Kicking footedness and movement discrimination by elite australian rules footballers

Kicking a football accurately with a certain velocity over a desired distance is dependent upon the speed of the kicking foot and the quality of contact between the foot and ball. Control of the swinging lower leg is critical to these factors and the overall performance of the kick, and this was assessed in 20 Australian Football League players. Assessment of movement extent discrimination of the swinging leg was made while standing on the other leg. An automated device accurately set a stop plate to five different positions and each subject was asked to swing the leg to the plate, and make a non-visual judgment of the movement extent. Forty forward and forty backward swings of each leg were assessed, and based on a subject's responses, non-parametric signal detection analysis resulted in a movement extent discrimination score. For left leg performance, coach ratings of overall kicking ability were correlated with movement discrimination ability. Left-foot kickers (0.83) had a higher movement discrimination score than right-foot kickers (0.77), and had a significantly higher score on their dominant side, whereas right-footers had no left-right side difference. Rating of kicking ability by coaches also reflected this difference between the dominant leg performance of left- and right-footers. These data showed left-foot kickers to have higher movement discrimination ability with their dominant leg, and this may be related to their on-field kicking ability.

Contractures in the post-stroke wrist: a pilot study of its time course of development and its association with upper limb recovery

BACKGROUND

Contractures are common in a stroke population, yet there is little information on the time course of development.

OBJECTIVES

Investigate quantitatively changes associated with contracture formation in an acute stroke population.

STUDY DESIGN

Longitudinal study on 22 subjects who were 2-4 weeks post stroke.

OUTCOME MEASURES

Contractures were assessed by quantifying the resting posture, resistance to passive movement and passive range of movement. Upper limb function was measured using the Action Research Arm Test and the Nine-Hole Peg Test. Active range of extension, wrist extension strength (isometric), grip strength and neglect were also measured. REPEATED MEASURES: Following an initial assessment, repeated measurements were taken at 4, 8, 20 and 32 weeks after recruitment.

RESULTS

Two distinct subgroups, one capable of some functional movement (F group; 8 subjects) and another which was not (NF group; 14 subjects), were identified at the start of the study. The NF group showed changes associated with contracture formation at the wrist, i.e., reduction in the passive range of movement, an increase in resistance to passive movement and a worsening of the flexion posture. Changes were observed from the time of recruitment even though neglect improved. The F group showed improvements in upper limb function and there was no evidence to support contracture formation.

CONCLUSIONS

Subjects most prone to contracture formation were those who showed no signs of early functional recovery (2-4 weeks after the stroke). Changes consistent with adaptive shortening were seen from week 4 of the study period.

Effects of dietary tallow level on performance of Alpine does in early lactation

Sixty Alpine does (initial BW 47+/-1.3kg) were used to determine effects of dietary inclusion of different levels of partially hydrogenated tallow on performance in early lactation (weeks 3-11). Treatments entailed a 30% concentrate, negative control (NC) diet and five diets higher in concentrate (42-46%) with 0, 1.5, 3.0, 4.5 or 6.0% DM of partially hydrogenated tallow (0T, 1.5T, 3.0T, 4.5T and 6.0T, respectively). DM intake was 1.54kg per day for the NC and 1.86, 1.80, 1.99, 2.17 and 1.96kg per day for the five tallow treatments, respectively, BW was similar among treatments and increased as the trial progressed (47.4, 48.4, 49.8, 50.4, 50.8 and 51.3kg at weeks 3, 5, 7, 9, 11 and 13, respectively). Milk yield was lower (P<0.05) for NC (2.61kg per day) compared with the mean of the other diets and changed quadratically (P<0.05) as tallow level increased (2.85, 3.08, 3.14, 3.21 and 2.69kg per day for the five tallow treatments, respectively). Milk fat concentration was lower (P<0.05) for NC (2.94%) than for the mean of other diets and increased linearly (P<0.05) with increasing tallow level (3.00, 3.17, 3.34, 3.48 and 3.58%) whereas, milk protein concentration was not affected by level of tallow (2.72, 2.80, 2.93, 2.85, 2.90 and 2.90% for NC, and the five tallow treatments, respectively). The estimated NE(l):4% fat-corrected milk yield ratio was 0.93Mcal/kg for NC and 1.30, 1.11, 1.21, 1.37 and 1.44Mcal/kg for the five tallow treatments, respectively. The results indicated that in Alpine does, milk yield in early lactation increased as dietary tallow level was increased to 3 and 4.5% but decreased when the level was increased to 6%, although milk fat concentration increased linearly and the protein level was unchanged. These results suggest beneficial usage by lactating Alpine does of low to moderate levels of partially hydrogenated tallow in diets moderate in concentrate level, although ingredient availability and costs will influence ultimate dietary ingredient decisions.

