Anaesthesia of laboratory, aquaculture and ornamental fish: Proceedings of the first LASA-FVS Symposium.

Following on from the Annual Fish Veterinary Society Conference, this symposium was organised with the Laboratory Animal Science Association and brought together experts from ornamental (pond and aquarium) fish practice, aquaculture and aquatic-research facilities to discuss good practice of anaesthesia. This proceedings paper gives an overview of relevant experiences involving a range of immersion drugs including tricaine, benzocaine and isoeugenol, as well as a summary of the main topics of discussion. While fish anaesthesia is commonplace, administration methods, drugs and monitoring procedures may often be regarded as antiquated when compared with mammalian practice. These limitations notwithstanding, individual fish will benefit from good anaesthetic monitoring. Although the most common anaesthetic drugs may be perceived as equally efficacious and therefore interchangeable for different settings, challenges are different for the anaesthesia of grouped fish, when determining species-dependent anaesthetic dosing in a multi-species tank, or adapting to farming requirements, nationally licensed products, costs and withdrawal periods. The fish anaesthetic arsenal fails to address premedication, analgesia and issues of averseness. The two latter factors should be part of the evaluation of anaesthetic protocols; therefore, instructions for the analgesic provision of lidocaine to fin clipped zebrafish are proposed. Euthanasia practices could sometimes be refined too. Alternative physical methods such as electrical stunning are options to be considered.

Pleasant touch moderates the subjective but not objective aspects of body perception.

Un-myelinated C tactile afferents (CT afferents) are a key finding in affective touch. These fibers, which activate in response to a caress-like touch to hairy skin (CT afferents are not found in palm skin), may have more in common with interoceptive systems encoding body ownership, than afferent systems processing other tactile stimuli. We tested whether subjective embodiment of a rubber hand (measured through questionnaire items) was increased when tactile stimulation was applied to the back of the hand at a rate optimal for CT afferents (3 cm/s) vs. stimulation of glabrous skin (on the palm of the hand) or at a non-optimal rate (30 cm/s), which should not activate these fibers. We also collected ratings of tactile pleasantness and a measure of perceived limb position, proprioceptive drift, which is mediated by different mechanisms of multisensory integration than those responsible for feelings of ownership. The results of a multiple regression analysis revealed that proprioceptive drift was a significant predictor of subjective strength of the illusion when tactile stimuli were applied to the back of the hand, regardless of stroking speed. This relationship was modified by pleasantness, with higher ratings when stimulation was applied to the back of the hand at the slower vs. faster stroking speed. Pleasantness was also a unique predictor of illusion strength when fast stroking was applied to the palm of the hand. However, there were no conditions under which pleasantness was a significant predictor of drift. Since the illusion was demonstrated at a non-optimal stroking speed an integrative role for CT afferents within the illusion cannot be fully supported. Pleasant touch, however, does moderate the subjective aspects of the rubber hand illusion, which under certain tactile conditions may interact with proprioceptive information about the body or have a unique influence on subjective body perception.

The role of the environment in eliciting phantom-like sensations in non-amputees.

Following the amputation of a limb, many amputees report that they can still vividly perceive its presence despite conscious knowledge that it is not physically there. However, our ability to probe the mental representation of this experience is limited by the intractable and often distressing pain associated with amputation. Here, we present a method for eliciting phantom-like experiences in non-amputees using a variation of the rubber hand illusion in which a finger has been removed from the rubber hand. An interpretative phenomenological analysis revealed that the structure of this experience shares a wide range of sensory attributes with subjective reports of phantom limb experience. For example, when the space where the ring finger should have been on the rubber hand was stroked, 93% of participants (i.e., 28/30) reported the vivid presence of a finger that they could not see and a total of 57% (16/28) of participants who felt that the finger was present reported one or more additional sensory qualities such as tingling or numbness (25%; 7/28) and alteration in the perceived size of the finger (50%; 14/28). These experiences indicate the adaptability of body experience and share some characteristics of the way that phantom limbs are described. Participants attributed changes to the shape and size of their "missing" finger to the way in which the experimenter mimed stroking in the area occupied by the missing finger. This alteration of body perception is similar to the phenomenon of telescoping experienced by people with phantom limbs and suggests that our sense of embodiment not only depends on internal body representations but on perceptual information coming from peripersonal space.

Space perception and William James's metaphysical presuppositions.

