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ABSTRACT Aim(s) Design Methods Results Conclusion Impact Patient and Public Contribution This study reports on the implementation of a registered advanced nurse practitioner intervention. Aims include improving access, service user outcomes and integration between primary and secondary care.This paper reports the quantitative results of a mixed methods implementation study. Qualitative data are reported separately. The PARiHS framework informs the implementation process itself, with considerations for nurses and other healthcare professionals explored.The CORE‐OM 34 item rating scale was administered both pre‐ and post‐intervention. Service user attendances in secondary care was monitored.Findings suggest that the intervention was associated with clinically significant improvements in global or generic distress, reported by service users, as evidenced by changes in the CORE‐OM scores. Access to care was recorded at an average of 3.6 days. Implementation science supported effective and safe implementation with clear governance structures.Registered advanced nurse practice in mental health clinics which provide full episodes of care results in improved integration and may be associated with positive patient outcomes. Implementation science is taught on Irish nursing programmes and this is important if innovative services are to be embedded in the healthcare system.The development of a model of care for mental health Registered Advanced Nurse Practitioners at the interface of primary and secondary care settings may be merited. Positive Advanced Recovery Connections may be associated with improving mental health outcomes and bolstering integration of primary and secondary care services. The utilisation of implementation science highlights the need for collaboration with all stakeholders to overcome barriers and recognise facilitators to attain the necessary model of integrated care.Peer recovery input was provided by members of the service Recovery College, with participation evident in all stages of the project. The psychosocial assessment template was also co‐designed. [ABSTRACT FROM AUTHOR]

Response of potential prey to the introduction of piscivores in a whole ecosystem is generally inferred from small-scale studies. Using distance sampling, two lakes that were initially without predators and three control lakes where predators were previously present were examined for the response of prey species to the introduction of brook trout ( Salvelinus fontinalis). Responses monitored included numerical changes in abundance, changes in habitat use patterns, and changes in the mean shoal sizes of potential prey species. No statistical changes in abundance or habitat use patterns were detected, whereas there was a significant increase in the mean shoal sizes of potential prey species in lakes where predators were added. We conclude that, in some natural systems, shoaling may be the first response potential prey initiate to reduce mortality risk. [ABSTRACT FROM AUTHOR]

The general case of analysis of embankment stability is examined with respect to an arbitrarily selected slip surface. [ABSTRACT FROM AUTHOR]

The macrocycle [2.1.1]-(2,6)-pyridinophane (L) binds to CuCI to give a monomeric molecule with tridentate binding of the ligand but in a distorted tetrahedral "3 + 1" geometry, where one nitrogen forms a longer (by 0.12 Å) bond to Cu. In dichloromethane solvent this pyridine donor undergoes facile site exchange with a second pyridine in the macrocycle, to give time-averaged mirror symmetry. Both experimental and density functional theory studies of the product of chloride abstraction, using NaBArF2 in CH2CI2, show that the Cu+ binds in a trigonal pyramidal, not planar, arrangement in LCu+. This illustrates the ability of macrocyclic ligand constraint to impose an electronically unfavorable geometry on 3-coordinate Cu(I). LCuBArF4 and a triflate analogue LCuI(OTf)readily react with oxygen in dichloromethane to produce, in the latter case, a hydroxo-bridged dimer [LCuII(µ-OH)]2(OTf)2, of the intact (unoxidized) ligand L. Since the analogous LCuCI does not react as fast with O2 in CH2CI2, outer-sphere electron transfer is concluded to be ineffective for oxidation of cuprous ion here. [ABSTRACT FROM AUTHOR]

To describe the relationship of the pronator teres, flexor carpi radialis, flexor digitorum superficialis, and flexor carpi ulnaris muscles to the medial collateral ligament at 30 degrees, 90 degrees, and 120 degrees of elbow flexion, we dissected 11 cadaveric specimens. The flexor carpi ulnaris muscle is the predominant musculotendinous unit overlying the medial collateral ligament in the majority of cases and is the only one at 120 degrees of elbow flexion. The flexor digitorum superficialis muscle is the only other significant contributor. The medial collateral ligament is the primary stabilizer of the medial elbow with elbow flexion greater than 30 degrees, as in throwing. The flexor carpi ulnaris muscle, because of its position directly over the medial collateral ligament, and the flexor digitorum superficialis muscle, with its near proximity and relatively large bulk, are the specific muscles best suited to provide medial elbow support. This is especially relevant to overhand throwing athletes who encounter extreme valgus force across the elbow during the cocking and acceleration phases of the throwing motion. Exercise and conditioning of the medial elbow musculature, specifically the flexor digitorum superficialis muscle and the flexor carpi ulnaris muscle, may prevent injury or assist in rehabilitation of medial elbow instability, especially in overhand throwing athletes. [ABSTRACT FROM AUTHOR]

