Mitochondrial abnormalities and oxidative imbalance in neurodegenerative disease

An increasing body of evidence now suggests the involvement of mitochondrial abnormalities in the etiology of neurodegenerative diseases, such as Parkinson's disease (PD) and Alzheimer disease. In this Perspective, we describe a recent study that shows that treatment of human patients with the antioxidant coenzyme Q(10'), which functions in concert with certain mitochondrial enzymes, reduced the worsening of symptoms associated with PD. These findings are consistent with the hypothesis that mitochondrial dysfunction plays a role in the pathogenesis of PD and that treatments that target mitochondrial biochemistry might ameliorate the functional decline observed in patients suffering from PD.     

Management of Parkinson's disease in older women

Elderly women with Parkinson's disease (PD) represent a specific patient population that may benefit from individualized treatment strategies. PD has been shown to occur approximately twice as often in men than in women, resulting in theories regarding estrogen being protective against the disease and as a potential treatment strategy. Given women's longer life expectancy, they are more likely to reach an age where antiparkinsonian medications are associated with side-effects. This paper will review medical and surgical treatments as well as the relationship of gender and age with respect to the management of PD.     

Parkinson's disease: current scientific understanding,and John's story

1. Parkinson's disease is a progressive, neurological disease that has no cure, although medications may delay or relieve symptoms. Surgical treatments are appropriate for some patients. 2. Monitoring symptoms of Parkinson's disease is important because all medications deemed helpful for patients can also have serious side effects, including delusions and hallucinations. 3. Clients who have difficulty expressing themselves need a family member or friend to inform caregivers of their interests and sources of enjoyment. 4. Efforts can be made to forestall isolation in the client's home or long-term residence. Suggestions and answers to commonly asked questions can be found on the Internet.     

Daily living abilities and work abilities of people with Parkinson's disease

A questionaire survey was conducted on 60 items of daily living abilities linked to 13 basic work abilities such as memory, learning, planning, muscular power and concentration etc. covering a total of 133 subjects with Parkinson's disease. Results of the survey were as follows: 1. Daily living abilities and work abilities decreased in accordance with Yahr's stages and the degree of daily living abilities. 2. Daily living abilities provided clues for aging and prognosis of the Parkinson's disease. 3. "Cope well with heat and coldness", "Being confident in the strength of legs and loins" and "Keep balance in the train" were difficult to do from the early stages of the onset. 4. Audio-visual ability, memory and judgement were well maintained despite the severity of the disease. 5. All subjects showed poor endurance, while learning, planning and manual dexterity showed higher performance in those under 59.     

The hunt for a cure for Parkinson's disease

Several exciting new scientific advances have been made in the past decade toward both understanding the causes of and finding a cure for Parkinson's disease. Heartened by an acceleration in research findings in the past several years, the government has recently called for an infusion of funds from both the National Institutes of Health and private foundations into this burgeoning area of biomedical research. Most currently available conventional treatments for the disease only temporarily delay symptom presentation while doing nothing to halt disease progression. However, the rapidly accelerating pace of research in this field has left researchers hopeful that Parkinson's will be the first major age-related neurodegenerative disease for which we have a viable cure. In this article, advances in various areas of Parkinson's disease research are reviewed.     

Leg-extension strength and chair-rise performance in elderly women with Parkinson's disease

The lower extremity performance in elderly female patients with mild to moderate Parkinson's disease (PD; n = 12) and controls (n = 16) was compared. Isometric dynamometry and force-plate measurements were used. PD patients had lower (p < .05) bilateral (BL) maximal isometric leg-extension force (MF), BL isometric MF relative to body mass, and maximal rate of isometric force development than control participants. BL strength deficit was greater (p < .05) in PD patients than in controls. A significantly longer chair-rise time and lower maximal rate of vertical-ground-reaction-force development while rising from a chair was found in PD patients than in controls. These findings suggest that elderly women with PD have lowered voluntary isometric force-generation capacity of the leg-extensor muscles. Reduced BL leg-extension strength might contribute to the difficulty of individuals with PD to rise from a chair.     