William James's overtly philosophical work may be more continuous with his psychological work than is sometimes thought. His Essays in Radical Empiricism can be understood as an explicit statement of the absolute presupposition that formed the basis of Jamesian psychology: that direct experience is primary and has to be taken at face value. An examination of James's theory of space perception suggests that, even in his early work, he presupposed the primacy of direct experience, and that later changes in his account of space perception can be understood as making his view more consistent with this presupposition. In his earlier view of space perception, James argued that sensations were directly experienced as spatial, though he accepted that spatial relations between sensations may be constructed by higher order thought. In his later view, however, James argued that spatial relations were just as directly experienced as sensations. The work of T. H. Green may have prompted James to recognize the full consequence of his ideas and to realize that taking experience at face value required that spatial relations be thought of as intrinsic to experience rather than the result of intellectual construction.

Biases in the subjective timing of perceptual events: Libet et al. (1983) revisited.

We report two experiments in which participants had to judge the time of occurrence of a stimulus relative to a clock. The experiments were based on the control condition used by Libet, Gleason, Wright, and Pearl [Libet, B., Gleason, C. A., Wright, E. W., & Pearl, D. K. (1983). Time of conscious intention to act in relation to onset of cerebral activities (readiness-potential): The unconscious initiation of a freely voluntary act. Brain 106, 623-642] to correct for any bias in the estimation of the time at which an endogenous event, the conscious intention to perform a movement, occurred. Participants' responses were affected systematically by the sensory modality of the stimulus and by the speed of the clock. Such findings demonstrate the variability in judging the time at which an exogenous event occurs and, by extension, suggest that such variability may also apply to the judging the time of occurrence of endogenous events. The reliability of participants' estimations of when they formed the conscious intention to perform a movement in Libet et al.'s (1983) study is therefore questionable.

Hyperbaric oxygen as a treatment for malabsorption in a radiation-damaged short bowel.

Radiation enteritis can be challenging to diagnose and treat. We report the case of a 44-year-old woman who was diagnosed with a squamous cell carcinoma of the cervix in 1978 and treated with hysterectomy and post-operative radiotherapy. Over the next 20 years she required multiple intestinal operations resulting in short bowel syndrome. She became symptomatic of severe hypomagnesaemia which could not be corrected with oral supplementation and which required intravenous magnesium sulfate every 5-7 days for an 11-month period. However, following 25 sessions of hyperbaric oxygen therapy, she was able to discontinue intravenous magnesium and maintain her serum magnesium level with oral treatment. Her weight and stoma output improved. For over 4 years subsequent to this therapy she has not required further intravenous magnesium although has needed temporary nutritional support. Her case is complicated by vitamin A, B and D deficiencies.

Older people with enduring or recurrent severe mental illness in the Eastern Region of Ireland.

OBJECTIVES: There has been no specific planning for older people with enduring or recurrent severe mental illness in Ireland. This survey aims to identify the number of affected over 65 year olds (graduates) and 55-64 year olds (prospective graduates) in the Health Service Executive, Eastern Region, their diagnoses and their use of psychiatric services. METHOD: A comprehensive survey of the ten general adult psychiatry and four old age psychiatry services in the (HSE) Eastern Region was undertaken for the year 2003 to determine the number of patients, their diagnoses and service utilisation. RESULTS: 649 people over 65 years old were identified within the general adult psychiatry services and a further 279 within the old age psychiatry services giving a total of 928. (This number rose to 1141 after correcting for missing outpatient data.) 1,397 people between the ages of 55-64 were identified. (This number rose to 1,916 after correcting for missing outpatient data.) Conclusions: There are substantial numbers of 'graduates' and 'prospective graduates' in the Eastern Region. It is essential that services for this population are specifically planned for and further qualitative research is required to inform this process.

Older people with enduring or recurrent severe mental illness (graduates): A literature review.

OBJECTIVES: To review the literature on older people with enduring or recurrent severe mental illness with an onset earlier than 65 years (graduates) and, in particular, to look at the specific features and needs of this group. METHOD: A Medline literature search produced 41 relevant papers and reports on the subject. RESULTS: There are a substantial number of older people with severe mental illness and the number will rise in line with increased longevity. As they age these patients' psychiatric disabilities are compounded by medical and social problems. The move to community based care has largely ignored the needs of graduates who were previously cared for in psychiatric institutions. CONCLUSION: There is an urgent need to plan and develop adequate services for this vulnerable group.

Hyperbaric oxygen and radiotherapy.

