An investigation into EMG activity in the upper and lower portions of the subscapularis muscle during normal shoulder motion

Background and Purpose . The subscapularis (SSc) muscle is considered to perform a variety of roles during normal shoulder movement. The SSc is innervated by two or more discrete motor nerves and previous studies have indicated some difference in electromyographic (EMG) activity between the upper and lower portions of the muscle. The purpose of the present study was to compare EMG activity between the upper and lower portions of the SSc muscle during voluntary shoulder movements in normal healthy subjects. Method . Eight subjects were evaluated. A pair of intramuscular electrodes was inserted into each portion of the muscle. EMG data were recorded during the following movements: sagittal flexion; abduction in the coronal plane; and abduction in the scapular plane. Results . EMG onset of the upper portion of subscapularis occurred significantly earlier compared to the lower portion. Differences were also seen in the level and pattern of activation between the two portions, with upper SSc demonstrating higher levels of activation than the lower portion. Conclusions . These findings suggest that the upper and lower portions of SSc are differentially active during voluntary shoulder movements. Copyright © 2006 John Wiley & Sons, Ltd.     

An investigation into the deformable characteristics of the human foot using fluoroscopic imaging

BACKGROUND: To determine the behaviour of the human foot during in vivo loading and unloading. METHODS: Fluoroscopic imaging was used to investigate the movement of the bones and 13 skin markers during loading and unloading for the medial aspect of the left foot. A foot-pressure measuring system was compared with a force plate used to gather kinetic information, simultaneously. Four male and two female subjects performed three tasks that mimicked jumping, walking, and sprinting. Two-dimensional vector displacements were calculated between bone landmarks over time. Foot rigidity was assessed by a 5 mm length variability threshold determined as the difference between the third and first quartiles of the data set. FINDINGS: The displacement between the first metatarso-phalangeal joint and distal aspect of the calcaneous varied more than the 5 mm threshold. A new foot model was developed which included three rigid segments joined together by hinge joints located at the first metatarso-phalangeal joint and between the anterior talus and navicular. The comparison between skin mounted markers and bone landmarks yielded a range of correlation slopes close to 1.00 for both the x- and y-directions. Foot pressure and force plate comparisons were promising (%RMS(error) approximately 10%) for the vertical ground reaction forces but not so for the centres of pressure (%RMS(error) up to 50%). INTERPRETATION: A multi-segment foot model is required to better represent the behaviour of a human foot. No consistent skin marker movement was determined. Better pressure distribution devices need to be developed to determine more accurate foot kinetics. Precise foot kinematics are required in order that accurate ankle moments and reaction forces be determined for the purpose of assessing foot and ankle function.     

An investigation into the effects of a unilaterally applied lumbar mobilisation technique on peripheral sympathetic nervous system activity in the lower limbs

Physiotherapeutic management of lumbar disorders often utilises specific segmental joint mobilisation techniques; however, there is only limited evidence of any neurophysiological effects and much of this has focused on the cervical spine and upper limbs. This study aims to extend the knowledge base underpinning the use of a unilaterally applied lumbar spinal mobilisation technique by exploring its effects on the peripheral sympathetic nervous system (SNS) of the lower limbs. Using a double blind, placebo controlled, independent groups study design and based upon power calculations, 45 normal na?ve healthy males were randomly assigned to one of three experimental groups (control, placebo or treatment; a unilaterally applied postero-anterior mobilisation to the left L4/5 zygopophyseal joint). SNS activity was determined by recording skin conductance (SC) obtained from lower limb electrodes connected to a BioPac unit. Validation of the placebo technique was performed by post-intervention questionnaire. Results indicated that there was a significant change in SC from baseline levels (13.5%) that was specific to the side treated for the treatment group during the intervention period (compared to placebo and control conditions). This study provides preliminary evidence that a unilaterally applied postero-anterior mobilisation technique performed, at a rate of 2 Hz, to the left L4/5 lumbar zygopophyseal joint results in side-specific peripheral SNS changes in the lower limbs.     

An investigation into the feasibility of fetal lung maturity prediction using statistical textural features

Fetal lung and liver tissues were examined by ultrasound in 240 subjects during 24 to 38 weeks of gestational age in order to investigate the feasibility of predicting the maturity of the lung from the textural features of sonograms. A region of interest of 64 x 64 pixels is used for extracting textural features. Since the histological properties of the liver are claimed to remain constant with respect to gestational age, features obtained from the lung region are compared with those from liver. Though the mean values of some of the features show a specific trend with respect to gestation age, the variance is too high to guarantee definite prediction of the gestational age. Thus, we restricted our purview to an investigation into the feasibility of fetal lung maturity prediction using statistical textural features. Out of 64 features extracted, those features that are correlated with gestation age and less computationally intensive are selected. The results of our study show that the sonographic features hold some promise in determining whether the fetal lung is mature or immature.     

