bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute Suppurative Otitis Media in Children
Authors: Hayden Gregory F.
Published: July 2008

Practicing pediatricians were surveyed via mailed questionnaire and a review was made of the pertinent literature in an attempt to identify suitable criteria for making the clinical diagnosis of acute suppurative otitis media (ASOM) in children. Clinical diagnostic criteria were described in only 26 of the 43 studies reviewed; 18 different sets of criteria were used. Use of identical criteria in more than one study was usually the result of multiple publications by particular authors rather than agreement between two investigators. One hundred and sixty-five questionnaire respondents proposed 147 different sets of criteria. Only 11 criteria sets were proposed by more than one respondent, and no single set was listed by more than six respondents. Greater standardiza tion of clinical diagnosis is desirable, but difficult to achieve and will require additional studies to correlate clinical findings with objective measures of diagnosis, such as tympanocentesis.
Ampicillin-Resistant Hemophilus influenzae Type B Septic Arthritis in Children
Authors: Chang Margan J. , Controni Guido , Rodriguez William J.
Published: July 2008

Three cases of ampicillin-resistant Hemophilus influenzae type B septic arthritis are described. These patients presented over a four-month period (November 1978 to February 1979). All were less than 18 months of age, all had positive blood and joint aspirate cultures, and counter-current immuno electrophoresis (CIE) on serum positive for Hemophilus influenzae type B. The ampicillin minimum inhibitory concentration (MIC) for all three isolates was 6.25 μg/ml or greater. All patients recovered uneventfully with intra venous chloramphenical therapy. We suggest that chloramphenicol be con sidered in the initial therapy of children under 18 months of age who present with septic arthritis, at least in geographic areas where the incidence of ampicillin resistance is high.
Adoption Planning for Handicapped Children
Authors: Davis Joseph H. , Montgomery Patricia A.
Published: July 2008

Major changes are taking place in the field of adoption. Once concerned primarily with the placement of newborn infants, the field has broadened, with a major emphasis on the adoption of older children, often from foster care and many times with major handicaps or problems.

These children require special families who are willing to adopt them. They require the services of skilled social workers to effectively place them, and they require the understanding of the physician who may be involved either with their placement examination or with their subsequent management as an adoptee. A new objective approach to the problem is necessary.
Rapid Glucose Disappearance in Infants with Infection
Authors: Leake Rosemary D. , Fiser Robert H. , Oh William
Published: July 2008

Altered carbohydrate metabolism has been reported during episodes of neo natal infection. To document that there is more rapid glucose disappearance during infection, intravenous glucose tolerance tests (IVGTT) and serial plasma growth hormone and insulin levels were determined in eight full-term neonates during the first three days of an acute episode of infection and during convalescence, 5 to 15 days later. Eight healthy infants were each studied once using the same study protocol.

Glucose disappearance rates, measured as Kt of glucose, were increased (p < 0.01) during both the acute septic period (3.7 ± 0.3% disappearance/min; mean ± S.E.M.) and convalescent period (2.5 ± 0.2%/min) when compared with values in control infants (1.3 ± 0.3%/min). Gram-negative, gram-positive, and viral infections were all associated with rapid glucose disposal. The ab normality in carbohydrate homeostasis persisted for at least 5 to 15 days after treatment was begun. Baseline and stimulated (20-minutes post bolus glucose infusion) plasma insulin and growth hormone levels did not differ among the groups. Thus, there is no evidence that hyperinsulinism produced the rapid glucose disappearance rate and enhanced glucose utilization. The reason for the disturbed carbohydrate metabolism in neonatal infections remains un known.
Thrombocytopenia in Neonatal Infection
Authors: Modanlou Houchang D. , Ortiz Oscar B.
Published: July 2008

Serial platelet counts by phase microscopy were done for three groups of neonates who were admitted to the Special Care Unit of the Miller Children's Hospital. Group 1 (78 neonates) was evaluated for septicemia. Group 2 (28 neo nates) was randomly selected sick neonates whose working diagnosis was not septicemia. Group 3 (16 neonates) was clinically normal preterm neonates (28 to 36 weeks gestation). For groups 1 and 2, platelet counts were done serially, at the time blood and cerebrospinal fluid cultures were obtained and then 12, 24, 48 and 72 hours later. For group 3, platelet counts were done on the second, seventh, fourteenth, twenty-first, and twenty-eighth day of life. Sixteen of the group 1 infants were found to have septicemia; ten of these 16 had thrombo cytopenia (platelets <100,000/mm3). In group 2, five infants had thrombocyto penia, one because of isoimmune disease and four as a result of possible disseminated intravascular coagulation. Thrombocytopenia persisted for 1 to 10 days; platelet counts of group 3 were the same as those of older children and adults.
Avid Thyroid Uptake of [Tc-99m] Sodium Pertechnetate in Children with Goitrous Cretinism
Authors: Kim E. Edmund , Domstad Peggy A. , Choy Young C. , DeLand Frank H.
Published: July 2008

