Lack Of Appropriate Conditions Research Articles

البرمجة الضبابية وتحسين أداء الخوارزميات في بيئة متعددة المتغيرات الرتيبة

In many situations of daily life, when we start statistical analysis, we encounter data that we suffer from inaccuracy in its measurement, either due to observation or measurement errors or the lack of appropriate conditions for collecting this data, such as failure times of machines, equipment, electrical devices, medical, engineering and economic data. In many medical studies, the researcher may have a strong conviction that the regression function used to describe the relationship between two variables has a certain form or formula that can be characterized by certain ordering restrictions such as monotonicity; monotonic regression has important applications in statistics, operations research, and signal processing, and these applications are often characterized by a very large value of n. For such large-scale problems, it is of great practical importance to develop algorithms whose complexity does not increase rapidly with increasing n. It is a nonparametric regression technique that preserves order. In this thesis, the proposed fuzzy autoregressive monotonic method, fuzzy autoregressive monotonic least squares (FILSR), fuzzy autoregressive M estimator (FIM), and fuzzy autoregressive maximum likelihood estimator (FIML) were proposed. The best method for estimating the autoregressive function is the fuzzy autoregressive maximum likelihood method with a mean square error of (0.51455).

Teachers’ Perceptions of the Application of Dyslexia-Friendly Schools in Saudi Arabia

This study contributes to the exploration of the most promising practices for dyslexic students in overcoming difficulties. In this study, I investigate teachers’ views regarding the instillation of dyslexia-friendly schools (DFS) in Saudi Arabia. I use the qualitative approach through semi-structured interviews. The sample addressed eleven teachers who specialized in learning disabilities (LD) in public schools. The results showed generally positive attitudes toward DFS. However, there were differing views regarding the possibility of currently applying this model. Different reasons for this view were given, such as the lack of appropriate conditions (e.g., funds, time and awareness) for applying DFS’ criteria. Some implementation challenges, however, seemed surmountable. Different suggestions were proposed to help schools become friendly for dyslexic students, such as developing school environments by providing the necessary support and providing appropriate training for teachers besides the planning offered by the school administration. In light of these results, I recommend the implementation of DFS in some model schools in Saudi Arabia in addition to studying the results and effects of such a practice.
 
 Received: 1 November 2022 / Accepted: 26 December 2022 / Published: 5 January 2023

The Right of a Defense Attorney to Visit as a Prerequisite for the Effective Defense Case Strategy Development during the Preliminary Investigation

The development and implementation of a successful case strategy is one of the priority tasks for a attorney in the course of a preliminary investigation. The paper examines the question of what factors favorably influence the formation of a successful case strategy by the defense attorney at the stage of preliminary investigation. The author argues that the right of a defender to visit his client as provided by the legislator is a prerequisite for an attorney to build up an effective position to protect the rights and legitimate interests of the client, in accordance with which the content of his future work is determined. The paper also examines the problem of the lack of appropriate conditions provided for by law for organizing a meeting between an attorney and his client in the investigation and inquiry bodies, and offers practical recommendations to strengthen the guarantees of the independence of an attorney during a preliminary investigation.