Behavioral risk management. A partnership between occupational health nursing and occupational psychiatry

1. The estimated prevalence of behavioral disorders among adults in the United States is 29.5%, affecting more than 52 million individuals each year. 2. Numerous or persistent problems in work performance increase the likelihood of either a psychiatric illness or unresolved psychosocial factors. Assessing work functions can help identify individuals early on with potential warning signs for employment problems. 3. Occupational health nurses can partner with occupational psychiatrists to clarify the complex scenarios that present to companies and recommend intervention. 4. Proactive intervention for employees, an effective team, and input and participation from the various stakeholders can produce positive outcomes for both the employee and the employer.

Effects of dietary protein concentration on postweaning growth of Boer crossbred and Spanish goat wethers

Boer (3/4) x Spanish (1/4) (BC; n = 23) and Spanish (SP; n = 22) goat wethers, 4 to 4.5 mo of age and 17.6 and 19.4 kg initial BW, respectively (SE = 0.57), were used to determine effects on growth of protein concentration in 70% concentrate diets provided for ad libitum intake for 30 wk in confinement. Offered diets contained 10.2, 14.2, 18.3, and 23.6% CP (DM basis), and CP concentration in consumed DM was 9.3, 13.8, 17.1, and 22.1% (P1, P2, P3, and P4, respectively); supplemental protein was from soybean meal for P1 and P2 and from soybean meal plus a blend of blood, fish, and feather meals for P3 and P4. Dry matter intake was similar between breeds and among diets (732, 712, 698, and 740 g/d for P1, P2, P3, and P4, respectively; SE = 27.0). Average daily gain was greater for P2 (P = 0.07) and P4 (P < 0.05) than for P1 (76, 90, 85, and 100 g/d for P1, P2, P3, and P4, respectively; SE = 5.3) and for BC than for SP (97 vs 78 g/d, SE = 3.7; P = 0.05). Similarly, ADG:DMI was lowest (P < 0.05) among diets for P1 (0.106, 0.126, 0.121, and 0.132 for P1, P2, P3, and P4, respectively; SE = 0.0053) and greater (P < 0.05) for BC than for SP (0.135 vs 0.108; SE = 0.0037). In conclusion, with 70% concentrate diets, the protein requirement for both BC and SP seemed to have been met by consumption of diets with at least 14% CP, with no apparent benefit from addition of ruminally undegraded protein.

Lactic acidosis and hepatic steatosis associated with use of stavudine: report of four cases

BACKGROUND

An association between use of zidovudine and didanosine and a rare but life-threatening syndrome of hepatic steatosis, lactic acidosis, and myopathy has been reported.

OBJECTIVE

To describe the syndrome of hepatic steatosis, lactic acidosis, and myopathy in four patients taking stavudine.

DESIGN

Case series.

SETTING

A community hospital in Washington, D.C., and National Institutes of Health Clinical Center, Bethesda, Maryland.

PATIENTS

Two men and two women with HIV-1 infection who were taking stavudine presented with lactic acidosis and elevated levels of aminotransferases. All patients required intensive care.

MEASUREMENTS

Levels of lactic acid, alanine aminotransferase, aspartate aminotransferase, amylase, and lipase; computed tomography of the abdomen; liver biopsy (two patients); and muscle biopsy (two patients).

RESULTS

Histologic findings consistent with mitochondrial injury confirmed the diagnosis of hepatic or muscle abnormality.

CONCLUSION

Because hepatic steatosis may be life-threatening, physicians should consider it as a possible cause of elevated hepatic aminotransferase levels among patients taking stavudine.

Strategic human resource management: redefining the role of the manager and worker

Health-care managers have long been sensitive to the importance of physical resources (technology, space) and financial resources to the success of service delivery. During the last several decades, the value and potential for development of a third element, the human resource has gained new recognition. The importance of viewing personnel as an expandable resource, addressed in an organization's strategic plan, is crucial to meet challenges faced in a rapidly changing health-care environment.

Young clients' exposure to community violence: how much do their therapists know?

