Daily sightings of traffic cones were logged over a six-month period in an attempt to provide data about the frequency and novelty of such encounters, and to yield examples of the variety of uses for cones. Analysis of the data show that traffic cones were seen nearly every day and usually in new situations not previously encountered. Many unique uses were observed, both for hazardous conditions and for non-hazardous purposes. Though impressive in variety and inventiveness, these fall into general categories of use. Due to the multiplicity of purpose and the frequency of encounter it is argued that the public may not always perceive the message intended by the cone owner.

The incidence of secondary syphilis precipitating catastrophic antiphospholipid syndrome (CAPS) is not known despite that antiphospholipids react with reagin. We report a case of CAPS in a patient with secondary syphilis. CAPS should be considered in patients with secondary syphilis in whom thromboembolism occurs. Treatment must be prompt; a 50% mortality rate is associated with CAPS. [Infect Med. 2009;26:18-21,22]

OBJECTIVE:To assess the appropriateness of narcotic-prescribing practices in an ambulatory clinic for patients infected with HIV.DESIGN, SETTING, AND PATIENTS:The medical records of 220 (190 HIV-positive) patients, seen in a clinic primarily designed for the long-term follow-up of ambulatory HIV-infected patients and located in an inner-city, public teaching hospital, were retrospectively reviewed to determine the prevalence and appropriateness of prescribing Drug Enforcement Administration schedule 2 narcotics. Appropriateness was based on published guidelines for the use of narcotics in the treatment of cancer patients.MEASUREMENTS AND MAIN RESULTS:The prevalence of narcotic use among the HIV-positive patients was 15%. Narcotics were prescribed for 38% of the patients who died, 33% of those with AIDS [Centers for Disease Control and Prevention (CDC) clinical class C], 4% of those with AIDS-related complex (ARC) (CDC clinical class B), and 5% of asymptomatic HIV-positive patients (CDC clinical class A). None of the HIV-negative patients seen in the clinic received narcotics. Narcotics were more likely to be prescribed for patients with AIDS than for patients with ARC (p < 0.001) or for HIV-positive patients (p < 0.001). For the three CDC clinical classes, there was no significant difference among the proportions of patients receiving narcotics inappropriately (p = 0.108). Among the risk groups, intravenous drug abusers were more likely to be prescribed narcotics inappropriately than were men who were homosexual (p < 0.001) or individuals who were heterosexual (p = 0.013); transfusion recipients were also more likely to be prescribed narcotics inappropriately than were homosexual men (p = 0.026) or heterosexual men or women (p = 0.032). Narcotics were more likely to be prescribed for patients with disseminated histoplasmosis (p = 0.022), Pneumocystis carinii pneumonia (p = 0.001), candidal esophagitis (p = 0.020), Kaposi's sarcoma (p < 0.001), or wasted appearance (p = 0.043). Inappropriate prescriptions were more likely to be given to patients with dementia (p = 0.005) or wasted appearance (p = 0.019).CONCLUSIONS:Physicians tend to prescribe narcotics inappropriately to patients known to have previously abused drugs and to those who appear wasted or have dementia. Physicians have a duty to prescribe narcotics appropriately as guided by recognized medical indications and the patients' views concerning their current medical needs.

A new nurse practitioner service at a public teaching hospital received patients from internal medicine teaching services. To determine the characteristics of the patients, the ratings by the residents, and the professional team costs, the authors performed a case-series study of the first 248 patients. Transferred patients had conditions that necessitated long hospitalizations, most frequently cerebrovascular accident, dementia, and pneumonia. Housestaff rated the service positively. Estimated professional costs were similar to teaching service costs after 15 months. The nurse practitioner inpatient service effectively cared for internal medicine patients with long lengths of stay and received favorable housestaff ratings.