Changes in executive function after acute bouts of passive cycling in Parkinson's disease

Individuals with Parkinson's disease (PD) often experience cognitive declines. Although pharmacologic therapies are helpful in treating motor deficits in PD, they do not appear to be effective for cognitive complications. Acute bouts of moderate aerobic exercise have been shown to improve cognitive function in healthy adults. However, individuals with PD often have difficulty with exercise. This study examined the effects of passive leg cycling on executive function in PD. Executive function was assessed with Trail-Making Test (TMT) A and B before and after passive leg cycling. Significant improvements on the TMT-B test occurred after passive leg cycling. Furthermore, the difference between times to complete the TMT-B and TMT-A significantly decreased from precycling to postcycling. Improved executive function after passive cycling may be a result of increases in cerebral blood flow. These findings suggest that passive exercise could be a concurrent therapy for cognitive decline in PD.     

Analysis of urban cleanness agents' workstation on the appearance of work related musculoskeletal disorders

This study had as objective to evaluate the workstation of the responsible for the collection of urban garbage in relation to the factors associates with the appearance or aggravation of WMRD, as well as identifying signals and symptoms of these illnesses in the related professionals. For this, was developed a form with open and closed questions, that approached item relative to the identification of the searched, to the organization and execution of the work and to the signals and symptoms of WMRD, e that was applied in 44 agents in a company of collection of urban residues in a Brazilian metropolis. As the results can be evidenced that between the factors that the cleanness' agents are susceptible to the appearance of WMRD can detach the lack of orientation of these professionals as the positions adopted in the work, the lack of training and qualification, as well as the repetitivity of tasks and not use of individual protection equipment. However, yet with the existence of innumerable factors of risk, evidenced a small incidence of pain.     

Tai Chi-based exercise for older adults with Parkinson's disease: a pilot-program evaluation

The primary objective of this study was to provide preliminary evaluation of the feasibility, safety, and efficacy of a newly developed Tai Chi-based exercise program for older adults with Parkinson's disease (PD). Using a one-group pretest-posttest design, 17 community-dwelling adults (mean age 71.51 years) with mild to moderate idiopathic PD (Stage I, II, or III on the Hoehn and Yahr scale) and stable medication use completed a 5-day, 90-min/day Tai Chi exercise-evaluation program. Outcome measures included face-to-face exit interviews on appropriateness and safety and physical performance (i.e., 50-ft speed walk, up-and-go, functional reach). At the end of this brief intervention, exercise adherence was 100% and the program was shown to be safe. Exit interviews indicated that the program was well received by all participants with respect to program appropriateness, participant satisfaction and enjoyment, and intentions to continue. Furthermore, a significant pretest-to-posttest change was observed at the end of the 5-day program in all three physical-performance measures (p < .05). The results of this pilot evaluation suggest that Tai Chi is an appropriate physical activity for older adults with PD and might also be useful as a therapeutic exercise modality for improving and maintaining physical function. These preliminary findings warrant further investigation.     

Effect of ergonomic and workstyle risk factors on work related musculoskeletal disorders among IT professionals in India

'Workstyle' can be described as a mechanism by which ergonomic and psychosocial risk factors interact to affect the development, exacerbation and/or maintenance of upper limb pain and functional limitations. Workstyle is associated with the increase in the work demand. In today's life use of computer in the workplace is very common and it causes to increase the work demand among the workers who are working with computer. As work demand increase, according to the characteristic of workstyle, risk of the development of musculoskeletal disorders also increased. This study aimed at to findout the association between ergonomics risk factors, workstyle and WRMSD. Two hundred IT professionals participated in this study. Result revealed that most prevalenet body regions were lower back (20%), Upper back (16%) and shoulder (14%). Study result says that there is a positive association between workstyle score with musculoskeletal pain (r=0.85). Also it revealed that posture and regional pain is associated (r=0.62), per day use of computer and musculoskeletal pain (r=0.46), micro breaks and pain (r=0.87) and productivity and the pain (r=0.95). This study further validates these observations and extends support for the assessment of working postures and workstyle behaviors during the design of WMSD treatment.     

Age-related neurodegenerative changes and how they affect the gut

The enteric nervous system (ENS) is the division of the autonomic nervous system that regulates gastrointestinal (GI) function. Although large numbers of enteric neurons may be lost with age, the GI tract remains surprisingly functional. Exceptions to this generality include swallowing disorders and reduced colonic motility in the elderly. Evidence of age-related neurodegenerative changes in structure and function of the ENS is briefly reviewed in this Perspective.     

