Medication non-compliance has become one of the most prevalent reasons for hospitalization and doctor's visits by the elderly. As the elderly population is more likely to have decreased cognitive abilities, it is suggested that neuropsychological factors, especially executive function, are more influential in medication non-compliance than once thought. This study looked at executive function performance on a traditional battery of neuropsychological tests, self-report of perceived ability to perform executive function tasks, and the newly developed Pillbox Test, a performance based IADL measure. The Pillbox Test is designed to replicate a type of medication-management specific IADL as a means to asses executive function. Standard executive function measures only tap a portion of executive function, but it is believed that the Pillbox Test incorporates all four theoretical domains of executive function. The multiple measures of executive function performance were compared in three prevalent subgroups of the elderly population (mixed neurological group, cardiac medical-control group, and healthy community-control group). Results found significant differences, where the community-control and cardiac groups outperformed the mixed neurological group on the large majority of executive function tasks. Smaller differences were also noted between the community-control and cardiac groups and between the cardiac and mixed neurological groups. Together, these findings provide support for the diagnostic prevalence of mild cognitive impairment in the older adult cardiac population. Results also indicated the level of executive dysfunction on standardized neuropsychological measures was highly correlated with performance on both the Pillbox Test and the IADL based Direct Assessment of Functional Status measure. Finally, the Pillbox Test has moderate to strong ecological validity with 75% sensitivity and 87.5% specificity for five or more errors on this test.

Background Past studies from this laboratory have shown that quinpirole administration from postnatal day (P) 1–21 produces persistent supersensitization of the dopamine D2 receptor that persists throughout the animal's lifetime. Methods In Experiment 1, both male and female rats were treated with quinpirole or saline from P1–21 and tested on the place and match-to-place versions of the Morris water task (MWT) from P22–28. In Experiment 2, both male and female rats were administered either acute or chronic injections of quinpirole (1 mg/kg) or saline beginning on P1 until analysis for corticosterone (CORT) on P7, 14, or 21. Results Neonatal quinpirole treatment produced deficits on both versions of the MWT compared with saline control. One day after behavioral testing, brain tissue was harvested, and the hippocampus was analyzed for nerve growth factor (NGF) and brain-derived nerve growth factor (BDNF); NGF was found to be significantly decreased by neonatal quinpirole treatment. Acute or chronic quinpirole treatment on P14 produced a larger increase in CORT than controls and produced larger increases in CORT than control rats on P21. Conclusions These results demonstrate that neonatal quinpirole treatment produces cognitive deficits that could be related to decreases in hippocampal NGF and increases in CORT, resulting in abnormalities in hippocampal development.

Thesis (M.A. (Social Work)) -- University of Limpopo, 2019 / Young offenders’ criminal behaviour is a global problem that affects the society. In addressing this problem, parents are expected to provide effective parental role in order to minimise the problematic behaviour of their children. The overall aim of the study was to explore perceptions of young offenders regarding parental influence on their criminal behaviour. The objectives of the study were to determine the perceived impact of parental practice on young offenders’ criminal behaviour; to assess how parental care influences the positive behaviour of young offenders; to appraise how coercive child-rearing influences young offenders to be involved in criminal activities; and to establish gaps between parents and young offenders in terms of parental practice. The researcher used explorative research