Three children with goitrous hypothyroidism had thyroid scans with [Tc-99m] sodium pertechnetate, which showed symmetrically enlarged thy roid glands with uniformly increased activities compared to little activities in the salivary glands and low body background activities. These scan findings, simulating those of Graves' disease, reflect avid trapping of this tracer, analogous to that seen with 1-131. Perchlorate discharge test was positive in two patients, indicating an organification defect.
Persistent Purulent Otitis Media
Authors: Schwartz Richard H. , Rodriguez William J. , Khan Waheed N.
Published: July 2008

Of 429 children with acute otitis media who returned for follow-up evalu ation, 49 (11%) were unresponsive to a 10- to 14-day course of ampicillin, amoxicillin, or erythromycin/sulfisoxazole. Patients with persistent purulent otitis media were noted to have immobile, bulging, yellow or grey, abscessed tympanic membranes at the follow-up visit. A myringotomy was performed on 45 children. Cultures of middle-ear exudate yielded ampicillin-resistant Haemophilus influenzae in 14 (31%), ampicillin-susceptible pathogens ( H. in fiuenzae or Streptococcus pneumoniae) in 23 (51%), and no growth in 8 (18%).
The Psychosocial Functioning of Young Adults Born with Cleft Lip or Palate
Authors: Heller A. , Tidmarsh W. , Pless I.B.
Published: July 2008

A follow-up study of 96 young adults born with a cleft lip and/or cleft palate was conducted to determine their present psychosocial adjustment and to evaluate the services offered to them. Medical histories were obtained from hospital charts. Telephone interviews focusing on educational achievement, work performance, and social integration showed that 10 to 33%, depending on the criteria used, experienced psychosocial maladjustment. There was a high rate of persistent dissatisfaction with appearance, hearing, speech, teeth, and social life. An analysis of the services offered to these young adults, in the light of their adjustment status and expressed needs, prompts the recommenda tion that counseling or other social support might be offered routinely during childhood and, of equal importance, during adolescence when further medi cal, surgical, and dental treatment may also be required.
Superior Mesenteric Artery Syndrome with Encephalitis
Authors: Shapir Yehuda , Bar-Maor J.A. , Berant Moshe
Published: July 2008

Duodenal obstruction occurred in a 7-year-old girl who suffered from encephalitis. She was of asthenic build, had recently lost much weight and had been lying supine for several days. A diagnosis of superior mesenteric artery syndrome (SMAS) was entertained and subsequently confirmed by roentgenologic studies and by the clinical course. Unnecessary surgery was thus avoided. Because of its varied expression and the alleged infrequent occurrence in children, there is special need for awareness and recognition of SMAS in the pediatric patient.
Congenital Dislocation of the Hip
Authors: Sherk Henry H. , Pasquariello Patrick S. , Watters William C.
Published: July 2008

Congenital dislocation of the hip usually results from capsular stretching caused by fetal malposition and crouching late in the third trimester. Early recognition of hip dislocation or instability soon after birth permits prompt treatment. Ortolani's and Barlow's maneuvers, respectively, reduce into and displace from the acetabulum a femoral head that is insecurely contained therein. The diagnosis of CDH in the first month of life usually depends on these clinical components of the physical examination of the newborn, because radiologic findings are undependable at this time. The Pavlik harness, or similar device, in this age group can usually maintain the displaced hip in sufficient flexion and abduction to permit reduction and normal development. By 3 months of age, the nuclei of the pelvis and upper femur have ossified enough to permit radiologic diagnosis of CDH. Problems related to treatment increase as the child grows older. In infants up to 6 months of age, closed methods with a harness usually succeed. Beyond 6 months, the soft tissues shorten and prevent easy reduction. These patients almost always require pre-reduction traction. An adductor tenotomy also facilitates reduction and apparently lessens compressive forces on the femoral head, an important consideration in preventing avascular necrosis of the head. Children over 1 year old develop bony changes, such as excessive femoral valgus and antever sion and deformity of the acetabulum. Treatment in these patients requires realignment of bony deformities with femoral or pelvic osteotomies in addi tion to the measures noted previously. The gentleness and high success rate of early treatment make early diagnosis of CDH an important consideration in infants and newborns.
The Myth of Nonmongoloid Trisomy G
Authors: Patil Shivanand R. , Zellweger Hans
Published: July 2008

Reexamination of the chromosomes of a patient previously reported as having trisomy 22 yielded a partial trisomy of chromosome 13. Observations led to the conclusion that not every trisomy of a small acrocentric autosome in an individual without mongoloid features represents trisomy 22. Chromo somal analysis, preferably with a high resolution banding, of the parents may help in establishing the correct provenance of the extra chromosomal fragment. The clinical picture of partial trisomy of the proximal portion of chromosome 13 is fairly typical, yet by no means pathognomonic.
Dopamine-induced Paroxysmal Supraventricular Tachycardia in an Infant
Authors: Shahar Eli , Lotan Danny , Barzilay Zohar
Published: July 2008