STIMULATION OF EFFECTIVE EMPLOYMENT IN THE CONDITIONS OF SOCIAL VULNERABILITY

The purpose. The purpose of the article is to substantiate the need to improve the modern state employment policy under the intensification of external migration of the population of Ukraine. Effective institutional-administrative, organizational-economic, and information tools of the state employment policy should be used to create and improve the quality of existing jobs, intensify employment in rural areas, eliminate shadow employment and wages, equalize imbalances in supply and demand in the labor market. Design/Methodology/Approach. To study the need to develop modern state employment policy in Ukraine, the authors used the following research methods - theoretical and logical explanation, statistical analysis, systematization and explanation, semantic analysis. The study was conducted within the framework of institutional economic theory, migration, and state regulation of the economy. Conclusions. The studies have shown that the containment of external migration processes by increasing the number and improving the quality of jobs, in connection with which the task of developing the state employment policy against the background of high migration activity of the population of Ukraine is relevant. It is substantiated that the main challenges of the modern sphere of employment in Ukraine lead to an increase in external migration, namely: formation of labor shortage in the national labor market, intensification of destructive changes in employment; low pay, especially for budget sphere workers, the spread of shadow employment schemes, which leads to a decrease in social protection of employees; strengthening of professional and qualification imbalance in demand and proposals in the labor market due to the mismatch in training the specialists for the needs of the economy. Other challenges are the unformed labor market in rural areas, preservation trends of open and hidden unemployment among the rural population, reducing the demand for labor in rural areas; lack of appropriate conditions for the development of inclusive labor market, the insufficient realization of opportunities and potential of the state employment services in ensuring the innovative development of employment. The objective necessity of realization of effective institutional-administrative, organizational-economic, and information tools of the state employment policy is proved, which largely depends on the natural containment of migration processes in Ukraine. The implementation of the presented tools is focused on economic stabilization of the situation in the country and regions by stimulating the de-shadowing of business and income, increase the welfare of the population, increase of opportunities for young people in employment, and the growth of aspirations of migrant workers to remigration and realization of own business goals on the territory of Ukraine. Originality/value. The value of the research lies in the development of the mechanisms to ensure the competitiveness of national and regional labor markets as a tool for regulating external labor migration, as well as for improvement of the state employment policy, especially the development of innovative and creative types of work.

Harmonic Analysis of the Spatiotemporal Pattern of Thunderstorms in Iran (1961–2010)

The current study aimed at investigating cycles and the spatial autocorrelation pattern of anomalies of thunderstorms in Iran during different periods from 1961 to 2010. In this analysis, 50-year periods (1961–2010) of thunderstorm codes have been collected from 283 synoptic stations of Meteorological Organization of Iran. The study period has been divided into five different decades (1961–1970, 1971–1980, 1981–1990, 1991–2000, and 2001–2010). Spectral analysis and Moran’s I were used to analyze cycles and the spatial autocorrelation pattern, respectively. Furthermore, in order to conduct the calculations, programming facilities of MATLAB have been explored. Finally, Surfer and GIS were employed to come up with the graphical depiction of the maps. The results showed that the maximum of positive anomalies mainly occurred in the northwestern and western parts of Iran due to their special topography, during all the five studied periods. On the other hand, the minimum of negative anomalies took place in central regions of the country because of lack of appropriate conditions (e.g., enough humidity). Moran’s I spatial analysis further confirmed these findings as Moran’s I depicts the positive and negative spatial autocorrelation patterns in line with negative and positive anomalies, respectively. However, in recent decades, this pattern has experienced a declining trend, especially in southern areas of Iran. The results of harmonic analysis indicated that mainly short-term and midterm cycles dominated Iran’s thunderstorms.

The environment of a prison school as described by imprisoned students

The article presents the findings of a survey that covered 52 male convicts - students of the Center for Continuing Education at the Correctional Facility in Stargard, a city in northwest Poland. It examined their perception of selected elements of the prison school’s environment. It determined how they described themselves as students and what characteristics and behaviors they ascribed to their teachers. They were also asked to estimate the resocialization value of instruction and suggest possible changes to be made to the school environment. The survey showed that the respondents’ education followed a dubious course. Their main motivating factor for entering education at the prison school was their desire to gain new or additional qualifications as well as to leave the cell. The survey also showed that, first of all, it was a broad knowledge of the subject taught that the students attributed to their teachers. At the same time, they thought their teaching staff lacked the ability to stimulate motivation for change in students. In the respondents’ opinion, instruction turned out to be of moderate significance as compared to other means resocialization value is ascribed to. The students pointed to some deficiencies of the prison school environment. Their correction could translate into increased value of instruction in the prison. The too narrow and obsolete educational offer received the most negative feedback from the students. They had a lot of critical comments about the school’s infrastructure. They were particularly unhappy about school supplies, which they thought were too modest, and the lack of appropriate conditions for intellectual work in the cells.

