Network solutions for home health care applications.

The growing number of the elderly in industrialised countries is increasing the pressure on respective health care systems. This is one reason for recent trends in the development and expansion of home health care organisations. With Internet access available to everyone and the advent of wireless technologies, advanced telehomecare is a possibility for a large proportion of the population.

Individual consequences of volunteer and paid work in old age: health and mortality.

The impacts of the productive social activities of volunteer and paid work on health have rarely been investigated among the oldest Americans despite a recent claim for their beneficial effect (Rowe and Kahn 1998). This paper used data from Waves 3 and 4 of the Asset and Health Dynamics among the Oldest Old (AHEAD) Study to (1) investigate the impact of these activities on health measured as self-reported health and activities of daily living (ADL) functioning limitations and to (2) explore possible causal mechanisms. Using multinomial logistic regression analysis, amounts of volunteer and paid work over a minimum of 100 annual hours self-reported at Wave 3 were related to poor health and death as competing risks measured at Wave 4, controlling for health measured at Wave 2 and for other predictors of poor health and death.

Transcranial magnetic stimulation evidence of a potential role for progesterone in the modulation of premenstrual corticocortical inhibition in a woman with catamenial seizure exacerbation.

A transcranial magnetic stimulation paired-pulse paradigm was used to determine that cortical excitability was less during the late luteal phase than in the early follicular phase in a woman with epilepsy who had premenstrual seizure exacerbation. The data are consistent with the possibility that a reduction in GABA-mediated cortical inhibitory activity may be responsible. The administration of progesterone, a reproductive steroid with potent GABAergic metabolites, during the luteal phase restored cortical excitability to normal range.

Late-onset congenital adrenal hyperplasia: presentation as nonepileptic seizures.

This is a report of a woman with refractory nonepileptic seizures, anxiety disorder, and rapidly cycling mood changes in whom high levels of excitatory neuroactive steroids due to late-onset congenital adrenal hyperplasia origin may have played a role in pathogenesis and in whom endocrine treatment was the only efficacious therapeutic modality.

Seizure exacerbation associated with inhibition of progesterone metabolism.

The reduced progesterone metabolite tetrahydroprogesterone is a potent positive modulator of GABA(A) chloride conductance that exerts powerful neuroinhibitiory and anti-seizure effects in animal models. Cyclic natural progesterone use may lessen seizure frequency in women with catamenial seizure exacerbation. We report a case in which efficacy was eliminated during concomitant treatment with a reductase inhibitor.

GnRH-immunoreactive fiber changes with unilateral amygdala-kindled seizures.

Purpose: To assess whether unilateral amygdala seizures are associated with a change in the number and lateral distribution of gonadotropin releasing hormone (GnRH)-staining fibers in the ventromedial hypothalamus of female rats.

Methods: The study compared three groups of female rats: (1) amygdala seizures induced by focal injection of kainic acid (KA); (2) saline injected controls; and (3) nai;ve controls. The animals were sacrificed at 4 weeks in the diestrus phase.

Social engagement and its relationship to health.

Older age is a time of life when major life tasks such as work and raising children have typically been completed. As a consequence, the daily demands for involvement in their social environment have lessened for older adults. It is believed that, because of their many possible benefits, social activities ultimately promote physical and mental health in older age.

Reproductive dysfunction in women with epilepsy: recommendations for evaluation and management.

Background: Epilepsy is commonly associated with reproductive endocrine disorders. These include polycystic ovary syndrome (PCOS), isolated components of this syndrome such as polycystic ovaries, hyperandrogenaemia, hypothalamic amenorrhoea, and functional hyperprolactinaemia.

Objective: To summarise the currently known relations between epilepsy and reproductive endocrine disorders.

Conflict resolution in a nutshell: tips for everyday nursing.

Current health care is a breeding ground for conflicts, both small and large. The effects of discord range from wasted personal energy to destruction of people and institutions. Nurses from direct patient care, administration, education, and research all need effective conflict resolution skills to maximize the benefit of nursing's all too scarce resources.

Informal caregiving time and costs for urinary incontinence in older individuals in the United States.

Objectives: To obtain nationally representative estimates of the additional time, and related cost, of informal caregiving associated with urinary incontinence in older individuals.