Dopamine is an effective inotropic agent in the management of circulatory collapse. Ventricular dysrhythmias are reported to occur during dopamine in fusion. The following report describes an infant with circulatory failure who experienced an episode of paroxysmal supraventricular tachycardia while receiving dopamine. Instability or immaturity of the cardiac conduction system during early infancy may contribute to the induction of an arrhythmia of supra ventricular origin.
The Mongolian Spot
Authors: Cordova Alberto
Published: July 2008

Four hundred thirty-seven consecutively born full-term neonates, delivered at Jackson Memorial Hospital, were examined for the presence of mongolian spots (MS). The spots were found in 96% of the Negro children, 46% of the Hispanic children, 9.5% of the Caucasian children, and in both of the Asian children in the series. The sacro-gluteal region was the most frequent site of pigmentation, with the shoulders next in frequency. Almost all the spots on the extremities were located on the extensor surfaces. The color was most fre quently blue-green, but was also commonly greenish-blue, blue-gray, or brown. In a concurrent review of 124 newborn records, MS was not described by house officers in any, although the probability of its occurrence would have been approximately 90 cases, based on the results of the study. A comprehen sive review of the history of the description of MS and theories of its develop ment, as well as a review of the clinical aspects, is presented.
Pediatric and Psychiatric Collaboration in the Management of Childhood Asthma
Authors: Fritz Gregory K. , Steiner Hans , Hilliard Jomary , Lewiston Norman
Published: July 2008

With many asthmatic children for whom emotional factors are significant, joint pediatric and psychiatric management is essential. A three-level model of collaboration is presented, including (1) pediatric care, (2) psychiatric consulta tion, and (3) inpatient psychosomatic treatment. The organization, professional roles, and treatment protocol of the psychosomatic inpatient service are described. A review of the first 16 asthmatic children who received inpatient care in the program suggests that such a model may present a viable alternative to long-term residential care.
Severe Psychosomatic Illness in Children
Authors: Fialkov Martin J. , Miller J. Allen
Published: July 2008

Observations of a pediatric ward's response to the repeated hospitaliza tion of an asthmatic child revealed a close parallel to the transactional pat terns described in families of children with psychosomatic illnesses. Char acteristics of such families include enmeshment, overprotectiveness, rigidity and resistance to change, lack of conflict resolution, and use of the child's sick role to relieve tension and discomfort within the family. In this article we have attempted to demonstrate the similarity of responses between these families and groups of hospital ward personnel. Resolution of the ward personnel's internal conflict was followed by changes in the coping abilities of the staff, with a successful outcome for a second child with a similar clinical condition.
Balance is Everything: Bicycle Messengers, Work and Leisure
Authors: Fincham Ben
Published: July 2008

The conceptual separation of `work' and `life', as distinct elements of social activity, has become established as shorthand for the social and psychological dislocation felt by being at work and not being at work.There is a literature on the work/life balance driven by governmental rhetoric, based on the idea of flexible working. This article suggests that distinctions between `work' and `life', implying a dichotomy in adult life, are overstated. Using material from a study of bicycle messengers this article presents a rich account of a group of workers for whom the binary distinction between work and life is meaningless. The account of this world of work is more closely aligned with those of the jazz musicians described by Becker or the boxers of Weinberg and Arond, where the occupation, identity and culture are not confined to hours of work.
`It's Just Easier for Me to Do It': Rationalizing the Family Division of Foodwork
Authors: Beagan Brenda , Chapman Gwen E. , D'Sylva Andrea , Bassett B. Raewyn
Published: July 2008

While women continue to do the lion's share of foodwork and other housework, they and their families appear to perceive this division of labour as fair. Much of the research in this area has focused on families of European origin, and on the perceptions of women. Here we report findings of a qualitative study based on interviewing multiple family members from three ethno-cultural groups in Canada. Women, men and children employed similar rationales for why women did most of the foodwork, though explanations differed somewhat by ethno-cultural group. Explicitly naming foodwork as women's work was uncommon, except in one ethno-cultural group.Yet more individualized, apparently gender-neutral rationales such as time availability, schedules, concern for family health, foodwork standards, and the desire to reduce family conflict were grounded in unspoken assumptions about gender roles. Such implicit gender assumptions may be more difficult to challenge.
More or Better?
Authors: Fleischer Aliza , Rivlin Judith
Published: July 2008

The tourism industry faces a dilemma. To grow tourism expenditures, industry decision makers must either increase capacity or improve quality. The ability to decompose tourism expenditures into their quality and quantity components can provide insight to this process. In this study, a theoretical model of household demand for tourism was developed, distinguishing between quality and quantity of the households' vacations. Income and price elasticities for both level of quality and number of vacation days are derived. By applying this model to Israeli data, it was found that about half of the increase in vacation demand, measured in quality units, is due to increases in the level of vacation quality, and the other half to increases in the number of vacation days.
Potential for Alcohol Policy to Decrease the Mortality Crisis in Russia
Authors: Khaltourina Daria A. , Korotayev Andrey V.
Published: July 2008