Prognostic parameterization of cloud ice with a single category in the aerosol-climate model ECHAM(v6.3.0)-HAM(v2.3)

Abstract. A new scheme for stratiform cloud microphysics has been implemented in the ECHAM6-HAM2 general circulation model. It features a widely used description of cloud water with two categories for cloud droplets and raindrops. The unique aspect of the new scheme is the break with the traditional approach to describe cloud ice analogously. Here we parameterize cloud ice by a single category that predicts bulk particle properties (P3). This method has already been applied in a regional model and most recently also in the Community Atmosphere Model 5 (CAM5). A single cloud ice category does not rely on heuristic conversion rates from one category to another. Therefore, it is conceptually easier and closer to first principles. This work shows that a single category is a viable approach to describe cloud ice in climate models. Prognostic representation of sedimentation is achieved by a nested approach for sub-stepping the cloud microphysics scheme. This yields good results in terms of accuracy and performance as compared to simulations with high temporal resolution. Furthermore, the new scheme allows for a competition between various cloud processes and is thus able to unbiasedly represent the ice formation pathway from nucleation to growth by vapor deposition and collisions to sedimentation. Specific aspects of the P3 method are evaluated. We could not produce a purely stratiform cloud where rime growth dominates growth by vapor deposition and conclude that the lack of appropriate conditions renders the prognostic parameters associated with the rime properties unnecessary. Limitations inherent in a single category are examined.

О ПРАВОЗАЩИТНОЙ ФУНКЦИИ НАЛОГОВЫХ ОРГАНОВ

The article examines the place, role and competence of tax authorities in ensuring the subjective rights and legitimate interests of taxpayers. The administrative procedure for resolving tax disputes arising between the taxpayer and the tax authority is analyzed. There is a lack of appropriate conditions for resolving the tax dispute on the basis of the principle of objectivity due to the combination of arbitration and accusatory functions of the higher tax authority that considers the complaint. It is concluded that it is impossible to implement the human rights function of tax authorities within the departmental format. The introduction of personal responsibility of officials for illegal actions, inaction, wrongly adopted non-normative acts is proposed as a guarantee instrument for protecting the rights and legitimate interests of the taxpayer.

COMPETITIVIDAD DE LAS EMPRESAS VASCAS DE ALTA TECNOLOGÍA EN RELACIÓN CON SUS CONDICIONES PARA LA TRANSFERENCIA DE CONOCIMIENTO: ESTUDIO EMPÍRICO BASADO EN ANÁLISIS MULTIVARIANTE

La transferencia de conocimiento (TC) en un complejo fenomeno relacionado con el desarrollo de innovaciones y con el exito empresarial gracias a la mejora de competitividad de la empresa, lo cual es especialmente relevante en el caso de empresas de alta tecnologia cuya viabilidad depende del eficiente manejo de sus activos de conocimiento. Trazar la conexion existente entre la dinamica de TC y los parametros de competitividad empresarial es una linea de investigacion con grandes posibilidades de contribucion a una mejor gestion empresarial. Esta investigacion pretende demostrar empiricamente que el capital intelectual y el capital economico de una organizacion de alta tecnologia se incrementan de forma relevante gracias a una optima gestion de la TC realizada durante un periodo de tiempo sostenido. Siguiendo una metodologia de investigacion empirica se realiza una encuesta entre empresas de fabricacion y desarrollo de alta tecnologia en la comunidad autonoma vasca cuyas respuestas se procesan mediante tecnicas de analisis multi-variante. Los resultados prueban que la existencia de caracteristicas organizativas y mecanismos aptos para la TC no asegura por si mismo un mejor desempeno empresarial ya que los mecanismos deben estar adecuadamente disenados e implantados. Sin embargo, la carencia de condiciones adecuadas para la TC si aboca a un pobre rendimiento y falta de competitividad, implicando que estas organizaciones deben considerar la gestion de la TC como una herramienta de estrategia empresarial. Asi mismo, el estudio evidencia desorientacion entre las empresas a la hora de estructurar y organizar la dinamica de TC, y la existencia de una probabilidad menor al 50% para que una organizacion de alta tecnologia comprometida con la innovacion opere correctamente y se este beneficiando de la TC. Por tanto, otra implicacion radica en que las politicas publicas y los agentes facilitadores deben aportar soluciones de sensibilizacion, comprension y fomento. Palabras Clave: Transferencia de conocimiento, competitividad, empresas de alta tecnologia, rendimiento del negocio, mecanismos y atributos para la transferencia de conocimiento