The purpose of this study was to describe and compare electrical activity patterns in 12 shoulder muscles during the breaststroke in 25 competitive swimmers who had normal shoulders and in 14 who had painful shoulders while they performed this stroke in a pool. The electromyographic analysis was synchronized with high-speed cinematography to discern phases of the breaststroke. Means, standard deviations, and t-tests were done for each phase. The differences in muscle activity between the two groups of swimmers demonstrated an increase in the internal rotators in the group with painful shoulders. They also demonstrated a decrease in the teres minor, supraspinatus, and the upper trapezius muscles. These factors increase the risk of impingement. Both the serratus anterior and teres minor muscles in the swimmers with normal shoulders consistently fired at or above 15% manual muscle test throughout the breaststroke cycle and were thus subject to fatigue. Based on these results, exercises for the breaststroke swimmer should be directed toward endurance training of the serratus anterior and teres minor muscles while balancing the internal and external rotators of the shoulder as well as the deltoid and supraspinatus muscles. [ABSTRACT FROM AUTHOR]

Focuses on the use of the high-resolution powder x-ray diffraction in reporting the ab initio structure solutions, relating to the solvent which contains potassium phenoxides. Industrial importance of the carboxylation of alkali phenolates, known as Kolbe-Schmitt synthesis; Sublimation of phenol; Similarity of coordination of the potassium ions for both compounds; Information on these structure solutions.

Lateral epicondylitis occurs frequently in tennis players and appears to be caused by tears in the extensor aponeurosis. The purpose of this study was to compare the electromyographic activities of 5 muscles in players with lateral epicondylitis with those of injury-free players during the single-handed backhand tennis stroke. Fine-wire electrodes were placed into the extensor digitorum cummunis, extensor carpi radialis longus and brevis, pronator teres, and flexor carpi radialis muscles in competitive tennis players; 8 players had lateral epicondylitis and 14 had normal upper extremities. The backhand stroke then was recorded on high-speed film and synchronized with the electromyographic signal. The injured players had significantly greater activity for the wrist extensors and pronator teres muscles during ball impact and early follow-through. This activity increase may have been caused by the abnormal mechanics evident on film, including a 'leading elbow,' wrist extension and an open racquet face near the time of ball impact, and ball contact in the lower half of the strings. These mechanics not only result in a lower level of play but also leave the wrist extensors and the pronator teres muscles vulnerable to injury. This is the first study that documents increased activity in muscles that have been previously injured. [ABSTRACT FROM AUTHOR]

The purpose of this study was to describe and compare the muscle firing patterns of the muscles controlling the ankle during running. Fine-wire electrodes monitored the activity of the gastrocnemius, soleus, peroneus brevis, tibialis posterior, and tibialis anterior muscles during 3 paces of running. High-speed film was used to synchronize the electromyographic data with the phases of running. The subjects were 15 recreational and competitive runners who were injury-free. There were 3 significant findings. First, the firing patterns of all of the posterior muscles demonstrated peak activity during midstance phase. Thus, these muscles were contracting in an eccentric fashion to control ankle dorsiflexion as the center of gravity passed over the ankle. Second, the tibialis anterior muscle fired above the fatigue threshold for 85% of the time. This may account for the high number of fatigue-related injuries to the tibialis anterior muscle seen in runners. Third, there was a significant increase of activity in the peroneus brevis muscle as the pace increased. This indicates the importance of training this muscle when pace is increased. Using this information, a sport-specific effective and efficient exercise program for runners can developed. [ABSTRACT FROM AUTHOR]

Cereport™ (RMP-7) is a selective bradykinin B2 receptor agonist which increases the permeability of the 'blood-brain tumour barrier' (BBTB) to increase delivery of chemotherapeutic agents to brain tumours. A series of experiments was performed in an RG2 rodent model of glioma to evaluate and refine intravenous (i.v.) parameters to optimize Cereport's clinical utility. The first experiment demonstrated that while carboplatin levels were increased by twofold when given as a bolus during the Cereport infusion, no increase in carboplatin levels were seen when Cereport and carboplatin were simultaneously co-infused for 15 min. A subsequent experiment established that a major factor responsible for the lack of an effect with the co-infusion paradigm was tachyphylaxis to Cereport during the 15 min infusion, for a progressively diminished response to Cereport occurred over that time frame, as plasma levels of carboplatin were rising. A final experiment adjusted the timing of the Cereport and carboplatin infusions so that higher plasma carboplatin levels were achieved prior to initiating the Cereport infusion. Significant uptake effects were achieved when the carboplatin infusion preceded the Cereport infusion by 10 min (i.e. 5 min overlap in the delivery of the two agents). Collectively, these data provide the first systematic evaluation of dosing parameters involving receptor-mediated changes in BBTB permeability and provide new information regarding the pharmacodynamics and potential clinical use of Cereport. [ABSTRACT FROM AUTHOR]

Using dynamic surface electrode electromyography, we evaluated muscle activity in 13 male professional golfers during the golf swing. Surface electrodes were used to record the level of muscle activity in the right abdominal oblique, left abdominal oblique, right gluteus maximus, left gluteus maximus, right erector spinae, left erector spinae, upper rectus abdominis, and lower rectus abdominis muscles during the golfer's swing. These signals were synchronized electronically with photographic images of the various phases of the golf swing; the images were recorded in slow motion through motion picture photography. The golf swing was divided into five phases: take away, forward swing, acceleration, early follow-through, and late follow-through. Despite individual differences among the subjects' swings, we observed reproducible patterns of trunk muscle activity throughout all phases of the golf swing. Our findings demonstrate the importance of the trunk muscles in stabilizing and controlling the loading response for maximal power and accuracy in the golfer's swing. This study provides a basis for developing a rehabilitation program for golfers that stresses strengthening of the trunk muscles and coordination exercises. [ABSTRACT FROM AUTHOR]