Post-Soviet Russia experiences among the world's highest prevalence of alcohol-related problems, which contributes to high mortality rates in this region. Reduction in alcohol-related problems in Russia can have strong effects on mortality decline. This article considers the plausibility of application of general principles of alcohol policy translated in the Russian Federation. We conclude that alcohol policy approaches could be implemented in the same ways as they have been in other countries. In addition, there should be special attention to decreasing distilled spirits consumption, illegal alcohol production, nonbeverage alcohol consumption, and enforcement of current governmental regulations.
Malignant Myopericytoma-like Tumor in a Fischer Rat
Authors: Takahashi Naofumi , Yoshida Toshinori , Takeuchi Yukiko , Kuwahara Maki , Nakashima Nobuaki , Chiba Yuko , Harada Takanori
Published: July 2008

Myopericytoma is a perivascular tumor that has been recently described in humans, but not in laboratory rodents. The authors encountered an intra-abdominal tumor resembling human malignant myopericytoma in a Fischer rat. Grossly, the tumor was found as two brown-colored masses located in the mesentery of rectum. Microscopically, the tumor was composed of oval to spindle-shaped cells, which were arranged in sheets around numerous thin-walled branching vessels and partly showed a concentric perivascular growth pattern. Mitoses were frequently seen, and the tumor cells showed a local invasion. Immunohistochemically, the tumor cells were strongly positive for alpha-smooth muscle actin and weakly positive for vimentin and desmin. Ultrastructurally, the tumor cells had dendritic processes, actin-like thin filaments with dense bodies, basement membranes, hemidesmosomes, and micropinocytotic vesicles. These findings suggest that the most appropriate term for diagnosis of the present case could be a malignant myopericytoma.
Speaking to power: Tony Blair, complex multicultures and fragile white English identities
Authors: Wetherell Margaret
Published: July 2008

This paper reflects on one example of knddowledge transfer conducted by the ESRC Identities and Social Action Programme which involved briefing Tony Blair for his December 2006 speech on multiculturalism and extremism. Two key themes in the report prepared for Blair and his speech-writer are described — the nature of contemporary complex multicultures and the `fragility' of white English identities. These are contrasted with themes in Blair's speech which, in general, celebrated (white) British national character and took a traditional `divided communities' perspective on UK multiculturalism while introducing further measures to encourage `integration'. The paper describes the dilemmas and challenges faced in formulating a report for this context, in particular issues about developing a narrative in a highly contested field, complicity with power and credentials to speak. It argues, too, that although ostensibly an exceptional opportunity, more mundane acts of knowledge transfer might be more effective.
`There is a little bit more than just delivering the stuff': Policy, pedagogy and the education of Gypsy/Traveller children
Authors: Cudworth David
Published: July 2008

Concerns over the underachievement of Gypsy/Traveller children in the UK educational system, and a commitment to improve provision for these children, are something that has been acknowledged across a series of government reports and other documents over the last forty years. Yet despite this commitment, and the rhetoric around equality of opportunity and inclusion in which `Every Child Matters', children from Gypsy/Traveller communities continue to experience discrimination and remain the worst achieving minority group in the UK schooling system. This article argues that with the official National Curriculum of most schools often failing to recognize the particular cultures of Gypsy/Traveller children, there does seem to be a mismatch between policy and practice wherein some children matter more than others. With a school system based on attendance and high standards, defined in certain kinds of ways which lead to achievement in league tables, thus securing the roll base and demand for that school, school provision becomes organized around certain kinds of needs rather than the needs of all. Despite improvements in the educational participation and successes of Gypsy/Traveller children in some schools, the article argues that there is still a long way to go. In order to investigate how policy is being `played out' in schools and the extent to which practice may be denying equality of opportunity for all children, this article draws on interview material with primary teachers and education support staff in East London, and an ethnographic study in a school with a significant proportion of Gypsy/Traveller children on roll. Finally, the article suggests ways in which these investigations may be used in policy terms, in order to meet the needs of and include children from these communities so that they are able to meet their full potential and enjoy their right to an education.
Articles, adjectives and age of onset: the acquisition of Dutch grammatical gender
Authors: Blom Elma , Polišenská Daniela , Weerman Fred
Published: July 2008

A comparison of the error profiles of monolingual (child L1) learners of Dutch, Moroccan children (child L2) and Moroccan adults (adult L2) learning Dutch as their L2 shows that participants in all groups massively overgeneralize [—neuter] articles to [+neuter] contexts. In all groups, the reverse gender mistake infrequently occurs. Gender expressed by Dutch attributive adjectives reveals an age-related asymmetry between the three groups, however. Whereas participants in the child groups overgeneralize one particular suffix (namely the schwa), adult participants use both adjectival forms, the schwa-adjective and the bare adjective, incorrectly. It is argued that the asymmetry observed in adjectives reflects that adult learners exploit an input-based, lexical learning route, whereas children rely on grammar-based representations. The similarity in article selection between all groups follows from the assumption that adults, like children, make use of lexical frames. Crucially, lexical frames can successfully describe the distribution of gender-marked articles, but they cannot account for gender in adjectives.
Depression after stroke
Authors: Collin SJ , Tinson D. , Lincoln NB
Published: July 2008

