A Study of the Safety and Functionality of Gamified Electromyographic Biofeedback for Children with Cerebral Palsy.

Cerebral palsy is a neurodevelopmental condition that affects 17 million individuals worldwide. Traditionally, methods of therapy are repetitive and monotonous, generating immense difficulty in maintaining patient motivation and engagement. This project's objective was to provide a novel method of therapeutic intervention that was co-designed by therapists and had the capacity to increase patient motivation and enjoyment. The system developed incorporated the use of muscle activations retrieved from a bespoke surface electromyography subsystem, to control custom computer games to increase therapy uptake. The safety and functionality of this device was verified through a series of trials performed on adults without any muscular impairments. Furthermore, a feasibility evaluation was conducted whereby the system was demonstrated to a group of healthcare professionals to gain their feedback. The trial results confirmed the safety and functionality of the system, with professional therapists confirming its clinical potential and its perceived benefits.

The effect of modeled recharge distribution on simulated groundwater availability and capture.

Simulating groundwater flow in basin-fill aquifers of the semiarid southwestern United States commonly requires decisions about how to distribute aquifer recharge. Precipitation can recharge basin-fill aquifers by direct infiltration and transport through faults and fractures in the high-elevation areas, by flowing overland through high-elevation areas to infiltrate at basin-fill margins along mountain fronts, by flowing overland to infiltrate along ephemeral channels that often traverse basins in the area, or by some combination of these processes. The importance of accurately simulating recharge distributions is a current topic of discussion among hydrologists and water managers in the region, but no comparative study has been performed to analyze the effects of different recharge distributions on groundwater simulations. This study investigates the importance of the distribution of aquifer recharge in simulating regional groundwater flow in basin-fill aquifers by calibrating a groundwater-flow model to four different recharge distributions, all with the same total amount of recharge. Similarities are seen in results from steady-state models for optimized hydraulic conductivity values, fit of simulated to observed hydraulic heads, and composite scaled sensitivities of conductivity parameter zones. Transient simulations with hypothetical storage properties and pumping rates produce similar capture rates and storage change results, but differences are noted in the rate of drawdown at some well locations owing to the differences in optimized hydraulic conductivity. Depending on whether the purpose of the groundwater model is to simulate changes in groundwater levels or changes in storage and capture, the distribution of aquifer recharge may or may not be of primary importance.

Ineffectiveness and potential proarrhythmia of atrial pacing for atrial fibrillation prevention after coronary artery bypass grafting.

BACKGROUND: Atrial pacing is often used empirically to suppress atrial ectopy and prevent atrial fibrillation after coronary artery bypass grafting. METHODS: To determine whether atrial overdrive pacing reduces atrial fibrillation and atrial ectopy after coronary artery bypass grafting, 100 patients were randomized to no atrial pacing (Control) versus AAI pacing at 10 beats/min or more above the resting heart rate (Paced), started by postoperative day 1 and continued through day 4. Major end points were new atrial fibrillation and frequency of atrial ectopy during the first 4 days after coronary artery bypass grafting. RESULTS: Atrial fibrillation occurred by day 4 in 13 of 51 (25.5%) Paced and in 14 of 49 (28.6%) Control patients, p = 0.90. Control patients who developed atrial fibrillation had significantly more atrial ectopy than those who did not. Atrial ectopy was paradoxically more frequent in the Paced group (2,106+/-428 versus 866+/-385 per 24 hours, p = 0.0001). Loss of capture, sensing, and consistent atrial pacing occurred frequently during atrial pacing. CONCLUSIONS: Contrary to prevailing opinion and practice, postoperative atrial overdrive pacing significantly increases atrial ectopy and does not reduce the likelihood of atrial fibrillation.

Neurobehavioral effects of acute exposure to inorganic mercury vapor.

