No description available.

No description available.

No description available.

Alzheimer's disease (AD) is a condition marked by progressive intellectual decline and memory loss, which typically affects individuals over the age of 60. Its origins are unknown but genetic factors are suspected in some cases. There is limited information about the subjective experience of AD although it is often described as a calamity that inevitably destroys the self irrespective of its victims' social circumstances. This dissertation offers an alternative to this nihilistic portrayal that draws on a critical phenomenological framework. It explores the loss of self as an intersubjective phenomenon that is mediated by three contexts: (1) Western representations of the self as autonomous and individualistic; (2) the public description of AD; and (3) the biomedical practices that construct AD as a diagnostic object. / The dissertation examines the experiences of 16 patients and 37 family members who participated in a multi-disciplinary assessment at a dementia clinic. The participants also include 14 clinicians and staff members from the clinic. The findings are derived from a prospective study that includes in-depth, at-home interviews and observations of clinical assessment activities and research-based genetic counseling. The dissertation examines how memory trouble interferes with the intersubjective fabric of everyday life in families as affected participants lose the ability to meaningfully reciprocate on the basis of their individualistic identities. The analysis emphasizes the role of the clinical assessment, diagnosis, and public description in restoring intersubjective order. A salient aspect of this process is the way in which medicalized interpretations of memory trouble facilitate reinterpretation of the eroding self as being animated by pathology. The self is thus rendered meaningful again as it is being indexed to lay descriptions of what people do and say in AD. The analysis also considers how this process extends to participants who came to perceive themselves as victims of AD although they were assessed as not having a dementia disorder. The dissertation finally considers the impact of acquiring genetic knowledge about AD on interpretations of the self. Overall, the research underscores the loss of self in AD as a phenomenological process that is mediated by familial and institutional contexts.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 7 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 7 uppsatser.

Diss. Stockholm : Karol. inst. / Titel från omsl.

In order to identify patients with severe coronary artery disease (CAD) and at a higher risk of future cardiac events after uncomplicated myocardial infarction, 105 consecutive patients were studied prospectively. There were 93 men and 12 women with a mean age of 56 +/- 8.2 years. Treadmill testing, exercise radionuclide ventriculography, thallium-201 myocardial imaging and selective coronary arteriography were performed 6-8 weeks after infarction. Patients were grouped into those who had single and multiple vessel disease. Multiple regression analysis of 18 noninvasive indices was carried out using generalized linear interactive modelling (GLIM) and the results were compared with the severity of underlying CAD and the clinical outcome after a mean follow-up period of 18.8 +/- 3. 4 months. At the end of the follow-up period, patients were categorized into those who had no cardiac events, minor and major cardiac events. Multivariate analysis produced an algorithm from three factors found to be most predictive of the severity of CAD. These included ST-segment depression on exercise, total score of rest and exercise regional wall motion and the presence of significant redistribution on thallium-201 imaging. The sensitivity of this algorithm for predicting multiple vessel disease was 42%, with a specificity of 94%, and a predictive accuracy of 69%. However, the total score of regional wall motion abnormalities was the single most predictive factor of major cardiac events with a sensitivity of 94%, a specificity of 57%, and predictive accuracy of 63%. None of the other factors produced additional prognostic information. Therefore, exercise radionuclide ventriculography appears to be the investigation of choice in assessing prognosis after myocardial infarction.

In the present study, the syntactic deficit of Alzheimer's patients was investigated, using an object manipulation task. Four case studies were presented, using data from test batteries devised by Caplan (pers. comm.) and the author. Subjects responded by acting out stimulus sentences presented in aural and written modes, using a set of small figurines. Responses were evaluated following criteria described by Caplan (1986, pers. comm.). Data from the four subjects were compared with each other, and with data obtained from a similar battery administered to aphasic patients. An impairment in the ability to interpret certain syntactic structures was found for all subjects, indicating that Alzheimer's patients do suffer from a syntactic comprehension deficit in the early stages of the disease. Several syntactic structures which caused errors in the responses of the Alzheimer's subjects, also caused errors for the aphasic patients, suggesting that the parsing model underlying the design of the stimuli, described by Caplan (in press) is a valid description of normal language function. Results of the present investigation are examined in relation to a model of syntactic comprehension suggested by Caplan (in press). Contradictions to hypotheses proposed are noted. The limitations and diagnostic use of the object manipulation test, are discussed. / Medicine, Faculty of / Audiology and Speech Sciences, School of / Graduate

The fact therefore remains that, at the present time, Crohn's disease is still an enigma. The aetiology and pathogenesis are obscure, the clinical findings and progression of the disease are unpredictable and the histological findings are often nonspecific. With this in mind, this dissertation attempts to define and document the incidence of certain histological features at presentation in a population of Crohn's disease patients from Groote Schuur Hospital. The main aim is to determine the incidence of granulomas in the study group as a whole, as well as to establish the distribution of granulomas within the bowel. A correlation between the presence of granulomas and the clinical activity of the disease (as assessed by the Crohn's Disease Activity Index) is also sought.