The Prevalence of Fatigue Following Deep Brain Stimulation Surgery in Parkinson's Disease and Association with Quality of Life

Fatigue is a common and disabling nonmotor symptom seen in Parkinson's disease (PD). While deep brain stimulation surgery (DBS) improves motor symptoms, it has also been associated with non-motor side effects. To date no study has utilized standardized instruments to evaluate fatigue following DBS surgery. Our objective was to determine the prevalence of fatigue following DBS surgery in PD its impact on quality of life and explore predictive factors. We recruited 44 PD subjects. At least one year following DBS placement, we administered the Fatigue Severity Scale (FSS), the Parkinson's Disease Questionnaire (PDQ-39), the Beck Depression Inventory, the Beck Anxiety Inventory, the UPDRS, and a neuropsychological battery. Fifty-eight percent of subjects had moderate to severe fatigue. Fatigue was significantly associated with quality of life, depression, and anxiety. Depression preoperatively was the only predictive factor of fatigue. Fatigue is common following DBS surgery and significantly impacts quality of life

The Lantern Vol. 60, No. 1, December 1992

• Bacon and Incense • The Rubix Cube • Recovery • Untitled • Star Six Nine • Breakfast Talk • Life as a Worker Bee • Cabal • One Cold Sunday Morning With Eggs • By the End of February • Eight Years and Five Minutes Away • Distance • Stuart\u27s Gift • Solitary Remembrance • The Gene Thing • Addictionhttps://digitalcommons.ursinus.edu/lantern/1139/thumbnail.jp

Recommendations From the International Consortium on Professional Nursing Practice in Long-Term Care Homes

AbstractIn response to the International Association of Gerontology and Geriatrics' global agenda for clinical research and quality of care in long-term care homes (LTCHs), the International Consortium on Professional Nursing Practice in Long Term Care Homes (the Consortium) was formed to develop nursing leadership capacity and address the concerns regarding the current state of professional nursing practice in LTCHs. At its invitational, 2-day inaugural meeting, the Consortium brought together international nurse experts to explore the potential of registered nurses (RNs) who work as supervisors or charge nurses within the LTCHs and the value of their contribution in nursing homes, consider what RN competencies might be needed, discuss effective educational (curriculum and practice) experiences, health care policy, and human resources planning requirements, and to identify what sustainable nurse leadership strategies and models might enhance the effectiveness of RNs in improving resident, family, and staff outcomes. The Consortium made recommendations about the following priority issues for action: (1) define the competencies of RNs required to care for older adults in LTCHs; (2) create an LTCH environment in which the RN role is differentiated from other team members and RNs can practice to their full scope; and (3) prepare RN leaders to operate effectively in person-centered care LTCH environments. In addition to clear recommendations for practice, the Consortium identified several areas in which further research is needed. The Consortium advocated for a research agenda that emphasizes an international coordination of research efforts to explore similar issues, the pursuit of examining the impact of nursing and organizational models, and the showcasing of excellence in nursing practice in care homes, so that others might learn from what works. Several studies already under way are also described

The Grizzly, November 13, 1990

Clergy Assembly Meets Ninth Consecutive Year • Career Day: An Information Session for Students • U.S. Energy Policy Anti-American? • The Ursinus Tutoring Program • Being British Without Being English • Election Results • Students React to Reimert Security Doors • Greeks Sponsor Halloween Party • F.W. Olin Foundation • Wilk 3 Protest • The History of Olin Grant • The Changeling • INXS • Television: Whose Reality is it Anyway? • Swimmers Wash Out Washington • Cross-Country Team Pleased with Regionals • Steimy Starts Club • Men\u27s Basketball Looks for Improvement in 1991 Season • Football Finishes Season with a Loss • Letters: No Defense for Personal Abuse; Zeta Chi Missed the Point! • Uncle Sam Wants Everyone • Pre-Med Prognosis Improving • Ursinus Grad in Sticky Situation • Brownback-Anders Meetinghttps://digitalcommons.ursinus.edu/grizzlynews/1264/thumbnail.jp

Altered Ratio of D1 and D2 Dopamine Receptors in Mouse Striatum Is Associated with Behavioral Sensitization to Cocaine

BACKGROUND: Drugs of abuse elevate brain dopamine levels, and, in vivo, chronic drug use is accompanied by a selective decrease in dopamine D2 receptor (D2R) availability in the brain. Such a decrease consequently alters the ratio of D1R:D2R signaling towards the D1R. Despite a plethora of behavioral studies dedicated to the understanding of the role of dopamine in addiction, a molecular mechanism responsible for the downregulation of the D2R, in vivo, in response to chronic drug use has yet to be identified. METHODS AND FINDINGS: ETHICS STATEMENT: All animal work was approved by the Gallo Center IACUC committee and was performed in our AAALAC approved facility. In this study, we used wild type (WT) and G protein coupled receptor associated sorting protein-1 (GASP-1) knock out (KO) mice to assess molecular changes that accompany cocaine sensitization. Here, we show that downregulation of D2Rs or upregulation of D1Rs is associated with a sensitized locomotor response to an acute injection of cocaine. Furthermore, we demonstrate that disruption of GASP-1, that targets D2Rs for degradation after endocytosis, prevents cocaine-induced downregulation of D2Rs. As a consequence, mice with a GASP-1 disruption show a reduction in the sensitized locomotor response to cocaine. CONCLUSIONS: Together, our data suggests that changes in the ratio of the D1:D2R could contribute to cocaine-induced behavioral plasticity and demonstrates a role of GASP-1 in regulating both the levels of the D2R and cocaine sensitization