Referral patterns of Israeli pediatricians of common primary care office procedures.

BackgroundPediatric primary care is the cornerstone of health care services for children. Performance of common office procedures is an integral part of primary care. Ideally, the community-based primary care pediatrician provides comprehensive health care services and only refers a small minority of patients for consultation. However, knowledge regarding Israeli pediatricians’ practices of office procedures is scant.ObjectivesTo describe primary care pediatricians’ patterns in the provision of common office procedures and to analyze factors associated with performance or referral.MethodsDesign: Self-completed structured questionnaire consisting of 1) demographic variables; 2) practice characteristics description; 3) List of ten procedures (treatment of subungual hematoma, laceration suturing and adhesive closure, elbow subluxation/reduction , urinary bladder catheterization, supra-pubic aspiration, inguinal hernia reduction, umbilical granuloma and labial fusion treatment, and short lingual frenulum management) followed by questions regarding referral practice for each procedure; and 4) causes and indications for referral when relevant. Participants: Primary care pediatricians attending anational pediatric conferences. Analysis: Descriptive statistics and association assessment.ResultsThe questionnaire was completed by 162 primary care pediatricians, 58.7 % male; mean age 53 ± 9 years, 88.4 % board certified. Of the respondents, 57 % worked in group practices and the remainder solo; salaried employees 68.2 %, independent contractors 31.8 %.Referral rate varied by procedure; least likely to be referred was labial fusion (7.7 %) and most likely was short lingual frenulum (81.3 %). For most procedures, the most frequent non-performance cause was lack of expertise followed by lack of appropriate conditions. The overall number of procedures in which the response selected was out-of-clinic referral was not associated with demographic or employment characteristics. However, association was found for certain specific procedures (e.g. experience with catheterization, gender with suturing and adhesive closure).Conclusions Many common office procedures are referred out of primary care pediatric community settings in Israel. Considerable variability was found among procedures. Lack of experience or lack of appropriate conditions were frequently reported causes for referral and need to be addressed in reducing unnecessary referral with its attendant costs and patient inconvenience. Possible approaches include updates in pediatric residency training, focused in-service training, time allocation and work environment reorganization.

The Impact of the Psychological Trauma in School Adjustment and with Same Age Peers in Middle Childhood

Traumatic and disastrous events are part of our everyday life. Every day, the media is full of cases of natural catastrophes, violence, murders and accidents. Unfortunately, the children are not saved from these events. Experiencing trauma has a deep impact on emotional, social, cognitive and behavioral life of children. School is the first environment after the family where the impact of the trauma can be seen and the manifestation of traumatic events experienced. The purpose of the study is to explore the impact of the psychological trauma in school adjustment and with same age peers and the way of supporting and helping these children at school. Questions that guide this study are: “How are the relationships of the children who experience trauma in middle childhood, with their peers and teachers? How do they adapt in the learning process? Does the collaboration with parents and school impact higher performance? How are these children treated and helped at school?” Data collection was analyzed through a case study, and the protagonist is a 7-year-old girl who has experienced trauma when her mother died. The other instruments used were semi-structured interviews with teachers and documentation analysis. The data collected through interviews and documentation study are examined through content analysis. Results show that the most common way of experiencing the trauma at this age is the solitude, the silence and the aggression. Also the results show that good cooperation with parents of children positively impacts student success and better adjustment of these children with peers. From the study it also emerged that although there is an Individual Education and Development Plan, it is not utilized, due to lack of appropriate conditions and framework. DOI: 10.5901/ajis.2015.v4n2s2p35