designs. The data was collected through semi-structured face-to-face interviews from sixteen (16) young offenders who were detained at Mavambe Child and Youth Care Centre situated in Malamulele, Limpopo province, South Africa. The sample consisted of young offenders who were available and ready to participate in the study, and sixteen young offenders who were staying with their parents. The researcher used thematic data analysis and followed its steps. Ethical considerations were considered. Based on the findings, parenting has a direct influence on young people’s behaviour. However, it was also discovered that there are other internal and external contributory factors which make this problem complex and interrelated. Some of these factors are environmental or community and economic related problems. The researcher recommend that the Department of Social Development should render positive parenting skills programmes. These programmes should consider issues related to the parent-child relationship, disciplinary strategies, supervision and monitoring. Key words: perceptions, young offenders, parent, parental influence and criminal behaviour

This dissertation considers the factors affecting the acquisition of a second language and those factors thought to be the most important in the acquisition of English as a second language. An examination of the theories of language acquisition is followed by a literature study and discussion of the factors appearing to be of importance in second language acquisition. The account of the empirical investigation, conducted in an English medium school in Botswana, includes the formulation of hypothesis, discussion of the sample, a description of the measuring instruments used and a summary of the general procedure followed. The results of the empirical investigation suggest that the most important factors in the acquisition of English as a second language are age, intelligence, the amount of English spoken at home, pupil perception of parental support and first language acquisition. In conclusion, some of the educational implications of this investigation are considered. / Psychology of Education / M. Ed. (Psychology of Education)

This study investigated stable-isotope ratio evidence of weaning for the late Anglo-Saxon population of Raunds Furnells, Northamptonshire, UK. delta(15)N and delta(13)C values in rib collagen were obtained for individuals of different ages to assess the weaning age of infants within the population. A peak in delta(15) N values at about 2-year-old, followed by a decline in delta(15) N values until age three, indicates a change in diet at that age. This change in nitrogen isotope ratios corresponds with the mortality profile from the site, as well as with archaeological and documentary evidence on attitudes towards juveniles in the Anglo-Saxon period. The pattern of delta(13) C values was less clear. Comparison of the predicted age of weaning to published data from sites dating from the Iron Age to the 19th century in Britain reveals a pattern of changing weaning practices over time, with increasingly earlier commencement and shorter periods of complementary feeding in more recent periods. Such a change has implications for the interpretation of socioeconomic changes during this period of British history, since earlier weaning is associated with decreased birth spacing, and could thus have contributed to population growth.

<p>UVOD: Moždani udar spada u grupu masovnih nezaraznih bolesti, koje se smatraju najče&scaron;ćim oboljenjima savremenog čoveka. On predstavlja jedan od najče&scaron;ćih uzroka mortaliteta i invaliditeta u savremenom svetu. Među brojnim pratećim komplikacijama moždanog udara, navode se psihički poremećaji: depresija, anksioznost i psihotični poremećaji. Utvrđivanje povezanosti moždanog udara sa psihičkim poremećajima, kao i mehanizma njihovog nastanka predstavlja značajan doprinos boljem razumevanju ovog veoma čestog oboljenja, a njihov rani tretman omogućio bi brži i potpuniji oporavak nakon moždanog udara. CILJ: Utvrditi karakteristike psihičkog funkcionisanja osoba nakon ishemičnog moždanog udara, utvrditi uticaj lokalizacije lezije na nastanak određenih psihičkih poremećaja nakon