Neural features of the reach and grasp

The concept of canonical representations within the motor system has been both supported and refuted using a variety of behavioral studies. Here, based upon neurophysiological data, I discuss the relationship amongst those neuronal substrates of action and the behavioral components of a movement. A novel view of reaching and grasping has been proposed which predicts that movements with similar kinematic and dynamic properties have a similar representation within the nervous system (Smeets & Brenner, 1999). However this is broadly inconsistent with a variety of neurophysiological findings that emphasize the independence amongst representations of action.

Association Between Continuing Education and Job Satisfaction of Nurses Employed in Long-Term Care Facilities

BACKGROUND

The purpose of this descriptive, correlational study was to investigate the relationship between continuing education and job satisfaction among RNs and licensed practical nurses (LPNs) employed in long-term care facilities.

METHOD

Herzberg's Motivational-Hygiene Theory was used as a framework to guide the design of the study. The Professional Educational Activities Scale and the McCloskey/Mueller Satisfaction Scale were completed by 110 nurses employed in long-term care facilities.

RESULTS

No difference was found between type of employment status (full-time versus part-time) on the level of professional educational activities. However, RNs participated in more continuing education activities than LPNs. Nurses who reported higher family incomes also had greater participation in educational activities. Registered nurses reported greater job satisfaction than LPNs. No significant difference was found between the degree of job satisfaction for Black and White nurses. The results of this study indicated nurses who participated in more continuing education activities scored higher on the job satisfaction scale.

CONCLUSION

As the elderly population increases, a critical need exists for nurses to be knowledgeable about current research-based information, including the economic and psychosocial effects of illness in later life. To provide the most effective care for the elderly population, nurses in long-term care must be knowledgeable about the complexity and specific characteristics of chronic illnesses. Continuing education activities are an important way to access this information.

Visuomotor adaptation during inactivation of the dentate nucleus

Recent experiments have suggested that the process of visuomotor adaptation depends on how a visual distortion is introduced. The cerebellum is thought to be involved in adapting to rapidly introduced visual distortions; however its role in adapting to a gradually introduced distortion is unknown. We tested adaptation to a sudden or a gradual introduction of a visual distortion, during reversible inactivation of a monkey's dentate nucleus. There was significant adaptation in both of these tasks without any lignocaine infusion and during saline infusions. However after inactivation the ability to adapt to either visual distortion was slightly impaired. This dysfunction was significant when the visuomotor distortion was introduced over several trials, suggesting that the cerebellum has a differential contribution to visual adaptation depending on the type of visuo-motor disturbance encountered.

Renocolic fistula: a case report

Renocolic fistulas are amongst the commonest causes of a renoalimentary fistula. We report a case in which the diagnosis was made on CT examination and confirmed by a barium study and at surgery. A review of literature on causes and investigation of renoalimentary fistulae is presented.

Multi-joint limbs permit a flexible response to unpredictable events

The human arm is kinematically redundant, which may allow flexibility in the execution of reaching movements. We have compared reaching movements with and without kinematic redundancy to unpredictable double-step targets. Subjects sat in front of a digitising tablet and were able to view an arc of four targets reflected in the mirror as virtual images in the plane of the tablet. They were instructed to move, from a central starting point, in as straight a line as possible to a target. In one-third of trials, the target light switched to one of its neighbours during the movement. Subjects made 60 movements using shoulder, elbow and wrist and then another 60 movements in which only shoulder and elbow movement were allowed. By restraining the wrist, the limb was made non-redundant. The path length was calculated for each movement. In single-step trials, there was no significant difference between path lengths performed with and without wrist restraint. As expected there was a significant increase in path length during double-step trials. Moreover this increase was significantly greater when the wrist was restrained. The variability across both single- and double-step movements was significantly less while the wrist was restrained. Importantly the performance time of the movements did not alter significantly for single-step, double-step or restrained movements. These results suggest that the nervous system exploits the intrinsic redundancy of the limb when controlling voluntary movements and is therefore more effective at reprogramming movements to double-step targets.

Can radiologists detect osteopenia on plain radiographs?