Ecological Capability Evaluation of Outdoor Recreation by Integrating Geographic Information System (GIS) and Index Overlaying (IO)

The current study focuses on determining suitable areas for establishment of outdoor recreation using Geographic Information System (GIS) and ecological capability evaluation. Actually, ecological land capability evaluation is a way to determine the natural potentials of a land and to avoid adverse effects resulting from land use changes. It is also an attempt towards sustainable development. In this research, in order to identify the outdoor recreation potential of Shahrood County, GIS as the best suitable software for land evaluation and site selection studies was used along with Index Overlaying (IO). In this way, after specifying the ecological resources of the study area, the required map layers were prepared on the scale of 1:250,000 and overlaid through Arc GIS 9.2 Software. This research was done in six stages. After preparing the slope, aspect and elevation layers, they were overlaid in ArcGIS to produce the landform layer. Afterwards, the map of the final environmental units was prepared by overlaying the layers including landform, land use, soil, land cover and wildlife. Subsequently, the outdoor and extensive and intensive out door recreation models of Iran was applied for final comparison and analysis. According to the results, the study area has a high potential for tourism development particularly, the outdoor recreation. The obtained results indicated that 68.8 % out of whole study area is placed in the first class regarding indoor recreation potential while the second class allocates itself 19.1 % of total. Besides, 93.2 and 5.3 % of entire area are, respectively, belonged to the first and second classes of outdoor potential. Totally, 13.6 % of the study area is allocated to the third class (protection zone) due to high ecological sensitivity and lack of appropriate conditions for tourism development. Finally, the recreational activities suited to each zone were recommended.

The Humanized Multiple Myeloma Mouse Model: Opportunities for Studying the Pathogenesis of MM in Its Natural Environment.

Abstract 1847Poster Board I-873Multiple myeloma (MM), one of the most common hematological malignancies in adults, is a neoplasm of terminally differentiated B cells, i.e. plasma cells. The transition of a plasma cell to a fully transformed, aggressive myeloma is a multistep process, which requires the acquisition of mutations in multiple genes. Most of this evolution takes place in the bone marrow (BM). Studying the pathogenesis of MM is seriously hampered by the lack of appropriate conditions for the engraftment of patient derived MM cells (pMM) which, unlike MM cell lines, strongly depend on a human microenvironment to engraft, survive and expand, indicating that the interaction of MM cells with the cellular and extracellular components of the human BM microenvironment plays a crucial role in the growth behavior of MM cells. To date only few animal models are described that facilitate the outgrowth of pMM, however, they depend on the co-implantation of human fetal tissues or prior implantation of rabbit bone. Moreover, these do not represent the human adult BM microenvironment in which MM cells normally exist (e.g. in the SCID-Rab model and in the NOD-SCID mouse model) or there are ethical concerns (e.g. the SCID-Hu model).Here we report the development of a unique mouse model to study the pathobiology of MM by implementing a technology for creating a natural human bone environment in the immune deficient RAG2−/−γc−/− mouse. To this end we combined a procedure to culture-expand human BM-derived mesenchymal stromal cells (MSC) that were seeded on biphasic calcium phosphate (BCP) particles and subsequently implanted subcutaneously in RAG2−/−γc−/− mice. Within 6 to 8 weeks this leads to the formation of so-called ossicles that contain substantial amounts of human bone, while the remaining open structures are filled with hematopoietic cells (of mouse origin) at various stages of erythroid, megakaryocytic and myeloid differentiation, creating an environment that strongly resembles the human bone marrow. A stricking finding was that this humanized environment in the mouse proved to be capable to not only support human GFP-luciferase gene-marked MM cell lines but also pMM cells. Intravenous or intracardial injection of MM cell lines or pMM cells showed homing to, engraftment and outgrowth of tumor cells in connection with the human bone layer in the ossicles. Hence, this novel humanized mouse model will provide the first opportunity to investigate patient derived MM plasma cells in their natural environment which may lead to better insights in the pathogenesis of this disease and serve as a model for preclinical testing of new therapeutic approaches for the treatment of Multiple Myeloma patients. Disclosures:de Weers:Genmab: Employment.

