Meeting patients' nutritional needs is a complex aspect of care which may benefit from introduction of structured guidelines. However, the potential of screening tools to improve care is limited by diverse factors, which warrant further exploration.

The hair pluck procedure alters the anatomy of the anagen hair bulb. Hemorrhage can occur in the mesenchymal sheath and breaks at the proximal epithelium, above or around the upper third of the dermal papilla, have been reported. We hypothesized that innervation, as identified with protein gene product 9.5 (PGP 9.5), and expression of the neuropeptide Substance P (SP) within the dermal papilla would also be altered following plucking. We focused on studying SP as this neuropeptide has been associated with several cellular responses, including anagen hair growth in the C57BL/6 mouse model. Four millimeter punch biopsies were obtained from the occipital scalp of two healthy adults. Hair was then plucked and additional biopsies were obtained immediately, and at 1 d, 1 wk, and 1 mo after plucking. Each set was processed for immunohistochemical analyses and in-focus optical sections of the dermal papilla were captured by laser scanning confocal microscopy and later reconstructed into single images. Following injury, SP was expressed in a disorganized pattern below the dermal papilla. There was also a significant reduction in labeled neuronal cells, and SP expression was enhanced within peribulbar blood vessels at 1 d and 1 wk. By 1 mo, peribulbar nerves, vessels, and SP expression were similar to baseline observations. It remains to be ascertained whether PGP 9.5, also known as unbiquitin hydrolase, and SP are involved in the proliferation of new matrix cells in the human scalp hair follicle following injury.

Supplementary motor area syndrome is characterized by impaired initiation of volitional movement and commonly occurs following dominant or bilateral supplementary motor area (SMA) lesions. Initiation deficit is extremely disruptive to functional performance due to the pervasive nature of the impairment. We present a functional treatment approach, based on a Lurian model of neuropsychological intervention, involving the verbal regulation of movement. Using a single-case experimental design (i.e., extended ABAB), involving planned intermittent treatment withdrawal, we treated the severe initiation deficit of a 53-year-old male with supplementary motor area syndrome, secondary to a dominant SMA lesion. Significant gains were demonstrated in response latency, time to completion of multiple-step upper limb movements, activities of daily living (ADL), and mobility. Despite severely impaired initiation, the patient was able to learn and independently utilize a structured cuing sequence, which significantly increased his capacity to initiate purposeful voluntary movement.

If you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. AbstractPurpose -Workplaces are described as "excellent" locations for promoting health as many employees spend more time here than in other locations, yet, many organisations overlook this opportunity. This paper seeks to examine the inhibitors and enablers that small and medium-sized enterprises (SMEs) face when promoting health within their workplaces. Previous research within workplace health promotion has largely focused on large, often multi-national organisations. Design/methodology/approach -A descriptive qualitative approach was adopted which involved interviewing health-promotion champions/co-ordinators within five SMEs located in south Wales in the UK. A thematic content analysis was undertaken and key themes identified. Findings -The results identify key enablers to participating in health-promotion programmes as being an external facilitator and the appointment of an internal health champion/co-ordinator. The main inhibitors were resources, time and the longevity of the external support funded by a government initiative. Practical implications -The paper identifies the enablers and barriers to SMEs promoting workplace health. An adaptation of a framework is provided to assist SME owner/managers to promote workplace health. Originality/value -Few studies have examined the workplace health promoting activities of SMEs and particularly the role of externally supported programmes. This paper fills some of the gaps.