Although experiences of community violence are widespread and may have deleterious psychosocial consequences for children and youth, results of this exploratory study indicate that therapists lack substantial knowledge of their young clients' exposure to such violence. These findings suggest a need for professionals to adopt strategies to assess more systematically the role of community violence exposure in the problems presented by youth.

Electrical stimulation of wrist extensors in poststroke hemiplegia

BACKGROUND AND PURPOSE

It has been suggested that cyclic neuromuscular electrical stimulation (ES) may enhance motor recovery after stroke. We have investigated the effects of ES of the wrist extensors on impairment of wrist function and on upper-limb disability in patients being rehabilitated after acute stroke.

METHODS

We recruited 60 hemiparetic patients (mean age, 68 years) 2 to 4 weeks after stroke into a randomized, controlled, parallel-group study comparing standard rehabilitation treatment with standard treatment plus ES of wrist extensors (3 times 30 minutes daily for 8 weeks). Isometric strength of wrist extensors was measured using a device built for that purpose. Upper-limb disability was assessed with use of the Action Research Arm Test (ARAT). Observations were continued for 32 weeks (24 weeks after the finish of ES or the control intervention phase).

RESULTS

The change in isometric strength of wrist extensors (at an angle of 0 degrees extension) was significantly greater in the ES group than the control group at both 8 and 32 weeks (P=0.004, P=0.014 by Mann Whitney U test). At week 8 the grasp and grip subscores of the ARAT increased significantly in the ES group compared with that in the control group (P=0.013 and P=0.02, respectively); a similar trend was seen for the total ARAT score (P=0.11). In the subgroup of 33 patients with some residual wrist extensor strength at study entry (moment at 0 degrees extension >0), the ARAT total score had increased at week 8 by a mean of 21.1 (SD, 12.7) in the ES group compared with 10.3 (SD, 9.0) in the control group (P=0.024, Mann Whitney U test); however, at 32 weeks the differences between these 2 subgroups were no longer statistically significant.

CONCLUSIONS

ES of the wrist extensors enhances the recovery of isometric wrist extensor strength in hemiparetic stroke patients. Upper-limb disability was reduced after 8 weeks of ES therapy, with benefits most apparent in those with some residual motor function at the wrist. However, it is not clear how long the improvements in upper-limb disability are maintained after ES is discontinued.

TCR alpha beta chains associate with the plasma membrane independently of CD3 and TCR zeta chains in murine primary T cells

The TCR is a multisubunit complex composed of the clonotypic alpha/beta disulfide-linked heterodimer and noncovalently linked invariant CD3 gamma epsilon and CD3 delta epsilon and TCR zeta chains. Recent studies demonstrate that the surface expression of CD3 components can occur independently of the clonotypic TCR complexes in both thymocytes and splenic T cells. In this study, we report that free noncovalently associated TCR alpha beta heterodimers that exist independently of CD3 and TCR zeta chains are expressed on the cell surface of immature thymocytes and peripheral T cells, but not of T cell lines and T cell hybridomas. This suggests that the regulation of surface expression of TCR alpha beta heterodimers differs between primary T cells and T cell lines or T cell hybridomas. The isolation and biochemical characterization of surface clonotype-independent CD3 complexes and free membrane-associated TCR alpha beta complexes may provide a structural basis for the quantitative difference in amount of T cell proliferation stimulated by anti-CD3 epsilon and anti-TCR beta.

The natural history of the anterior cruciate ligament-deficient knee. Changes in synovial fluid cytokine and keratan sulfate concentrations

Restoring knee stability through reconstruction, while providing symptomatic relief, has not been shown to decrease the incidence of degenerative changes after rupture of the anterior cruciate ligament. This suggests that posttraumatic osteoarthritis may not be purely biomechanical in origin, but also biochemical. To test this, we measured the levels of seven cytokine modulators of cartilage metabolism in knee joint synovial fluid after anterior cruciate ligament rupture. We also measured keratan sulfate, a product of articular cartilage catabolism. The sample population consisted of patients with uninjured knee joints (N = 10), and patients with acute (N = 60), subacute (N = 18), and chronic (N = 8) anterior cruciate ligament-deficient knees. Synovial fluid samples were analyzed by enzyme-linked immunosorbent assays. Normal synovial fluids contained high levels of the interleukin-1 receptor antagonist but low concentrations of other cytokines. Immediately after ligament rupture there were large increases in interleukins 6 and 8, tumor necrosis factor alpha, and keratan sulfate. Interleukin-1 levels remained low throughout the course. As the injury became subacute and then chronic, interleukin-6, tumor necrosis factor-alpha, and keratan sulfate levels fell but remained considerably elevated 3 months after injury. Concentrations of interleukin-1Ra fell dramatically. Granulocyte-macrophage colony-stimulating factor concentrations were normal acutely and subacutely but by 3 months after injury were elevated 10-fold. Our data reveal a persistent and evolving disturbance in cytokine and keratan sulfate profiles within the anterior cruciate ligament-deficient knee, suggesting an important biochemical dimension to the development of osteoarthritis there.

