Rehabilitation for persons with epilepsy : Assessment of a comprehensive rehabilitation program

Epilepsy is one of the most common serious neurological disorders with an estimated prevalence of approximately 0.5%. In addition to the obvious medical risk associated with epilepsy, psychosocial consequences may be extensive. These can include problems related to different comorbidities and disabilities as well as cognitive impairment. Low self-esteem and self-efficacy may furthermore contribute, and result in increased unemployment rates. Besides the need to manage a situation with unpredictable recurrent seizures, people with epilepsy can be stigmatized and have to face prejudiced attitudes from their environment. To manage this wide range of problems, some persons with epilepsy are offered comprehensive multi-professional rehabilitation. Rehabilitation programs for persons with epilepsy are sparse and systematic evaluations of their effectiveness rare. Given this and our experience from the neurological rehabilitation clinic at the Stora Sköndal Foundation, we found it urgent to assess this rehabilitation program, the overall aim being to provide a basis for further development and refinement of rehabilitation programs for persons with epilepsy. The specific aims of the two included studies were To describe the current situation of patients who completed epilepsy rehabilitation program between 1993 and 2009, with emphasis on their employment or education (EoE) status, and to identify factors associated with a favourable development of EoE after rehabilitation (Paper I) To identify and describe issues, experienced as essential in rehabilitation, for persons with epilepsy and for members of the rehabilitation team. (Paper II) The first study was a long-term follow-up of 124 patients with epilepsy that had participated in the rehabilitation program. Data were collected from medical records at admission and discharge from the rehabilitation, and from a structures telephone interview 1-17 years after the rehabilitation. Participation in EoE improved from admission to follow-up in 38 patients. Tonic-clonic seizures at admission as well as decreased frequency of tonic-clonic seizure from admission to follow up were associated with increased participation in EoE in univariable analysis, but the association was no longer statistically significant in an adjusted multivariable analysis. In the second study, we carried out five focus group interviews with patients (n=17) and one focus group interview with staff members (n=5) of the rehabilitation team. The groups were asked to discuss “What is experienced as important in rehabilitation for persons with epilepsy?” Using content analysis, two themes emerged: Life with epilepsy and Rehabilitation experiences. The result emphasizes that rehabilitation for persons with epilepsy should be designed individually, in structure and in content. Encounters between patients were important, as well as the team’s attitude in the meeting with the patients. Therapeutic working alliance is essential between patients and staff for creating an individual rehabilitation. In conclusion, while EoE participation was improved at follow-up, we could not identify specific clinical factors associated with a favorable development of EoE participation after rehabilitation, whereas focus group interviews of patients and staff revealed a number of components that were experienced as important in epilepsy rehabilitation

Studies on Schistosome Dermatitis (\u27Swimmer\u27s Itch ) in Minnesota

A preliminary study was conducted to determine the causative agents of schistosome dermatitis ( swimmer\u27s itch ) in Minnesota and to determine the incidence schistosome infection in vector snails. A total of 1180 snails were collected from ten different localities, eight of which were sites of known schistosome activity . The incidence of schistosome infection in snails from individual areas was always less than 10 percent. Cercariae of Trichobilharzia ocellata from Lymnaea stagnalis were the most frequently-found schistosomes in our study

Long-term follow-up after comprehensive rehabilitation of persons with epilepsy, with emphasis on participation in employment or education

The objective of this study was to describe the current situation of patients with epilepsy after rehabilitation with emphasis on employment and education and to investigate if clinical factors at admission were associated with increase in employment or education. All patients that participated in a comprehensive rehabilitation were eligible. Data were collected from medical records at admission, during rehabilitation, at discharge and from a structured telephone interview at follow-up 1-17 years after admission. In total, 124 patients participated in the follow-up. Participation in employment or education improved from admission to follow-up in 38 patients. In univariable analysis, active epilepsy with tonic-clonic seizures at admission was significantly associated with increased participation in employment or education at follow-up, so was decreased frequency of tonic-clonic seizures from admission to follow-up. The significance of the associations disappeared in adjusted multivariable analysis. Participation in employment or education was improved for many patients at follow-up.AFA InsuranceAccepte

Cometary Ionospheres: An Updated Tutorial

This chapter aims at providing the tools and knowledge to understand and model the plasma environment surrounding comets in the innermost part near the nucleus. In particular, our goal is to give an updated post-Rosetta view of this ionised environment: what we knew, what we confirmed, what we overturned, and what we still do not understand

Cometary Ionospheres: An Updated Tutorial

This chapter aims at providing the tools and knowledge to understand and model the plasma environment surrounding comets in the innermost part near the nucleus. In particular, our goal is to give an updated post-Rosetta view of this ionised environment: what we knew, what we confirmed, what we overturned, and what we still do not understand.Comment: 41 pages, 14 figures, 3 tables; To be published in Comets III (2023), K. J. Meech and M. Combi (Eds.), University of Arizona Press, Tucso