moždanog udara, utvrditi uticaj vaskularnog statusa na nastanak psihičkih poremećaja, te utvrditi korelaciju između psihičkih komplikacija moždanog udara i brzine i stepena oporavka op&scaron;te životne aktivnosti. MATERIJAL I METODE: Istraživanje je izvedeno kao prospektivna studija, obuhvatilo je 101 pacijenta oba pola obolelih od moždanog udara, koji su hospitalno lečeni na Klinici za neurologiju u Novom Sadu. Svim pacijentima je uzeta anamneza o toku bolesti, faktorima rizika za moždani udar, kao i laboratorijska dijagnostika. Svim pacijentima načinjena je kompjuterizovana tomografija (CT) mozga (ili magnetna rezonanca - MRI mozga), ultrazvučni pregled karotidnih arterija, vertebrobazilarnih i krvnih sudova Willisovog poligona. Stepen neurolo&scaron;kog deficita i praćenje funkcionalnog oporavka u akutnoj fazi i nakon 3 meseca vr&scaron;eno je primenom Skale Moždanog Udara Nacionalnog Instituta za Zdravlje (NIHSS), Rankinove skale i Bartelovog indeksa. Svim pacijentima je načinjena eksploracija psihičkog statusa u akutnoj fazi bolesti primenom Bekove Skale Depresije 2 (BDI-2), Skale procene anksioznosti kao stanja i odlike (STAI), Skale pozitivnih i negativnih sindroma (PANSS) i Kornelovog regrutnog indeksa (CSI). Kontrolno testiranje gore navedenim testovima obavljeno je nakon 3 meseca. Od statističkih metoda kori&scaron;ćena je deskriptivna statistika: tabelarni prikazi učestalosti i procentualna izraženost kod neparametrijski (nominalno ili ordinarno) organizovanih varijabli. Za ukr&scaron;ten prikaz dve varijable kori&scaron;ćene su tabele kontingencije. Takođe su kori&scaron;ćene mere centralne tendencije (aritmetička sredina) i mere disperzije (standardna devijacija) kod parametrijski korektno uređenih varijabli. Pored toga, kori&scaron;ćen je Hi-kvadrat test za utvrđivanje razlika između grupa za varijable nominalnog nivoa merenja, Kramerovo V za utvrđivanje povezanosti između nominalnog nivoa merenja, Pirsonov koeficijent korelacije r, za utvrđivanje povezanosti između varijabli intervalnog nivoa merenja, te analiza varijanse (ANOVA) za utvrđivanje značajnosti razlika između aritmetičkih sredina vi&scaron;e grupa. REZULTATI: U ispitivanje je uključen 101 pacijent, 65.3% mu&scaron;kog pola, 34.7% ženskog pola. Prosečna starost bila je 60.69 godina (medijana=62.00, standardna devijacija =10.828, statistička gre&scaron;ka=1.077). 38.6% je imalo lokalizaciju u desnoj hemisferi velikog mozga, 34.7% u levoj hemisferi, 4% u cerebelumu, 11.9% u moždanom stablu, dok je 10.9% imalo vi&scaron;estruku lokalizaciju infarkta. 39.6% je imalo teritorijalni infarkt, a 59.4% lakunarni infarkt. Distribucija faktora rizika za moždani udar bila je uobičajena za podneblje na kojem je vr&scaron;eno istraživanje. 26.7% je imalo uredan nalaz na karotidnim krvnim sudovima, 26.7% je imalo difuznu ateromatozu, 27.7% je imalo stenozu ACI &lt;70% , dok je 18.8% pacijenata imalo stenozu ACI&gt;70%. U odnosu na nalaz u VB slivu, 52.5% je imalo uredan nalaz, a 47.5% patolo&scaron;ki nalaz (stenozu i difuznu ateromatozu). 54.5% pacijenata je imalo uredan nalaz na arterijama Willisovog poligona, a 45.5% je imalo patolo&scaron;ki nalaz (stenozu i difuznu ateromatozu). 5.9% je imalo depresivni poremećaj, 29.7% anksiozni poremećaj, 9.9% neurotski poremećaj i 2% psihotični poremećaj. U odnosu na pol, depresivni poremećaj javlja kod 3% mu&scaron;karaca i 11.4% žena, anksiozni kod 25.8% mu&scaron;karaca i 37.1% žena, neurotski kod 7.6% mu&scaron;karaca i 14.3% žena i psihotični kod 3% mu&scaron;karaca, dok kod žena nije zabeležen. U odnosu na životno doba, kod mlađih od 45 godina depresija nije bila prisutna, anksioznih je bilo 30%, 10% psihotičnih, dok neurotičnih nije bilo. U grupi 46-65 godina depresivnih je bilo 6.9%, anksioznih 22.4%, neurotičnih 12.1%, a psihotičnih 1.7%. U grupi starijih od 65 godina, depresivnih je bilo 6.1%, anksioznih 42.4%, neurotičnih 9.1%, dok psihotičnih nije bilo. Distribucija odgfovora dobijenih na BDI-2 skali ukazivala je na veću učestalost depresivnog poremećaja kod lezija u levoj hemisferi velikog mozga. Distribucija odgovora dobijenih primenom STAI ukazivala je na veću učestalost anksioznog poremećaja kod lezija desne hemisfere. Distribucija odgovora