Depression was identified by means of questionnaire in a group of stroke patients who had been admitted to hospital and were between one and two years after onset. A high proportion (42%) of patients were found to be depressed but there were no differences between depressed and nondepressed patients in age, sex distribution, hemisphere affected, number of previous strokes or time in hospital.
Consumer report on intermittent pneumatic compression devices
Authors: Rithalia Svs , Sayegh A. , Edwards J.
Published: July 2008

This study reports the assessment of seven pneumatic intermittent compression devices for user characteristics and the accuracy of the instrumentation.
Spinal cord lesions: coping and mood states
Authors: Bermond B. , Schuerman J. , Nieuwenhuijse B. , Fasotti L. , Elshout J.
Published: July 2008

Forty-two patients with spinal cord lesions were asked to fill out the Amsterdam Mood Questionnaire in order to ascertain whether this group of patients with reduced sensorimotor capacities would show a deviant pattern of moods. An overall reduction in mood state levels had to be expected for these patients on the basis of various emotion theories, and various theories about the psychological consequences of severe handicaps. The various mood state levels for these patients did not differ from those for the norm group, with the exception of the mood state 'fatigued'. It is concluded that spinal cord lesions do not affect mood states in a direct way. Success or failure in coping with the lesion-induced handicap does, however, effect mood state levels. Failure in coping is related to depression and an accentuation of negative moods, whereas successful coping is related to lack of depression and an accentuation of positive moods. The results of this study indicate that the theories mentioned need reconsideration as do the therapeutic strategies based upon them.
Diaper doer's hand: stenosing tenosynovitis in the postpartum period
Authors: Cosgrove James L , Welch Dan A , Richardson George S , Nicholas John J
Published: July 2008

Three cases of stenosing tenosynovitis occurred three to six months postpartum. Childcare activities aggravated the symptoms of pain and swelling in both patients. In two cases, a specific method of carrying the child was implicated as the mechanism of injury. Although there was no evidence of generalized inflammatory arthritis, all patients had very low positive titres of anti-nuclear antibodies. While it is likely that tenosynovitis was caused by mechanical factors, the possibility of increased susceptability to inflammatory disease in the postpartum period cannot be discounted. The patients were successfully treated with a low temperature plastic splint, superficial heat and gentle mobilization.
Longterm effects of a social rehabilitation programme for elderly people: physiological predictors and mortality data
Authors: Arnetz Bengt B , Theorell Töres
Published: July 2008

The purpose of this study was to assess possible effects on five-year survival rates of a social rehabilitation programme for elderly institutionalized people. A total of 50 elderly people were randomly selected and allocated to either a control group or a social activation intervention group. A number of physiological parameters were assessed as was the initial health status. Five-year mortality rates showed no differences between the control (10 dead out of the original 27) and the intervention group (8/23). The former, however, tended to have a higher relocation rate to geriatric hospitals, 7/27 and 4/23 respectively. Survivors, in general, had lower systolic blood pressure (145 vs 152 mmHg) and lower serum cholesterol (6.0 vs 6.4 mmol/I). The results indicate a need to reassess the assumed beneficial effects on survival of social activation programmes initiated in late life. The study indicates that risk factors for early death from cardiovascular diseases in a younger population (systolic blood pressure and serum cholesterol) also hold true for older institutionalized subjects, with the possible exception for high density lipoprotein- cholesterol (HDL), which showed an inverse relationship to survival. Larger scaled studies are warranted.
The frequency of perceptual deficits after stroke
Authors: Edmans JA , Lincoln NB
Published: July 2008

The frequency of perceptual problems in stroke patients was assessed using a standardised assessment, The Rivermead Perceptual Assessment Battery.1 One hundred and fifty stroke patients (75 right hemiplegic and 75 left hemiplegic), admitted consecutively to two general hospitals, were assessed one month after stroke, to identify the proportion with perceptual difficulties. Perceptual difficulties were identified in 71 % of right hemiplegic stroke patients and 81 % of left hemiplegic patients. They were identified in 97% of dysphasic right hemiplegic patients, compared to 47% of nondysphasic right hemiplegic patients and 84% of female hemiplegic patients, compared to 67% of male hemiplegic patients. Unilateral neglect was identified in both right and left hemiplegic patients. The proportion of patients with neglect varied according to the measure chosen. The results indicate that perceptual problems are common following both right and left hemiplegic stroke, with unilateral neglect accounting for a relatively small proportion of the problems.
Why is there a lower prevalence of chronic immobility in geriatric departments with a high turnover of patients?
Authors: Milnes JP , Hill DN , Rowe J. , Allen-Narker Rac , Brooks Rws , Desai HN , Dunn AM , Hewetson KA , Howard DJ , Misra KK , Wood GM
Published: July 2008