Public Perceptions of Birthmothers of Adopted Children

A woman who has experienced an unintended pregnancy and chooses to place the child for adoption is known as a birthmother. When faced with an unintended pregnancy, women typically have three courses of action. They may choose to parent the child, terminate the pregnancy, or place the child for adoption. There is limited research on birthmothers themselves or societal perceptions of them. When it comes to societal perceptions of abortion, religiosity is a significant factor. Contrary to popular belief, many of the women who choose to abort do so in order to preserve the lives of their families. Single mothers are judged as poor workers due to their devotion to their children, a viewpoint that is compounded if the mother is black. This indicates that race may also play a role in perceptions of birthmothers. This research aimed to discover public perceptions of birthmothers and test factors that might contribute to those perceptions namely, abortion opinions. This study utilized data collected from a previous study with an online survey of 501 students from a university population conducted in the spring of 2015. Survey questions were open ended, multiple choice, and Likert scale. This study discovered that opinions of birthmothers are largely positive and that opinions on abortion may have a link with opinions of birthmothers. The findings of this study are important because there is minimal research on birthmothers and it helps shed light on public perceptions of this marginalized group. Research has shown that many birthmothers experience a lack of social support that could be remedied from programming that helps these women cope within society and efforts to educate the public about them

Polar cap arcs from the magnetosphere to the ionosphere: kinetic modelling and observations by Cluster and TIMED

On 1 April 2004 the GUVI imager onboard the TIMED spacecraft spots an isolated and elongated polar cap arc. About 20 min later, the Cluster satellites detect an isolated upflowing ion beam above the polar cap. Cluster observations show that the ions are accelerated upward by a quasi-stationary electric field. The field-aligned potential drop is estimated to about 700 V and the upflowing ions are accompanied by a tenuous population of isotropic protons with a temperature of about 500 eV. <br><br> The magnetic footpoints of the ion outflows observed by Cluster are situated in the prolongation of the polar cap arc observed by TIMED GUVI. The upflowing ion beam and the polar cap arc may be different signatures of the same phenomenon, as suggested by a recent statistical study of polar cap ion beams using Cluster data. <br><br> We use Cluster observations at high altitude as input to a quasi-stationary magnetosphere-ionosphere (MI) coupling model. Using a Knight-type current-voltage relationship and the current continuity at the topside ionosphere, the model computes the energy spectrum of precipitating electrons at the top of the ionosphere corresponding to the generator electric field observed by Cluster. The MI coupling model provides a field-aligned potential drop in agreement with Cluster observations of upflowing ions and a spatial scale of the polar cap arc consistent with the optical observations by TIMED. The computed energy spectrum of the precipitating electrons is used as input to the Trans4 ionospheric transport code. This 1-D model, based on Boltzmann's kinetic formalism, takes into account ionospheric processes such as photoionization and electron/proton precipitation, and computes the optical and UV emissions due to precipitating electrons. The emission rates provided by the Trans4 code are compared to the optical observations by TIMED. They are similar in size and intensity. Data and modelling results are consistent with the scenario of quasi-static acceleration of electrons that generate a polar cap arc as they precipitate in the ionosphere. The detailed observations of the acceleration region by Cluster and the large scale image of the polar cap arc provided by TIMED are two different features of the same phenomenon. Combined together, they bring new light on the configuration of the high-latitude magnetosphere during prolonged periods of Northward IMF. Possible implications of the modelling results for optical observations of polar cap arcs are also discussed

Making waves: Mirror Mode structures around Mars observed by the MAVEN spacecraft

We present an in-depth analysis of a time interval when quasi-linear mirror mode structures were detected by magnetic field and plasma measurements as observed by the NASA/Mars Atmosphere and Volatile EvolutioN (MAVEN) spacecraft. We employ ion and electron spectrometers in tandem to support the magnetic field measurements and confirm that the signatures are indeed mirror modes. Wedged against the magnetic pile-up boundary, the low-frequency signatures last on average $\sim$10 s with corresponding sizes of the order of 15-30 upstream solar wind proton thermal gyroradii, or 10-20 proton gyroradii in the immediate wake of the quasi-perpendicular bow shock. Their peak-to-peak amplitudes are of the order of 30-35 nT with respect to the background field, and appear as a mixture of dips and peaks, suggesting that they may have been at different stages in their evolution. Situated in a marginally stable plasma with $\beta_{||}\sim$1, we hypothesise that these so-called magnetic bottles, containing a relatively higher energy and denser ion population with respect to the background plasma, are formed upstream of the spacecraft behind the quasi-perpendicular shock. These signatures are very reminiscent of magnetic bottles found at other unmagnetised objects such as Venus and comets, also interpreted as mirror modes. Our case study constitutes the first unmistakable identification and characterisation of mirror modes at Mars from the joint points of view of magnetic field, electron and ion measurements. Up until now, the lack of high-temporal resolution plasma measurements has prevented such an in-depth study.Comment: 37 pages, 11 figures, 1 tabl