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Heirloom tomato (Solanum lycopersicumL.) are a high‐value crop for organic vegetable growers. Tomato plants have a high N requirement and are adversely affected by insufficient, excessive, and poorly timed N fertilization. However, little information is available about N dynamics in heirloom tomato and whether their nutritional needs differ from those of hybrid fresh‐market (HFM) tomato. The project's goals were to (a) develop seasonal N accumulation curves for the popular heirloom tomato cultivar Brandywine, (b) measure the N removed with the harvested fruits, and (c) determine whether N concentrations from recently matured leaves from adequately and underfertilized fields as well as N accumulation and partitioning fell within published thresholds for HFM tomato plants. We tracked the leaf N concentrations, growth, yields and N accumulation of organically grown Brandywine tomato in a 2‐yr replicated field trial under low‐ and high‐N availability treatments. We also collected leaf and fruit samples from fertilized and unfertilized plots on local commercial organic fields. Total N accumulation ranged between 25 to 45 g N per linear bed meter and did not differ with N treatment. The N removed with the harvested fruit averaged 1.14 kg Mg−1fresh fruit across all sites and years and differed by site but not N fertility. On average, 70–80% of tomato N demand occurred between full bloom and early harvest. The observed N accumulation per unit yield, seasonal N accumulation pattern, and leaf sufficiency thresholds for Brandywine tomato were within the ranges published for HFM tomato varieties. We tested N accumulation and partitioning in ‘Brandywine’ heirloom tomato.Total N accumulation ranged between 25 and 45 g N per linear bed meter.On average, 70–80% of total N accumulation occurred between full bloom and early harvest.On average, 1.14 kg N was removed per tonne fresh fruit.Nitrogen needs were within published ranges for hybrid fresh‐market tomato.

OBJECTIVE--To examine the hypothesis that vitamin D deficiency (VDD) is associated with an increased prevalence of microvascular complications in young people with type 1 diabetes. RESEARCH DESIGN AND METHODS--In a [...]

Abstract:A profile essay of poet Jack Gilbert through Lloyd's private correspondence and conversations at the poetry workshop Group 18. In moving between the concrete details of Gilbert's life and Lloyd's personal journey as a poet, Gilbert's voice as a critic shows through, which doubles as a tool for examining and evaluating poetry overall. Lloyd cites published sources, transcripts, personal notes as well as photographs of 3 of the letters.

To manage nitrogen (N) efficiently, organic growers must be able to predict the amount and timing of plant‐available N from organic amendments. In this study, we measured N mineralization from a variety of organic amendments, including composted animal manures and plant material, pelleted and granular organic fertilizer formulations, slaughter waste products, and hydrolyzed liquid fertilizers. In a laboratory incubation, we measured net N mineralization from materials mixed with either organically or conventionally managed soil at 23°C and 60% water holding capacity after 0, 7, 21, 42, and 84 d. We found that net mineral N change in the amended soils after 84 d of incubation fell into four categories: immobilization to 5% of applied N for yard trimmings composts, 15–30% for poultry manure composts, 35–55% for granular fertilizers, and 60–90% for quick release products. However, across all amendments the amount of plant‐available N after 84 d of incubation was well correlated with the carbon (C)/N ratio (R2= 0.92). Within amendment types, the C/N ratio predicted N mineralization for yard trimmings composts (R2= 0.91), manure composts (R2= 0.81), and specialty fertilizer and slaughter products (R2= 0.88) but not liquid products (R2= 0.11). Soil management history did not consistently affect net N mineralization but may have influenced timing.

The incidence of type 2 diabetes mellitus (T2DM) studies among indigenous and non-indigenous Australian young people less than 19 years conducted in 2001-2006 accounted for 11% of incident cases of diabetes due to overweight.

The incidence of childhood type 1 diabetes mellitus (T1DM) in New South Wales (NSW) from 1997 to 2002 was determined to compare with previously published rates and analyze trends in incidence from 1990 to 2002. Results reveal that the incidence of childhood-onset T1DM has increased significantly in all age groups in NSW since 1990.

