Background: Our prior six-year review (n=2165) revealed 24% of patients undergoing posterior decompression surgeries (laminectomy or discectomy) sought emergency department (ED) care within three months post-surgery. We established an integrated Spine Assessment Clinic (SAC) to enhance patient outcomes and minimize unnecessary ED visits through pre-operative education, targeted QI interventions, and early post-operative follow-up. Methods: We reviewed 13 months of posterior decompression data (n=205) following SAC implementation. These patients received individualized, comprehensive pre-operative education and follow-up phone calls within 7 days post-surgery. ED visits within 90 days post-surgery were tracked using provincial databases and compared to our pre-SAC implementation data. Results: Out of 205 patients, 24 (11.6%) accounted for 34 ED visits within 90 days post-op, showing a significant reduction in ED visits from 24% to 11.6%, and decreased overall ED utilization from 42.1% to 16.6% (when accounting for multiple visits by the same patient). Early interventions including wound monitoring, outpatient bloodwork, and prescription adjustments for pain management, helped mitigate ED visits. Patient satisfaction surveys (n=62) indicated 92% were “highly satisfied” and 100% would recommend the SAC. Conclusions: The SAC reduced ED visits after posterior decompression surgery by over 50%, with pre-operative education, focused QI initiatives, and its individualized, proactive approach.

We construct a Divisia money measure for U.K. households and private non-financial corporations and a corresponding dual user cost index employing a consistent methodology from 1977 up to the present. Our joint construction of both the Divisia quantity index and the Divisia price dual facilitates an investigation of structural vector autoregresssion models (SVARs) over a long sample period of the type of non-recursive identifications explored by Belongia and Ireland (2016, 2018), as well as the block triangular specification advanced by Keating et al. (2019). An examination of the U.K. economy reveals that structures that consider a short-term interest rate to be the monetary policy indicator generate unremitting price puzzles. In contrast, we find sensible economic responses in various specifications that treat our Divisia measure as the indicator variable.

THE WELSH LABOUR PARTY COULD HAVE ANTICIPATED THE FIRST elections to the National Assembly with a fair degree of equanimity, if not optimism. In the 1997 General Election, the party had won 55 percent of the vote and delivered on its promise of a devolution referendum which it won, albeit by a narrow majority. The architect of Labour's devolution policy, Ron Davies, the Welsh Secretary of State, who was widely respected within and beyond the Labour Party, had spoken of a new Welsh politics, with policy-making open to and inclusive of other Welsh parties. All this, however, was called into question by what Ron Davies subsequently described as his ‘moment of madness’ on Clapham Common in October 1998. Although the circumstances remain unclear, they resulted in his resignation from the post of Secretary of State and leader of the Welsh Labour Party. Alun Michael, a Cardiff MP and a minister at the Home Office, was appointed Welsh Secretary and subsequently endured a bitter and bruising leadership contest with Rhodri Morgan, during which claims were made that he was Blair's man, and not really an enthusiastic devolutionist but part of the Millbank control system. Large sections of the party were disillusioned by the process and serious questions were raised as to what extent disillusioned party activists would be involved in the Assembly election campaign.

THE QUESTION OF DECENTRALIZATION IS ONE WHICH THE British Labour Party has always found difficult to handle because of its inheritance of contradictory traditions in relation to the British state. Labour's roots in anti-authoritarian radicalism and in the British periphery make it sympathetic to decentralist demands and this has been reinforced by the need to compete electorally for support in the periphery. However, to gain power at Westminster it needs more than peripheral support; it needs to capture power at the centre and, in order to benefit the periphery, to strengthen the power of the centre. Ideologically, the party also possesses a socialist tradition which preaches the indivisibility of working-class interests and deplores nationalism and separatism.

The agricultural land classification (ALC) of England and Wales is a formal method of assessing the quality of agricultural land and guiding future land use. It assesses several soil, site and climate criteria and classifies land according to whichever is the most limiting. A common approach is required for calculating the necessary agroclimatic parameters over time in order to determine the effects of changes in the climate on land grading. In the present paper, climatic parameters required by the ALC classification have been re-calculated from a range of primary climate data, available from the Meteorological Office's UKCP09 historical dataset, provided as 5 km rasters for every month from 1914 to 2000. Thirty-year averages of the various agroclimatic properties were created for 1921–50, 1931–60, 1941–70, 1951–80, 1961–90 and 1971–2000. Soil records from the National Soil Inventory on a 5 km grid across England and Wales were used to determine the required soil and site parameters for determining ALC grade. Over the 80-year period it was shown that the overall climate was coolest during 1951–80. However, the area of land estimated in retrospect as ‘best and most versatile (BMV) land’ (Grades 1, 2 and 3a) probably peaked in the 1951–80 period as the cooler climate resulted in fewer droughty soils, more than offsetting the land which was downgraded by the climate being too cold. Overall there has been little change in the proportions of ALC grades among the six periods once all 10 factors (climate, gradient, flooding, texture, depth, stoniness, chemical, soil wetness, droughtiness and erosion) are taken into account. This is because it is rare for changes in climate variables all to point in the same direction in terms of ALC. Thus, a reduction in rainfall could result in higher grades in wetter areas but lead to lower classification in drier areas.