一起特殊群体结核病暴发疫情流行病学调查

目的了解劳动教养人员结核病暴发疫情的流行病学特征。方法采用结核菌素试验、胸透、结核分支杆菌检查以及流行病学调查。结果查出结核病例26例,罹患率达3.43%,其中肺结核涂阳3例、涂阴17例,肺外结核6例。结论引起本次疫情的原因复杂,可能与新劳教人员未进行体检、首例病例未得到及时规范的治疗以及劳教场所人群集居等因素有关。     

An investigation into the structure and bioavailability of alpha-tocopherol dispersions in Gelucire 44/14.

In this investigation we describe the preparation, physical characterisation and in vivo behaviour of solid dispersions of a liquid nutraceutical, alpha-tocopherol, in Gelucire 44/14 with a view to establishing whether dispersion in this matrix may provide a means of formulating a liquid drug in a solid dosage form while also improving the oral bioavailability. Using Vitamin E Preparation USP as the source of alpha-tocopherol, dispersions were prepared using a melt-fusion method with active loadings up to 50% (w/w) and characterised using differential scanning calorimetry and optical microscopy. Capsules containing 300 IU alpha-tocopherol were manufactured and the absorption profiles compared to a commercial soft gelatin capsule preparation in healthy human volunteers. Confocal laser scanning microscopy (CLSM) studies were performed in order to elucidate the mechanism by which drug release may be occurring. Differential scanning calorimetry studies indicated that the presence of the active had a negligible effect on the melting profile of the carrier, indicating limited miscibility between the two components, a conclusion supported by the microscopy studies. Similarly, the dispersions were shown to exhibit a glass transition corresponding to the incorporated drug, indicating molecular cooperativity and hence phase separation from the lipid base. Despite the phase separation, it was noted that capsules stored for 18 months under ambient conditions showed no evidence of leakage. Bioavailability studies in six healthy male volunteers indicated that the Gelucire 44/14 formulation showed an approximately two-fold increase in total alpha-tocopherol absorption compared to the commercial preparation. Confocal laser scanning microscopy studies indicated that, on contact with water, the dispersions formed two interfacial layers, from which the Gelucire 44/14 disperses in the liquid medium as small particles. Furthermore, evidence was obtained for the dispersed material becoming incorporated into the hydrated lipid. In conclusion, the dispersion of the liquid drug in Gelucire 44/14 appears to allow the dual advantages of the preparation of a solid formulation and improved bioavailability of this material.     

An investigation into the use of aromatherapy in intrapartum midwifery practice

OBJECTIVE: The principal aim of the study was to examine the contribution of aromatherapy to the promotion of maternal comfort during labor and as a tool to improve the quality of midwifery care. DESIGN: Evaluative study. SETTING: Delivery suite in a large British teaching hospital with approximately 6,500 deliveries per annum. SUBJECTS: A total of 8,058 mothers were evaluated between 1990 and 1998. INTERVENTIONS: Women were offered aromatherapy to relieve anxiety, pain, nausea and/or vomiting or to strengthen contractions. Routine data collected on the use of aromatherapy over the period were analyzed. Data from the unit audit were used to provide a comparison group of mothers not given aromatherapy (n = 15,799) from the study center. OUTCOME MEASURES: Outcome measures include mothers' ratings of effectiveness, outcomes of labor, use of pharmacologic pain relief, uptake of intravenous oxytocin, reported associated symptoms, and annual costs. RESULTS: The use of aromatherapy during childbirth was an increasingly popular care option with mothers and midwives. More than 50% of mothers rated it as helpful, and only 14% found it unhelpful. The use of aromatherapy was not confined to low-risk mothers. Sixty percent of the sample were primigravidae, and 32% overall had had their labor induced. The administration of aromatherapy in childbirth did appear to reduce the need for additional pain relief in a proportion of mothers. More than 8% of primigravidae and 18% of multigravidae used no conventional pain relief during labor after using essential oils. During the years of the study, the use of pethidine in the study center declined from 6% to 0.2% of women. The study also showed that aromatherapy may have the potential to augment labor contractions for women in dysfunctional labour. A very low number of associated adverse symptoms were reported (1%). CONCLUSION: This study represents a successful example of the integration of a complementary therapy into mainstream midwifery practice and forms a basis for future research.     

An investigation of the effect of 2 sedation regimens on patient mood state following upper extremity surgery using local anesthesia

Sedation techniques for patients undergoing minor outpatient surgery frequently include a variety of intravenous agents. The present study was designed to look for differential effects of 2 different sedation regimens on perioperative mood states. Twenty-two patients undergoing upper extremity surgery using local anesthesia were randomized to receive either propofol or midazolam intravenously for intraoperative sedation. Subjects were asked to complete a Profile of Mood States survey before and after surgery. The results of this survey were examined for differences in mood between the 2 groups that may be attributable to differences in drug effect. No significant differences were identified between propofol or midazolam regarding their effect on patient mood. Patients in both groups experienced a reduction in perioperative anxiety.     