Journal of the American Geriatrics SocietyVolume 39, Issue 2 p. 205-208 Clinical Experience Rocky Mountain Spotted Fever in the Elderly Robert E. Morrison MD, Corresponding Author Robert E. Morrison MDDivision of General Internal Medicine, The University of Tennessee, Memphis, TennesseeAddress correspondence and reprint requests to Robert E. Morrison, MD, The University of Tennessee, Department of General Internal Medicine, 842 Jefferson, Room A607, Memphis, TN 38103.Search for more papers by this authorLaura Lancaster MD, Laura Lancaster MDDivision of Infectious Diseases, Department of Medicine, The University of Tennessee, Memphis, Tennessee.Search for more papers by this authorDanny J. Lancaster MD, Danny J. Lancaster MDDivision of General Internal Medicine, The University of Tennessee, Memphis, TennesseeSearch for more papers by this authorMack A. Land MD, Mack A. Land MDDivision of Infectious Diseases, Department of Medicine, The University of Tennessee, Memphis, Tennessee.Search for more papers by this author Robert E. Morrison MD, Corresponding Author Robert E. Morrison MDDivision of General Internal Medicine, The University of Tennessee, Memphis, TennesseeAddress correspondence and reprint requests to Robert E. Morrison, MD, The University of Tennessee, Department of General Internal Medicine, 842 Jefferson, Room A607, Memphis, TN 38103.Search for more papers by this authorLaura Lancaster MD, Laura Lancaster MDDivision of Infectious Diseases, Department of Medicine, The University of Tennessee, Memphis, Tennessee.Search for more papers by this authorDanny J. Lancaster MD, Danny J. Lancaster MDDivision of General Internal Medicine, The University of Tennessee, Memphis, TennesseeSearch for more papers by this authorMack A. Land MD, Mack A. Land MDDivision of Infectious Diseases, Department of Medicine, The University of Tennessee, Memphis, Tennessee.Search for more papers by this author First published: February 1991 https://doi.org/10.1111/j.1532-5415.1991.tb01628.xCitations: 3 From the Regional Medical Center, The University of Tennessee, Memphis, Tennessee Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat REFERENCES 1Wilfert CM, MacCormack JN, Kleeman K, et al. Epidemiology of Rocky Mountain spotted fever as determined by active surveillance. J Infect Dis 1984; 150: 469–479. 2Taylor JP, Gregory RI, McChesney TC. The epidemiology of Rocky Mountain spotted fever in Arkansas, Oklahoma, and Texas, 1981 through 1985. Am J Epidemiol 1988; 127: 1295–1301. 3Helmick CG, D'Angelo LJ, Bernard KW. Rocky Mountain spotted fever: clinical, laboratory, and epidemiological features of 262 cases. J Infect Dis 1984; 150: 480–488. 4Hattwick MAW, Retailliau H, O'Brien RJ, et al. Fatal Rocky Mountain spotted fever. JAMA 1978; 240: 1499–1503. 5Peters AH. Tick-borne typhus (Rocky Mountain spotted fever) epidemiologic trends, with particular reference to Virginia. JAMA 1971; 216: 1003–1007. 6Salgo MP, Telzak EE, Currie B, et al. A focus of Rocky Mountain spotted fever within New York City. New Engl J Med 1988; 318: 1345–1348. 7Kaplowitz LG, Fischer JJ, Sparling PF. Rocky Mountain spotted fever: a clinical dilemma, In: JS Remington, MN Swartz, eds. Current Clinical Topics in Infectious Diseases, Vol 2. New York: McGraw-Hill, 1981, pp 89–108. 8Westerman EL. Rocky Mountain spotless fever. A dilemma for the clinician. Arch Intern Med 1982; 142: 1106–1107. 9Morrison RE, Lancaster DJ, Smith WR. Rocky Mountain spotted fever. (American tick typhus). J Tenn Med Assoc 1988; November: 691–694. 10Paterson PY, Youmans GP. Rickettsial diseases. In: GP Youmans, PY Paterson, HM Sommers, eds. The Biologic and Clinical Basis of Infectious Diseases, 3rd ed. Philadelphia: WB Saunders, 1985, pp 679–692. 11Goodwin JS. Immunology, In: CK Cassel, JR Walsh, eds. Geriatric Medicine, Vol. I. New York, Springer-Verlag, 1984, pp 299–310. 12Massey EW, Thames T, Coffey CE, Gallis HA. Neurologic complications of Rocky Mountain spotted fever. South Med J 1985; 78: 1288–1290. 13Marin-Garcia J, Barrett FF. Myocardial function in Rocky Mountain spotted fever: echocardiographic assessment. Am Cardiol 1983; 51: 341–343. 14Hersey DF, Colvin ML, Shephard CC. Studies on the serologic diagnosis of murine typhus and Rocky Mountain spotted fever: human infections. J Immunol 1957; 79: 409–415. 15Pincoffs MC, Guy EG, Lister LM, et al. The treatment of Rocky Mountain spotted fever with Chloromycetin. Ann Intern Med 1948; 29: 656–663. 16Ross S, Schoenbach EB, Burke FG, et al. Aureomycin therapy of Rocky Mountain spotted fever. JAMA 1948; 138: 1213–1216. 17Harrell GT. Treatment of Rocky Mountain spotted fever with antibiotics. Ann NY Acad Sci 1952; 55: 1027–1042. 18Woodward TE. Rocky Mountain spotted fever: epidemiological and early clinical signs are keys to treatment and reduced mortality. J Infect Dis 1984; 150: 465–468. Citing Literature Volume39, Issue2February 1991Pages 205-208 ReferencesRelatedInformation

The relative legibility of a telephone directory that used horizontally compressed print was determined in comparison to one that did not use compression but was otherwise identical, by measuring the speed and accuracy with which present and absent targets could be searched by college students (20) and senior citizens (9). The compressed print significantly increased response times, more markedly for senior citizens. Error rates were not significantly different. The data also showed that compression decreased legibility for phone numbers more than for names, and this effect was more pronounced for the aged.