BACKGROUND: Hyperbaric oxygen (HBO) therapy is the inhalation of 100% oxygen at a pressure of at least 1.5 atmospheres absolute (150 kPa). It uses oxygen as a drug by dissolving it in the plasma and delivering it to the tissues independent of hemoglobin. For a variety of organ systems, HBO is known to promote new vessel growth into areas with reduced oxygen tension due to poor vascularity, and therewith promotes wound healing and recovery of radiation-injured tissue. Furthermore, tumors may be sensitized to irradiation by raising intratumoral oxygen tensions. METHOD: A network of hyperbaric facilities exists in Europe, and a number of clinical studies are ongoing. The intergovernmental framework COST B14 action "Hyperbaric Oxygen Therapy" started in 1999. The main goal of the Working Group Oncology is preparation and actual implementation of prospective study protocols in the field of HBO and radiation oncology in Europe. RESULTS: In this paper a short overview on HBO is given and the following randomized clinical studies are presented: a) reirradiation of recurrent squamous cell carcinoma of the head and neck after HBO sensitization; b) role of HBO in enhancing radiosensitivity on glioblastoma multiforme; c) osseointegration in irradiated patients; adjunctive HBO to prevent implant failures; d) the role of HBO in the treatment of late irradiation sequelae in the pelvic region. The two radiosensitization protocols (a, b) allow a time interval between HBO and subsequent irradiation of 10-20 min. CONCLUSION: Recruitment of centers and patients is being strongly encouraged, detailed information is given on www.oxynet.org.

Barotrauma.

Barotrauma is pressure-induced injury. The application of direct pressure to the body may cause trauma, including positive pressure from artificial ventilation. Trauma may also be caused by the effects of pressure changes on gas-containing body spaces, not in communication with the environment. This can include the external ear, the middle ear (and, indirectly, the inner ear), the para-nasal sinuses, the lungs, the gut, and abscess cavities (for example, in the teeth). Gas may penetrate tissues adjoining the affected space (such as the anterior cranial fossa, via the ethmoid sinus), or may embolise via the blood stream. The most severe expression of this is cerebral arterial gas embolism, which may present as a stroke. The management of these problems includes prevention, the use of pressure-equalizing techniques, vasoconstrictor drugs, surgery, and hyperbaric oxygen therapy.

Transfer of route learning from virtual to real environments.

The authors investigated the extent to which route learning in a virtual environment (VE) transfers to the real world. In Experiment 1, active VE exploration, on its own or with a map, produced better transfer of training than either no VE training at all or passive VE training; however, transfer was achieved after shorter training times with the map. Experiment 2 demonstrated that VE + map training was not superior to training with a map alone, and Experiment 3 demonstrated that the poorer performances observed after passive VE training were not simply due to a lack of attention but to the lack of active navigational decisions. The authors concluded that the present VE technology does not provide better route learning than studying a map.

Performance of a skilled motor task in virtual and real environments.

Three experiments compared the performances of adult participants (three groups of 10) on a perceptuo-motor task in both real world (RW) and virtual environments (VEs). The task involved passing a hoop over a bent wire course, and three versions of the task were used: a 3-D wire course with no background, a flattened version of the 3-D course (2(1/2)-D course) with no background, and the 2(1/2)-D course with added background to provide spatial context. In all three experiments the participants had to prevent the hoop from touching the wire as they moved it. In the first experiment, the VE condition produced about 18 times more errors than the RW task. The VE 2(1/2)-D task was found to be as difficult as the 3-D, and the 2(1/2)-D with the added background produced more errors than the other two experiments. Taken together, the experiments demonstrate the difficulty of performing fine motor tasks in VEs, a phenomenon that has not been given due attention in many previous studies of motor control in VEs.

Can virtual reality be used to measure and train surgical skills?

The quantitative literature on the use of virtual environments to measure and train a variety of surgical skills is critically reviewed. We selected works from the years 1995-2000. Theoretical perspectives, such as those of Saltzman (1979), Bernstein (1967) and Schmidt (1975) and techniques, such as hierarchical task analysis, are presented and contrasted with the largely atheoretical approach of the practitioners of virtual surgery. It is concluded that the quantitative work discussed provides few findings of value to practising surgeons. This may be due in part to the lack of consideration paid to fundamental issues in the learning of motor skills, such as whether motor skills learning is most effective with varying training conditions and the distinction between purely motoric aspects and knowledge of procedures. Possible ways forward for surgical training are outlined. It is suggested that the theoretical perspectives and techniques available in the area of motor behaviour should be incorporated into future experimental studies of surgery in virtual environments.

On-Line Updating of Spatial Information Druing Locomotion Without Vision.

Two experiments are reported in which the control of locomotion without vision was investigated. In Experiment 1, subjects (N = 10) made similar, although less functional, locomotor adjustments when walking without vision to a target than they did when walking with vision. That result suggests that while walking without vision, the subjects updated their positions on-line with respect to a representation of the target rather than operating from a preformulated action plan. In Experiment 2, there was a significant weakening and loss of functionality of the locomotor adjustments when subjects (N = 10) had to walk without vision the correct distance to the target but in a direction opposite to its true location, as compared with when they walked without vision directly to the target. That finding suggests that the subjects were nonvisually updating their positions not with respect to an abstract representation of the target's distance but with respect to a representation of its relative location within the task environment.