An instrumented cylinder measuring pinch force and orientation

Background: The function of a cylinder allowing simultaneous measurements of the opposition axis of the index finger and thumb of the hand and the magnitude of pinch force is described.\ud Methods: The apparatus is made of two half-cylinders that are bonded together through a 6-axis force/torque sensor and allows the measurement of 3D orthogonal forces and moments of force. The amplitude of the pinch force exerted on the cylinder by the fingers is defined as the resultant of the forces in the different axes. A software program was developed to measure the barycentre of the forces on the instrumented cylinder, allowing calculation of the angle of the opposition axis between the fingers and the location of the resulting pinch force on the cylinder, assuming that the pinch or grip forces are co-linear through the center of the cylinder.\ud In order to assess the validity and reliability of the measurements, the cylinder was mounted on a milling table and seven calibrated weights (from 100 to 500 g) were successively applied perpendicularly to a 9*9 matrix of sites separated by 1 cm. With the exception of the extreme lateral parts of the cylinder, the dispersion of the calculated vertical position of the resulting force was always within 1 mm of the application point, suggesting a high reliability of these measurements. In addition, the errors in the angles of the applied force were calculated and found to be less than 2 degree with no clear patterns of variation across the different locations of the cylinder.\ud Results: The usefulness of the cylinder is demonstrated by evaluating the pinch force and the opposition axis in six healthy subjects lifting the cylinder from the table using three different orientations of their right hand. The magnitude of the grip force was not significantly different across orientations (45, 22 and -22 degrees relative to the midline of the subject) suggesting that force grip is controlled.\ud Conclusion: From these results, it has been concluded that the cylinder is a valid, reliable and precise instrument that may prove useful for evaluating opposition axis and grip force in healthy and pathological populations

Myocarditis related to Campylobacter jejuni infection: A case report

BACKGROUND: Myocarditis can develop as a complication of various infections and is most commonly linked to enterovirus infections. Myocarditis is rarely associated with bacterial infections; salmonellosis and shigellosis have been the most frequently reported bacterial cause. We report a case of myocarditis related to Campylobacter jejuni enteritis. CASE PRESENTATION: A 30-year-old previously healthy man presented with a history of prolonged chest pain radiating to the jaw and the left arm. Five days prior to the onset of chest pain, he developed bloody diarrhea, fever and chills. Creatine kinase (CK) and CK-MB were elevated to 289 U/L and 28.7 μg/L. Troponin I was 30.2 μg/L. The electrocardiogram (ECG) showed T wave inversion in the lateral and inferior leads. The chest pain resolved within 24 hours of admission. The patient had a completely normal ECG stress test. The patient was initiated on ciprofloxacin 500 mg po bid when Campylobacter jejuni was isolated from the stool. Diarrhea resolved within 48 hours of initiation of ciprofloxacin. The diagnosis of Campylobacter enteritis and related myocarditis was made based on the clinical and laboratory results and the patient was discharged from the hospital in stable condition. CONCLUSION: Myocarditis can be a rare but severe complication of infectious disease and should be considered as a diagnosis in patients presenting with chest pain and elevated cardiac enzymes in the absence of underlying coronary disease. It can lead to cardiomyopathy and congestive heart failure. There are only a few reported cases of myocarditis associated with Campylobacter infection

Struggling for recognition and inclusion—parents' and pupils' experiences of special support measures in school

During the last decade an increasing use of differentiated support measures for pupils with special educational needs, indicative of a discrepancy between educational policies and practices, has been witnessed in Sweden. Another trend has been the increased use of medical diagnoses in school. The aim of this study was to explore the main concern of support given to pupils with special educational needs and how pupils and parents experience and handle this. Interviews were conducted with eight pupils in Grades 7–9—and their parents—at two compulsory schools in a city in northern Sweden. A grounded theory approach was used for analyzing the interview data. A conceptual model was generated illuminating the main concern of special support measures for pupils and parents. The core category of the model, struggling for recognition and inclusion, was related to two categories, which further described how this process was experienced and handled by the participants. These categories were labeled negotiating expertise knowledge within a fragmented support structure and coping with stigma, ambivalence, and special support measures. The developed conceptual model provides a deeper understanding of an ongoing process of struggle for recognition and inclusion in school as described by the pupils and parents

