Background: Previous studies that have examined functional status in relation to vascular events have focused on the short term after events and have measured functional status a limited number of times. The trajectories of functional status before and after vascular events are not well characterized, and the factors influencing these trajectories are not well known. Methods: A comprehensive, structured, narrative review was performed on the topic of trajectories of disability and cognition surrounding vascular events. Then using 2 large population-based epidemiologic cohorts, the Northern Manhattan Study (NOMAS) and the Cardiovascular Health Study (CHS), trajectories of functional status were examined. In Analysis A, in NOMAS, the effect of inflammatory biomarkers (interleukin-6 [IL6], tumor necrosis factor receptor-1 [TNFR1], C-reactive protein [CRP], and lipoprotein-associated phospholipase-A2 [LpPLA2]) on the intercept and slope of functional status was determined over a median of 13 years, measured with yearly assessments by the Barthel index. In Analysis B, in NOMAS, a similar modeling strategy was used to examine whether subclinical ischemic disease on brain MRIs, measured by subclinical brain infarct (SBI) and white matter hyperintensity volume (WMHV), was associated with functional trajectories. In Analysis C, in CHS, participants had yearly assessments of disability with a combined activities of daily living (ADL) and instrumental ADL scale. The slope of change in disability was compared before and after vascular events (stroke and myocardial infarction [MI]). Results: In Analysis A, CRP (-0.41 BI points per 1 SD increase, 95% CI -0.82 to 0.002) and LpPLA2 (-0.40, 95% CI -0.75 to -0.04) were associated with baseline BI but not change over time. TNFR1 was associated with baseline BI (-0.93, 95% CI -1.59 to -0.26) and change over time (-0.36 BI points per year, 95% CI -0.69 to -0.03). In Analysis B, functional change was -0.85 BI points per year (95%CI -1.01 to -0.69); among those with SBI there were -0.88 additional points annually (-1.44 to -0.32). In WMHV models, annual functional change was -1.04 points (-1.2 to -0.88), with -0.74 additional points annually per SD WMHV increase (-0.99 to -0.49). In Analysis C, stroke (0.88, 95% CI 0.57-1.20, p<0.0001) was associated with a greater acute increase in disability than MI (0.20, 0.06-0.35, p=0.006). The annual increase in disability before stroke (0.06 points per year, 0.002-0.12, p=0.04) more than tripled after stroke (0.15 additional points per year, 0.004-0.30, p=0.04). The annual increase in disability before MI (0.04 points per year, 0.004-0.08, p=0.03) did not change significantly after MI (0.02 additional points per year, -0.07-0.11, p=0.7). Conclusions: In these large population-based studies with repeated measures of functional status and disability over long-term follow-up, several trajectories were found. In Analysis A, TNFR1 predicted worse overall functional status as well as accelerated decline over time. In Analysis B, both SBI and WMHV were associated with accelerated decline. In Analysis C, there was a steeper decline in function after stroke but not MI. These findings help to elucidate the course and potential etiologies of long-term functional decline related to vascular events, and they suggest directions for future research in this area.

Researchers have used electroencephalography (EEG) as a window into the activities of the brain. High temporal resolution coupled with relatively low cost compares favourably to other neuroimaging techniques such as magnetoencephalography (MEG). For many years silver metal electrodes have been used for non-invasive monitoring electrical activities of the brain. Although these electrodes provide a reliable method for recording EEG they suffer from noise, such as offset potentials and drifts, and usability issues, e.g. skin prepa- ration and short circuiting of adjacent electrodes due to gel running. Low frequency noise performance is the key indicator in determining the signal to noise ratio of an EEG sensor. In order to tackle these issues a prototype Electric Potential Sensor (EPS) device based on an auto-zero operational amplifier has been developed and evaluated. The absence of 1/f noise in these devices makes them ideal for use with signal frequencies ~10Hz or less. The EPS is a novel active electrode electric potential sensor with ultrahigh input impedance. The active electrodes are designed to be physically and electrically robust and chemically and biochemically inert. They are electrically insulated (anodized) and scalable. These sensors are designed to be immersed in alcohol for sterilization purposes. A comprehensive study was undertaken to compare the results of EEG signals recorded by the EPS with different commercial systems. These studies comprised measurements of both free running EEG and Event Related Potentials. Strictly comparable signals were observed with cross correlations of higher than 0.9 between the EPS and other systems.

