Development of motor system dysfunction following whiplash injury

Dysfunction in the motor system is a feature of persistent whiplash associated disorders. Little is known about motor dysfunction in the early stages following injury and of its progress in those persons who recover and those who develop persistent symptoms. This study measured prospectively, motor system function (cervical range of movement (ROM), joint position error (JPE) and activity of the superficial neck flexors (EMG) during a test of cranio-cervical flexion) as well as a measure of fear of re-injury (TAMPA) in 66 whiplash subjects within 1 month of injury and then 2 and 3 months post injury. Subjects were classified at 3 months post injury using scores on the neck disability index: recovered (30). Motor system function was also measured in 20 control subjects. All whiplash groups demonstrated decreased ROM and increased EMG (compared to controls) at 1 month post injury. This deficit persisted in the group with moderate/severe symptoms but returned to within normal limits in those who had recovered or reported persistent mild pain at 3 months. Increased EMG persisted for 3 months in all whiplash groups. Only the moderate/severe group showed greater JPE, within 1 month of injury, which remained unchanged at 3 months. TAMPA scores of the moderate/severe group were higher than those of the other two groups. The differences in TAMPA did not impact on ROM, EMG or JPE. This study identifies, for the first time, deficits in the motor system, as early as 1 month post whiplash injury, that persisted not only in those reporting moderate/severe symptoms at 3 months but also in subjects who recovered and those with persistent mild symptoms. (C) 2002 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.

Motor and functional skills of children with developmental coordination disorder: A pilot investigation of measurement issues

This paper reports on the motor and functional outcomes of 20 children with developmental coordination disorder (DCD) aged 4-8 years consecutively referred to a pediatric physiotherapy service. Children with a Movement ABC (M-ABC) score less than the 15th percentile, and with no concurrent medical, sensory, physical, intellectual or neurological impairments, were recruited. The Motor Assessment Outcomes Model (MAOM) [Coster and Haley, Infants and Young Children 4 (1992) 11] provided the theoretical base for measurement selection, and preliminary findings at the activities and participation levels of the model are reported in this article. Children with DCD performed at the lower end of the normal range on the Pea-body Developmental Motor Scales (fine motor total score) (M = 85.65, SD = 12.23). Performance on the Visual Motor Integration Test (VMI) standard scores was within the average range (M = 96.15, SD = 10.69). Videotaped observations of the children's writing and cutting indicated that 29% were left-handed and that a large proportion of all children (31%) utilized unusual pencil grasp patterns and immature prehension of scissors. Measurement at the participation level involved use of the Pictorial Scale of Perceived Competence and Social Acceptance (PCSA) and Pediatric Evaluation of Disability Inventory (PEDI). Overall, these young children rated themselves towards the more competent and accepted end of the PCSA over the dimensions of physical and cognitive competence and peer and maternal acceptance. The PEDI revealed generally average performance on social (M = 49.98, SD = 16.62) and mobility function (M = 54.71, SD = 3.99), however, self-care function was below the average range for age (M = 38.01, SD = 12.19). The utility of the MAOM as a framework for comprehensive measurement of functional and motor outcomes of DCD in young children is discussed. (C) 2003 Elsevier B.V. All rights reserved.

Adult onset Krabbe disease may mimic motor neurone disease

Krabbe's disease (galactocerebrosidase deficiency) rarely presents in adults, usually with predominantly upper motor neurone clinical features. We report a case in whom the clinical features were similar to motor neurone disease. Nerve conduction studies and neuroimaging were important in leading to the correct diagnosis. Differences in adult-onset presentations are described. (C) 2003 Elsevier Science Ltd. All rights reserved.

Effect of changing data collection parameters on statistical motor unit number estimates

The effect of number of samples and selection of data for analysis on the calculation of surface motor unit potential (SMUP) size in the statistical method of motor unit number estimates (MUNE) was determined in 10 normal subjects and 10 with amyotrophic lateral sclerosis (ALS). We recorded 500 sequential compound muscle action potentials (CMAPs) at three different stable stimulus intensities (10–50% of maximal CMAP). Estimated mean SMUP sizes were calculated using Poisson statistical assumptions from the variance of 500 sequential CMAP obtained at each stimulus intensity. The results with the 500 data points were compared with smaller subsets from the same data set. The results using a range of 50–80% of the 500 data points were compared with the full 500. The effect of restricting analysis to data between 5–20% of the CMAP and to standard deviation limits was also assessed. No differences in mean SMUP size were found with stimulus intensity or use of different ranges of data. Consistency was improved with a greater sample number. Data within 5% of CMAP size gave both increased consistency and reduced mean SMUP size in many subjects, but excluded valid responses present at that stimulus intensity. These changes were more prominent in ALS patients in whom the presence of isolated SMUP responses was a striking difference from normal subjects. Noise, spurious data, and large SMUP limited the Poisson assumptions. When these factors are considered, consistent statistical MUNE can be calculated from a continuous sequence of data points. A 2 to 2.5 SD or 10% window are reasonable methods of limiting data for analysis. Muscle Nerve 27: 320–331, 2003