dobijenih primenom CSI ukazivala je na veću učestalost neurotskog poremećaja kod vi&scaron;estrukih lezija. Distribucija odgovora dobijenih primenom PANSS ukazivala je na veću učestalost psihotičnog poremećaja kod lezija desne hemisfere. Upoređivanje lezije na karotidama i psihičkih poremećaja pokazalo je na progresivni porast učestalosti psihičkih poremećaja sa težinom lezije na karotidnim krvnim sudovima, kao i na potpuno odsustvo psihičkih poremećaja kod osoba koje su imale uredan nalaz na karotidama. Praćenje uticaja psihičkih poremećaja (sumarno i pojedinačno) na funkcionalni oporavak pacijenata nakon moždanog udara, nije pokazalo statistički značajan uticaj. Zabeleženo je statistički značajno udruženo pojavljivanje depresivnog i anksioznog, depresivnog i neurotskog i anksioznog i neurotskog poremećaja, bez značajne interakcije navedenih poremećaja sa psihotičnim poremećajem. ZAKLJUČAK: Kod pacijenata sa ishemičnim moždanim udarom najveća je učestalost anksioznog poremećaja, zatim depresivnog poremećaja, a najređe se javlja psihotični poremećaj. Depresivni i anksiozni poremećaj značajno su če&scaron;ći kod žena, dok se psihotični poremećaji isključivo javljaju kod mu&scaron;karaca. Depresivni poremećaj značajno se če&scaron;će javlja u srednjem i starijem životnom dobu, anksiozni poremećaj se če&scaron;će javlja u mlađem i srednjem životnom dobu, dok se psihotične manifestacije javljaju najče&scaron;će u srednjem životom dobu. Depresivni i anksiozni poremećaj jednako se često javljaju kod pacijenata sa teritorijalnim i lakunarnim infarktom, dok se psihotične manifestacije isključivo javljaju kod pacijenata sa teritorijalnim infarktom. Ne postoji značajna korelacija između prisustva faktora rizika za moždani udar i pojave psihičkih poremećaja, iako je upadljivo odsustvo psihičkih poremećaja kod pacijenata bez faktora rizika za moždani udar. Nakon 3 meseca od moždanog udara nije primećena značajnija regresija simptoma psihičkih poremećaja. Anksiozni poremećaj i psihotične manifestacije se statistički značajno če&scaron;će javljaju kod infarkta u desnoj hemisferi, dok za depresivni poremećaj nije potvrđeno statistički značajno če&scaron;će pojavljivanje kod infarkta u levoj hemisferi. Psihički poremećaji kod pacijenata sa moždanim udarom če&scaron;će se javljaju kod pacijenata sa lezijama u karotidnom slivu, &scaron;to se povećava sa težinom lezije i veličinom stenoze. Ne postoji statistički značajna korelacija između lezija krvnih sudova u vertebrobazilarnom slivu i Willisovom poligonu sa pojavom psihičkih poremećaja. Nije dokazan značajan uticaj psihičkih poremećaja na oporavak bolesnika nakon moždanog udara. Dokazan je visok stepen udruženog javljanja depresivnog i anksioznog poremećaja.</p> / <p>INTRODUCTION: Stroke belongs to noninfectious diseases, which are considered the most common diseases of modern man. It is one of the most common causes of mortality and disability in the modern world. The many associated complications of stroke include mental disorders: depression, anxiety and psychotic disorders. Determining the relationship between stroke and mental disorders, as well as enlightening their underlying mechanism, represents a significant contribution to a better understanding of this very frequent disease, and an early treatment of these associated disorders should allow a faster and more complete recovery from stroke. OBJECTIVE: To determine characteristics of mental functioning after ischemic stroke, to determine the impact of lesion localization on development of certain mental disorders after stroke, to determine the impact of vascular status on development of mental disorders, and to determine the correlation between the associated mental disorders and the speed and degree of recovery of general life activities. MATERIALS AND METHODS: The research was conducted as a prospective study that included 101 ischemic stroke patients of both sexes, hospitalized at the Clinic of Neurology in Novi Sad. Data about the course of disease and stroke risk factors was collected and laboratory diagnostics was performed in all patients. All patients underwent brain computed tomography (CT) (or magnetic resonance imaging - MRI), and ultrasound examination of