Educating older adults during atrial fibrillation (AF) screening events to recognize signs and symptoms and seek evaluation may promote detection of AF that occurs between screenings. The authors evaluated learning outcomes of AF awareness education provided during AF screening using a single-arm, pre/posttest design. Participants completed the Knowledge, Attitudes, Beliefs about Atrial Fibrillation Self-Monitoring and Treatment-Seeking (KABAF-SMTS) survey, participated in AF awareness education, and completed a KABAF-SMTS survey 2 weeks after education. Paired Educating older adults during atrial fibrillation (AF) screening events to recognize signs and symptoms and seek evaluation may promote detection of AF that occurs between screenings. The authors evaluated learning outcomes of AF awareness education provided during AF screening using a single-arm, pre/posttest design. Participants completed the Knowledge, Attitudes, Beliefs about Atrial Fibrillation Self-Monitoring and Treatment-Seeking (KABAF-SMTS) survey, participated in AF awareness education, and completed a KABAF-SMTS survey 2 weeks after education. Paired ttests revealed that knowledge of AF symptoms increased (p= 0.007). Scores for recognizing the seriousness of AF (p= 0.003), benefits of self-monitoring (p< 0.001), perception of barriers to self-monitoring (p= 0.002), and confidence (p< 0.001) to recognize AF and seek treatment improved. AF awareness education strengthened knowledge, beliefs, and attitudes that may be conducive to recognition and treatment-seeking for AF. [Journal of Gerontological Nursing, 45(9), 31–38.].

Abstract Objective To compare the cost effectiveness of general practitioner care and two general practice based psychological therapies for depressed patients. Design Prospective, controlled trial with randomised and patient preference […]

Abstract Objective To compare the clinical effectiveness of general practitioner care and two general practice based psychological therapies for depressed patients. Design Prospective, controlled trial with randomised and patient preference […]

EDITOR--We were interested in Slowie's suggestions on helping patients to communicate better with them[1] as we recently carried out a randomised controlled trial to test a written prompt to aid [...]

This article describes results from a state-wide survey of social services professionals (n= 259) regarding knowledge of the Child Abuse Prevention and Treatment Act Reauthorization of 2010 (CAPTA), clinically based markers of prenatal substance exposure (PSE), and appropriate child protection responses following a PSE referral. Few respondents were aware of CAPTA, and knowledge of clinical markers of PSE and appropriate child protective services responses to prenatal exposure varied according to substance type (alcohol or drugs). Regression models revealed that fewer years in practice and fewer annual drug referrals predicted more drug-exposure knowledge. Fewer years in practice and awareness of CAPTA predicted more alcohol-exposure knowledge. Policy implementation strategies are needed to increase the likelihood that CAPTA achieves its desired intent, particularly with professionals who have been in the field longer and may be less open to changing practice behaviors.

There is increased accountability of initial teacher education (ITE) programs in Australia to develop Graduate teachers who are better prepared. Most ITE programs have been designed using Pedagogical Content Knowledge. Informed by the growing Technological Pedagogical Content Knowledge (TPACK) research, this journal article suggests that ITE programs need to develop Graduate teachers who have the TPACK capabilities to use technologies to support teaching and student learning. Insights from the research and evaluation of the Teaching Teachers for the Future(TTF) Project,which was guided by the TPACK conceptualisation, are provided. The TTF Project, which involved all Higher Education Institutions providing ITE programs in Australia, drew upon the TPACK conceptualisation. The TTF Projectresearch and evaluation included the development and administration of a TTF TPACK Surveyand the implementation of the Most Significant Change Methodology. Key findings resulting from the employment of these methodologies are summarised to provide guidance to inform the improvement of ITE programs to develop Graduate TPACK capabilities.

Families in the child welfare system who are affected by substance abuse face distinct challenges to achieving reunification. Family drug courts (FDCs), which are child welfare courts based on a therapeutic framework of legal scholarship, arose 2 decades ago as an alternative approach for adjudicating these cases. A comprehensive review of prior empirical research on FDCs is presented to ascertain whether the model is a best practice for this population. The results of this review suggest that children in families that are involved in FDCs spend less time in foster care and are more likely to achieve reunification. This analysis incorporates findings from qualitative literature and undertakes methodological and values-based critiques in order to develop implications for social work research, practice, and policy.