This study descibes the fine-wire electromyographic profile of the normal knee. Twenty-two subjects with no prior history of knee injury volunteered for the study. Each subject had fine-wire electromyographic evaluation of 8 muscles (vastus medialis oblique, vastus lateralis, rectus femoris, semimembranosus, biceps femoris, tibialis anterior, gastrocnemius, and soleus muscles) while performing 7 functional activities. The percentage of maximum manual test for each muscle during each phase of the activities was used to determine means and standard deviations for the group. Walking and ramp and stair ascending and descending produced similar electromyographic profiles. Running and cross-cutting demonstrated unique electromyographic profiles with an overall higher muscle activity than the previous 5 activities. A quadriceps-hamstrings muscles' coordinated response was identified consistently in each activity. These findings illustrate the integral nature of each of the 8 examined muscles in knee motion. Furthermore, this study demonstrates a coordinated response of quadriceps-hamstrings muscles in the normal knee and may more thoroughly define the coordinated activity of these 2 antagonist muscle groups. Finally, this study provides a framework within which various knee conditions can be compared and from which specific rehabilitation recommendations can be generated. [ABSTRACT FROM AUTHOR]

This study compared the electromyographic activity of normal (N=22), rehabilitated anterior cruciate ligament-deficient (N=8), and -reconstructed knees (N=10) while subjects performed activities. Each subject had evaluation of 8 muscles during 7 functional activities. Sixty-seven percent of the differences in the quadriceps muscle reflected increased activity in the vastus lateralis muscle of the rehabilitated group; 75% of the differences in the hamstrings muscles noted increased biceps femoris muscle activity in the rehabilitated group; 56% of the differences in the lower leg musculature showed increased tibialis anterior muscle activity in the rehabilitated group. Eighty-six percent of the statistically different intervals involved rehabilitated subjects demonstrating increased activity over reconstructed or normal subjects or both. The presence of a quadriceps-hamstrings muscles coordinated response was identified consistently in all 3 groups in each activity. This study supports surgical reconstruction for the anterior cruciate ligament-deficient knee. It also demonstrates the importance of the vastus lateralis, biceps femoris, and tibialis anterior musculature in the rehabilitation of the anterior cruciate ligament-deficient patient. The presence of a quadriceps-hamstrings muscles coordinated response indicates that mechano-receptors mediating this reflex arc exist in structures other than the cruciate ligament. [ABSTRACT FROM AUTHOR]

It is generally believed that tennis players using a double-handed backhand rarely develop lateral epicondylitis since the helping arm appears to absorb more energy and changes the mechanics of the swing. The purpose of this paper was to compare muscle activity about the elbow in single- and double-handed backhand strokes in competitive tennis players. Muscle activity in 3 elbow extensors, a wrist flexor, and a forearm pronator of the dominant arm was compared during the single-handed (N=14) and double-handed (N=13) backhand ground strokes using indwelling electromyography and high-speed cinematography. Significantly higher activity was seen in the double-handed technique in the flexor carpi radialis muscle in the preparation phase and in the pronator teres muscle in the acceleration phase. Higher flexor carpi radialis muscle activity in preparation of the double-handed stroke appeared to be a function of the double-handed grip used on the racquet, and the increased pronator teres muscle activity in acceleration indicated maintenance of greater pronation provided by the grip of the nondominant hand. The decreased occurrence of lateral epicondylitis in players using a double-handed backhand may not be caused by decreased extensor activity, but rather by factors associated with flawed stroke mechanics more often seen in the single-handed technique. [ABSTRACT FROM AUTHOR]

Electromyography and high-speed film were used to examine the muscle activity in the elbows of pitchers with medial collateral ligament insufficiency compared to the activity in uninjured elbows. Ten competitive baseball pitchers with medial collateral insufficiency and 30 uninjured competitive pitchers were tested while throwing the fastball and the curveball. The extensor carpi radialis brevis and longus in the injured pitchers showed greater activity than in the uninjured pitchers for both pitches. The triceps, flexor carpi radialis, and pronator teres all showed less activity in the injured pitchers during the fastball, but only the triceps had less activity during the curveball. The differences were seen during the late cocking and acceleration phases, which place the greatest stress on the medial collateral ligament. If the flexor carpi radialis and pronator teres were substituting for the deficient medial collateral ligament and functioning as dynamic stabilizers, one would expect enhanced muscle activity. However, the opposite was found. This pattern of asynchronous muscle action with medial collateral ligament injury may predispose the joint to further injury. The muscular differences seen are critical to the understanding of the pathomechanics of patients with medial collateral ligament deficiency, and provide a basis for rehabilitation. [ABSTRACT FROM AUTHOR]