The main purpose of this study was to compare subjective estimates of vertebral ostepenia with bone mineral density (BMD) measurements of the same region in 200 (107 male, 93 female) subjects, aged 52-90 years, invited randomly from the community. Standardized plain thoracolumbar radiographs were examined by three senior radiologists, and given a semiquantitative osteopenia score using the method of Saville. The BMD of the anteroposterior (AP) lumbar spine and femoral neck was measured by dual energy X-ray absorptiometry. In addition BMD measurements were compared in subjects without significant vertebral deformity, and those with mild (20-25%) or definite (> 25%) reductions of vertebral height. For the Saville score, intraobserver agreement was moderate to good (kappa 0.46-0.57), and interobserver agreement was fair to moderate (kappa 0.25-0.41). Although the overlap between gradings was considerable, BMD was significantly related to visually estimated osteopenia. Subjects without apparent radiographic osteopenia (Saville grade 0) had a low risk (9-15%), compared to those with definite osteopenia (64-86%), of falling below the lowest quartile of BMD at either the femoral neck or the AP spine. In women (but not men), BMD measured at the hip and spine was related to vertebral deformity.

Computed tomography (CT) appearances of acute pancreatitis presenting as polyarthropathy with subcutaneous fat necrosis

A case of severe acute pancreatitis presenting with polyarthropathy and subcutaneous nodules but no abdominal pain is described. Abdominal CT showed multiple subcutaneous soft tissue densities which on histological examination were identified as areas of fat necrosis consistent with pancreatic disease. Such CT appearances have not been described previously.

Low-field (0.08 T) magnetic resonance imaging of the pancreas: comparison with computed tomography and ultrasound

Seventy-four patients referred for computed tomography (CT) and ultrasound examination with a presumptive diagnosis of pancreatic disease have been studied using a low-field (0.08 T) magnetic resonance (MR) imaging instrument. A further 50 patients being examined for non-pancreatic disease were also examined to assess the appearances of the normal pancreas. All the MR examinations were performed using an interleaved saturation-recovery/short inversion time (TI) inversion-recovery sequence. Part or all of the pancreas was seen in 96% of normal cases. In inflammatory disease, MR was more accurate than either CT or ultrasound for diagnosis, whilst for the demonstration of pancreatic tumours, MR was found to be no better or worse than either CT or ultrasound. The use of specific T1 measurement for soft-tissue characterization was not useful because of the large overlap in values between normal, inflamed and malignant pancreatic tissue. T1 measurement was found to be useful in differentiating different pathological fluids.

Abdominal pancreatic pseudocyst--an unusual cause of dysphagia

A 44 year old man with a long history of alcohol abuse developed progressive dysphagia. Radiological investigation revealed a pancreatic pseudocyst. Following percutaneous drainage the dysphagia resolved.

Role of computed tomography in assessing "operability" of bronchial carcinoma

To try to assess the accuracy of predicting "operability" (as defined by local policy) of bronchial carcinoma 300 patients underwent computed tomography of the thorax in a prospective study. The results of 141 patients showed an agreement between computed tomographic and surgical (including pathological) findings in those patients who had received operations. Most of the other patients had more advanced disease than suggested by the findings of computed tomography. A total of 118 patients did not receive operations: in 47 their disease was considered to be inoperable on the basis of computed tomographic findings alone, and this was accepted by the cardiothoracic surgeons after consultation. Thirty two other patients had further evidence of metastatic disease on other investigations. Computed tomography of the thorax should be performed early in the assessment of operability of patients with bronchial carcinoma and before the start of an extensive search for metastatic disease.

An assessment of intravenous urogram imaging using 100 mm and conventional films

A clinical trial was designed to compare the amount of useful diagnostic information obtained from the ten-minute (24 x 30 cm) film of an IVU when using either indirect (100 mm) or conventional radiography. The films for 50 patients were independently examined by ten radiologists. Eight observers considered conventional radiography to be significantly better than indirect (100 mm) radiography, P less than 0.05, and two observers considered that there was no significant difference. Possible applications of indirect radiography are briefly described.