Colocalization of substance P or enkephalin in serotonergic neuronal afferents to the hypoglossal nucleus in the rat.

The serotonergic innervation of the hypoglossal nucleus originates from the caudal raphe nuclei. Non-serotonergic neurons in the caudal raphe nuclei also project to the hypoglossal nucleus. We employed a triple-fluorescence technique to determine whether the substance P- or the enkephalin-containing neurons in the caudal raphe nuclei that projected to the hypoglossal nucleus also contained serotonin. Rhodamine latex microspheres were injected into the hypoglossal nucleus, and then serotonin and peptide dual-immunofluorescence was performed to colocalize perikarya containing serotonin, substance P, and rhodamine microspheres; or perikarya containing serotonin, enkephalin, and rhodamine microspheres. Our results demonstrate that most substance P-containing neuronal afferents to the hypoglossal nucleus colocalize serotonin. In contrast, few enkephalin-containing neuronal afferents to the hypoglossal nucleus also contain serotonin. These data suggest that substance P projections to the hypoglossal nucleus are a subset of serotonergic projections and that limited overlap exists between the populations of enkephalinergic and serotonergic neuronal afferents to the hypoglossal nucleus. Either substance P- or enkephalin-containing somata account for a very small proportion of non-serotonergic caudal raphe projections to the hypoglossal nucleus. Finally, these data demonstrate the medial tegmental field origins of the substance P projections and the enkephalin projections to the hypoglossal nucleus.

Using feedback and evaluation effectively in clinical supervision. Model for interaction characteristics and strategies.

Feedback and evaluation are both integral parts of daily communications that supervisors and instructors use to help employees and students learn and grow. The purpose of this article is to provide guidelines for the effective use of feedback and evaluation in the supervision and performance assessment of students and staff therapists and assistants. I define feedback and evaluation and give examples of their uses. Reactions of students and staff to feedback and evaluation are identified. Carkhuff's phases of helping are described and integrated in a model with interaction characteristics and strategies that supervisors and instructors use when giving feedback and evaluation. I describe and suggest applications of the model for using feedback and evaluation to facilitate the development of independent and competent physical therapists and assistants.

Identifying problems in clinical problem solving. Perceptions and interventions with nonproblem-solving clinical behaviors.

Students and practicing physical therapists are expected to be clinical problem solvers. The absence of clinical problem solving may result in decreased individuality of patient services. The purpose of this article is to assist clinical supervisors in identifying specific difficulties in clinical problem solving and to clarify confusions in the supervisor's perception of the problem-solving behaviors of students and therapists. I present a model by comparing the behaviors of the problem solver with the behaviors of the nonproblem solver at each step in the problem-solving process and then discuss sources of confusion in the perception of problem solving. I provide examples and suggest applications of the model for improving clinical problem-solving abilities.

Effect of videotape replay on the quality and accuracy of student self-evaluation.

This study was designed to determine the effect of videotape replay on the quality and accuracy of student self-evaluation. Thirty-two junior physical therapy students were asked to perform a clinical skill and to assess their performances using the Performance Evaluation Form (PEF) designed for this study. The students in the Experimental Group assessed their performances after viewing a videotape replay. Students in the Control Group assessed their performances without viewing videotape replays. Faculty judges used the PEF to rate each student's performance. The instructor and student ratings were compared to determine the accuracy of student ratings. In addition, two faculty judges used a scale designed for this study to rate the degree of quality of each student's self-evaluation. No significant differences were found between the Experimental Group and the Control Group on either of the variables tested. The data gathered in this study indicated that videotape replay lacks value in enhancing self-assessment when evaluation immediately follows the performance of a skill. Further study is indicated.

Equine herpesvirus 1 infection in mares vaccinated with a live-virus rhinopneumonitis vaccine attenuated in cell culture.

Vaccination, in July and again in either November or December 1976, of 55 pregnant Standardbred mares with a live-virus rhinopneumonitis vaccine attenuated in cell culture failed to protect some mares from infection with equine herpesvirus 1. From 1976-12-08 to 1977-03-08, 33 mares foaled healthy foals, 16 mares foaled dead foals or live foals which died usually within 48 hours and six mares aborted. Gross and histological examinations and virus isolation studies confirmed that equine herpesvirus 1 caused 18 of the 22 neonatal deaths, stillbirths or abortions.

