Post-stroke visual impairment (PSVI) affects more than 60% of the people who have a stroke but visual function is not routinely assessed in most stroke units. Recent high-quality research in this ...field has produced evidence-based assessment and management practices for PSVI. Orthoptists have integrated into the stroke care team in the United Kingdom (UK) to provide this valuable service. This paper outlines the development and implementation of the first known orthoptic PSVI service in North America. A pilot program was developed between the Ophthalmology, Neurology, and Physical Medicine and Rehabilitation Departments in Saskatoon, Saskatchewan, Canada. A new referral pathway was established to refer stroke patients with PSVI directly to an orthoptist with specialization in PSVI. Clinical findings from the first year of operation are reported. One hundred and seven visual deficits were suspected by the referring service. Visual field deficits were the most commonly reported PSVI. Diplopia was the most commonly reported oculomotor deficit in this cohort, and visual neglect/inattention was the most common visual perceptual deficit reported. Reading issues were the most commonly reported functional issues. Following assessment by an orthoptist, 45 additional visual deficits were identified and addressed. Stroke patients require assessment and treatment for PSVI. Orthoptists are perfectly suited to PSVI assessment and management. There is an opportunity to increase orthoptists' scope of practice in North America to ensure stroke patients receive specialized vision assessment and treatment.
De profundis : Psaumes du cachot Whelan, Ruth
Revue de théologie et de philosophie,
05/2024, Letnik:
156, Številka:
1
Journal Article
Le rôle central du chant des Psaumes dans le protestantisme réformé français à l’époque moderne est bien connu. Sa signification globale en tant que pratique dévotionnelle, pénitentielle et ...consolatoire, est également comprise. En revanche, il manque un véritable aperçu, voire un accès, à la dynamique interne de l’appropriation des Psaumes par les protestants français à cette époque, et plus particulièrement par les galériens, en raison de l’absence d’éditions critiques de leurs écrits. Cette étude de l’intériorisation des Psaumes par Élie Neau lors de son incarcération à la Citadelle Saint-Nicolas et au Château d’If à Marseille retrace la manière dont cent vingt citations, réminiscences, échos sémantiques ou emprunts textuels à cinquante Psaumes présents dans ses écrits ont façonné sa spiritualité militante et sa résistance aux horreurs des galères et des cachots au cours de la dernière décennie du XVIIe siècle.
It was recently reported that levels of plasma IgG antibodies against peptide antigens derived from proteins encoded by schizophrenia‐associated genes are altered in individuals with schizophrenia ...treated with antipsychotics. This study aimed to replicate the initial finding in antipsychotic‐naïve patients with first‐episode schizophrenia and to explore the possible mechanism by which immune tolerance of B cells may be altered in this disease. A total of 408 case–control plasma samples were collected for analysis of circulating IgG antibodies against fragments derived from TCF4, TSNARE1, ZNF804A, TRANK1, ERCC4, DPYD and CD25 using an in‐house ELISA. The Mann–Whitney U‐test revealed that patients with schizophrenia had a significant change in plasma anti‐TSNARE1 and anti‐CD25 IgG levels; male patients mainly contributed to the increased levels of anti‐TSNARE1 IgG and anti‐CD25 IgG. Receiver operating characteristic (ROC) curve analysis revealed that the anti‐TSNARE1 IgG assay had an area under the ROC curve of 0.625 with a sensitivity of 15.7% and a specificity of 95.2%. Work on a B‐cell model revealed that TRANK1‐derived antigen treatments could enhance the proportions of CD83+ cells and apoptotic B cells when compared with TSNARE1‐derived antigen and vehicle treatment. We conclude that there is a gender difference in autoimmune responses in schizophrenia and suggest that anti‐TSNARE1 IgG may be indicative of schizophrenia in a subgroup of male patients.
TRANK1‐derived peptide antigen is more likely to induce B‐cell apoptosis than TSNARE1‐derived peptide antigen. This observation suggests that different schizophrenia‐associated antigens have different tolerance patterns that may be involved in abnormal autoimmune responses in schizophrenia.
BackgroundFor ischaemic stroke, outcome severity is heavily time dependent. Systems of care need to be in place to ensure that patients with stroke are treated quickly and appropriately across entire ...health regions. Prior to this study, the province of Saskatchewan, Canada did not have a provincial stroke strategy in place.MethodsA quality improvement project was undertaken to create and evaluate a provincial stroke strategy. The Saskatchewan Acute Stroke Pathway was created using a multidisciplinary team of experts, piloted at five stroke centres and then implemented provincially. The number of stroke alerts, door-to-imaging, door-to-needle, door-to-groin puncture times and treatment rates were collected at all centres. Improvements over time were analysed using run charts and individuals control charts.ResultsThe number of stroke alerts province-wide trended upwards in the last 6 months of the study. There were no clear trends or shifts in the proportion of stroke alerts treated with alteplase or endovascular therapy. Across the province, the weighted mean door-to-imaging time decreased from 21 to 15 min, the weighted mean door-to-needle time decreased from 62 to 47 min and the mean door-to-groin puncture time decreased from 83 to 70 min. There was high variability in the degree of improvement from centre to centre.ConclusionsThe implementation of a province wide acute stroke pathway has led to improvement in stroke care on a provincial basis. Further work addressing intercentre variability is ongoing.