One woman examines her experiences with epilepsy over the past twenty years.

Thesis (M.A. (Psychology)) --University of Limpopo, 2009 / Conceptions of epilepsy were studied using Q-methodology. The study was conducted at the University of Limpopo (Turfloop Campus) and the surrounding communities. The aim was to examine perceptions of epilepsy among different categories of people and to explore and differentiate between these categories’ individual construction of what epilepsy is. Thirty three participants were recruited for the study. They included medical professionals (doctors and nurses), traditional and spiritual healers, university students (consisting of both health sciences and non-health sciences students), two ethnic groups (namely, the Bapedi and Vhavenda), people who are from both rural and urban areas, and high school teachers. Each category was represented by three people. Participants sorted thirty six statements developed from interviews. Four factors emerged from the analysis, and were labeled as medical perceptions of epilepsy, equality of treatment for epileptics, traditionalist perceptions of epilepsy, and religious beliefs of epilepsy. These factors are discussed. / National Research Foundation

<p><strong>Problemställning: </strong>Stroke är en världsomspännande, allvarlig och kostnadskrävande sjukdom. Sjuksköterskans omvårdnadsinsatser av patienter med stroke bör anpassas individuellt och syfta till att främja återhämtning och förhindra komplikationer. Det är därför av vikt för sjuksköterskan att ha kunskap om hur strokedrabbade patienter upplever sin sjukdom. <strong>Syftet </strong>var att belysa patienters upplevelse av att drabbas av och leva med stroke. <strong>Metod:</strong> En litteraturstudie där 11 kvalitativa och 1 kvantitativ artikel som svarade mot studiens syfte ingick. <strong>Resultat och konklusion: </strong>Att drabbas av stroke påverkar personens hela liv med förlorad kontroll över både kropp och personlighet. Oro för att drabbas av en ny stroke leder till ett liv i osäkerhet men också till förändrade levnadsvanor. Stroken påverkar den drabbades roll i familjen och förhållandet, ilska och frustration över situationen går ut över de närmaste. Den sociala relationen med familj och vänner försämras, eftersom kvarstående fysiska eller kognitiva funktionsnedsättningar gör det svårt att delta i sociala sammanhang på samma sätt som innan sjukdomen. Överdrivna känslomässiga yttranden och extrem trötthet försvårar ytterligare social samvaro. <strong>Implikation: </strong>Det är viktigt att sjuksköterskan får ökad medvetenhet om strokepatienternas upplevelser för att kunna ge en individuellt utformad omvårdnad. Det finns behov av vidare forskning kring copingstrategier samt strokepatienternas upplevelser av sjuksköterskans omvårdnad.</p> / <p><strong>Problem: </strong>Stroke is a worldwide, serious and costly disease. Nursing interventions of patients with stroke should be individualized and adapted to promote recovery and prevent complications. It is therefore important for nurses to have knowledge of how the stroke affected patients experience their illness. <strong>The purpose </strong>was to illustrate patients’ experience of suffering from and living with a stroke. <strong>Method: </strong>A literature study, where 11 qualitative and one quantitative article that met the study’s purpose, were used. <strong>Results and conclusion: </strong>To suffer a stroke, affects the patient’s whole life with loss of control over both body and personality. Worries concerning the possibility to suffer a new stroke often results in a life of uncertainty but also in changing of lifestyles. The stroke affects the patient’s role in the family and in the relationship with the spouse; anger and frustration over the situation affect the immediate family negatively. The social relationships with family and friends deteriorate, because the residual physical or cognitive disabilities make it difficult to participate in social contexts in the same way as before the illness. Exaggerated emotional expressions and extreme fatigue makes social interaction even more difficult. <strong>Implication</strong><strong>:</strong> It is important that nurses are more aware of stroke patients' experiences in order to provide individualized care. There is a need for further research on coping strategies and the stroke patients' experiences of nursing.</p>