Alimentary tract manifestations of bovine adenovirus infections.

Two calves and a feedlot steer with systemic bovine adenovirus infection had hemorrhagic and necrotizing lesions confined to the digestive tract. In one calf there was severe, multifocal, necrotizing, hemorrhagic rumenitis, omasitis, abomasitis, enteritis and colitis. Small intestinal lesions were predominantly in Peyer's patches. Multifocal necrotizing abomasitis was the principal change in the other calf. Large amphophilic intranuclear inclusions typical of bovine adenovirus were common in swollen vascular endothelial cells. Bovine adenovirus was isolated from the former calf. The steer had diffuse hemorrhagic enterocolitis and large numbers of BAV inclusions in vascular endothelial cells of the intestinal lamina propria. Serum-neutralization tests to bovine adenovirus type 3 on acute and convalescent samples from six clinically affected in-contact animals revealed fourfold elevations in two.

Effects of one night without nasal CPAP treatment on sleep and sleepiness in patients with obstructive sleep apnea.

Nasal continuous positive airway pressure (CPAP) has become the nonsurgical treatment of choice for obstructive sleep apnea syndrome (OSAS). Recent evidence suggests that intermittent use of CPAP by patients is more common than nightly compliance. To determine the consequences of intermittent CPAP use, in terms of a return of sleep-disordered breathing and daytime hypersomnolence, 15 OSAS subjects were evaluated at three times: (1) before CPAP treatment (pretreatment), (2) after 30 to 237 days posttreatment during a night of CPAP use (on CPAP), and (3) during a night without CPAP (off CPAP). Evaluations of sleep-disordered breathing and three domains of hypersomnolence, physiologic sleep tendency, subjective sleepiness, and performance, were accomplished with the respiratory disturbance index (RDI), multiple sleep latency test (MSLT), Stanford sleepiness scale (SSS), and psychomotor vigilance task (PVT), respectively. CPAP use was encouraged and monitored from pretreatment to post-treatment by daily diaries for most subjects and an electronic device for a subset of subjects. As expected, CPAP eliminated apneas and hypopneas, and following the on CPAP night, there were statistically significant improvements in objective measures of sleepiness (MSLT and PVT). Subjective measures of sleepiness and fatigue also showed improvement. Sleeping without CPAP for one night reversed virtually all of the sleep and daytime alertness gains derived from sleeping with CPAP. This occurred despite a statistically significant reduction in the RDI on the night off CPAP (M = 36.8, SD = 28.0 events/h) relative to the pretreatment night (M = 56.6, SD = 24.8 events/h), which may be due to a lessening of the edema of the upper airway following CPAP use.(ABSTRACT TRUNCATED AT 250 WORDS)

Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea.

Obstruction of the upper airway during sleep (OSAS) is widely treated by having patients self-administer nasal continuous positive airway pressure (CPAP). To obtain objective evidence of the patterns of CPAP use, information was gathered from two urban sites on 35 OSAS patients who were prescribed CPAP for a total of 3,743 days. Patients were given CPAP machines that contained a microprocessor and monitor that measured actual pressure at the mask for every minute of each 24-h day for an average of 106 days per patient. They were not aware of the monitor inside the CPAP machines. Monitor output was compared with patients' diagnostic status, pretreatment clinical and demographic characteristics, and follow-up self-reports of CPAP use, problems, side effects, and aspects of daytime fatigue and sleepiness. Patients attempted to use CPAP an average of 66 +/- 37% of the days monitored. When CPAP was used, the mean duration of use was 4.88 +/- 1.97 h. However, patients' reports of the duration of CPAP use overestimated actual use by 69 +/- 110 min (p < 0.002). Both frequency and duration of CPAP use in the first month reliably predicted use in the third month (p < 0.0001). Although the majority (60%) of patients claimed to use CPAP nightly, only 16 of 35 (46%) met criteria for regular use, defined by at least 4 h of CPAP administered on 70% of the days monitored. Relative to less regular users, these 16 patients had more years of education (p = 0.05), and were more likely to work in professional occupations.(ABSTRACT TRUNCATED AT 250 WORDS)