Prescrição e preparo de medicamentos sem formulação adequada para crianças: um estudo de base hospitalar

Este trabalho teve como objetivo identificar medicamentos cuja forma ou formulação farmacêutica representa um problema em pediatria (Medicamento Problema - MP), bem como analisar as estratégias empregadas pelos médicos, para sua utilização nas crianças e os riscos envolvidos. Trata-se de um estudo descritivo, que tem como base um inquérito com pediatras de um hospital de referência do SUS em Fortaleza-Ceará, conduzido para identificação dos MPs em julho-agosto de 2004; uma análise das prescrições contendo adaptação de formas sólidas e uma observação direta do preparo dos medicamentos, que foram conduzidas em dezembro de 2004 e janeiro de 2005, respectivamente. Os medicamentos foram agrupados pela classificação ATC e pelo cálculo de frequências das variáveis. Os pediatras (N=48, 98%) identificaram: 16 produtos sem forma injetável, 32 injetáveis necessários em concentrações menores e 30 MP sem formulação líquida para uso oral. Foram analisadas 89 prescrições contendo adaptação de formas sólidas, envolvendo 119 itens de medicamentos; todas continham inadequações, sendo a principal a partição de comprimidos. As doses prescritas corresponderam ao preconizado em 33,6% dos casos. Adaptações foram realizadas em local inadequado, por profissional não qualificado e sem as boas práticas. Concluindo, a carência de formulações apropriadas ao uso pediátrico repercute na prática médica e é agravada pela inexistência de condições adequadas para a manipulação de medicamentos por farmacêuticos, nos hospitais brasileiros.

Stimulation of the Lateral Hypothalamus Provokes the Initiation of Robust Long-Term Potentiation of the Thalamo-Cortical Input to the Barrel Field of the Adult, Freely Moving Rat

Long-term potentiation in the thalamo-cortical input to the somatosensory cortex barrel field has been reported to be inducible in vitro only during a narrow critical period of the first postnatal week. Here we explored whether this is due to inability of adult synapses to express LTP or lack of appropriate conditions for LTP induction in slice preparations. We recorded thalamo-cortical field potentials (FPs) from the barrel field of chronically prepared adult rats. In the first series, several parameters of conditioning tetanization of thalamus (T) have been tried. Statistically significant LTP of 135-150% relative to the baseline was observed only in rare cases (3/18) so that the mean changes were not statistically significant. In the second series, five trains of 100 Hz stimulation of T were paired with a "reinforcing" stimulation of the lateral hypothalamus (LH). In most cases (9/13), thalamo-cortical FPs were potentiated. The mean post-tetanic amplitude was 238 +/- 42% (+/- SEM) relative to the baseline (n = 13). The potentiation persisted for >1 h and typically even further increased when tested 24-48 h later. LTP magnitude strongly correlated with the initial paired-pulse ratio (PPR, coefficient of correlation r = 0.98) so that the LTP magnitude was larger (333 +/- 107, n = 6) in cases with PPR > 1.3. The mean PPR tended to decrease after LTP (from 2.05 to 1.65). Altogether the results suggest that LTP is inducible in the thalamo-cortical input to the barrel field of normal adult rats. The dependence of the LTP magnitude upon the initial PPR suggests that inputs with low initial release probability undergo larger LTP. Together with the tendency to a decrease in the PPR this suggests an involvement of presynaptic mechanisms in the maintenance of neocortical LTP.