An investigation into the structure and properties of Carbopol 934 gels using dielectric spectroscopy and oscillatory rheometry

Carbopols are polyacrylic acid polymers which may be used as bioadhesive vehicles for drug delivery. In order to have a greater understanding of the factors affecting drug release from these gels, it is necessary to develop methods of studying their physical properties. In this investigation, Carbopol 934 gels have been studied using dielectric spectroscopy and oscillatory rheometry. The effect of a number of variables on the dielectric and rheological behaviour have been studied; these include the presence of a gelling agent (triethanolamine), changing the concentration of polymer, the addition of propylene glycol and the addition of a model drug (chlorhexidine gluconate). The results are interpreted in terms of the structure of the gel network and suggest that the use of these two techniques in conjunction provides an effective means of assessing the properties of gel systems. In particular, the presence of both propylene glycol and chlorhexidine gluconate were shown to have a marked effect on the gel structure, although the results indicated that the mechanisms involved were different.     

An investigation into the demographics and motivations of students studying for a chiropractic degree

Objective

This research aimed to investigate motivations for studying chiropractic, and to determine what students look for in a course/college and potential barriers to studying chiropractic.

Methods

The study design was a cross-sectional survey. Following IRB/Ethical approval, a paper-based questionnaire was distributed to students at McTimoney College of Chiropractic. Demographic data were compared to another chiropractic college in the United Kingdom.

Results

The questionnaire response rate was 70.8% (n = 121). Motivating factors for studying chiropractic included a desire to help others (54.5%, n = 66), with 44.6% (n = 54) attracted by chiropractic''s holistic, drugless approach to health. Previous help from chiropractic influenced 55.4% (n = 67) and 22.3% (n = 27) felt chiropractic had “changed their life.” Just over half of the respondents (55.4%, n = 67) viewed the ability to work while studying as extremely important and 73.6% (n = 89) said they could not have studied chiropractic without this.

Conclusion

Previous help from chiropractic care was a common motivation for studying chiropractic. The ability to work while studying was seen as vital by many students and, without it, the vast majority felt they could not have studied chiropractic.Key Indexing Terms: Chiropractic, Education, Motivation, Students     

An experimental investigation of the vision of hyperopes and myopes using a hologram

A hologram of a specially designed multivergence target which displays real and virtual objects (numbers) simultaneously has been used to test the vision of various spectacle corrected subjects. Through the hologram, the subjects see standard '60-meter' numbers that have different amounts of blur. It is found that there is a difference between myopes and hyperopes in the amount of positive blur with which they can recognize numbers seen through the hologram and this difference is statistically significant. A similar study was then conducted in white light illumination using the '60-meter' numbers of a standard test chart at 6 meter distance and positive lenses to provide the blur at the eye. This study showed no difference between the refractive groups. Our results indicate that hyperopes may be relaxing their accommodation more than myopes in viewing through the hologram.     

An investigation into the use of serum albumin in pressure sore prediction

OBJECTIVES: To ascertain the relevance of serum albumin and serum sodium as predictors of pressure sores in addition to the Waterlow score. DESIGN: Observational study of patients at risk of developing decubitus ulcers. SETTING: Staffordshire, in the midlands of the United Kingdom. PARTICIPANTS: 773 elderly hospital in-patients of a district general hospital. MEASUREMENTS: Waterlow scores and serum albumin and sodium. Development of a pressure sore. RESULTS: Logistic regression analysis of serum albumin, serum sodium and the Waterlow score showed the Waterlow score and serum albumin were significant predictors of pressure sores. CONCLUSIONS: Serum albumin may, in this patient group (in-patients over 64 years of age), be a useful predictor of pressure sore occurrence, though further work is needed to establish whether this is the case. Risk assessment of pressure sores can possibly be improved by adding serum albumin to one of the pre-existing tools such as the Waterlow score.     

Ward sister – teacher or facilitator? An investigation into the behavioural characteristics of effective ward teachers

The ward sister role is increasingly coming under study. This paper summarizes research into learning in the ward environment. The study being one of several on a similar theme, to have been published in the past 2 years. The research concentrated in particular on the behavioural characteristics of trained nurses perceived as good teachers. Attitudes and perceptions of teaching and learning were investigated by interviewing trained and trainee nurses.
The data concerning good teachers collected at interviews were developed into a questionnaire and the results factor analysed. In the third phase of the study trained nurse-trainee verbal communications were observed and analysed to determine any relationship between verbal behaviours and effective teaching.
The findings of the study led to the conclusion that on the job teaching of nurses is a complex global act in which the role model presented to the learner has a powerful influence while it could not be said conclusively that a link between effective teaching and verbal behaviour was identified, a trend towards a more participative mode of communication was noted in two identified good teachers.     