Managing strategic challenges in community sector organisations

Like those in other sectors, managers in community-based organisations face an uncertain and challenging future. Research and writing about the community sector (non-government, notjor-profit, or third seclOr) has canvassed a wide range of issues. A selective review of the recent literature reveals the breadth of research interest in the challenges facing community sector managers. While some reflection on the implications for managers of current economic and social policy contexts is crucial for this sector, research effort needs to be focused on understanding how third sector managers construe their current strategic challenges and the strategies they use to address them A small sample ofmanagers working in a regional area in South East Queensland was asked to identify current strategic concerns related to the future viability of their organisations. The key issues raised by managers are compared with the issues raised in the research literature. Results -to date indicate that managers' concerns are reflected in the research literature, but that managers are also concemed about the current trends in social policy towards collaboration, amalgamation, and pannership. Implications of these findings for managers operating in this sector are discussed.

Parvalbumin-, calbindin-, and calretinin-immunoreactive neurons in the prefrontal cortex of the owl monkey (Aotus trivirgatus): A standardized quantitative comparison with sensory and motor areas

Recent studies have revealed regional variation in the density and distribution of inhibitory neurons in different cortical areas, which are thought to reflect area-specific specializations in cortical circuitry. However, there are as yet few standardized quantitative data regarding how the inhibitory circuitry in prefrontal cortex (PFC), which is thought to be involved in executive functions such as cognition, emotion and decision making, compares to that in other cortical areas. Here we used immunohistochemical techniques to determine the density and distribution of parvalbumin (PV)-, calbindin (CB)-, and calretinin (CR)-immunoreactive (ir) neurons and axon terminals in the dorsolateral and orbital PFC of the owl monkey (Aotus trivirgatus), and compared them directly with data obtained using the same techniques in 11 different visual, somatosensory and motor areas. We found marked differences in the density of PV-ir, CB-ir, and CR-ir interneurons in several cortical areas. One hundred and twenty eight of all 234 possible between-area pairwise comparisons were significantly different. The density of specific subpopulations of these cells also varied among cortical areas, as did the density of axon terminals. Comparison of PFC with other cortical areas revealed that 40 of all 66 possible statistical comparisons of the density of PV-ir, CB-ir, and CR-ir cells were significantly different. We also found evidence for heterogeneity in the pattern of labeling of PV-ir, CB-ir, and CR-ir cells and axon terminals between the dorsolateral and orbital subdivisions of PFC. These data are likely to reflect basic differences in interneuron circuitry, which are likely to influence inhibitory function in the cortex. Copyright (C) 2003 S. Karger AG, Basel.

Brazilian external sector so far in the 21st century

Although Brazil has traditionally been characterized by a culture of inward-looking policy making, the presence of foreign firms in the Brazilian productive sector has always been significant. The share of foreign-owned firms is one of the highest that can be found among developing countries. This article discusses the main features of the external sector of the Brazilian economy, regarding trade flows, foreign investment, the internationalization of Brazilian entrepreneurial groups and the short-term financial requirements in foreign currencies

Economic Analysis of Occupational Risk Prevention in the Construction Sector

The construction sector has one of the worst occupational safety and health records in Europe. The costs of this scenario are very high, namely costs for workers and their families, costs to organizations, resulting from the absence of workers due to illness, insurance premiums, costs resulting from reduced productivity, cost of replacement and training of workers, etc., and costs to society, which in turn increases the costs of health systems. This paper presents and discusses the development of a methodology for economic evaluation in the context of risk management, which will allow senior management to support decision making. The possible application of this methodology to the construction sector is discussed.

O balanced scorecard e a gestão ambiental: um estudo no sector público e privado português

Os aspectos sociais e ambientais são reconhecidos cada vez mais como estratégicos na organização, na medida que constituem novas oportunidades de criação de valor mediante o desenvolvimento de vantagens competitivas capazes de diferenciar as empresas dos seus concorrentes actuais e potenciais. A adopção e o desenvolvimento de novas tecnologias, estratégias e instrumentos de gestão das questões sociais e ambientais parece ser hoje uma matéria indiscutível. No entanto, são várias as dificuldades encontradas na quantificação económica e financeira das políticas de desenvolvimento sustentável, levando ao desenvolvimento ou adaptação de ferramentas de gestão, como é o caso do Balanced Scorecard (BSC). Assim, no sentido de averiguarmos se as organizações públicas e privadas portuguesas incluem nos seus scorecards indicadores sociais e ambientais e se existe relação entre a utilização do BSC e os sistemas de certificação ambiental enviamos um questionário a 591 organizações públicas e 549 organizações privadas portuguesas, com uma taxa de resposta de 31,3%. Os resultados obtidos permitem concluir que a maioria dos inquiridos inclui indicadores sociais e ambientais nos seus scorecards e que as empresas certificadas em termos ambientais utilizam mais o BSC do que as não certificadas.