The poem "Third Journey" by Margaret Lloyd is presented. First Line: What were we thinking as we picked up; Last Line: right arm draped over the back of the seat.

The medical profession is under increasing scrutiny with regard to the undesirable attitudes and behaviours of some of its members. Despite the setting of objectives for professional attitudes, it remains unclear how these can be taught and assessed. Having defined ‘attitudes', we consider some of the influences upon the development of professional attitudes within medicine. We then review possible ways of encouraging desirable attitudes and behaviours. Finally, we review and critique the main types of attitude assessment. We conclude that attitudes are complex, that the influence of medical culture is crucial, and that feasible assessment tools have yet to be developed.

Dual-chamber pacing improved hemodynamics acutely in a subset of patients with left ventricular (LV) dysfunction but conveyed no long-term symptomatic benefit in most. More recently, LV pacing and biventricular (multisite) pacing have been used to improve systolic contractility by altering the electrical and mechanical ventricular activation sequence in patients with severe congestive heart failure (CHF) and intraventricular conduction delay or left bundle branch block (LBBB). Intraventricular conduction delay and LBBB cause dyssynchronous right ventricular and LV contraction and worsen LV dysfunction in cardio-myopathies. Both LV and biventricular cardiac pacing are thought to improve cardiac function in this situation by effecting a more coordinated and efficient ventricular contraction. Short-term hemodynamic studies have shown improvement in LV systolic function, which seems more pronounced with monoventricular LV pacing than with biventricular pacing. Recent clinical studies in limited numbers of patients suggest long-term clinical benefit of biventricular pacing in patients with severe CHF symptoms. Continuing and future studies will demonstrate whether and in which patients LV and biventricular pacing are permanently effective and equivalent and which pacing site within the LV produces the most beneficial hemodynamic results.

AbstractThis article reports on a pilot project which is developing and testing an intervention to improve the management of the care pathway for people who have continuing and overlapping health and social care needs. The pilot group consists of people with Parkinson's disease and their carers. This is a follow-up to a community care study which examined how people with Parkinson's were faring under the ‘new’ community care arrangements. This research found disturbingly few community care assessments were being carried out and there were low levels of provision in some key community support services, despite high levels of need. The problems largely stemmed from weaknesses in joint working and interprofessional communication. The report recommended resourcing and supporting individual service users/carers in the management of their own care pathways. The article concludes by placing the study into the context of policy and service delivery priorities.

Background.Indications for extraction of an abandoned pacemaker lead (APL) are controversial. The purpose of this study was to determine whether or not APLs should be extracted in the absence of pacemaker-related problems. Methods and Results.We retrospectively reviewed, from 1977 through 1998, all patients with retained, non-functional leads and identified 433—266 males and 167 females. Mean age at initial pacemaker implantation was 68[emsp4 ]years. These patients received a total of 259 atrial and 948 ventricular leads. Of the total of 1,207 leads, 611 became non-functional. A total of 531 non-functional leads were abandoned, of which 18 were later extracted: one APL in 345 patients, two in 78, and three in 10. Indications for new lead placement when non-functional leads were abandoned included capture and/or sensing failure (243), lead recall (177), lead fracture (86), pacing system replacement to the contralateral side (11), accommodating patient growth (5), pacemaker function upgrade (5), replacement with implantable cardioverter defibrillator (ICD, 2), interference with ICD (1), and unknown (1). Complications that were associated with pacemakers were found in 24 patients (5.5%)—pacemaker system infection (8 patients) and venous occlusion at the time of a subsequent procedure of new lead placement when APLs had already been in place (16) which resulted in APL extraction (7) or transfer of the pacemaker system to the contralateral side (9). Neither venous thrombosis nor other complications were found in the remaining 409 patients (94.5%). The incidence of complications was higher in patients with three APLs than in patients with two or fewer APLs (40% vs. 4.7%, P=1×10−6), in patients with four or more total lead implantations than in patients with three or fewer total lead implantations (26.2% vs. 0.6%, P<1×10−10), and in patients with three or more procedures of new lead placements than in patients with two or fewer procedures of new lead placements (36.4% vs. 3.9%, P=1×10−10). Patients with complications were younger than those without complications both at the time of initial pacemaker implantation (59±16 vs. 68±17[emsp4 ]y, P=0.01) and when non-functional leads were abandoned (63±15 vs. 71±16[emsp4 ]y, P=0.04). Mean numbers of APLs, total leads implanted, and procedures of new lead placement were significantly larger in patients with complications than in those without complications (1.58±0.78 vs. 1.2±0.44, 4.96±1.23 vs. 2.66±0.8, and 2.13±0.85 vs. 1.25±0.53, P=0.03, 4×10−9and 4×10−5, respectively). Conclusions.1. With only 5.5% of patients having had pacemaker-related complications, the adverse outcome of APL is small. 2. Clinical clues to the possible occasion for pacemaker-related complications include three or more APLs, four or more total leads, three or more procedures of new lead placement, and a younger age at initial pacemaker implantation. 3. Patients with a large number of APLs, total lead implantations, and procedures of new lead placement should be carefully observed to detect possible pacemaker-associated complications.