An investigation into the assertive behaviour of trained nurses in general hospital settings

Nurses are often considered to be lacking in assertive skills. This exploratory study compares the assertive behaviour of trained nurses at work and in general life situations. Questionnaire and interview techniques are used to investigate the behaviour of a small sample of sisters, staff nurses and enrolled nurses in general hospital settings. Trained nurses are found to be less assertive at work than in general life situations. In the work situation sisters are more assertive than staff nurses. The enrolled nurses are the least assertive of the trained nurses. The complex nature of assertive behaviour becomes apparent. Factors which promote assertiveness at work include knowledge, confidence, experience and the wearing of uniform. Factors which inhibit this behaviour are tradition, training and the hierarchical structure within the hospital. The use of assertiveness tends to be situation specific. Assertiveness is viewed as a positive behaviour and is of value to nurses, but there are mixed feelings about the usefulness of assertiveness training.     

An exploratory investigation into the nursing management of aggression in acute psychiatric settings

The management of aggression in inpatient psychiatric facilities is a major concern for nurses. Despite the prevalence of research on aggression within psychiatric settings, very few studies have tracked the clinical management of identified patients in a systematic manner. The overall aim of this study was to explore the clinical management of patients identified as potentially aggressive in psychiatric inpatient settings. A multimethod approach was used to collect the data. This included surveys, focus groups, and a file audit of patients identified from a random sample of completed aggression incident forms. The findings indicated that 88% of nurses who participated in the survey were assaulted and indicated the need for risk assessment; team management and review; and the importance of the first 5 days of admission as crucial for assessment and review. The development of support structures, formal preceptoring and supervisory arrangements and postincident supports were suggested as part of an overall strategy to support nurses working in acute inpatient settings.     

An investigation into the role of antigen presenting cells in immunoglobulin synthesis in vitro

Controversy surrounds the respective roles of the monocyte-macrophage series of cells and dendritic (veiled) cells (DC) in the processes involved in antigen presentation. To try to examine this question we have investigated the influence of these accessory cell populations in vitro on pokeweed mitogen (PWM) driven IgG synthesis by peripheral blood mononuclear cells (PBM). Macrophages and dendritic cells obtained by Percoll and hypertonic metrizamide density gradient centrifugation respectively were cultured with lymphocytes and their role in inducing IgG synthesis examined. Additionally phenotypic analysis of the cell populations based both on cell size and cell surface antigen characteristics using the monoclonal antibodies OKM1 and HLA-DR was performed by FACS. Whilst macrophage-depleted lymphocytes secreted negligible amounts of IgG, DC depletion of PBM had little impact on IgG synthesis. When these DC-depleted lymphocytes were further depleted of macrophages by Percoll gradient centrifugation their IgG secretion was dramatically reduced. This response could be minimally reconstituted by adding back DC but was more successfully reestablished with the add back of a population of macrophage-enriched cells. Phenotypic analysis of the cell populations involved did not allow clear discrimination of the various cell groups. On the basis of the functional studies the macrophage cell series would seem to have the central role in driving PWM reduced IgG synthesis though the possible "contamination" of these cells by DC can still not be excluded. Until such time as reliable markers are available for the clear discrimination of these 2 cell populations it is difficult to envisage resolution of the controversy on their respective roles.     

An investigation into the alignment of a South African physiotherapy curriculum and the expectations of the healthcare system

Until 1994, physiotherapy education and training were aligned with the expectations of the South African healthcare system. Subsequent to policy shifts since 1994, the professional role of physiotherapists has expanded. In the absence of guiding strategies to support this change, physiotherapy curricula have remained relatively static.

Objective

The paper examines the discrepancies between physiotherapy education and training at a South African university post apartheid and the expectations of the healthcare system.

Design

Located within critical feminist research framings and employing narrative inquiry as the selected methodology, data were produced through multiple methods to obtain multiple perspectives and orientations.

Participants

This multisectorial data production approach involving student physiotherapists, physiotherapy academics and practising physiotherapists included in-depth focus group interviews, individual interviews, life-history biographies and open-ended questionnaires. The data were analysed separately for each group of research participants (physiotherapy students, practitioners and academics), followed by a cross-sector analysis.

Results

The analysis illustrated current disciplinary trends and shortcomings of the physiotherapy undergraduate curriculum, whilst highlighting that which is considered valuable and progressive in physiotherapy and health care. The dominant themes that emerged included issues relating to physiotherapy theory and practice, and issues that influenced the construction of relationships in the curriculum.

Conclusion

The significance of this study lies in the value of student and practitioner feedback to inform curriculum and professional development in the light of sociopolitical changes and healthcare expectations.