Design: Multivariate regression models using data from the 1993 Asset and Health Dynamics Study, a nationally representative survey of people aged 70 and older (N = 7,443).

Setting: Community-dwelling older people.

Troponin I converts the skeletal muscle ryanodine receptor into a rectifying calcium release channel.

The goal of our present studies has been to find novel ryanodine receptor (RyR1) interacting polypeptides that modulate the channel activity from the luminal side of RyR1. Using K(+) as charge carrier for recording of single channel events here we demonstrate a very unexpected observation that troponin I substantially alters RyR's gating behavior, and that RyR1 in association with troponin I becomes a rectifying Ca(2+) release channel. Troponin I rapidly locks the RyR1 in a non-conducting state only at a negative holding potential, and only when applied to the luminal side; switching to a positive holding potential results in the channel returning to its original activity, immediately.

Children's spatial behavior is differentially affected after traumatic brain injury.

Spatial behavior in 20 children with severe traumatic brain injury (TBI) and 20 healthy controls was investigated using the Kiel Locomotor Maze. Children had to remember defined locations in an experimental chamber with completely controlled intra- and extra-maze cues until learning criterion was reached. In a second experiment, spatial orientation strategies were assessed.

Spatial behaviour is driven by proximal cues even in mildly impaired Parkinson's disease.

This investigation addresses the question whether patients with mild to moderate Parkinson's disease (PD) show spatial deficits in real-life settings. Therefore, a "search through"-locomotor task incorporating basic features of both the radial arm maze and the Morris water maze paradigms was used. The participants had to find and remember five out of twenty hidden locations within a completely controlled environment.

Synthesis, structure, and reactivity of closo-2,3,4,5,6,7,8,9,10,11-decahydroxy-1,12-bis(sulfonic acid)-1,12-dicarbadodecaborane(12).

The reaction of closo-1,12-bis(lithio)-1,12-dicarbadodecaborane(12) (1,12-bis(lithio)-p-carborane) with SO(2) formed closo-1,12-bis(lithiosulfinato)-p-carborane (10) in nearly quantitative yield. The latter was converted to closo-1,12-bis(sulfinic acid)-p-carborane (13) via H(+)-exchange. The corresponding 1,12-bis(sulfonic acid) derivative of p-carborane (12) was obtained in high yield by treating 10 with SO(2)Cl(2) and subsequent AlCl(3) mediated hydrolysis of the closo-1,12-bis(chlorosulfonyl)-p-carborane intermediate.

Menstrual cycle interval and ovulation in women with localization-related epilepsy.

Article abstract-- In an investigation of 100 women with localization-related epilepsy, anovulatory cycles were significantly greater in proportion in women with 21-25 or 33-35 day cycles (Group B) and in women with less than 21 or more than 35 day cycles (Group C) than in women with normal 26-32 day intervals (Group A). Groups B and C also had significantly higher estradiol/progesterone ratios than Group A. Nevertheless, almost one-half (46.

National estimates of the quantity and cost of informal caregiving for the elderly with dementia.

Objective: Caring for the elderly with dementia imposes a substantial burden on family members and likely accounts for more than half of the total cost of dementia for those living in the community. However, most past estimates of this cost were derived from small, nonrepresentative samples. We sought to obtain nationally representative estimates of the time and associated cost of informal caregiving for the elderly with mild, moderate, and severe dementia.

Changes in driving patterns and worsening depressive symptoms among older adults.

Objectives: This study examined whether changes in driving patterns-driving cessation and reduction-have negative consequences for the depressive symptoms of older Americans and whether these consequences are mitigated for people with a spouse who drives.

Methods: The project used data from 3 waves of the Asset and Health Dynamics Among the Oldest Old (AHEAD) study. Depressive symptoms were assessed with an abbreviated Center for Epidemiologic Studies-Depression scale.

Coping strategies and health care-seeking behavior in a US national sample of adults with symptoms suggestive of overactive bladder.

Background: Although millions of individuals have symptoms suggestive of overactive bladder (OAB), few ever seek or receive medical treatment for their condition.

Objective: The purpose of this study was to describe coping strategies and health care-seeking behavior in a community-based sample of adults with symptoms suggestive of OAB.

Methods: A cross-sectional household telephone survey of an age- and sex-stratified sample of adults was conducted.