carotid and vertebrobasilar arteries and the circle of Willis. The degree of neurological deficit and functional recovery in the acute phase and at 3-month follow-up were assessed using the National Institute of Health Stroke Severity (NIHSS) scale, the Rankin scale, and the Barthel Index. All patients underwent psychological exploration of the mental status in the acute phase of stroke by using the Beck Depression Inventory 2 (BDI - 2), the State-Trait Anxiety Inventory (STAI), the Positive and Negative Syndrome Scale (PANSS), and the Cornell Services Index (CSI). Follow-up testing with the same tests was performed after 3 months. Statistical analysis included methods of descriptive statistics: tabular presentation of the frequency and percentages in case of nonparametric (nominal or ordinal) variables. Contingency tables were used to present relationships between two variables. In addition, measures of central tendency (arithmetic mean) and measures of dispersion (standard deviation) were used for parametric variables. The chisquared test was used to determine differences between groups for nominal measurement variables, Cramer&rsquo;s V was used to examine association between nominal levels of measurement. Association between interval measurement variables was measured by the Pearson correlation coefficient (r), and significance of differences between arithmetic means of more groups was determined by the analysis of variance (ANOVA). RESULTS: The study included 101 patients, 65.3% male and 34.7% female. The average age of patients was 60.69 years (median=62.00, standard deviation=10.828, statistical error=1.077). Stroke localizations were as follows: the right cerebral hemisphere in 38.6%, the left hemisphere in 34.7%, the cerebellum in 4%, the brainstem in 11.9%, and 10.9% of patients had multiple localizations. In 39.6% of patients, stroke was territorial, and in 59.4% lacunar. The distribution of risk factors for stroke was typical for the study area. Normal carotid arteries were found in 26.7%, 26.7% had diffuse atheromatosis, 27.7% had &lt;70% ACI stenosis, and 18.8% had &gt;70% ACI stenosis. As regards VB circulation, 52.5% had normal findings and 47.5% had pathological findings (stenosis and diffuse atheromatosis). As regards the circle of Willis, 54.5% had normal findings and 45.5% had pathological findings (stenosis and diffuse atheromatosis). Regarding mental functioning, 5.9% had depressive disorder, 29.7% had anxiety disorder, 9.9% had neurotic disorder, and 2% had psychotic disorder. In relation to sex, mental disorders were present as follows: depressive disorder in 3% of men and 11.4% of women, anxiety disorder in 25.8% of men and 37.1% of women, neurotic disorder in 7.6% of men and 14.3% of women, and psychotic disorder in 3% of men and none of women. With respect to age, among patients under 45 years of, age none had depressive disorder, 30% had anxiety disorder, 10% had psychotic disorder, and none had neurotic disorder. In the group of patients aged 46-65 years, 6.9% had depressive disorder, 22.4% had anxiety disorder, 12.1% had neurotic disorder, and 1.7% had neurotic disorder. In the group above 65 years of age, 6.1% had depressive disorder, 42.4% had anxiety disorder, 9.1% had neurotic disorder, and none had psychotic disorder. The distribution of responses obtained on the BDI-2 showed a higher prevalence of depressive disorder in patients with lesions in the left cerebral hemisphere. The distribution of responses obtained on the STAI showed a higher prevalence of anxiety disorder in patients who had lesion of the right hemisphere. The distribution of responses obtained on the CSI showed a higher prevalence of neurotic disorder in those who had multiple lesions. The distribution of responses obtained by the PANSS indicated a higher prevalence of psychotic disorder in those with lesion of the right hemisphere. Comparison of carotid artery lesions and mental disorders showed a progressive increase in the prevalence of mental disorders with increasing severity of the lesions, as well as a complete absence of mental disorders in people who had normal findings on carotids. The follow-up results showed that mental disorders (generally and