In some patients with hypertrophic cardiomyopathy, the dynamic left ventricular outflow tract obstructive gradient results in exercise-limiting symptoms of dyspnea, angina, and syncope. Dual chamber pacing has been proposed as a widely available alternative treatment for a subset of patients with symptomatic hypertrophic obstructive cardiomyopathy. Initial studies showed a reduction in gradient and an improvement in symptoms in almost 90% of patients with severe symptoms. We report the Mayo Clinic experience with dual chamber pacing in 38 patients with hypertrophic obstructive cardiomyopathy who had permanent pacemakers implanted for limiting symptoms intractable to medical therapy. After a mean ± SD follow-up of 24±14 months, subjective improvement was reported in 47% of patients. However, there was no statistical difference between the maximal oxygen consumption at last follow-up and AAI pacing (atrial sensing and atrial pacing) (18.6±1.1 mL·kg−1.min−1) (ie, when the pacemaker was implanted but not pacing continuously). This article discusses the clinical perspective on the utility of dual chamber pacing for patients with hypertrophic obstructive cardiomyopathy.

A family in which several members have medullary carcinoma and phaeochromocytoma is described. Four of the 5 patients in this family who had a phaeochromocytoma have died; in one of these the medullary carcinoma may have contributed to death but in general the thyroid cancers were slow growing. In our experience successful diagnosis and treatment of the phaeochromocytomas have presented the greatest challenge. The welfare of future generations with this syndrome would seem to depend upon regular clinical and biochemical surveillance of the individuals and expeditious diagnosis and treatment of their tumours, particularly the phaeochromocytomas.

The development of the psychiatric service in the French prisons has, from tentative beginnings in the last century, gathered momentum in the last 15 to 20 years. This article discusses the factors which have influenced the development of the French prison psychiatric service, the difficulties which still hamper its growth as a comprehensive national service, and proposals for its future expansion

After outlining the historical background, this survey of the special units for the difficult and violent mentally disordered patient in France examines their legal framework, their present provision and their operational difficulties, and finally considers their role in the general context of psychiatric care.

This paper traces the evolution of mental health legislation in France from the eve of the Revolution of 1789 to the present day. The outstanding landmark in these 200 years has been the law of 1838. The reasons for its influence are analysed and assessed in the light of subsequent developments

The concept of criminal responsibility in the French judicial system was first given formal recognition in the Napoleonic Penal Code of 1810. Since that date, it has developed and matured but in the face of increasing medical and psychiatric knowledge, it has also encountered growing difficulties in its practical application. In order to bring the notion of criminal responsibility more into line with present-day understanding of criminal behaviour, many attempts have been made in recent years to redefine this concept. It seems that a definitive formula has now been found.

A voluntary recall of the Telectronics Accufix models 330-801 and 329-701 “J”-shaped atrial pacemaker leads has been issued because of fracture and extrusion of the J-shaped retention wire. Such extrusion can result in laceration of the atrium or surrounding vascular structures. Herein we describe a patient with a fractured and extruded retention wire that was snared and removed percutaneously; the atrial lead was left intact, and pacing function was satisfactory. This unique procedure can be used to avoid the morbidity associated with percutaneous lead extraction or thoracotomy and to prevent potential dislodgment and embolization of the retention wire during lead extraction.

