Neurological impairment includes many specific types of changes in the central and the peripheral nervous systems, and the range of variation is enormous. This article presents a case study of Guillain-Barré syndrome, a particular neurological syndrome that affected the author. Patients, families, caregivers, and health professionals may find the insights useful for understanding and appreciating neurological impairments and for acting in ways that will be helpful to those with a neurological impairment.

Activities of Daily Living↗

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What happens after a traumatic brain injury?: four case studies.

This article reports on four women with traumatic brain injury (TBI). It describes what happened to the women during their initial trauma and what life was like for them following their injuries. TBI can have devastating lifelong consequences because the brain is the body's central functioning unit. Damage from a TBI trends to be comprehensive, extending beyond physical injuries and changing the way a person behaves and feels. It can even bring about a total change in personality and often leads to psychosocial problems. Family and friends of the person with TBI may have difficulty understanding and coping with these changes. The authors suggest nursing interventions to help both the patient and others deal with TBI.

Activities of Daily Living↗

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Caregivers of people with multiple sclerosis: a survey in New Zealand.

A survey carried out in the Manawatu and Wanganui area of New Zealand was designed to locate all those known to have multiple sclerosis; as part of the research, 31 primary caregivers (20 males, 11 females) of MS patients in the study were interviewed to gain information about their roles, self-defined tasks, and life situations.

Adaptation, Psychological↗

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Analgesic dosing strategies for chronic pain.

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Analgesics, Opioid↗

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Alexithymia and somatic amplification in chronic pain.

A controlled study was undertaken to assess alexithymia and somatic amplification among 50 medical outpatients with chronic pain referred for psychiatric consultation. Data were collected on demographics; DSM-IV diagnoses; and measures of anxiety, depression, and alexithymia, assessed with the Toronto Alexithymia Scale (TAS-20), as well as somatic amplification, assessed with the Somatosensory Amplification Scale (SAS). Data analysis revealed low scores on the TAS-20 and SAS for the pain patients, compared with a control group without pain. In this sample, depression and anxiety were the primary determinants of alexithymia and somatic amplification, rather than pain. These findings suggest that psychological markers for chronic pain may be different from those for other somatoform disorders.

Affective Symptoms↗

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Measuring counterdependency in patients with chronic pain.

OBJECTIVE: Some reports have characterized patients with chronic pain as counterdependent, that is, having emotional suppression, idealization of relationships, strong work ethic, a caregiver role-identity, and self-reliance. However, research has been hampered because formal measures of these traits have been lacking. In this article, we describe a five-item self-report questionnaire, the Counterdependency Scale (CDS), designed to elicit each of these traits on a Likert scale. METHODS: The CDS was administered to 150 consecutive patients evaluated in an outpatient psychiatry consultation program. RESULTS: CDS scores were normally distributed and had significant interitem correlations and test-retest reliability (r = 0.68). As expected, subjects with chronic pain (N = 100) had higher mean CDS scores than those without chronic pain (t = 5.6, p = .000). CDS scores were independent of demographic variables and measures of anxiety, depression, alexithymia, and somatic amplification. CONCLUSIONS: These results suggest that counterdependency can be described by a distinct and measurable cluster of traits associated with chronic pain.

Adult↗

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Pain location and psychological characteristics of patients with chronic pain.

The authors assessed psychological characteristics of 140 medical outpatients with chronic non-malignant pain referred for psychiatric consultation. Subjects completed the Toronto Alexithymia Scale, Somatosensory Amplification Scale (SSAS), and Counter-dependency Scale (CDS). The only psychological measure able to differentiate the chronic pain group from the control subjects was the CDS. However, SSAS scores were significantly higher in subjects having pain involving the head, chest, abdomen, or pelvis than in subjects having pain only in their backs or extremities. The latter subgroup had significantly higher CDS scores. The findings suggest that there are discrete subgroups within the chronic pain population defined by pain location and specific psychological characteristics.

Adult↗

PubMedDate not supplied

Can sertraline induce parkinson's disease?

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Aged↗

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A policy by and for people with disability.

Disabled Persons Assembly (New Zealand) Inc. is the umbrella group and voice of people with disabilities in New Zealand. Formed from three groups in the early 1980s, it is unique in that the organization includes both individual and corporate members. The former are largely people with disabilities or their relatives, while the latter are corporate agencies and service providers. The background for the design and development of a national policy for the organization is discussed. The content and substance of the policy are illustrated.

Persons with Disabilities↗

PubMedDate not supplied

Adenovirus-mediated p53 gene transfer inhibits growth of human tumor cells expressing mutant p53 protein.

Human malignancies are often characterized by mutations of the p53 tumor suppressor gene. In a large proportion of cases, the mutation results in production of an altered protein that can bind and inactivate the wild-type gene product. This "dominant-negative" activity of mutant p53 molecules may limit the utility of p53 gene therapy of cancer. Using replication-deficient recombinant adenoviruses (rAd-p53) as a p53 gene delivery system, we evaluated the effects of p53 reintroduction on a series of 45 human cell lines containing wild-type, mutated, or no p53 protein. Results indicate a p53-specific, dose-dependent, and promoter-specific growth inhibition of a majority of p53-altered cell lines that correlates with the degree of adenovirus transgene expression. Similar effects were not observed on cells containing wild-type p53. rAd-p53 inhibited the growth of cells expressing various mutant p53 proteins including those characterized as "dominant negative mutants", and the antiproliferative effects were not abrogated by high levels of endogenous mutated p53 protein. In vivo, rAd-p53 also suppressed tumor growth and increased survival of nude mice bearing tumors that express mutant p53. These results support a role for p53 gene therapy of cancer, including malignancies harboring mutations in this tumor suppressor gene.

Adenoviridae↗