A Study of School Board & Superintendent Relations: Strategies for Building Trust in the Mistrustful Context of K-12 Public Education

A Study of School Board & Superintendent Relations: Strategies for Building Trust in the Mistrustful Context of K-12 Public Education By Kelly Dawn Bowers Doctor of Education University of California, Berkeley Professor Heinrich Mintrop, Chair As illuminated in my study, which is only a small subset of the larger public education governance system, the mounting political pressure that school boards and superintendents face does not seem to be diminishing. It is well documented that boards under fire from constituents often make the superintendent the scapegoat, which undermines trust and threatens their strength of relationship with an uneven power dynamic. Whether attributed to general dissatisfaction with American governance which leaves superintendents subject to the political whims and winds of school boards (Lutz & Iannaccone, 1978); their increasingly limited sphere of influence in an era of high stakes external accountability (Howell, 2005), or the acute pressures of the politics of personalism (Feuerstein & Opfer, 1998), the odds of forming solid, trusting relational bonds are stacked against them. Over the past few decades, there has been a growing movement in many fields and industries, including public education, to develop new, collaborative models and approaches to managing and governing, as an alternative to more adversarial, bureaucratic and top-down methods (Ansell & Gash, 2008). With this move away from competitive toward collaborative governance, relationship building at all levels has taken on new importance. In this case study, I examined the conflict-ridden relationship dynamic and tense micropolitical climate inherited by two superintendents and boards, within a general context of distrust directed toward public education and elected officials, which is further exacerbated by negative interactions with their immediate predecessors. Using Bryk and Schneider’s (2002) concept of relational trust which was developed in other public school system settings, as an ideal measure, I was able to gather evidence of substantive change in the tenor and positive quality of the board/superintendent relationship over time. My findings highlighted two newly hired superintendents who took stock of their somewhat damaged and mistrustful board/ superintendent relationship status upon entry and strategically cultivated relational trust with their respective school boards, as substantiated by increased and genuine displays of mutual respect, personal regard, integrity and competence in their public and private interactions. My findings indicated that a board/superintendent relationship is not static but malleable, and with concentrated focus and customized strategic intervention by a new superintendent, a previously damaged governance team relationship can be repaired and trust restored. Even in a high-trust situation, however, my conclusions divulged cautionary implications, as a board and superintendent that become too close, too trusting in the public’s perception or reality, risk becoming insular or out of touch with the larger constituency they represent and serve

Autobiographical Memory: Influence of Right Hemisphere Damage on Emotionality and Specificity

This study investigated the ability of right hemisphere damaged (RHD) patients to recall autobiographical material in response to emotional versus nonemotional cues. A modified Crovitz paradigm was used in which patients were asked to recall a specific episode from their own life that related to a cue word. These episodes were rated for emotionality and specificity by independent raters. Patients also rated the emotionality of their own episodes. Independent raters judged the reports of the RHD patients as less specific and less emotional than those of matched nonneurologic control subjects. This was true for episodes in response to emotional as well as nonemotional cue words. RHD patients\u27 own ratings of these episodes, however, did not differ from those of controls. These findings are discussed in terms of RHD patients\u27 overall difficulties in processing emotional material and in terms of the nature of autobiographical memory

Bioptic Telescope Use and Driving Patterns of Drivers with Age-Related Macular Degeneration

Purpose To investigate the telescope use and driving patterns of bioptic drivers with age-related macular degeneration (AMD). Methods: A questionnaire addressing telescope use and driving patterns was administered by telephone interview to three groups of bioptic drivers: AMD (n = 31; median 76 years); non-AMD first licensed with a bioptic (n = 38; 53 years); and non-AMD first licensed without a bioptic (n = 47; 37 years). Driving patterns of bioptic AMD drivers were also compared with those of normal vision (NV) drivers (n = 36; 74 years) and nonbioptic AMD drivers (n = 34; 79 years). Results: Bioptic usage patterns of AMD drivers did not differ from those of the younger bioptic drivers and greater visual difficulty without the bioptic was strongly correlated with greater bioptic helpfulness. Bioptic AMD drivers were more likely to report avoidance of night driving than the age-similar NV drivers (P = 0.06). However, they reported less difficulty than the nonbioptic AMD drivers in all driving situations (P ≤ 0.02). Weekly mileages of bioptic AMD drivers were lower than those of the younger bioptic drivers (P < 0.001), but not the NV group (P = 0.54), and were higher than those of the nonbioptic AMD group (P < 0.001). Conclusions: Our results suggest that bioptic telescopes met the visual demands of drivers with AMD and that those drivers had relatively unrestricted driving habits. Translational Relevance Licensure with a bioptic telescope may prolong driving of older adults with AMD; however, objective measures of bioptic use, driving performance, and safety are needed

Emotional Modulation of the Late Positive Potential during Picture Free Viewing in Older and Young Adults.

Hedonic bias during free viewing of novel emotional and neutral scenes was investigated in older adults and college students. A neurophysiological index of emotional picture processing-the amplitude of the centroparietal late positive potential (LPP)-was recorded from the scalp using a dense sensor array while participants (29 older adults; 21 college students) viewed emotionally engaging or mundane natural scenes that varied in specific content. Both students and older adults showed LPP enhancement when viewing affective, compared to neutral, scenes, and there was no difference in LPP amplitude between older individuals and college students when viewing neutral everyday scenes. However, compared to the college students, older individuals showed attenuated LPP amplitude when viewing emotional scenes, regardless of hedonic valence or specific content. Age related differences could be mediated by a reduction in reactive emotional arousal with age, possible mediated by repeated life exposure to emotional stimuli