Mercury has well-established toxic effects on the central nervous system. This article describes comprehensive neuropsychological and emotional functioning of a group of 13 workers exposed to inorganic mercury vapor compared to that of a normal control group. The exposed group was exposed over a 2- to 4-week period and had elevated blood mercury levels. The evaluations were conducted between 10 and 15 months after exposure was terminated. Observed cognitive deficits included impairment in the following domains: motor coordination, speeded processing with and without a motor component, cognitive flexibility, verbal fluency, verbal memory, and visual problem solving and conceptualization. Emotional problems included increased focus on physical functioning, depression, anxiety, and social withdrawal. Cognitive deficits were, for the most part, not significantly associated with the degree of depression present.

Self-inflicted injury in a case of Hallervorden-Spatz disease.

Hallervorden-Spatz disease (HSD) is a rare neurodegenerative disorder characterized by abnormally high deposits of iron in the brain. This report describes a child with HSD who presented with self-inflicted ulceration of the lip and tongue, which was initiated during periods of intense oro-facial spasms. Other findings included dental caries and trauma to the primary incisors. Comprehensive dental care was carried out under general anaesthesia. The self-mutilation of the oro-facial mucosa was eliminated by placement of upper and lower soft resin bite guards.

Consent and the handicapped patient.

Changes in the care of handicapped people has resulted in them being more evenly distributed within the community. This increases the likelihood that they, or their carers, will seek treatment from general dental practitioners. It is, therefore, important to be aware of the regulations and forms involved in consent of a handicapped patient.

A note on the synonomy of Bothriocephalus acheilognathi Yamaguti, 1934, B. aegyptiacus Rysavý and Moravec, 1975 and B. kivuensis Baer and Fain, 1958.

Examination of stained and mounted syntype and topotype specimens of Bothriocephalus aegyptiacus Rysavý and Moravec 1974, syntype specimens of B. kivuensis Baer and Fain 1958, and paratype specimens of B. acheilognathi Yamaguti 1934 showed there to be no characters which could be used to differentiate the three species. A scanning electron microscope study of the scolices of paratype specimens of B. aegyptiacus, syntype specimens of B. kivuensis and specimens of B. acheilognathi also revealed no differences. It is therefore suggested that the three species are synonymous, with priority given to the name B. acheilognathi.

Mortality among New Zealand Maori and non-Maori Mormons.

Mortality rates for New Zealand Maori and non-Maori Mormons in the period 1970-77 have been compared with those for non-Mormons in the census year 1976 to measure the impact of the Mormon lifestyle on differences in mortality between Maoris and non-Maoris. Maori mortality was much lower among Mormons than non-Mormons suggesting that environmental, rather than genetic factors, play a predominant role in the relatively high overall Maori mortality. However the prevalence of smoking among Maori Mormons was not much lower than for the general Maori population. Reasons for the relative mortality advantage of Maori Mormons were therefore not clear, although attitudes to health and health services utilization, and the influence of strong social support networks, might be involved. Paradoxically, non-Maori Mormon mortality rates were similar to those for non-Mormons. A combination of factors appeared to contribute to this finding including the fact that 26% of non-Maori Mormons were of Pacific Island origin, non-Maori Mormons were of lower socioeconomic status than other non-Maoris, and part Maoris probably constitute a high, but unknown, proportion of Mormons classified as non-Maoris.

The effect of praziquantel on the pseudophyllidean cestode Bothriocephalus acheilognathi in vitro.

Adult Bothriocephalus acheilognathi were incubated in solutions containing 0 (control), 0.1, 1.0, 10.0 and 100 micrograms praziquantel per ml (0, 10(2), 10(3), 10(4) and 10(5) micrograms l-1) of 0.9% saline for 5, 15 and 60 min at a temperature of 18 degrees C. The worms contracted immediately upon being placed in the drug. Scanning and transmission electron microscopy revealed considerable tegumental damage particularly in the neck region. Vacuolization and 'bubbling' of the tegument occurred in all of the drug solutions tested. Exposure to drug concentrations of more than 1.0 micrograms ml-1 (10(3) micrograms l-1) praziquantel for 15 min or greater resulted in many of the 'bubbles' bursting and releasing their contents to the exterior. Mature proglottides were distorted and had occasional large swellings resulting in the mass expulsion of eggs. Praziquantel had no ovicidal activity. Exposure to drug concentrations of 100 micrograms (10(5) micrograms l-1) praziquantel per ml saline for 24 h was not lethal to the worms.