There is little information available about the characteristics of patients admitted to geriatric units with high and low turnover rates of patients. It is often suggested that high turnover units do not admit the more physically disabled person. This study set out to investigate whether this view is true. Six geriatric units with different patient discharge rates were investigated. Those units with a high turnover of patients tend to admit more severely immobile people per bed, when compared to those units with below average throughput. Although these immobile people admitted to high turnover units suffered a higher mortality rate, a significantly greater proportion regained the ability to transfer themselves independently from bed to chair and to the toilet.
The assessment of patients with foot problems using the pedobarograph
Authors: Hughes Janet
Published: July 2008

Pressure measurement is becoming recognised as a clinically useful method of analysis of foot problems. The number of centres using the pedobarograph to do this is increasing. There are no established standards with which to compare patients recordings and analysis depends largely upon the experience of the operator and the clinician in the interpretation of results. The author has used this equipment in both its simple and computerized forms over a period of several years. A technique of studying the results has evolved. This is described with examples recorded on the pedobarograph using the Sheffield system of computerized analysis. 1
Observation of eating skills after stroke: dribbling food and chewing
Authors: Carr EK , Hawthorn PJ
Published: July 2008

Eating difficulties after stroke are common. The mealtime care of patients is a nursing responsibility, but there are few tools to guide nurses in their assessment of patients' eating skills. In this paper the efficacy of observations of patients eating, as a means of identifying those who have difficulty with dribbling food and chewing, is considered. Twenty patients after a first stroke and 20 general medical patients were observed while eating lunch. They were also interviewed and assessed on eight subtests of the Frenchay Dysarthria Assessment (FDA). In stroke patients, significant correlations were found between the observations and scores from the interviews and tests. Stroke patients dribbled food and had difficulty chewing more often than the general medical patients. The FDA subtest for drooling could be used to screen for patients likely to dribble food.
The Wimbledon Self-Report Scale: emotional and mood appraisal
Authors: Coughlan Anthony K , Storey Peter
Published: July 2008

Self-rating scales currently in use for the detection of mood disturbance may not be suitable for use with neurological patients, or patients with substantial physical illness, because they employ items concerning activity and somatic or cognitive disorder and so are liable to produce a high level of false positive misclassifications. The development of a more suitable scale based purely on feelings, the Wimbledon Self-Report Scale (WSRS), is described. The WSRS provides a catalogue of the patient's adverse emotions for use in counselling and detects levels of mood disturbance that warrant further exploration. The classifications yielded by the scale are reliable and false positive and false negative rates are low. WSRS scores appear unaffected by sex or by age within the 18-80 year range.
Remediation of acquired dyslexia
Authors: Moody Sylvia
Published: July 2008

The purpose of the study was to design treatment programmes for various types of reading disorder in such a way as to allow a valid evaluation of their efficacy. The study investigated whether specific forms of therapeutic intervention helped specific forms of disorder. Studies on five patients with different patterns of reading difficulty showed that specific treatment programmes were responsible for significant improvement in the patients' reading performance.
Physiotherapy benefits patients with Parkinson's disease
Authors: Banks Moira A , Caird FI
Published: July 2008

Thirty-six patients with Parkinson's disease, of Hoehn and Yahr grade I-IV, on optimal unchanging drug therapy, were taught physiotherapeutic exercises in their own homes. They were assessed by timed tests twice before and once after a fortnight's exercises. A postal follow-up was conducted at three months.

There were statistically significant improvements in walking (17%), turning over in bed, sitting from lying, and standing from sitting (each approximately 30%). Improvement was irrespective of the duration of disease, and was seen with all degrees of initial impairment of mobility.

After three months, half the patients were still doing their exercises daily. Intercurrent illness, tiredness, and lack of perceived benefitwere the main reasons for discontinuance.
The stroke patient in an urban environment
Authors: Kettle Melvyn , Chamberlain M Anne
Published: July 2008

A cohort of 70 patients who had had a stroke a median of 19 months, for males, and 23 months, for females, beforehand and had been treated intensively in a rehabilitation unit, was compared with an age matched control group (25) of normal people living in the same city.

Two thirds of patients were moderately or severely limited in their independence on the Barthel Scale; only4% had a normal level of social activities (Frenchay Index) and half were depressed (Wakefield Scale). Mobility was severely impaired, only 15% being able to walk more than 440 yards. Only one subject drove a car, few could use public transport, and only two people returned to work full time. Use of health services and social services was low. No control subjects had any such problems. Therefore, the social effects of stroke are severe; they persist for many years and they are not addressed by current inpatient treatment. New models of treatment must be devised and evaluated to reduce social isolation and depression in the patient and carer.
No more flat tyres: a trial of a tyre insert for wheelchairs
Authors: Penn ND , Belfield PW , Young JB , Whitley AJ , Mulley GP , Mascie-Taylor BH
Published: July 2008