individually) did not have a statistically significant effect on functional recovery of stroke patients. There were statistically significant comorbidities of depressive disorder and anxiety disorder, depressive disorder and neurotic disorder, and anxiety disorder and neurotic disorder, and no significant interactions of any of these disorders with psychotic disorder. CONCLUSION: In patients with ischemic stroke, anxiety disorder has the highest prevalence, followed by depressive disorder, whereas psychosis is the rarest. Depressive and anxiety disorders are significantly more common in women, while psychotic disorder occurs exclusively in men. Depressive disorder is significantly more common in the middle and old ages, anxiety disorder is more frequent in the younger and middle ages, while psychotic manifestations occur most often in the middle age of life. Depressive and anxiety disorders are similarly prevalent in patients with territorial and lacunar strokes, while psychotic manifestations occur exclusively in patients with territorial stroke. There is no significant correlation between the presence of stroke risk factors and mental disorders, although there is an evident absence of mental disorders in patients without stroke risk factors. Three months after stroke, no significant regression of the symptoms of mental disorders was observed. Anxiety disorder and psychotic manifestations are significantly more common in right hemispheric stroke, while as regards depressive disorder, there is no statistically significant association with left-hemispheric stroke. Mental disorders in stroke patients are more common in those with carotid lesions and increase in severity with increasing severity of lesion and degree of stenosis. There are no statistically significant correlations between lesions in the vertebrobasilar circulation or the circle of Willis and development of mental disorders. No significant impact of mental disorders on recovery from stroke was found. A high prevalence of comorbid depressive and anxiety disorders was proven/confirmed.</p>

Há escassos estudos sobre a monitorização eletrocardiográfica ambulatorial em casuísticas brasileiras de indivíduos assintomáticos submetidos ao exame clínico. Com a finalidade de avaliar a freqüência cardíaca, as arritmias cardíacas, e os distúrbios atrioventriculares de condução, foram estudados 625 indivíduos assintomáticos, com exame clínico normal. A idade variou de 15 a 83 (média 42, desvio padrão 11,9) anos; 276 (44,2%) eram homens e 349 (55,8%) mulheres. Os indivíduos foram submetidos ao exame clínico, que incluiu história, exame físico e avaliação laboratorial, além da monitorização eletrocardiográfica ambulatorial de 24 h. Foram estudadas as variáveis obtidas na monitorização eletrocardiográfica ambulatorial nas 24 h de gravação e nos períodos das 6h às 22h, e das 22h às 6h em relação às variáveis do exame clínico-laboratorial. Para a análise dos dados, depois da estatística descritiva, as variáveis contínuas foram examinadas com o emprego da correlação canônica, da regressão linear simples e da regressão linear múltipla. As variáveis categóricas foram analisadas por meio da regressão logística. A freqüência cardíaca mínima nas 24h e no período das 22h às 6h elevou-se com o aumento da idade apenas nos homens. A idade foi a principal influência nas variáveis de freqüência cardíaca na correlação canônica (0,55; p<0,01). A freqüência cardíaca máxima nas 24h e a freqüência cardíaca média nas 24h diminuíram com o aumento da idade. A freqüência cardíaca mínima nas 24h aumentou com a idade em homens e mulheres. A freqüência cardíaca média das 22h às 6h elevou-se com o aumento da idade nos homens e diminuiu nas mulheres. A freqüência cardíaca máxima no eletrocardiograma de esforço não demonstrou correlação com a duração do exercício. A freqüência cardíaca média nas 24 h, das 6h às 22h e das 22h às 6h aumentaram com o aumento do índice de massa corpórea. As arritmias supraventriculares ocorreram em 509 (81%) indivíduos. As extra-sístoles supraventriculares variaram de 1 a 3694 (média de 66,6; desvio padrão de 314,4 e mediana de 5). As arritmias ventriculares ocorreram em 399 (64%) indivíduos. As extra-sístoles