Dental care for the handicapped adolescent.

A total of 932 physically, mentally and multiple handicapped children, including many adolescents, were examined at their special schools in a mobile dental unit, during a 4-year pilot period, and 744 were treated. Their dental needs were compared with those of 450 children at normal schools. Although a greater proportion of handicapped children were caries-free, more required extractions and periodontal treatment. In the group aged 12-16 years there were more decayed teeth, more missing teeth and fewer fillings than in the controls of the same age. Over 90 per cent of the 744 children were treated satisfactorily in the mobile clinic, cooperation being acceptable in 79 per cent. Only 2 per cent were totally uncooperative and required a general anaesthetic, even for an examination. In total, 8.5 per cent of the children received some treatment under general anaesthesia. Treatment should aim to create understanding by adolescent or parent of good dental health, to obtain oral health, to create the most pleasing appearance possible, to encourage acceptance of further treatment and, where possible, to involve adolescent patients by providing treatment along normal lines.

A modified radioimmunoassay for 1,25-dihydroxycholecalciferol.

A radioimmunoassay for 1,25-dihydroxycholecalciferol which did not cross react with 1,25-dihydroxyergocalciferol is described. IgG fractions were prepared from the serum of rabbits that had been immunized with 1,25-dihydroxycholecalciferol-3-hemisuccinate coupled to bovine albumin. Radioligand binding by the IgG fractions was time-, temperature-, and pH-dependent. The IgG fractions had a high affinity for 1,25-dihydroxycholecalciferol but cross reacted with 25-hydroxycholecalciferol and 24,25-dihydroxycholecalciferol. Vitamin D2 metabolites did not cross react in the assay when amounts up to 9 ng per tube were tested. The determination of 1,25-dihydroxycholecalciferol in human serum required an organic extraction and chromatographic isolation of the metabolite. Radioligand binding was influenced by the presence and concentration of the proteins in the phosphate buffer. The mean concentration of 1,25-dihydroxycholecalciferol in serum from normal adults was 56 (SEM 5.7) ng/L. 1,25-Dihydroxycholecalciferol was not detectable in serum from a nephrectomized subject and the concentration in serum was lower than normal in hypoparathyroid patients. Ingestion of 1,25-dihydroxycholecalciferol by nephrectomized or hypoparathyroid patients restored the concentration of 1,25-dihydroxycholecalciferol in serum to the normal range. The stability of the IgG fraction, the relatively short incubation interval, and the ability to measure 1,25-dihydroxycholecalciferol without interference from 1,25-dihydroxyergocalciferol are unique aspects of this radioimmunoassay.

Rehabilitation--an emerging allied health profession.

Rehabilitation is perceived as the third phase of health care following preventive health care and curative medicine. The rehabilitation specialist assists the health care team in facilitating the patient to live and work with what he has left. The unique role of the rehabilitation specialist in the health care system is described, as well as his/her relation to traditional helth care personnel. The University of Texas Health Science Center at Dallas in the School of Allied Health Sciences has offered professional education at both the undergraduate and graduate levels in the Department of Rehabilitation Science for the past five years. The curriculum description, student characteristics, and employment placements are distinguishing features of each program and describe how this rehabilitation specialist is educated.

Assisting African countries in the field of demography.

PIP: Demographic aid is needed in African countries, but it should consist of the development of the country's own demographers and planners who will be able to implement population policies in the future. Problems with past aid have been the appropriation of most aid to a few Anglophone countries, and the overemphasis of family planning. However it should not be assumed that donor agencies have underlying motives for their aid, nor should Aid be considered an attempt to avert social change. Future aid should therefore consist of multilateral aid in the areas of data collection and analysis, with fertility and family planning seen only as 1 aspect of population policy.^ieng