Episodic memory deficits are a core feature of neurodegenerative disorders. Muscarinic M1 receptors play a critical role in modulating learning and memory and are highly expressed in the hippocampus. We examined the effect of GSK1034702, a potent M1 receptor allosteric agonist, on cognitive function, and in particular episodic memory, in healthy smokers using the nicotine abstinence model of cognitive dysfunction. The study utilized a randomized, double-blind, placebo-controlled, cross-over design in which 20 male nicotine abstained smokers were tested following single doses of placebo, 4 and 8 mg GSK1034702. Compared to the baseline (nicotine on-state), nicotine abstinence showed statistical significance in reducing immediate (p=0.019) and delayed (p=0.02) recall. GSK1034702 (8 mg) significantly attenuated (i.e. improved) immediate recall (p=0.014) but not delayed recall. None of the other cognitive domains was modulated by either nicotine abstinence or GSK1034702. These findings suggest that stimulating M1 receptor mediated neurotransmission in humans with GSK1034702 improves memory encoding potentially by modulating hippocampal function. Hence, selective M1 receptor allosteric agonists may have therapeutic benefits in disorders of impaired learning including Alzheimer's disease.

Commission 46 had held two sessions of business meetings during the General Assembly in Rio de Janeiro. Both of them were chaired by Magda Stavinschi.

Commission 46 continues its task in the triennium, which started in September 2006. It seeks to further contribute to the development and improvement of astronomical education at all levels all over the world through various projects initiated, maintained and to be developed by the Commission, and by disseminating information concerning astronomy education.

The British Artificial Nutrition Survey 2001 recorded 507 home parenteral nutrition (HPN) patients (Crohn's disease 31.5%, vascular disease 19.7%, cancer 6.9%). Parenteral nutrition was administered via tunnelled central line (92%) and supplied by a commercial homecare company in 89% of cases. The majority of HPN patients live at home (95.5%) with an independent life (74%), normal activity (59.2%) and 92% survive 1 year. However, there is good evidence that the geographical distribution of HPN patients is uneven (prevalence no patients to thirty-six patients per million of the population) suggesting inequity of access. Patients are increasingly concerned about the distances travelled to main centres and variable standards of more local support. Funding issues continue to cause difficulties as commissioning of health care transfers from Health Authorities to Primary Care Trusts. The two nationally-funded intestinal failure units provide HPN services to 220 HPN patients. HPN-related readmissions have displaced those awaiting admission for intestinal failure treatment, for which the waiting list mortality in one unit has risen to 14%. The government has now recognised HPN as a specialised service distinct from intestinal failure and that existing medium-sized HPN units should be encouraged to take on HPN patients from intestinal failure units and smaller units. In Scotland a Managed Clinical HPN Network supported by the Scottish administration now cares for seventy-two patients under common protocols. The challenge for the future is how to provide high-quality care to all who need it in the rest of the UK.

This study aimed to describe clinical findings, pedigrees, and possible environmental risk factors in children with clinical anophthalmos and remnant microphthalmos in either eye in southern India. Twenty-four children (14 male, 10 female; mean age 10.3 years, age range 1.3 to 18 years,) were recruited from schools for the blind, hospitals, and community-based rehabilitation programmes in Andhra Pradesh, India, over 1 year. Family members were examined, and mothers interviewed. Fifteen children had anophthalmos and nine had remnant microphthalmos in one or both eyes. Twelve children had associated systemic findings, of which six were major and six were minor abnormalities. Information on consanguinity was available in 19 children, 12 of whom had consanguineous parents. Five children had a positive family history. Two mothers had a history of night blindness, and one had a history of pesticide exposure during pregnancy. High rates of consanguinity suggest a genetic recessive aetiology.

A cluster of serious Escherichia coli infections was identified among patients in a neonatal intensive-care unit. Infection control staff identified the outbreak because they realized that E coli rarely caused infections in this unit. Pulsed-field gel electrophoresis confirmed that one strain of E coli was transmitted among patients.

8090SPF alloy sheet has been in commercial production for about three years. This paper describes some of the property statistics of the commercially produced material, including tensile and superplastic results.

Properties have been determined for test components formed with back pressure with different levels of superplastic strain. Results from tensile and corrosion tests are presented.