The challenge of predicting patients at risk for falling: development of the Conley Scale.

Patient falls are an elusive clinical problem. The purpose of this project was to develop and evaluate a fall risk assessment scale for use in an acutely ill population. The Conley Scale demonstrates acceptable reliability, validity, sensitivity, and specificity, is quick and easy to use.

Accumulation of paralytic shellfish toxins by surfclams, Spisula solidissima (Dillwyn, 1897) in the Gulf of Maine: seasonal changes, distribution between tissues, and notes on feeding habits.

Accumulation of paralytic shellfish poisoning (PSP) toxins by surfclams, Spisula solidissima, was studied over a period of two years at two inshore locations in southern Maine and at six stations on Georges Bank in the Gulf of Maine. Whole animals as well as individual tissues (siphon, mantle, digestive gland, foot, adductor muscle, gill) were analyzed for PSP-toxicity levels using the standard AOAC mouse bioassay. Analyses of gut contents were carried out on surfclams from both inshore and offshore locations to identify the type of particles ingested. Surfclams feed primarily on phytoplankton and detrital material characteristic of the overlying seawater and surface sediment. No evidence was found for any selection based on particle size or type. Elevated levels of PSP toxins were noted in surfclams from Georges Bank more than two years after initial toxification. Toxins were not evenly distributed among the various tissues of surfclams. Initially, maximum toxicity among surfclam tissues was found in digestive glands; however, subsequent analyses of samples collected later in the year indicated that toxicity in gill and mantle tissues had increased relative to initial values. No toxicity was detected in adductor muscles. Surfclams are characterized by a high variation in total toxin load among individual animals, with a tendency for decreasing variation as toxin levels increase. Archived data from the Main Department of Marine Resources revealed annual and seasonal patterns of toxin accumulation by surfclams, i.e., toxin accumulation is an annual event, with initial increases in toxicity usually occurring in early spring.

Seasonal persistence of resting cyst toxicity in the dinoflagellate Gonyaulax tamarensis var. excavata.

Resting cysts collected in the autumn from bottom sediments were stored in the laboratory, in the dark at 4 degrees C, through the winter. Over a six month period, toxicity of the stored resting cysts was compared with toxicity of cysts from freshly-collected sediments. Resting cysts retained toxin over the winter months. Toxin levels show an apparent rise. Toxicity measurements of cysts from sediment samples kept in the laboratory reflect in situ levels.