The Scientific Knowledge Base of Special Education: Do We Know What We Think We Know?

Leading scholars in special education acknowledge that the field has recently come under intense public criticism. Various defenses have been offered, including the lack of appropriate conditions under which to implement the knowledge base of special education. The nature of this knowledge base is examined, in particular the claim that special education possesses scientifically derived technologies. Specifically, a case is made that the term “science” is misused, and that the methods of empiricist science are inappropriately applied to study of special education. It is concluded that many, if not most, of the criticisms leveled at special education can be traced back to this misunderstanding of science. As a result, the field would do well to reconsider its philosophical ancestry.

The clock drawing test as a cognitive screening tool for elderly patients in an acute-care hospital.

An important part of CGA is the evaluation of cognitive status , which relates to , and may even predict, functional status (1). Research has indicated that 15-30% of elderly persons admitted to hospital suffer from cognitive impairment (2, 3). According to epidemiological surveys, this impairment often goes unrecognized. There are several tools available for evaluating cognitive status (4-6), and the most widely used is the well-validated Mini-mental State Examination (MMSE) (7-9). Unfortunately, many of these tools cannot be administered in acute-care hospitals due to the brevity of hospitalization, and lack of appropriate conditions for administration. The Clock Drawing Test (COT) is a quick, simple , easily-administered, low-cost tool for assessing cognitive status, which can be administered at the patient's bedside. It requires visuo-spatial orientation, concentration , short-term memory and planning ability, and is widely used as a sensitive marker of dementia of the Alzheimer 's type (10-18). The objective of our study was to validate the COT for use with elderly patients admitted to acute-care hospitals, and determine its suitability for use in this setting . in 1991 , a geriatric consultation team (GCT) was established in the Hadassah Medical Center, an acutecare university hospital in Jerusalem, Israel. Each patient aged 75+ admitted to the hospital is screened by a member of the GCT to determine whether he/she requires CGA. The study population comprised elderly patients admitted through the emergency room (the majority to internal medicine departments), and was representative of elderly patients given CGAs. Reasons for non-inclusion included coma, severe cognitive impairment, and an inability to write. The process of administering the COT has been described in the literature (12, 14). Briefly, the patient is given a pencil and paper, and instructed to "draw a clock" (this takes about one minute on average) . On completing the drawing , the patient is asked to indicate "ten past eleven " on the clock. In our study, the test was administered to patients when their acute condition had stabilized. An MMSE was then administered (taking approximately 25 minutes). For scpring, we employed the Clock Drawing interpretation Scale (CDIS) used by Mendez et al. (16) (maximum score = 20), defining three score categories : "severe impairment" (0-10), "moderate impairment" (11-16), and "normal" (17-20). We also defined three categories for the MMSE: "severe impairment" (0-15), "moderate impairment" (16-24), and "normal" (25-30). Pearson correlation coefficients were used to examine the relationship between the COT and the MMSE: CDIS scores were compared to MMSE scores for sensitivity and specificity, and positive and negative predictive values were calculated . The study population comprised 71 elderly patients (43 male). The average age was 81 .7 (SD±5.6) years , and 31 % were aged> 85. Forty-four were not married (the majority widowed). Prior to hospitalization, 30 lived alone, 37 with a spouse or relative, and 4 in sheltered housing projects. The average length of hospitalization was 16.5 (±19.1) days. Prior to hospitalization, 40% of the patients were fully independent in ADL. Positive correlations were found between CDIS and MMSE scores (r=0.76), and between the CDIS score categories and the MMSE score categories (r=0 .66) . We compared the "normal" and "moderate/ severe impairment" scores on the COT with those on the MMSE (Table 1). Discrepancies between the two scores were found in 11 patients: eight patients