Most wheelchairs are fitted with pneumatic tyres. Deflated or punctured tyres may result in secondary brake failure and make wheelchairs difficult to propel. 'Flexel' is a nonpneumatic alternative to conventional innertubes. We have compared this punctureproof tyre insert with a pneumatic inner tube in 50 wheelchairs. The pneumatic tyres needed regular attention (reflation on 237 occasions, 7 punctures and 4 leaking valves) and were associated with secondary brake failure (130 episodes). In marked contrast the tyre insert was virtually maintenance free (readjustment on 2 tyre rims). There were no episodes of secondary brake failure with the insert. The tyre insert improves wheelchair safety and is likely to reduce maintenance costs.
Effectiveness of a rehabilitation programme in chronic bronchitis and emphysema
Authors: Prince KL , Helm M.
Published: July 2008

Thirty-nine patients with stable chronic bronchitis and emphysema were randomly allocated into two groups. Eight withdrew before the study and six during the study. One group received six weeks active outpatient rehabilitation, the other (control) group six weeks attendance without rehabilitation. Before entry, patients were examined to assess stability and measure arterial blood gases. On both entry and completion the following were recorded: smoking history; carboxyhaemoglobin; FEVI; six minute walking distance (6MD); the General Health Questionnaire (GHQ) and visual analogue scale (VAS) of breathlessness.

The treatment group showed a significant (p > 0.01) reduction in GHQ score after rehabilitation, suggesting a decrease in psychiatric symptoms. In the control group, the GHQ score reduction was not statistically significant. The control group, but not the treatment group, showed a significant (p > 0.05) increase in 6MD. No significant difference was found in FEV1, VAS score, or the number of patients smoking after rehabilitation. Our rehabilitation programme appeared to benefit patients' psychological wellbeing, but this may be due to attendance at the groups rather than the rehabilitation programme per se. Underlying disease severity or perception of disability did not change.
Review articles : Minimizing fatigue for functional electrical stimulation of muscle
Authors: Cooper Robert G , Stokes Maria J , Gibson Henry , Edwards Richard HT
Published: July 2008

Interest in the possibility of using electrically stimulated muscular contractions in rehabilitation medicine is increasing. Progress is impeded by the phenomenon of fatigue which impairs effectiveness and consistency of contractions. Various methods for minimizing fatigue have been proposed and are presently discussed. These include fibre type conversion as a result of chronic low frequency conditioning stimulation, sequential stimulation, optimization of stimulation parameters and the use of hybrid orthoses.
Hemiplegic shoulder pain: a study of two methods of physiotherapy treatment
Authors: Partridge CJ , Edwards SM , Mee R. , van Langenberghe Hvk
Published: July 2008

A study was undertaken to examine the effectiveness of two methods of physiotherapy treatment for hemiplegic shoulder pain. Sixty-five patients were randomly allocated to receive either cryotherapy or the Bobath approach. Patients were assessed before and after a four-week period of treatment. The differences between the scores of the two groups on exit were not found to reach statistically significant levels for severity of pain at rest, on movement, or for reported distress; however the proportion of patients who reported no pain after the four weeks' treatment was greater in those who received the Bobath approach. The differences in reported frequency of occurrence of pain reached a significant level (p < .05), those in the Bobath group reporting less frequent pain. It is suggested that reasons forthe lack of expected differences in outcome between the two groups may be in part due to the diversity of underlying pathology, and to further trauma which occurred in the study period.

The difference between before and after ratings for all pain variables was significant; for reported severity and frequency p < .05, and for reported distress p < .001. These findings suggest that physiotherapy may have a role to play in the treatment and management of hemiplegic shoulder pain, but further investigations are needed. It may be appropriate to set up and monitor programmes of careful handling to see if shoulder pain can be avoided, and it is also suggested that those with severe pain at rest and on movement may be considered as a separate group for study.
Effects of supervised exercise training on physical work capacity in a group of patients with severe chronic obstructive pulmonary disease
Authors: Lahdensuo Aarne , Laitinen Jukka , Karvonen Juha
Published: July 2008

Thirty-six patients with severe disability due to chronic obstructive pulmonary disease (COPD) completed a three-week exercise programme carried out in hospital. Maximum exercise capacity and the total work accomplished during a treadmill exercise test more than doubled (p < 0.001) compared with measurements obtained at the end of an initial three-week control period. Six months afterthe end of the exercise programme both maximum exercise capacity and total work had declined, but were still significantly (p < 0.001) above control values.
The value of the Frenchay Aphasia Screening Test in screening for dysphasia: better than the clinician?
Authors: O'Neill PA , Cheadle B. , Wyatt R. , McGuffog J. , Fullerton KJ
Published: July 2008

We have evaluated the Frenchay Aphasia Screening Test (FAST) in an elderly population living in the community, and in patients with a first stroke. Fifty-one elderly people aged 69-90 years were screened. Ten subjects failed the test (score < 25/30). There was an inverse relationship between age and the FAST score ( r s = -0.35, p = 0.02, 95% Cl 0.09-0.57). I n a group of 82 elderly patients, mean age 80 (6 years), admitted with a first stroke, the FAST was applied at one and seven days and the result compared with a clinical assessment and a speech therapy assessment. At day one 28 patients failed the test due to a reduced level of consciousness. The use of the FAST increased the sensitivity of screening from 87% to 96%, but reduced its specificity from 100% to 61 %. The positive and negative predictive values were 65% and 95% respectively.
An investigation of the effects of cervical traction
Authors: Moffett JA Klaber , Hughes GI , Griffiths P.
Published: July 2008

