Widespread cerebral haemodynamics disturbances occur early in amyotrophic lateral sclerosis.

We wished to longitudinally assess early changes in cerebral perfusion (CP) and its relationship to cognitive impairment (CI) in ALS. Fourteen ALS patients at time of diagnosis and 11 spousal controls, both without CI, were longitudinally assessed to determine a relationship between CP and incidence of CI in early stage disease. Neuropsychological testing and CP measurements were performed in both ALS and control groups at the initial assessment (T0) and two time-periods post initial assessment, T1 and T2, taken on average 6.

Neuropsychological functioning in PLS: a comparison with ALS.

Objective: In order to characterize the nature and extent of neuropsychological dysfunction in primary lateral sclerosis (PLS), we studied prospectively cognitive, emotional, and behavioral functioning in PLS, and compared performances to functioning in amyotrophic lateral sclerosis (ALS).

Methods: Eighteen patients with PLS and 13 patients with ALS completed a neuropsychological test battery assessing both cognitive skills and emotional/behavioral functioning.

Results: Both PLS and ALS groups scored broadly within normal limits (mean T-scores greater than 40) on all cognitive measures and no significant between-group differences were found with the exception of one variable.

Cerebral haemodynamic changes accompanying cognitive impairment in primary lateral sclerosis.

Our objective was to elucidate the relationship between cognitive decline and cerebral haemodynamics in patients with PLS. We examined 18 patients with PLS and contrasted both neuropsychological and cerebral perfusion findings with seven age- and education-matched non-PLS controls. PLS patients were stratified into two groups based on the number of abnormal neuropsychological test scores: 1) cognitively intact PLS patients (PLS; those having zero or one abnormal scores (n =14)), and 2) cognitively-impaired PLS patients (PLSci; those having two or more abnormal test scores (n =4)).

Differentiation between primary lateral sclerosis and amyotrophic lateral sclerosis: examination of symptoms and signs at disease onset and during follow-up.

Background: Motor neuron diseases can affect the upper motor neuron and/or the lower motor neuron. Both amyotrophic lateral sclerosis (ALS) and primary lateral sclerosis (PLS) are motor neuron diseases, and there is much debate as to whether these are 2 separate disorders or simply 2 points on a continuum.

Objective: To determine which clinical features at onset and during follow-up could help differentiate between PLS and ALS.

Prognosis of amyotrophic lateral sclerosis with respiratory onset.

Respiratory muscle involvement is a recognised, but often late, complication of amyotrophic lateral sclerosis (ALS). The clinical features and prognosis of 21 patients with respiratory onset ALS are reported here. On a retrospective chart review, it was found that 2.

The effect of involvement in participatory research on parent researchers in a Sure Start programme.

Involving service users, patients and members of local communities in health and social care research is becoming increasingly common. However, surprisingly little research has been carried out to examine the experiences of such lay researchers. This paper presents the findings of a study to investigate the experiences of a group of parent researchers involved in a community survey within a UK Sure Start programme.

Tian ma, an ancient Chinese herb, offers new options for the treatment of epilepsy and other conditions.

Our purpose is to bring attention to the antiepileptic properties of the Chinese herb tian ma and its constituents, as well as to suggest the potential for the development of new antiepileptic drugs (AEDs) related to this herb. All available literature regarding the chemistry, pharmacology, animal data, and clinical use of tian ma and its constituents are reviewed, showing that tian ma, its constituents, and its symbiotic fungus Armillaria mellea have antiepileptic properties in in vitro and in vivo models. One clinical study reportedly demonstrated the AED effects of a component of tian ma, vanillin.

Use of complex adaptive systems metaphor to achieve professional and organizational change.

Aim: This paper uses the experiences of a programme designed to bring about change in performance of public health nurses (health visitors and school nurses) in an inner city primary care trust, to explore the issues of professional and organizational change in health care organizations.

Background: The United Kingdom government has given increasing emphasis to programmes of modernization within the National Health Service. A central facet of this policy shift has been an expectation of behaviour and practice change by health care professionals.

The development and application of a public health skills assessment tool for use in primary care organisations.

The public health skills assessment instrument described in this paper was developed to provide a key group of UK primary care practitioners (health visitors) with a personal development planning tool and researchers with a robust assessment tool for use in evaluations of innovative local public health programmes. Pilot testing with over 120 practitioners has provided evidence of its reliability and validity as a research instrument as well as yielding useful insights for public health educators, practitioners and policy-makers. Factor analysis confirms 10 core competency domains for health visitors which are remarkably consistent with those recently identified for UK public health specialists, interpreted here as grounds for optimism in the greater co-ordination between strategic and front-line approaches to public health work in primary care.

Public health nursing: barriers and opportunities.

This paper reports the findings of a descriptive study that examined the understanding and practice of public health nursing in one English NHS Region. Using questionnaires and focus groups, data were collected from nurses working in Health Authorities, senior Trust management, operational management and nursing practice across hospital and community services. The data were analysed using qualitative methods.