Low-temperature co-fired ceramic (LTCC) enables development and testing of critical elements on microsystem boards as well as nonmicroelectronic meso-scale applications. We describe silicon-based microelectromechanical systems packaging and LTCC meso-scale applications. Microfluidic interposers permit rapid testing of varied silicon designs. The application of LTCC to micro-high-performance liquid chromatography (m-HPLC) demonstrates performance advantages at very high pressures. At intermediate pressures, a ceramic thermal cell lyser has lysed bacteria spores without damaging the proteins. The stability and sensitivity of LTCC/chemiresistor smart channels are comparable to the performance of silicon-based chemiresistors. A variant of the use of sacrificial volume materials has created channels, suspended thick films, cavities, and techniques for pressure and flow sensing. We report on inductors, diaphragms, cantilevers, antennae, switch structures, and thermal sensors suspended in air. The development of ''functional-as-released'' moving parts has resulted in wheels, impellers, tethered plates, and related new LTCC mechanical roles for actuation and sensing. High-temperature metal-to-LTCC joining has been developed with metal thin films for the strong, hermetic interfaces necessary for pins, leads, and tubes.

<p>Relocation stress syndrome is a nursing diagnosis characterized by symptoms such as anxiety, confusion, hopelessness, and loneliness. It usually occurs in older adults shortly after moving from a private residence to a nursing home or assisted-living facility. The primary purpose of this study was to validate the symptoms of relocation stress syndrome. Eight nursing home residents and 8 assisted-living facility residents were interviewed 2 to 10 weeks after admission, when symptoms of relocation stress syndrome are most likely to appear. Results of this study indicate that the incidence of relocation stress syndrome may be overestimated. More accurate diagnosis and treatment of depression in older adults is needed.</p> <h4>ABOUT THE AUTHORS</h4> <p>Dr. Walker is Associate Professor, Dr. Curry is Professor, and Dr. Hogstel is Professor Emeritus, Harris College of Nursing &amp; Health Sciences, Texas Christian University, Fort Worth, Texas.</p> <p>The authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly in this activity. Partial funding for this study was obtained from Beta Alpha Chapter of Sigma Theta Tau International.</p> <p>Address correspondence to Charles A. Walker, PhD, RN, C, Associate Professor, Harris College of Nursing &amp; Health Sciences, Texas Christian University, TCU Box 298620, Fort Worth, TX 76129; e-mail: <a href="mailto:c.walker@tcu.edu">c.walker@tcu.edu</a>.</p>

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SUMMARY1. The circadian rhythms of rectal temperature and biogenic amine levels in mid-brain and caudate nucleus have been measured in normal and adrenalectomized rats adapted to and maintained under fixed illumination cycle.2. Rectal temperature reaches a peak value between 24.00 hr and 06.00 hr during the dark phase of the illumination cycle at a time when motor activity is maximal. In adrenalectomized rats, the pattern is similar but the peak is significantly lower.3. Highest histamine levels in the caudate nucleus and mid-brain of normal and adrenalectomized rats are found at the time when body temperature and motor activity is maximal.4. Similarly, caudate nucleus and mid-brain noradrenaline levels reach their peak during the dark phase of the illumination cycle. These levels are significantly different from those found during the light phase of the illumination cycle. The rise in noradrenaline in the mid-brain of adrenalectomized rats, however, was not significant.5. Peak 5-hydroxytryptamine (5-HT) levels in the caudate nucleus of normal rats and the mid-brain of adrenalectomized rats were found to be 12 hr out of phase with peak values obtained for other parameters that were measured.6. The significance ofthese circadian rhythms in relation to states of sleep and wakefulness, general metabolism, and motor activity is discussed.

Older adults use more prescription and OTC medications than any other age group. Because their medication regimens often are complicated by many medications and different doses, times, and administration methods, older adults are at high risk for medication mismanagement. The most common errors associated with medication mismanagement include mixing OTC and prescription medications, discontinuing prescriptions, taking wrong dosages, using incorrect techniques, and consuming inappropriate foods with specific medications. Both human and environmental factors contribute to medication mismanagement among older adults. Human factors include faulty communication between the health care provider and the patient; the patient's lack of knowledge; ADRs; alcohol-drug interactions; use of OTC medications and herbal products; cognitive, sensory, and motor impairments; and polypharmacy. Environmental factors include high cost of prescribed medications, improper medication storage, and absence of clearly marked expiration dates. Nurses need to take advantage of both formal and informal teaching opportunities in all settings to prepare a patient for medication self-management. Teaching should be individualized and based on a thorough assessment of the patient's abilities to administer medication safely and the specific medication regimen. By involving older adults as active partners in their health care, many errors and medication-related health problems can be prevented. New technologies and devices have the potential for improving the patient's self-management of medications. The role of nurses in educating older adults and their families about proper medication management is vital.