To document a cumulative experience with removal of the Telectronics 330–801 Accufix atrial lead after it was withdrawn from the market.

The accuracy of students' self-recording of on-task behavior in several self-control conditions was observed in a special education classroom. Initially, when students were asked to record their own behavior, accuracy was low. When reinforcers were then made available either for recording accurately or for recording ontask behavior regardless of actual on-task behavior (self-reinforcement), accuracy was high. After repeated experience with these conditions, accuracy in the self-reinforcement condition decreased substantially. Results are discussed in the context of the students' ability to discriminate the self-reinforcement condition decreased substantially. Results are discussed in the context of the students' ability to discriminate the self-reinforcement contingency. Recommendations for the use of classroom self-reinforcement procedures for long periods of time without the addition of contingencies on accuracy should be made with caution.

Preschool children were tested on a modified form of the Wechsler Preschool and Primary Scale of Intelligence. Equal numbers of high and low scoring children were assigned to token and no-token groups. The tokens, exchangeable for back-up items, were shown to be reinforcers for each of the children in the study. Four weeks later, the children were retested. This time children in the token group received tokens for correct answers. High- as well as low-scoring children who received tokens did better than children who did not receive tokens. This suggests that high-scoring children, like low-scoring children, are not all maximally motivated to do their best by intrinsic reinforcement and that preschool children are similar to older children in this regard.

Abstract: While the ways in which people deal with dying and bereavement have been comprehensively researched, there is little which integrates psychological, emotional, philosophical, and religious perspectives. The role of religion is generally considered in terms of a simple linear relationship between presence or absence of religious belief and coping capacity. This article uses qualitative material from a small-scale study concerned with individuals' philosophical and religious frameworks to point towards multi-factor analysis. Comment is offered around the themes of theodicy; meaning; death-transcendence modes, and psychological and emotional adjustment.

The Social Model of Disability is increasingly recognised as the theoretical and ideological underpinning for the collectivisation and politicisation of disabled people. This paper examines the Social Model from the perspective of disabled women. It then considers the position of disabled women in relation to both the women's movement and the disability movement. It argues that the former is oriented towards non-disabled women and the latter towards disabled men, with a consequent further marginalisation and disempowering of disabled women. Drawing on the history of black feminism, the author (who is a white non-disabled woman, and who teaches anti-discriminatory social work practice based on an integrated theoretical model) concludes by offering to disabled women a reframing of the analysis in which to explore their simultaneous experiencing of their gender and disability.

Cyclosporine represents the foundation for current immunosuppressive therapy following solid organ transplantation. CsA use is associated with renal insufficiency and systemic hypertension. We hypothesized that CsA would enhance the vascular actions of endo-thelin (ET). Three groups of anesthesized dogs (n=15) were studied. Group 1 received CsA alone (1 mg/kg), group 2 received ET alone (1 ng/kg/min), and group 3 received combined CsA (1 mg/kg) and ET (1 ng/kg/min). The hemodynamic and renal effects were evaluated after 30 min. Combined treatment resulted in a profound reduction in mean arterial pressure (-62±14 mmHg (P<.05) and cardiac output (-2.2±0.4 1/min (P<.05). The reduction in mean arterial pressure and cardiac output were significantly greater than that observed with CsA or ET alone. Systemic vascular resistance was not significantly changed. Combined CsA and ET resulted in a significant reduction in renal blood flow (195±18to 101±11 ml/mm P<.05) but without evidence of active renal vasoconstriction. The decline in GFR (31.8±5.6 ml/min to being unmeasurable) was of greater magnitude than the change in renal blood flow, suggesting enhanced afferent anteriolar vasoconstriction or an alteration in the ultrafiltration coefficient. These studies demonstrate an important and synergistic cardiode-pressor effect when CsA and ET are combined.

Several letters to the editor are presented in response to articles within the previous issue which includes the article on Fangio W196 automobile by Doug Nye, "Flat out in Fast cars," by Mel Nichols and "Octane Cars," by Mark Dixon.