<p>The three evolutionarily related peptides neuropeptide Y (NPY), peptide YY (PYY) and pancreatic polypeptide (PP) are ligands to at least five G-protein coupled receptors in mammals, which are denoted by numbers. NPY has many physiological effects including stimulation of appetite and regulation of circadian rhythm and blood pressure. This work describes the ancient origin of the NPY receptor genes as deduced from molecular cloning of six receptors in four distantly related vertebrate species. Three of the receptors have been functionally expressed <i>in vitro</i> to determine ligand binding properties. </p><p>The first Y2 receptor from any non-mammalian species was cloned from the chicken. The receptor was found to exhibit substantial structural and pharmacological differences to mammalian Y2, but showed similar anatomical distribution. </p><p>A receptor was cloned in a primitive vertebrate, an agnathan fish, the river lamprey <i>Lampetra fluviatilis</i>. Phylogenetic analyses indicated that it represents an orthologue to the ancestor of Y4 and the teleost subtypes Yb and Yc. </p><p>Three NPY receptors were cloned from a shark, the spiny dogfish <i>Squalus acanthias</i>. These were found to correspond to the three mammalian subtypes Y1, Y4 and y6, and was thereby the first complete Y1 subfamily in any species outside the mammalian lineage. This suggests that all three receptor subtypes arose in the common ancestor of sharks and mammals 420-450 million years ago. </p><p>The sixth described receptor was cloned from the zebrafish, <i>Danio rerio</i>, and was shown to have equal identity to all three mammalian Y1 subfamily receptors. Phylogenetic analyses including the shark and lamprey sequences suggested that Yb may represent a fourth Y1 subfamily gene.</p><p>It has previously been found that the genes for Y1, Y4 and y6 are located on separate chromosomes. Taken together, these results show that the NPY receptor family expanded by chromosomal duplications early in vertebrate evolution, prior to the origin of gnathostomes. This work will be important for the determination of the time points for the origin of the many functions of NPY as well as for the understanding of the processes that shaped the vertebrate genome.</p>

The three evolutionarily related peptides neuropeptide Y (NPY), peptide YY (PYY) and pancreatic polypeptide (PP) are ligands to at least five G-protein coupled receptors in mammals, which are denoted by numbers. NPY has many physiological effects including stimulation of appetite and regulation of circadian rhythm and blood pressure. This work describes the ancient origin of the NPY receptor genes as deduced from molecular cloning of six receptors in four distantly related vertebrate species. Three of the receptors have been functionally expressed in vitro to determine ligand binding properties. The first Y2 receptor from any non-mammalian species was cloned from the chicken. The receptor was found to exhibit substantial structural and pharmacological differences to mammalian Y2, but showed similar anatomical distribution. A receptor was cloned in a primitive vertebrate, an agnathan fish, the river lamprey Lampetra fluviatilis. Phylogenetic analyses indicated that it represents an orthologue to the ancestor of Y4 and the teleost subtypes Yb and Yc. Three NPY receptors were cloned from a shark, the spiny dogfish Squalus acanthias. These were found to correspond to the three mammalian subtypes Y1, Y4 and y6, and was thereby the first complete Y1 subfamily in any species outside the mammalian lineage. This suggests that all three receptor subtypes arose in the common ancestor of sharks and mammals 420-450 million years ago. The sixth described receptor was cloned from the zebrafish, Danio rerio, and was shown to have equal identity to all three mammalian Y1 subfamily receptors. Phylogenetic analyses including the shark and lamprey sequences suggested that Yb may represent a fourth Y1 subfamily gene. It has previously been found that the genes for Y1, Y4 and y6 are located on separate chromosomes. Taken together, these results show that the NPY receptor family expanded by chromosomal duplications early in vertebrate evolution, prior to the origin of gnathostomes. This work will be important for the determination of the time points for the origin of the many functions of NPY as well as for the understanding of the processes that shaped the vertebrate genome.