The biology of aging

Reproduced with permission     

Risk factors, clinical features and outcome of treatment of work related musculoskeletal disorders in on-site clinics among IT companies in India

Workrelated musculoskeletal disorders among the IT professional is a common area of concern worldwide. This study was taken up to analyze the prevalence of risk factors, clinical features and outcome of treatment in onsite clinics in vaious information technology companies in India. Result revealed poor office ergonomics (54%), lack of keyboard tray (25%), lack of mouse tray (35%), lack of foot rest (60%), improper monitor height (80%) were the major self reported risk factors. Major identified MSD were Myofascial Pain Syndrome (49.20%), Thoracic outlet syndrome (25.02%), Fibromyalgia syndrome (8.5%). Majorly affected body regions were neck (64.9%), shoulder (42.1%), lower back (56.5%) and thigh (34.2%). The results were comparable with the literature. Feedback of the participants also revealed most of the participants were well satisfied with SHARAN's protocol.     

Reflections of the Annual Meeting

Abstract

In preparation for planning counseling and mental health services at Columbia University, the authors conducted a mental health needs assessment survey that sampled representative numbers of students. Respondents were most concerned about academic and school-related issues, followed by concerns in the area of love relationships. Multiple regression analysis revealed certain subgroups that were more likely to have these concerns and certain health and mental health problems that were significantly associated with these concerns. The study identified serious psychological problems, including suicidal/homicidal thoughts and sexual abuse, and surveyed respondents' treatment preferences. Finally, the authors discuss how the study findings contributed to sharpening and expanding focus on different aspects of program development in the collaboration between mental health and health education.     

Musculoskeletal disorders and productivity

Conclusion On balance, the evidence supports an association of higher productivity increases with lower MSD rates and greater reductions in MSD rates. Across all industries for which data were available, lower MSD rates were significantly correlated with higher productivity increases. Since both changes in MSDs and in productivity have many varied causes, the effects of efforts specifically intended to reduce MSDs are difficult to isolate from these data. Nevertheless, in two subsets of industries those effects may be more likely to be discernible: industries with the largest reductions in MSD rates would be more likely to have made changes intended to reduce MSDs, and industries with lower productivity growth may reduce the effects of unrelated productivity gains on MSD/ productivity observations. Statistically significant correlations between reductions in MSDs and increases in productivity were found among both of these groups. In addition, among industries with the highest MSD rates in 1992, the extent of implementation of ergonomic controls was significantly correlated with increases in productivity. A special thank you is extended to William Weber, William McCarthy, and Linda Garris of the Bureau of Labor Statistics, Office of Safety, Health and Working Conditions, for providing MSD industry data for 1992 and 1998. The opinions expressed in this article are those of the authors and do not necessarily reflect the official positions of the department or agency with which the writers are affiliated. Jens Svenson is currently on detail to the Office of Management and Budget.     

The controversial promises of cholinesterase inhibitors for Alzheimer's disease and related dementias: A qualitative study of caregivers' experiences

Since their introduction, clinicians have been engaging in debates over the therapeutic benefits of cholinesterase inhibitors (ChEIs) in Alzheimer's disease and related dementias (ADRD). Against this backdrop of controversy, caregivers' views and experiences have been largely ignored. This has occurred despite the fact that this group may provide insights into these drugs in ways not captured by clinical research. To address this gap in knowledge, the current study examines 25 caregivers' narratives about the treatment of relatives diagnosed with mild to moderate ADRD and treated with ChEIs. The findings reveal an appraisal of cholinergic effects whereby caregivers question the benefits of the drugs, generally not knowing whether to attribute stabilization or improvements to them or not but also fearing termination of the drug ‘just in case’ there is some benefit. Caregivers justify their belief in ChEIs' long-term effectiveness primarily by invoking non-medicated prognostic scenarios of more rapid decline and loss of self. In addition, the study explores the meaning caregivers attribute to ChEI effects vis-à-vis a pharmaceutical discourse which frames these drugs as a source of hope.