enhance, and maintain the reliability of the exam item pool for the AgHOs certification process. Item development was based on the HOSTA-supported Gearing Up for Safety: Production Agriculture Safety Training for Youth curriculum. To ensure adequate item availability, the current item pool was expanded to include a minimum of two test items for each of the 157 cognitive-based core competencies developed as part of the Gearing Up curriculum design process. Administering 70-item exams that were generated from the item pool to 568 youth, ages 13-18 years, provided evidence of item validity. The result was a pool of 367 validated exam items.

AIR synthetase in cowpea nodules: a single gene product targeted to two organelles?

A cDNA (VUpur5) encoding phosphoribosyl aminoimidazole (AIR) synthetase, the fifth enzyme of the de novo purine biosynthesis pathway has been isolated from a cowpea nodule cDNA library. It encodes a 388 amino acid protein with a predicted molecular mass of 40.4 kDa. The deduced amino acid sequence has significant homology with AIR synthetase from other organisms. AIR synthetase is present in both mitochondria and plastids of cowpea nodules. A signal sequence encoded by the VUpur5 cDNA has properties associated with plastid transit sequences but there is no consensus cleavage site as would be expected for a plastid targeted protein. Although the signal sequence does not have the structural features of a mitochondrial targeted protein, it has a mitochondrial cleavage site motif (RX/XS) close to the predicted N-terminus of the mature protein. Southern analysis suggests that AIR synthetase is encoded by a single gene raising questions as to how the product of this gene is targeted to the two organelles. VUpur5 is expressed at much higher levels in nodules compared to other cowpea tissues and the gene is active before nitrogen fixation begins. These results suggest that products of nitrogen fixation do not play a role in the initial induction of gene expression. VUpur5 was expressed in Escherichia coli and the recombinant protein used to raise antibodies. These antibodies recognize two forms of AIR synthetase which differ in molecular size. Both forms are present in mitochondria, although the larger protein is more abundant. Only the smaller protein was detected in plastids.

A new method of accurately identifying costs of individual patients in intensive care: the initial results.

OBJECTIVES: To analyse the patient-related and non-patient-related costs of intensive care using an activity-based costing methodology. DESIGN: A retrospective cost analysis of 68 patients admitted sequentially over a 10-week period. SETTING: The Adult General Intensive Care Unit of the Royal Hallamshire Hospital, Sheffield. RESULTS: The results showed large variations in the costs obtained for individual patients. The calculation of the costs for the initial period of stay showed a wide variation depending on whether the costs were determined per calendar day or per first 24-h period. Significant correlations of costs between the first 24 h of stay and the admitting Acute Physiology and Chronic Health II score (p < 0.004) and daily costs with the Therapeutic Intervention Scoring System scores (p < 0.0001) were found. The average daily patient-related cost of care was Pounds 592. Overhead costs were calculated at Pounds 560 per patient day, which made the total cost of a day's treatment in intensive care Pounds 1152. CONCLUSIONS: The use of average costs or scoring systems to cost intensive care is limited, as these methods cannot determine actual resource usage in individual patients. The methodology described here allows all the resources used by an individual patient or group of patients to be identified and thus provides a valuable tool for economic evaluations of different treatment modalities.

The shine methodology--identifying telematic service opportunities for healthcare.

The SHINE methodology has been developed to analyse the business needs of healthcare providers. It forms part of an overall SHINE framework that offers complete support from the development of an information technology strategy through to evaluating the implementation of telematic services. The five stages of the methodology are described together with its position in the overall framework. An example is presented showing the impact of applying the methodology to the entitlement assessment of medical cards and compares this approach with a more conventional approach.

Cocaine treatment outcome: cocaine use following inpatient, outpatient, and no treatment.

Based upon a sample of 83 cocaine users self-selected into one of 3 programs, several conclusions seem possible. There seems to be little difference in Ss populations who choose hospital, outpatient or self-help/no treatment. Current hospital aftercare programs may not be appropriately oriented for cocaine users. It appears the hospital program in this study retained fewer than 30% of the Ss in aftercare. Outpatient treatment for cocaine dependency is a viable form of treatment which Ss will participate in for up to 6 months on a fee for service basis. Only about 20% of the Ss who were referred to self-help groups attended more than one meeting. Preliminary outcome data suggest that outpatient treatment may result in a lower relapse rate to cocaine than hospital or no treatment. However, this conclusion is extremely guarded due to a large number of methodological issues and the short follow-up period. Relapse to cocaine use is higher among Ss who returned to alcohol or marijuana.

Efficacy of psychotherapeutic counselling during 21-day ambulatory heroin detoxification.

Structured, psychotherapeutic counselling during 21-day heroin detoxification was evaluated by randomly assigning a group of 25 heroin addicts to a detoxification treatment regimen with mandatory counselling by a therapist and 25 to a control group who received only standard detoxification without counselling. There was no significant difference between groups in the number who successfully detoxified as measured by conversion of morphine positive urine to morphine negative urine. The counselling intervention group did, however, improve the attendance of subjects while in detoxification treatment, and significantly more patients entered long-term treatment following detoxification. Maximal use of a counselor during 21-day heroin detoxification may best be realized by directing therapy toward engaging patients in long-term care.

Efficacy of psychotherapeutic counselling during 21-day ambulatory heroin detoxification.

Structured, psychotherapeutic counselling during 21-day heroin detoxification was evaluated by randomly assigning a group of 25 heroin addicts to a detoxification treatment regimen with mandatory counselling by a therapist and 25 to a control group who received only standard detoxification without counselling. There was no significant difference between groups in the number who successfully detoxified as measured by conversion of morphine positive urine to morphine negative urine. The counselling intervention group did, however, improve the attendance of subjects while in detoxification treatment, and significantly more patients entered long-term treatment following detoxification. Maximal use of a counselor during 21-day heroin detoxification may best be realized by directing therapy toward engaging patients in long-term care.

Partial inactivation of cytochrome c oxidase by nonpolar mercurial reagents.

Purified beef heart cytochrome c oxidase is inactivated to the extent of 35 to 50% by the nonpolar mercurial reagents mercuric chloride and ethylmercuric chloride. The inactivation is complete within 5 min. In titrations of activity, the plateau level of inactivation is attained at added ethylmercuric chloride:heme a ratios of about 1:1. Up to 3 mercury atoms/heme a are bound to the oxidase, although only the first of these affects its enzymatic activity. Incubation of the ethylmercury-modified oxidase with sulfhydryl compounds reverses the inactivation, with 2,3-dimercaptopropanol being most effective of the reagents tested. Spectrophotometric and polarographic assays of enzymatic activity show that Km values for the native and the ethylmercury-modified enzymes are practically indistinguishable, and that the partial inactivation observed for the latter is reflected exclusively in a lower value of Vmax compared to that of the native enzyme. Based on these results, we propose that ethylmercuric chloride reacts with a single crucial--SH group per heme a, and that electron transfer processes in the modified product are partially inhibited.