Mechanical cervical traction is often used on the assumption that it reduces muscle tension.1-5 The first 52 patients, included in a larger clinical trial of 100 patients with neck and arm pain described elsewhere6 who had been randomly allocated to weighted or placebo traction, had surface electromyography (EMG) recordings taken over the upper trapezius muscle. Results were based on 44 sets of useable data, and showed that both forms of traction (weighted and placebo) significantly reduced muscle tension when patients were reclining ( p<0.05). This reduction was not maintained when the patient returned to an upright position. No significant differences in EMG reductions were found between placebo and weighted traction.
Net functional outcome poststroke
Authors: Friedman Paul J
Published: July 2008

The functional outcome of 342 elderly stroke subjects was assessed by calculating the net Barthel activities of daily living score as the area under of the plot of Barthel score, measured at 7, 30, 60, 90, 120 and 180 days poststroke, and time. The net Barthel score was highly correlated with the Barthel score at the time of hospital discharge. Using generalized linear models, univariate predictors of net Barthel and discharge Barthel were similar. Hence, in this study population the net Barthel score offered no advantage over the discharge Barthel score as a outcome variable.
Effects of an intervention aimed at memory on perceived burden and self-esteem after traumatic head injury
Authors: McGuire Brian E , Greenwood Richard J
Published: July 2008

This paper investigates the effects of a six-week memory rehabilitation programme on the self-esteem of 18 patients with traumatic head injury, and the effects of the intervention on the level of subjective burden experienced by 18 relatives or primary carers of the head-injured patients, regardless of the efficacy of the programme itself. The study found a significant improvement in the head-injured patients' self-esteem and a significant decrease in the perceived burden of the relatives at the end of the six-week intervention. Possible explanations for these findings are suggested, and the practical implications for rehabilitation are discussed
Surgery combined with continuing post operative stretching and management for knee flexion contractures in cases of multiple sclerosis - a report of six cases
Authors: Pope Pauline M , Bowes Christine E , Tudor Maureen , Andrews Brian
Published: July 2008

Contractures are a common complication of advanced multiple sclerosis. In consequence the care load is increased. Sitting in the wheelchair becomes difficult if not impossible and there is a high risk of pressure sores due to inadequate weight distribution. The greatest impedance to care and maintenance was thought to be the bilateral knee flexion contractures and unilateral hip adduction contracture frequently found in the severely paralysed MS patient. It was postulated that release of contracture would ease the care load and management. Comfort and quality of life would improve as a result. Surgery to release the bilateral knee flexion contracture was combined with passive stretching to associated contractures in an attempt to improve the physical condition. A routine regimen of maintenance was introduced postoperatively and continued indefinitely. A comparison of postoperative method to increase range using continuous passive motion (CPM) and plaster of Paris (POP) serial splinting was carried out. The results of the six reported cases show a markedly increased range of movement at the knee, a reduction in care load and an improved sitting posture postoperatively which was maintained when reassessed at nine months. Little difference between the postoperative regimens of CPM and POP fixation was found.
The Leeds Family Placement Scheme: principles, participants and postscript
Authors: Geddes Jml , Chamberlain MA , Bonsall M.
Published: July 2008

A follow-up survey to measure functional ability was carried out on a group of patients with acute stroke who had received community-based rehabilitation from the Leeds Family Placement Scheme for stroke patients (FPS). A previous study at one year poststroke showed that patients receiving this additional support - placed patients (n = 10) - were more likely to maintain their three- month poststroke functional ability than were patients discharged directly home (n = 61). The follow-up contacted all survivors who were living in the community at 42 months poststroke. The proportion of patients who had maintained or improved their three-month poststroke Barthel score was statistically significantly greater in the group of placed patients (n = 8) than in the group of unplaced patients (n = 48). This paper describes the principles of the FPS, which provides patient-oriented, community-based rehabilitation, and suggests that its success in producing sustained and measurable improvement in functional ability may be largely due to the opportunity it provides for consolidating skills that have been learnt during hospital-based rehabilitation and in transferring these skills to the home.
Aspects of life stress after myocardial infarction: implications for a multifactorial rehabilitation
Authors: Larsson Pär A , Fridlund Bengt
Published: July 2008

Some baseline data for a multifactorial rehabilitation model with a caring intention after myocardial infarction (MI) are presented and discussed. The subjects consisted of 86 consecutive M I sufferers, none of whom was older than 65 years of age, in a medium-sized health care district in Sweden. Fifty-three MI sufferers who fulfilled certain criteria were sent a questionnaire one and two years after MI about their subjective need for social support related to MI in their present life. An overall need for social support was expressed by 74% (n = 42) one and 44% (n = 41) two years after MI. Long-lasting biopsychosocial complaints were reported from 62% and 80% of the patients one and two years after MI. The results suggest a shift in biopsychosocial complaints, indicating a resignation in parallel with a decreasing coping capacity.