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The intervention, which is consistent with federal and clinical practice guidelines, significantly improved functional outcomes but did not reduce the incidence and costs of selected acute health conditions. The cost of implementing these labor-intensive interventions for frail nursing home residents will have to be justified based on functional and quality-of-life outcomes and are unlikely to be offset by savings in medical care costs in this population.

Time-distance helioseismology analysis of Dopplergrams from the Michelson Doppler Imager instrument on board the Solar and Heliospheric Observatory spacecraft provides a very accurate measurement of meridional flows. This shows a sinusoidal variation with a period of 1 yr and was identified by P. Giles to be due to an error in the determination of the solar rotation axis. The phase and amplitude of the annual variation of meridional flows are used to determine the error in the Carrington elements. After comparing with other recent estimates of the Carrington elements, we suggest the following values:and . i p 7Њ .155 ‫ע‬ 0Њ .002 Q p Ϫ73Њ .5 ‫ע‬ 0Њ .1

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