Dynamic visual inspection is required in many different industrial contexts. This article will focus on the process of inspecting items moving along a conveyor belt for defects of one form or another. A limited capacity queueing model (LCQM) of subjects' behavior in dynamic visual inspection tasks is proposed. The LCQM is shown to fit the results from a recent study by Wentworth and Buck (1982). In addition, it is shown how one can increase both productivity and profits in dynamic visual inspection tasks using the LCQM.

Eye Guidance in Extrafoveal Choice Reaction February 1982 Robert E. Morrison, B.S., Union College M.S., University of Massachusetts Directed by: Professor Keith Rayner Although it has been amply demonstrated that eye movements are influenced by the presence of complex information in visual displays , the nature of the control of this behavior remains unclear. Because of the brevity of the eye fixations, a major theoretical dispute has arisen over whether the eyes are guided to new fixation positions immediately, on the basis of information glimpsed during the immediately preceding fixation, or on a delayed basis , because new information is not available early enough in a fixation to influence the direction of the next eye

Subjects either named or made lexical decisions about words presented in parafoveal vision. In one condition, subjects were required to maintain fixation, and in another condition, they were allowed to make eye movements. In the no eye movement condition, performance decreased as the stimulus was presented further from fixation. Words could be identified more quickly when eye movements were made than when they were not. The experiments also indicated that holding fixation takes up a certain amount of processing capacity, so that foveally presented targets are identified more quickly when eye movements are allowed than when they are not.

A window or visual mask as moved across text in synchrony with the reader's eye movements. The size of the window or mask was varied so that either information in foveal or parafoveal vision was masked on each fixation. In another experiment, the onset of the mask was delayed for a certain amount of time following the end of the saccade. The results of the experiments point out the relative importance of foveal and parafoveal vision for reading and further indicate that most of the visual information necessary for reading can be acquired during the first 50 msec that information is available during an eye fixation.

Recently there has been a considerable amount of research involving the use of eye movements to study the reading process (Rayner, 1978). This trend is similar to another large-scale research effort undertaken a number of years ago that also dealt with eye movements and reading (Huey, 1908; Tinker, 1958, 1963; Woodworth, 1938). One difference between the earlier research and the more current work is that more sophisticated equipment is now used and display changes contingent upon the position of the eye can be made (McConkie & Rayner, 1975; O'Regan, 1980; Rayner, 1975). Much of the research using dynamic display changes has focused on perceptual aspects of the reading process. Despite this widespread activity, it is still the case that a rather elementary aspect concerning visual factors has not been adequately resolved. That is, it remains unclear as to whether saccades are executed to traverse a certain amount of visual angle or a certain number of letters. For example, eye movements in reading might average around 2 deg of visual angle (Rayner, 1978) because they serve the purpose of bringing text into foveal vision for detailed analysis. If saccades are determined by a critical visual angle, then when viewing distance is decreased (or if the letters are larger) and fewer characters fall within the fovea, the number of characters per saccade will decrease. On the other hand, larger letters or closer viewing distances might allow the letters to be perceived farther out in extrafoveal vision. Is so, readers might execute saccades of a greater visual angle in order to cover a desired number of characters. If either of these alternatives is correct, measures of saccade length in one metric (either visual angle or character spaces) will remain constant as letter size or viewing distance is altered (both change the size of the retinal image, hence the number of letters falling within the fovea), while measures in the other metric will change drastically as retinal image size changes. Huey (1908) and O'Regan (1980) have addressed

The volume scattering function, σ(ϕ), was observed for unpolarized green light near 5300 Å in a variety of water bodies over a wide range of scattering angle, ϕ. These data, includingin situ values measured to an extreme foward angle of 0.2o, permit a statistical study of parameters describing the shape of the σ(ϕ) curve and provide detailed information on small angle contributions to forward scattering. The angular limit, θ1/2, which determines one-half the total scattering coefficient upon integration of σ(ϕ) over small angles, is determined from measured data and ranges between about 2o for clear ocean water and about 5o for turbid coastal water. Use of σ(ϕ), measured at a single fixed angle, is investigated further as an indicator of the total scattering coefficient, and results of other studies showing a high correlation between the total scattering coefficient and σ(45o) are further substantiated.