Fetal hypothalamic transplants into brain irradiated rats: graft morphometry and host behavioral responses.

This study was designed to test the hypothesis that neural implants can ameliorate or prevent some of the long-term changes associated with CNS irradiation. Using a rat model, the initial study focused on establishing motor, regulatory, and morphological changes associated with brain radiation treatments. Secondly, fetal hypothalamic tissue grafts were placed into the third ventricle of rats which had been previously irradiated. Adult male Long Evans rats received one of three radiation doses (15, 22.5, & 30 Gy) or no radiation. Three days after irradiation, 7 animals in each dose group received an embryonic day 17 hypothalamic graft into the third ventricle while the remaining 8-9 animals in each group received injections of vehicle solution (sham). Few changes were observed in the 15 and 22.5 Gy animals, however rats in the 30 Gy treatment group showed stereotypic and ambulatory behavioral hyperactivity 32 weeks after irradiation. Regulatory changes in the high dose group included decreased growth rate and decreased urine osmolalities, but these measures were extremely variable among animals. Morphological results demonstrated that 30 Gy irradiated animals showed extensive necrosis primarily in the fimbria, which extended into the internal capsule, optic nerve, hippocampus, and thalamus. Hemorrhages were found in the hippocampus, thalamus, and fimbria. Defects in the blood brain barrier also were evident by entry of intravascularly injected horseradish peroxidase into the parenchyma of the brain. Animals in the 30 Gy grafted group showed fewer behavioral changes and less brain damage than their sham grafted counterparts. Specifically, activity measures were comparable to normal levels, and a dilute urine was not found in the 30 Gy implanted rats. Morphological changes support these behavioral results since only two 30 Gy implanted rats showed necrosis in the fimbria, internal capsule, and other areas of the brain. These results suggest that grafts of fetal neural tissue exert a beneficial influence on the host brain, although the mechanism by which the implant exerts its effect is still unknown. Evidence supporting the role of trophic factors is reviewed. These preliminary results suggest a potential for tissue grafts in the treatment of CNS irradiated patients.

Retrain, don't restrain: the educational intervention of the National Nursing Home Restraint Removal Project.

This article describes an educational program that contributed to a 90% reduction in the use of physical restraints in 16 randomly selected nursing homes over a two-year period. The educational program advocated assessments by a multidisciplinary team to generate individualized, restraint-free interventions. The program consisted of a workshop, telephone and quarterly on-site consultations, regional meetings, a newsletter, and written and audio-visual materials. The workshop and site visits were powerful motivators, and participants also found the video very useful. Most nursing homes can easily adapt components of this project to create their own restraint-removal programs.

Post-stroke hip fractures.

Fifty-six fractures of the proximal femur in 53 stroke survivors are described in this retrospective review. The side of fracture was found to be positively correlated with the side of hemiparesis (P less than 0.001). In all cases, the immediate proximate cause of the hip fracture was described as a fall. Falls most frequently occurred in the bathroom or during transfer activities. Though this group was largely ambulatory and living at home prior to fracture, only a minority of individuals were either ambulatory (40%) or able to return home (39%) immediately after discharge.

Nursing administration and personnel administration.

This article proposes that the personnel department could be of far greater assistance to nursing directors and hospital administrators than is commonly perceived. Although many of the nursing directors, hospital administrators, and personnel directors polled by the authors expressed a desire for more support from the personnel department, their priorities concerning the degree of increased involvement differed. Analysis of the respondents' answers to questions regarding specific areas of administrative responsibility are discussed. Managers at all levels will find this article to be a fruitful basis for discussing those areas within which the personnel department could play an expanded role.

The three faces of personnel--or, PAIR department activities as seen by executives, line managers, and personnel directors.

More so than most other departments, the personnel department shares responsibility for its activities--notably with executives and line managers. But the division of responsibility is far from clear-cut, and where to draw the line is subject to controversy, as seen in this discussion of survey results on the viewpoints of 326 PAIR directors, 162 executives, and 217 line managers. The survey was conducted by the authors, all from Arizona State University: George W. Bohlander, associate professor of management; Harold C. White, professor of management; and Michael N. Wolfe, assistant professor. They queried the three groups on four major activities--setting policy, counseling and advising line managers, providing services, and controlling personnel activities in other departments--and 17 duties. The responses are broken down according to degree of unionization in respondent firms. Discrepancies among the viewpoints of the three groups suggest a need for two kinds of programs, say the authors: one to communicate to an organization's line managers and executives the role actually performed by the PAIR department and the other to instruct them on PAIR's potential for greater contribution.