End-of-Life Care for Stroke Jolly, Shelley; Whelan, Ruth; Davy, Kimberly
Journal of pain and symptom management,
December 2018, 2018-12-00, Letnik:
56, Številka:
6
Journal Article
ABSTRACT
Current Canadian helmet bylaws focus mainly on bicycle helmet use. In this way, law makers are ignoring head injuries associated with other wheeled sports. Cycling, in‐line skating, ...skateboarding, and scootering can all cause serious injury to participants if proper protective gear is not worn. Legislation has been shown to work in promoting helmet use and decreasing injuries. Nurses, using theory and research to guide practice, can be key players in advocating for healthy public policies and amendments to provincial legislation. Nurses have the opportunity to play an active leadership role that can be guided by PEACE, a philosophy that encompasses praxis, empowerment, awareness, cooperation, and evolvement.
A recent genome-wide association (GWA) study confirmed 108 genetic loci that were strongly associated with schizophrenia. Fifteen schizophrenia-associated genes were selected for this study based on ...a number of selection criteria including their high expression in both brain tissues and B-lymphocyte cells. We aimed to investigate whether individuals with schizophrenia showed different levels of plasma IgG antibodies against protein-derived fragments encoded by these 15 genes. A total of 356 plasma samples were used to analyze circulating IgG antibodies against 18 target peptide antigens using an in-house enzyme-linked immunosorbent assay. Of 18 antigens tested, 6 (derived from DPYD, MAD1L1, ZNF804A, DRD2, TRANK1, and MMP16, respectively) showed increased IgG levels and 3 (derived from TSNARE1, TCF4, and VRK2, respectively) showed decreased IgG levels in patients with schizophrenia compared with control subjects. Receiver operating characteristic (ROC) curve analysis revealed that the anti-TRANK1 IgG assay had the area under the ROC curve of 0.68 (95% CI = 0.62-0.73), with the highest sensitivity of 20.7% against specificity of 95.2% among all 18 tests. There was no difference in positivity of anti-double strand DNA IgG between the patient group and the control group and no correlation between total IgG levels and each individual IgG level tested. Although risperidone treatment showed confounding effects on overall IgG levels in the circulation (combined P = .005), anti-TRANK1 IgG levels did not appear to be significantly affected (t = 1.358, P = .176). In conclusion, this study suggests that circulating anti-TRANK1 IgG is likely to serve as a biomarker for identification of a subgroup of schizophrenia.
The aims of this thesis were to investigate the immune response to linear peptide fragments derived from 15 distinct proteins encoded by schizophrenia-related genes. An antibody test was developed ...in-house to detect plasma IgG antibodies against selected target molecules in patients with schizophrenia and control subjects. Six peptide antigens derived from DPYD, MAD1L1, ZNF804A, DRD2, TRANK1 and MMP16 showed an increase in plasma IgG levels and three derived from TSNARE1, TCF4 and VRK2 showed a decrease. As the initial study was conducted with medicated patients with chronic schizophrenia and healthy controls from a European-derived Caucasian population, the initial findings were thus replicated in antipsychotic-naïve patients with first-episode schizophrenia from a Chinese population. The drug-naïve patients showed different results; notably, the significant decrease in plasma IgG levels against TSNARE1 was not observed, showing instead an increase. The inconsistency may result from different ethnicities, B-cell diversity, medication or other confounding factors. To examine the possible mechanism underlying abnormal immune response to these schizophrenia-related peptides, a B-cell model was developed with four immortalized B-cell lines derived from a Caucasian population, 2 cell lines derived from healthy donors and 2 from patients with schizophrenia. These four B-cell lines have proportionally different stages of maturation and differentiation, showing distinct responses to treatment either with target protein-derived antigens or antipsychotic drugs. For example, TRANK1-derived peptide antigen could induce an increase in the proportion of CD83 positive cells and apoptotic cells; antipsychotic treatment generated a dose-dependent reduction in both cell number and viability. Taken together, this PhD work identified novel autoantibodies that might play a role in underlying schizophrenia. A possible mechanism by which abnormal immune responses contribute to the development of schizophrenia was then discussed.
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