Sir David K Henderson and the origins of British occupational therapy.

Sir David K Henderson made several major contributions in the field of psychiatry, gaining an international reputation but, perhaps lesser known is his role in the introduction of occupational therapy in the United Kingdom. The part Henderson played in establishing occupational therapy as an aspect of his evolving approach to treating mental illness in Scotland is discussed, as is the influence he had in stimulating and supporting the early pioneers of the profession elsewhere in the UK.

Anoxic brain injury: Clinical patterns and functional outcomes. A study of 93 cases.

Background: Anoxic brain injury (ABI) is a syndrome of diverse aetiology, most case series published to date being confined to ABI of a single aetiology or to a limited numbers of patients.

Methods: This study performed a retrospective analysis on all patients admitted for rehabilitation following ABI over a 14-year period. It identified 93 cases and presents a summary of their clinical patterns and functional and psychometric outcome measures.

Depression and anxiety symptoms after lower limb amputation: the rise and fall.

Objective: To examine the time course of anxiety and depressive symptoms over a three year period after amputation.

Design And Settings: A prospective study in inpatients admitted to a rehabilitation ward after lower limb amputation.

Subjects: Successive admissions over a one-year period of whom 68 were alive at follow-up, 2-3 years later.

Zolpidem in a minimally conscious state.

Background: Case reports of the use of zolpidem in Permanent Vegetative States (PVS) have led to interest by the media and court judgements defining treatment with such drugs. It is uncertain whether this paradoxical effect of zolpidem in raising consciousness may be evident in other low awareness states such as Minimally Conscious State (MCS).

Case Study: This study treated a 44 year old male with MCS some 4 years after his traumatic brain injury with zolpidem for 1 week on and 1 week off treatment.

A survey of information given to head-injured patients on direct discharge from emergency departments in Scotland.

Aim: To survey the information provided to head-injured patients on discharge from emergency departments (EDs) in Scotland.

Methods: EDs throughout Scotland were asked to supply a copy of their head injury advice pamphlet for analysis. Each pamphlet was assessed against a template and an Excel spreadsheet was created.

Parkinson's disease and driving ability.

Objectives: To explore the driving problems associated with Parkinson's disease (PD) and to ascertain whether any clinical features or tests predict driver safety.

Methods: The driving ability of 154 individuals with PD referred to a driving assessment centre was determined by a combination of clinical tests, reaction times on a test rig and an in-car driving test.

Results: The majority of cases (104, 66%) were able to continue driving although 46 individuals required an automatic transmission and 10 others needed car modifications.

Alphabetical prejudice in team discussions (or would Zebedee ever get seen on a ward round).

Purpose: To ascertain whether the order in which patients are discussed in a team meeting determines the time spent on discussion.

Design: Prospective study over 18 consecutive multidisciplinary team meetings.

Setting/subjects: Multidisciplinary team meetings on a Brain Injury Rehabilitation Unit, Edinburgh.

Myasthenia gravis masquerading as post-poliomyelitis syndrome.

A 79-year-old man with previous bulbar poliomyelitis developed dysphagia and was diagnosed as having post-polio syndrome. Over 2 years, his swallowing deteriorated and he suffered an aspiration pneumonia. Only after the subsequent development of fatigue and facial weakness was myasthenia gravis diagnosed.

Access inequalities addressed by audit.

The Disability Discrimination Act (1995) protects disabled people from discrimination in access to services, facilities and goods as well as in education and employment. All hospitals have an inherent duty to enable access to services but this will now be enshrined in law. As the health sector has most contact with disability, it may be expected that most hospitals would already be in a good position to comply with the Act, especially one treating many patients with disability.

Training in brain injury rehabilitation.

Purpose: To evaluate our current training programme for professionals involved in brain injury rehabilitation, which involves disability simulation, and to consider the ethics and consequences of such programmes.

Method: Seventy-two professionals took part in a brain injury disability simulation exercise and completed questionnaires pre and post the workshop.

Results: Results suggest that participants have increased insight into the challenges faced by people with brain injuries.

Pain in the Guillain-Barré syndrome: a clinical review.

The Guillain-Barré syndrome, or acute inflammatory polyneuropathy, is often regarded as a predominantly motor neuropathy with few sensory features, which has a good prognosis in most cases. However, pain is a common symptom occurring in up to 72% of cases. The types of pain are protean including paraesthesiae, dysaesthesia, axial and radicular pain, meningism, myalgia, joint pain and visceral discomfort, etc.