Disruptive vocalization (DV) is both a prevalent and disturbing problem in nursing homes. We developed a computer-assisted data collection system for real-time observation and recording of DV and various environmental contextual factors. Both frequency and duration of DV were recorded for 11 residents along with their location in the nursing home, their activity, environmental sound, the social environment, and whether or not the resident was physically restrained. The actual time of all events was also recorded. Measures of cognitive and ADL status were administered. The average occurrence of DV was 22 per hour and the average duration per occurrence was 26 seconds. The results show a significant upward linear trend in the occurrence of DV across the day. This is consistent with the "sundowning" hypothesis. A Cox Proportional Hazards Regression model indicates that another person present in the setting (p = .004) and resident presence at the nursing home hairdresser (p = .07) were associated with shorter duration episodes of DV. Correlational analyses indicate that both higher frequency and longer duration DV are related to greater cognitive impairment, and higher frequency DV is related to greater ADL impairment. We conclude that this computer-assisted real-time observational system is a useful and promising tool for studying disruptive behavior in its environmental context.

Lung-clearance classifications for 238U, 232Th, 230Th, 228Th, 226Ra, 210Pb and 210Po in respirable coal fly ash were estimated for use with the lung clearance model proposed by the ICRP Task Group on Lung Dynamics. Estimates were based on measurements of the dissolution rates for these radionuclides from sized fly-ash samples into simulated lung fluid at 37 degrees C. The estimates were expressed in the classification terms of the model, i.e. D, W and Y, indicating lung clearance half-times of 0-10 days, 11-100 days, and more than 100 days, respectively. Ash from eastern bituminous coal, western bituminous coal and mid-western bituminous coal was examined. Both Class-D and Class-Y components of 238U were found in all samples, whereas all the other radionuclides dissolved very slowly and were classified 100% Class Y. The fraction of 238U in Class D increased with decreasing particle size and increased linearly from 0.02 to 0.17 as the concentration of U in the volatile-metal portion of the samples increased. This relationship suggests that a major fraction of the U in coal fly ash may be shielded from exposure to simulated lung fluid by more-abundant metals deposited on the outer surface of fly ash during coal combustion.

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