Kenneth I. Hume

A FIELD STUDY OF AGE AND GENDER DIFFERENCES IN HABITUAL ADULT SLEEP

The sleep of 52 healthy paid subjects (23 male) divided into three age‐bands (20–34, 35–49 and 50–70 y) were recorded at night in their homes for a total of 190 subject‐nights while following their normal daily activities and habitual sleep‐wake schedule. There was a shortening in both nocturnal total sleep period and total sleep time (TST) with age, the oldest group sleeping 46 min less than the youngest. Also, the mid‐point of sleep occurred 32 min earlier in the oldest group compared with the youngest group. The reduction in TST with age was due, in part, to increased wake periods within sleep. The youngest subjects showed more Movement Time which progressively decreased with age while the amount of stage 1 increased with age. The amount of slow‐wave sleep (SWS, stages 3+4) was reduced, stage 4 was more than halved, while REM was slightly reduced with age. There were far fewer significant gender differences in the sleep variables: males, particularly in the middle and oldest age bands, had more stage 1 than females, while females had more SWS, particularly stage 3, than males. In general, despite relatively limited subject selection criteria, there was good agreement with previous laboratory‐based normative sleep values for the effect of age and gender.

Effects of alcohol, at two times of day, on EEG-derived indices of physiological arousal.

Effects of alcohol consumption (0.8 ml/kg) on sleep propensity, spectral characteristics of the EEG and self-rated activation in 16 young male subjects, were investigated during sessions at each of two times of day (08.00 and 16.00). Within-session, time-related changes in the pattern of stage-1 sleep occurrence, and of spectral power in different EEG bands indicated that, irrespective of time of day, physiological arousal increased as estimated blood alcohol concentration (BAC) was rising, and decreased as BAC was falling. Subjective activation was reduced by alcohol during both phases of the BAC curve. A pattern of reduced stage-1 sleep occurrence, higher absolute high alpha power and higher ratings of activation suggested that, irrespective of alcohol condition, physiological and subjective arousal was higher during sessions starting at 16.00 than during those starting at 08.00. There were no significant interactions between alcohol and time of day in respect of any dependent variable. However, the degree to which effects reflecting circadian variation may have been masked by effects of limited sleep restriction prior to morning sessions remains unclear. Subjects reported having slept on only 23.5% of occasions when sleep was scored. Comparison of patterns of statistically significant changes in absolute and relative power in different bands indicated that the two indices do not provide exactly equivalent information about changes in the EEG.

Assessment following Hand Trauma: A Review of some Commonly Employed Methods

Accurate assessment strategies underpin appropriate implementation and review of surgical and therapeutic intervention. This paper explores some of the commonly described assessment methods used following hand injury, including measures of range of motion (ROM), strength, sensation, hand function and patient self-evaluation. The strengths and limitations of some methods are discussed. It is suggested that accurate assessment tools and standardised approaches to assessment will promote effective evaluation of intervention. In addition long-term review and comparative studies may be facilitated by such an approach.

Effects of alcohol on the sleep-stage structure of a nap in the afternoon

The effects of the ingestion of 0.8 ml/kg alcohol on the sleep-stage structure of nap sleep were compared with those of a non-alcoholic drink in 8 young male subjects napping between 14.00 h and 15.00 h. During nights immediately preceding experimental sessions, time to bed and time in bed (hence, sleep duration) were controlled. While not affecting total nap sleep duration, alcohol significantly increased time in stage 4 sleep, primarily at the expense of time in stage 2.

A Survey of Current Hand Assessment Practice in the UK

A range of physical assessment strategies is available to hand therapists although approaches to their use may be variable. Inconsistent use of standardised assessments may compromise the information available to therapists to provide an evidence base for, and inform, practice. Potential research opportunities may also be lost as comparative studies are difficult in such circumstances. This study aimed to review hand therapy assessment practices in the UK. Following a pilot study, a survey of the membership of BAHT (n=493) was undertaken using a self-completed postal questionnaire and a 50.5% response rate (n=249) was secured. Findings suggest that UK hand therapists are using assessment tools of variable accuracy in an environment of limited resources. Therapist time invested in physical measurement may be providing a poor return in terms of the quality of information generated. The need for accurate and easy-to-use measurement tools is evident as is the desire for patient-centred outcome measures. User-friendly and inexpensive measurement tools might facilitate hand therapy research, minimise the potential for researcher bias and enhance the evidence base for hand therapy. Subsequent work has begun to explore assessment tools that may evaluate patient outcome more effectively.