Impaired plasma membrane targeting of Grb2-murine son of sevenless (mSOS) complex and differential activation of the Fyn-T cell receptor (TCR)-zeta-Cbl pathway mediate T cell hyporesponsiveness in autoimmune nonobese diabetic mice

Nonobese diabetic (NOD) mouse thymocytes are hyporesponsive to T cell antigen receptor (TCR)-mediated stimulation of proliferation, and this T cell hyporesponsiveness may be causal to the onset of autoimmune diabetes in NOD mice. We previously showed that TCR-induced NOD T cell hyporesponsiveness is associated with a block in Ras activation and defective signaling along the PKC/Ras/MAPK pathway. Here, we report that several sequential changes in TCR-proximal signaling events may mediate this block in Ras activation. We demonstrate that NOD T cell hyporesponsiveness is associated with the (a) enhanced TCR-beta-associated Fyn kinase activity and the differential activation of the Fyn-TCR-zeta-Cbl pathway, which may account for the impaired recruitment of ZAP70 to membrane-bound TCR-zeta; (b) relative inability of the murine son of sevenless (mSOS) Ras GDP releasing factor activity to translocate from the cytoplasm to the plasma membrane; and (c) exclusion of mSOS and PLC-gamma1 from the TCR-zeta-associated Grb2/pp36-38/ZAP70 signaling complex. Our data suggest that altered tyrosine phosphorylation and targeting of the Grb2/pp36-38/ZAP70 complex to the plasma membrane and cytoskeleton and the deficient association of mSOS with this Grb2-containing complex may block the downstream activation of Ras and Ras-mediated amplification of TCR/CD3-mediated signals in hyporesponsive NOD T cells. These findings implicate mSOS as an important mediator of downregulation of Ras signaling in hyporesponsive NOD T cells.

Assessing the impact of community violence on children and youths

Social workers often encounter young clients who have been exposed to violence in their communities. Although the devastating effects of community violence have been well documented, surprisingly little concern in social work practice has been focused on attending to young clients' experiences with community violence. This article explores the manifestations and consequences of community violence in the lives of children and youths and presents an assessment framework with which social workers may examine the impact of community violence in the lives of their young clients at risk.

Multidisciplinary management--an opportunity for service integration

The management team of the future will enter an environment requiring facilitation, participation, clinical, and empowerment skills. Those individuals who possess a clinical orientation as well as business expertise will be sought to manage multidisciplinary units. The rapid changes in the health-care environment have forced organizations to restructure their operations. To achieve quality care, customer satisfaction, cost-effectiveness, and efficiency, service integration across the organization will be required. As we approach the 21st century, this standard will evolve until "all levels are managing patient care." Some of the restructuring trends occurring in the health-care industry have been collaboration service integration, management consolidation, and job elimination. The emphasis for the multidisciplinary manager of the future will include integrating the professional and clinical services, managing information, building community partnerships, promoting physician collaboration, and managing the change process. A model organization in the next century will move toward a people-oriented system with inclusion and empowerment initiatives. Service integration will affect all organizations, but the disciplines within the Clinical Support System will be the most affected. Future opportunities of leadership will exist for pathologists, nurses, or medical technologists as the professional silos of managers and clinicians continue to crumble.

Cost implications of allergy and recent Canadian research findings

The cost to hospital's managing latex allergy problems, and of instituting a co-operative response to the problem is estimated, and compared with the estimated cost of ignoring the problem. The costs and benefits of the interventional strategies, i.e. complete elimination of powdered latex gloves in favour of powder free latex gloves, are described in detail. It is demonstrated that the chosen interventional strategy not only reduced overall costs, but surprisingly, also reduced glove purchase costs.