El Cuadro de Mando Integral como Herramienta de Gestión Estratégica en el Sector Sanitario Portugués

La búsqueda incesante de nuevas herramientas y técnicas de gestión como forma de solucionar dificultades financieras sin la pérdida del nivel de calidad esperado de la población, ha sido una constante en las instituciones que prestan cuidados de salud en todo el mundo. La utilización de modernas técnicas de gestión, en particular del Cuadro de Mando Integral (CMI), en el control más eficaz de los costes y la mejora de la calidad y efectividad en los servicios prestados en el sector de la salud, tiene registrado un importante desarrollo en los últimos años. Así, el presente artículo tiene como objetivo proporcionar algunas ideas acerca de qué factores influyen en la aplicación del CMI en el sector sanitario, qué ventajas o inconvenientes proporciona su empleo, qué perspectivas son las más adecuadas, qué caracterizan a las organizaciones que lo adoptan, cuál el grado de conocimiento y utilización en los hospitales portugueses, así como qué causas de abandono o no implantación se identifican. Para averiguar si dichas organizaciones conocen y están a adoptar el CMI, hemos enviado un cuestionario a 61 hospitales portugueses, con una tasa de respuesta del 24,6%. Los resultados obtenidos permiten concluir que aunque la mayoría de los encuestados conoce el CMI, su utilización en dichas organizaciones es muy reducida.

O Balanced Scorecard como Ferramenta de Gestão Estratégica no Sector Hoteleiro

O sector hoteleiro opera num mercado com transformações acentuadas, em que ressalta a necessidade de utilização de técnicas de gestão mais sofisticadas para melhorar o seu desempenho. O Balanced Scorecard (BSC) assume-se como uma poderosa ferramenta de Gestão Estratégica para enfrentar a forte concorrência. Esta comunicação tem como objectivo proporcionar algumas ideias sobre a importância e necessidade da implementação de metodologias de avaliação de desempenho no sector hoteleiro, em concreto da ferramenta de contabilidade de gestão, o BSC. Constatamos que a adopção desta ferramenta ainda está pouco documentada no sector hoteleiro, o que impõe a necessidade de desenvolver investigação sobre esta temática.

Factores determinantes do nível de divulgação sobre instrumentos derivados de acordo com as recomendações do Basel Committee on Banking Supervision e da Organisation of Securities Commissions - evidência empírica no sector bancário português

Este estudo analisa o nível de divulgação sobre instrumentos derivados e seus factores determinantes nas entidades bancárias portuguesas. Para o efeito, foi utilizado um índice de divulgação, baseado nas recomendações emitidas pelo Basel Committee on Banking Supervision e pela Organisation of Securities Commissions, e analisados os Relatórios & Contas anuais, individuais, relativos a 2009. Conclui-se que o número de empresas que apresenta informação sobre a utilização de instrumentos derivados é bastante elevado, mas o valor médio de divulgação apresentado é bastante reduzido. Identificam-se, como factores determinantes do nível de divulgação, o tamanho da empresa, a qualidade do auditor externo e o facto de a empresa ter procedido a um aumento de capital durante o exercício económico em análise.

Grau de cumprimento com as recomendações do Basel Committee on Banking Supervision e da Organisation of Securities Commissions, sobre divulgação de informação relacionada com instrumentos derivados - evidência empírica no sector bancário português

This study analyzes the level of disclosure on derivatives, in accordance with the recommendations issued by the Basel Committee on Banking Supervision and the Organization of Securities Commission, by Portuguese banks. We have analyzed individual annual reports related to 2009, using a disclosure index based on those recommendations. We concluded that the number of companies that provides information about derivative instruments is quite high, but the average value of disclosure is very low. The information disclosed more frequently is that related to general aspects, followed by information related to accounting and valuation methods.

Estudo do grau de cumprimento com as recomendações do Basel Committee on Banking Supervision e da Organisation of Securities Commissions, sobre divulgação de informação relacionada com instrumentos derivados, pelas entidades portuguesas pertencentes ao sector bancário

Este estudo analisa o nível de divulgação sobre instrumentos derivados, de acordo com as recomendações emitidas pelo Basel Committee on Banking Supervision e pela Organisation of Securities Commissions, pelas entidades bancárias portuguesas. Para o efeito, foi utilizado um índice de divulgação e analisados os Relatórios & Contas anuais, individuais, relativos a 2009. Conclui-se que o número de empresas que apresenta informação sobre a utilização de instrumentos derivados é bastante elevado, mas o valor médio de divulgação apresentado é bastante reduzido. A informação mais divulgada é a relativa a informações gerais, seguida da informação relacionada com contabilidade e métodos de avaliação.