Service dogs: a compensatory resource to improve function.

Objective. This study examined the physical, emotional, social, and economic functions of service dogs, the training methods for service dog/owner teams, and problems encountered with service dogs in relationship to occupational therapy literature and domain of concern. Method. A 31-question survey was developed based on the literature and Uniform Terminology (AOTA, 1994) and was completed by 202 service dog owners from 40 states and Canada. Results. Owners reported that service dogs assisted them in 28 functional tasks, helped them to feel safe, increased their social interaction, and reduced physical assistance by others. Problems with service dogs included difficulty with dog maintenance and public awareness of their role as a worker or assistant to the owner. Over 80% of respondents desired additional training in alternative ways to perform daily living tasks. Conclusion. The use of service dogs is consistent with the occupational therapy domain of concern and practice. Occupational therapists might collaborate with service dog trainers and potential owners in referral, assessment, training, and follow-up services.

The use of out of hours health services: a cross sectional survey.

OBJECTIVES: To determine the use and costs of the principal out of hours health services in Buckinghamshire. DESIGN: Prospective cross sectional survey and cost description of patient contacts with out of hours services. SETTING: Buckinghamshire during March and April 1995. SUBJECTS: General practices, accident and emergency departments, ambulance services, and community nursing services. MAIN OUTCOME MEASURE: Contacts with patients and cost of out of hours services. RESULTS: 438 patient contacts/1000 population/year were recorded at an annual incremental cost of between 4.6 m Pounds and 7.2 m Pounds (depending on the costing of general practitioner services), for a population of 660,000. Of these contacts, 21,649 (45%) were with general practitioners. Night time contacts with all services diminished sharply after 10 pm. General practitioners considered that 40% of contacts were unnecessary or could have waited until morning. Over 70% of contacts were for upper respiratory tract infections, earache, gastroenteritis, and other minor ailments. Nursing care was predominantly for elderly people, and 33% of nursing contacts were to supervise medication. Accident and emergency care was predominantely for young adults, especially men, and 41% of attendances were for medical conditions. CONCLUSIONS: New models such as multidisciplinary primary care centres with telephone advice lines and triaging are required to ensure high quality, cost effective care that is responsive to the needs of both consumers and professionals.

Repair of the ependyma in hydrocephalic brains.

Hydrocephalus was induced in 12-day-old rats by the cisternal infusion of concentrated kaolin suspension. At 19 days of age, a lesion, 100 or 150 microns in diameter, was made in the ependymal lining of the lateral ventricles. Animals were killed at intervals from 1 h to 20 days after the lesion was made. The damaged area was examined by scanning electron microscopy, light and transmission electron microscopy. Between 1 h and 48 h the hole was still open. Small round cells, identified as free subependymal cells, were associated with the edges of the hole from 1 h after the lesion was made. From 48 h, the lesion was completely covered with cell bodies and their processes and no hole was present. Signs of differentiation were seen in the free subependymal cells from 4 days, the cells becoming more electron lucent. By 15 days, three types of cell arrangement were seen within the damaged area: 1 clusters of small cells, with few processes, resembling subependymal cells; 2 small numbers of cells with flat cytoplasmic processes which formed the lining of the ventricular wall; 3 clusters of cells with long thin processes attached to the surface of the ventricular wall but not forming the ependymal lining. The results of this study suggest that, in the hydrocephalic brain, ependymal damage and the repair of a defect within the ventricular wall is initiated by subependymal cells.

Muscle gene activation by induction and the nonrequirement for cell division.

We are investigating the mechanism by which animal cells of an amphibian blastula are induced to differentiate as muscle after contact with blastula vegetal cells. After briefly summarizing previous work on this system, we have asked whether this response of animal cells to vegetal induction requires cell division. Animal and vegetal parts of a blastula were placed in contact with each other, and the resulting conjugates cultured in medium containing a sufficient concentration of colchicine or cytochalasin B to inhibit cell division. Muscle differentiation, as indicated by cardiac actin gene transcription, is induced when cell division is inhibited, though at a substantially reduced rate. However, cytoskeletal actin gene transcription, which does not depend on induction, is also much reduced under the same inhibitory conditions. We conclude that, although the cell division inhibitors seem to reduce all gene transcription, they have no preferential effect on the response to induction, and therefore that this process does not require cytoplasmic or nuclear division.

Activation of muscle-specific actin genes in Xenopus development by an induction between animal and vegetal cells of a blastula.

Muscle gene expression is induced a few hours after vegetal cells of a Xenopus blastula are placed in contact with animal cells that normally develop into epidermis and nerve cells. We have used a muscle-specific actin gene probe to determine the timing of gene activation in animal-vegetal conjugates. Muscle actin RNA is first transcribed in a minority of animal cells at a stage equivalent to late gastrula. The time of muscle gene activation is determined by the developmental stage of the responding (animal) cells, and not by the time when cells are first placed in contact. The minimal cell contact time required for induction is between 1 1/2 and 2 1/2 hr, and the minimal time for gene activation after induction is 5-7 hr.

All components required for the eventual activation of muscle-specific actin genes are localized in the subequatorial region of an uncleaved amphibian egg.

Fertilized Xenopus eggs have been ligated with a hair loop into separate fragments before the first cleavage. The plane of the ligation was varied in relation to the animal-vegetal and dorso-ventral axes. The fragments that contained a nucleus were cultured for 24 hr until controls reached the neurula stage; they were then analyzed by S1 nuclease protection for their content of muscle-specific actin mRNA, using a gene-specific probe. We find that all egg components required for the eventual activation of these actin genes are localized, already at the 1-cell stage, in a region below the equator, and mostly on the dorsal (grey crescent) side. This material subsequently occupies the equivalent position in 8-cell and 32-cell embryos. We interpret our results, in combination with the previous work of others, to mean that mesoderm (including muscle) formation in Amphibia depends both on cytoplasmic substances already localized in the egg as well as on inductive cell interactions during cleavage.

Cell type-specific activation of actin genes in the early amphibian embryo.

Muscle actin genes are the earliest yet described to show cell type-specific activation in amphibian embryos. Gene-specific probes show that alpha-skeletal and alpha-cardiac actin genes start to be transcribed simultaneously at the end of gastrulation, but only in those regions of the mesoderm that subsequently form embryonic muscle. Their expression provides a molecular marker for early cell determination.

Transcription of muscle-specific actin genes in early Xenopus development: nuclear transplantation and cell dissociation.

Cloned cDNA probes that recognize muscle-specific alpha-actin gene transcripts have been used to analyze two kinds of experimental embryos in Xenopus. In one, genetically marked nuclei of larval muscle cells were transplanted to wild-type enucleated eggs; alpha-actin genes became transcriptionally inactive in the resulting blastulae but were reactivated when these embryos reached the normal stage of alpha-actin expression (late gastrula). In the other, blastula embryos reared from fertilized eggs were separated into animal, vegetal, and equatorial regions, and their cells dissociated and reaggregated. alpha-Actin RNA was synthesized at the normal time in development, but only by equatorial cells. We conclude that alpha-actin gene transcription is normally regulated in nuclear-transplant embryos and is undisturbed by the absence of cell contacts during cleavage.