ventriculares variaram de 1 a 24.900 (média de 214,8; desvio padrão de 1491,7 e mediana de 3). O bloqueio atrioventricular de segundo grau Mobitz I ocorreu em 2,2% dos indivíduos. A presença de bloqueio atrioventricular de segundo grau Mobitz I revelou associação com o aumento dos triglicérides e com a freqüência cardíaca no eletrocardiograma de repouso menor que 60 batimentos por minuto. As arritmias supraventriculares e ventriculares, embora comuns, foram pouco freqüentes. Os bloqueios atrioventriculares foram pouco freqüentes; entretanto demonstrou-se associação entre bloqueios atrioventriculares e hipertrigliceridemia e com a freqüência cardíaca em repouso inferior a 60 batimentos por minuto. A freqüência cardíaca mínima nas 24h, das 6h às 22h e das 22h às 6h modifica-se com o aumento da idade, modificação essa que foi diferente nos homens e nas mulheres, sem que, entretanto tenha ficado demonstrada relação com a duração do exercício no eletrocardiograma de esforço. Em conclusão, a freqüência cardíaca mínima e máxima se modificaram com o aumento da idade, de modo diferente em homens e mulheres e sofreram influência da massa corpórea. As arritmias foram freqüentes, de baixa densidade e a freqüência aumentou com a idade. A freqüência de distúrbios da condução atrioventricular aumentou com a idade e com o aumento dos triglicérides. / There are few studies on ambulatory electrocardiographic monitoring in brazilian asymptomatic individuals without heart disease. To study heart rate, cardiac arrhythmias, and atrioventricular conduction disturbances, we evaluated 625 asymptomatic individuals with normal clinical examination. The age ranged between 15-83 (mean 42, standard deviation 11,9) years; 276 (44,2%) were men and 349 (55,8%) women. The individuals were submitted to clinical examination, including clinical history, physical examination, laboratory evaluation, and continuous 24h ambulatory electrocardiographic monitoring. After the descriptive statistics, the continuous variables were examined with canonic correlation, simple linear regression and multiple linear regression. The categorical variables were analyzed by logistic regression. The minimum heart rate, during the 24h-period and of the 6h-22h period, increased with aging only in men. The age was the main influence on heart rate on canonic correlation (0,55; p<0,01). The maximum and mean heart rate in 24h decreased with aging. The minimum heart rate in 24h increased with the age in men and women. The mean heart rate from 22h to 6h increased with advancing of age in men and decreased in women. The maximum heart rate and the duration of exercise in the stress electrocardiographic examination did not demonstrate correlation with the heart rate on ambulatory electrocardiographic monitoring. The mean heart rate during 24h period, 6h to 22h period and 22h to 6h periods increased with the elevation of the body mass index. Supraventricular arrhythmia occurred in 509 (81%) individuals. Isolated supraventricular arrhythmia rate varied from 1 to 3694 (mean 66,6; standard deviation 314,4 and median of 5) beats. Ventricular arrhythmias were detected in 399 (64%) individuals. The ventricular arrhythmia rate varied from 1 to 24900 (mean 214,8; standard deviation 1491,7; median of 3) beats. Second-degree atrioventricular block, Mobitz I, occurred in 2,2% of the individuals. Second-degree atrioventricular block, Mobitz I, was associated with to the increase of serum triglycerides and the heart rate in the under 60 beats per minute on the rest electrocardiogram. The supraventricular and ventricular arrhythmias were common but a low frequency. The atrioventricular blocks were infrequent. The minimum heart rate in the periods of 24h, from 6 to 22h and from 22h to 6h was modified by aging, but occurred differently in men and women, without demonstrating any relation to the duration the exercise. In conclusion, the minimum and maximum heart rate were modified with the increase of the age, in a different fashion in men and women, and influence of the body mass index. Arrhythmias were frequent, but had low density and increased with the age. The atrioventricular conduction block increased with the increase of age and triglycerides.