Predicting the Effect of Surface Texture on the Qualitative Form of Prehension

Reach-to-grasp movements change quantitatively in a lawful (i.e. predictable) manner with changes in object properties. We explored whether altering object texture would produce qualitative changes in the form of the precontact movement patterns. Twelve participants reached to lift objects from a tabletop. Nine objects were produced, each with one of three grip surface textures (high-friction, medium-friction and low-friction) and one of three widths (50 mm, 70 mm and 90 mm). Each object was placed at three distances (100 mm, 300 mm and 500 mm), representing a total of 27 trial conditions. We observed two distinct movement patterns across all trials—participants either: (i) brought their arm to a stop, secured the object and lifted it from the tabletop; or (ii) grasped the object ‘on-the-fly’, so it was secured in the hand while the arm was moving. A majority of grasps were on-the-fly when the texture was high-friction and none when the object was low-friction, with medium-friction producing an intermediate proportion. Previous research has shown that the probability of on-the-fly behaviour is a function of grasp surface accuracy constraints. A finger friction rig was used to calculate the coefficients of friction for the objects and these calculations showed that the area available for a stable grasp (the ‘functional grasp surface size’) increased with surface friction coefficient. Thus, knowledge of functional grasp surface size is required to predict the probability of observing a given qualitative form of grasping in human prehensile behaviour

Comparison between REBT and Visual/Kinaesthetic Dissociation in the Treatment of Panic Disorder: An Empirical Study

The aim of this study was to test the efficacy of two brief treatment methods for panic disorder: Rational Emotive Behaviour Therapy (REBT) and Visual/Kinaesthetic Dissociation (VKD), neither of which have been the object of scientific enquiry. The study is a two-way between-groups pre-test/post-test experimental design with baseline and follow-up measures. An innovative four-session treatment protocol was developed for each treatment method. Eighteen participants in North-East Surrey, England, who responded to media advertisements for cognitive-behavioural treatment for panic disorder and who met Diagnostic and Statistical Manual of Mental Disorders criteria for panic disorder with or without agoraphobia were randomly assigned to either REBT or VKD. Pre-test/post-test changes in panic were measured using the ACQ, PASQ, and HADS scales and a global panic rating measure. At post-test there was a statistically significant improvement on all measures for both groups, which was maintained at one-month follow-up. Taking into consideration limitations such as the small sample size and a short follow-up period, implications of this study and recommendations for future research are discussed

Estimating the Relevance of World Disturbances to Explain Savings, Interference and Long-Term Motor Adaptation Effects

Recent studies suggest that motor adaptation is the result of multiple, perhaps linear processes each with distinct time scales. While these models are consistent with some motor phenomena, they can neither explain the relatively fast re-adaptation after a long washout period, nor savings on a subsequent day. Here we examined if these effects can be explained if we assume that the CNS stores and retrieves movement parameters based on their possible relevance. We formalize this idea with a model that infers not only the sources of potential motor errors, but also their relevance to the current motor circumstances. In our model adaptation is the process of re-estimating parameters that represent the body and the world. The likelihood of a world parameter being relevant is then based on the mismatch between an observed movement and that predicted when not compensating for the estimated world disturbance. As such, adapting to large motor errors in a laboratory setting should alert subjects that disturbances are being imposed on them, even after motor performance has returned to baseline. Estimates of this external disturbance should be relevant both now and in future laboratory settings. Estimated properties of our bodies on the other hand should always be relevant. Our model demonstrates savings, interference, spontaneous rebound and differences between adaptation to sudden and gradual disturbances. We suggest that many issues concerning savings and interference can be understood when adaptation is conditioned on the relevance of parameters