Problemställning: Stroke är en världsomspännande, allvarlig och kostnadskrävande sjukdom. Sjuksköterskans omvårdnadsinsatser av patienter med stroke bör anpassas individuellt och syfta till att främja återhämtning och förhindra komplikationer. Det är därför av vikt för sjuksköterskan att ha kunskap om hur strokedrabbade patienter upplever sin sjukdom. Syftet var att belysa patienters upplevelse av att drabbas av och leva med stroke. Metod: En litteraturstudie där 11 kvalitativa och 1 kvantitativ artikel som svarade mot studiens syfte ingick. Resultat och konklusion: Att drabbas av stroke påverkar personens hela liv med förlorad kontroll över både kropp och personlighet. Oro för att drabbas av en ny stroke leder till ett liv i osäkerhet men också till förändrade levnadsvanor. Stroken påverkar den drabbades roll i familjen och förhållandet, ilska och frustration över situationen går ut över de närmaste. Den sociala relationen med familj och vänner försämras, eftersom kvarstående fysiska eller kognitiva funktionsnedsättningar gör det svårt att delta i sociala sammanhang på samma sätt som innan sjukdomen. Överdrivna känslomässiga yttranden och extrem trötthet försvårar ytterligare social samvaro. Implikation: Det är viktigt att sjuksköterskan får ökad medvetenhet om strokepatienternas upplevelser för att kunna ge en individuellt utformad omvårdnad. Det finns behov av vidare forskning kring copingstrategier samt strokepatienternas upplevelser av sjuksköterskans omvårdnad. / Problem: Stroke is a worldwide, serious and costly disease. Nursing interventions of patients with stroke should be individualized and adapted to promote recovery and prevent complications. It is therefore important for nurses to have knowledge of how the stroke affected patients experience their illness. The purpose was to illustrate patients’ experience of suffering from and living with a stroke. Method: A literature study, where 11 qualitative and one quantitative article that met the study’s purpose, were used. Results and conclusion: To suffer a stroke, affects the patient’s whole life with loss of control over both body and personality. Worries concerning the possibility to suffer a new stroke often results in a life of uncertainty but also in changing of lifestyles. The stroke affects the patient’s role in the family and in the relationship with the spouse; anger and frustration over the situation affect the immediate family negatively. The social relationships with family and friends deteriorate, because the residual physical or cognitive disabilities make it difficult to participate in social contexts in the same way as before the illness. Exaggerated emotional expressions and extreme fatigue makes social interaction even more difficult. Implication: It is important that nurses are more aware of stroke patients' experiences in order to provide individualized care. There is a need for further research on coping strategies and the stroke patients' experiences of nursing.

The neuropathology of Tourette Syndrome (TS) is poorly characterized. This thesis provides the first quantitative stereologic immunohistochemical study of the basal ganglia in TS. TS is a childhood neuropsychiatric disorder characterized by motor and vocal tics. Previous imaging studies found alterations in caudate (Cd) and putamen (Pt) volumes. To investigate possible alterations in cell populations, postmortem basal ganglia tissue from individuals with TS and normal controls (NC) was analyzed using unbiased stereological techniques. A markedly higher (>160% of control) total neuron number and density was found in the internal segment of the globus pallidus (GPi) of TS (p<0.025). An increased number (>220% of control) and proportion of these GPi neurons were positive for the calcium-binding protein parvalbumin (PV) in the tissue from TS subjects (p<0.025). In contrast, a lower number (<60% of control) of neurons was observed in the external segment (GPe) (p<0.025). In addition, there was a lower density of PV-positive interneurons in both Cd (<50% of control) and Pt (<65% of control) (p>0.025). The imbalance in striatal and GPi inhibitory neuron distribution suggests that the functional dynamics of cortico-striato-thalamic circuitry are fundamentally altered in severe, persistent TS.

Thesis (M.Sc.)--Memorial University of Newfoundland, 2001. / Bibliography: leaves 47-54.