One in three American older adults fall every year, making falls the leading cause of nonfatal injury treated in the emergency department (Centers for Disease Control and Prevention [CDC], 2013). Fall-related injuries cost the United States healthcare system nearly $30 billion a year and result in 27,000 deaths per year (Burns, Stevens, & Lee, 2016). The risk of falls increases with age, occurring more often in women than man. Age-related muscle weakness and functional decline contribute to fall risk. Age-related changes in neuroendocrine hormone production and shifts in circadian rhythms promote sleep disorders, affecting nearly two-thirds of older adults. Poor sleep quality over time leads to drowsiness and impaired attention span and judgment. The purpose of this secondary analysis of a previously collected data set was to describe the relationships among frailty, subjective sleep quality, and falls in community-dwelling older adults. This secondary analysis also sought to determine the extent to which frailty and subjective sleep quality predict risk of future falls among community-dwelling older adults. Correlational analyses were performed to determine the nature and significance of the relationship between sleep quality and falls, frailty and falls, and sleep quality and frailty. A multiple regression analysis was performed to determine if sleep quality and frailty combined could predict falls. Frailty was found to account for a small variance in fall risk. However, sleep quality was not significantly related to falls nor was sleep quality predictive of falls. Risk for falls should be assessed at every clinical encounter and efforts to promote restful sleep should be addressed at least annually to reduce the risks of falls, functional decline, and sleep disorders among older adults in the community. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2017. / FAU Electronic Theses and Dissertations Collection

Oxidative stress is the major driving force behind the aging process and many age-related diseases. However, direct experimental evidence of whether antioxidants, such as ascorbate (AA) and lipoic acid (LA) can slow the progression of aging process and/or reduce risks of developing degenerative disease is largely absent. This suggests a better understanding of the precise mechanism of how dietary micronutrient affect parameters of involved in cellular redox balance and aging are warranted. In this dissertation, young and old rats were used as our model to understand potential pro-oxidant events that contribute to increases in oxidative stress in various tissues and how antioxidants such as ascorbate and lipoic acid influence these events. Our major findings are that the age-related impairment of mitochondria and increased deposition of iron contribute significantly to heighten levels of oxidative stress, as evidenced by the resultant increases in the rates of oxidant appearance and in the levels of oxidative damage to DNA, lipids and proteins. We find that AA and LA strongly protected against transition metal-ion dependent increases in oxidative stress. AA effectively inhibited transition metal-mediated lipide peroxidation in human plasma. LA in its reduced form effectively binds iron and copper in a redox inactive manner and reversed chronically elevated levels of iron in the brain without removing enzyme bound transition metal ions. LA also significantly attenuated the age-related increase in oxidative stress associated with mitochondrial decay in the heart, as evidenced by the improvements in AA levels and glutathione redox status. The declines in tissue GSH levels in aged rats were strongly associated with the diminished γ-GCL activity (in parallel with decreased expression of the catalytic and modulatory subunits), and lowered Nrf2 expression and binding to ARE sequence in rat liver. Remarkably, all these events were effectively reversed by the administration of LA, modulating the parameters to return to the observed in young animals. The implications of this work open new avenues not only for further understanding of the aging process but also for possible strategies in its modulation by the micronutrients. / Graduation date: 2004

Immunity to asexual blood-stage of Plasmodium falciparum malaria is believed to be associated with protective antibodies of certain immunoglobulin classes and subclasses. This thesis addressed the importance of antibodies in relation to malaria infection and their effective interactions with Fc gamma receptor IIa (FcyRIIa) polymorphisms. Our data indicate that the frequency of FcyRIIa-R/R131 genotype was statistically significantly higher in Sudanese patients with severe malaria, while the FcyRIIa-H/H131 genotype showed a significant association with mild malaria. The levels of IgG1 and IgG3 subclass antibodies were statistically higher in the mild malaria patients. The Fulani ethnic group in West Africa has been shown to be relatively resistant to malaria. We investigated the possible impact of FcyRIIa polymorphisms in the Fulani and non-Fulani in Mali and Sudan, and analysed their malaria-reactive IgG subclass profiles. The FcyRIIa-H/H131 genotype and H131-allele were found to be prevalent in the Fulani while R131-allele was prevalent in non-Fulani. The Fulani had higher serum levels of IgG1-3, with higher proportion of IgG2 than the non-Fulani. Most clinico-epidemiology studies have been in areas with holo- and hyper-malaria endemicity. We have analysed antibody responses to a panel of six blood-stage antigens in relation to clinical malaria outcome in mesoendemic Sudan. Our results revealed a linear association with anti-AMA-1 IgG1 antibodies and reduced risk of severe malaria while a non-linear relationship with IgG3 antibodies was observed for MSP-2, MSP-3 and GLURP. In the combined final model, the highest levels of IgG1 subclass antibodies to AMA-1, GLURP-R0, and the highest levels of IgG3 subclass antibodies reactive to 3D7 MSP-2 were independently associated with a reduced risk of clinical malaria. Taken together, these data suggest a possible association between FcyRIIa-R/H131 and anti-malarial antibody responses in the clinical outcome of malaria.