Increasing Range (increasing + range)

Distribution by Scientific Domains

Selected Abstracts

Hereditary parkinsonism: Parkinson disease look-alikes,An algorithm for clinicians to "PARK" genes and beyond,,

Christine Klein MD
Abstract In the past decade, a number of genetic causes of parkinsonism have been identified. As a consequence, clinicians have to consider an increasing range of differential diagnoses when confronted with a patient with parkinsonism with a positive family history. While well-established monogenic forms with PARK acronyms have been reviewed extensively, less emphasis has been placed on other inherited conditions that may also present with signs of parkinsonism or even mimic idiopathic Parkinson's disease clinically. In this review, we focus on three different scenarios in patients with an overall early age of onset of parkinsonism: (i) atypical features in patients with mutations in one of the "PARK" genes; (ii) classical parkinsonism due to mutations in "other than-PARK" genes or yet other genes where parkinsonism may be a well-recognized, concomitant, or even an isolated feature; (iii) atypical parkinsonism in other genetic disorders which are, however, typically characterized by features other than parkinsonism. Atypical features in patients from Group I include, for example, a slower disease course (PARK2, PARK6, PARK7) or dementia (PARK1/4, PARK14). Conditions in Group II have been designated by a DYT or SCA acronym (for example, DYT5 or SCA3) and also include patients with heterozygous GBA mutations, mitochondrial gene mutations. Group III comprises mutations in the FMR1, MAPT, GRN, ATP7B, PANK2, FBXO7, CHAC, FTL1, Huntingtin, JPH3 genes, and a number of even rarer, miscellaneous conditions. 2009 Movement Disorder Society [source]

Towards a more place-sensitive nursing research: an invitation to medical and health geography

Gavin J. Andrews
During recent years, nursing research has adopted and integrated perspectives and theoretical frameworks from a range of social science disciplines. I argue however, that a lack of attention has been paid in past research to the subdiscipline of medical geography. Although this may, in part, be attributed to a divergence between research priorities and foci, traditional ,scientific' geographical approaches may still be relevant to a wide range of nursing research. Furthermore, a recasting, redirecting and broadening of medical geography in the 1990s, towards what is termed health geography, has enhanced the discipline and provided a more cultural and expansive recognition of health, and a more comprehensive understanding of the dynamic relationship between people, health and place. Given the increasing range of places where health-care is provided and received, and some recent linkages made between nursing and place by nurse-theorists, these newer perspectives and concepts may be particularly useful for interpreting nurses' and patients' relationships both within and with a variety of healthcare settings and living spaces. Indeed, although a more place-sensitive nursing research is potentially a trans-disciplinary academic endeavor, a range of geographical approaches would be central to such a project. [source]

Government,nonprofit relations in comparative perspective: evolution, themes and new directions

Jennifer M. Brinkerhoff
This overview article for the Symposium on Government,Nonprofit Relations in Comparative Perspective summarizes our current understanding of government,nonprofit relations, addresses several themes emerging from the collective papers and Symposium discussions, and discusses new and evolving trends in government,nonprofit relations. The review of government,nonprofit relations encompasses governance models and their incorporation of nonprofits, sector failures and their contribution to government,nonprofit relationships, and cross-sectoral analytic frameworks. Themes addressed include the material and normative benefits sought through nonprofits; various features of government,nonprofit interactions, including their increasing range and multiple facets, the impact of origins, relationship dynamism, and impacts; and what is public and what is private. The article concludes with the identification of selected new and evolving trends, including the influence of information technology on organizational structures and processes, the rise of supranational spheres of government,nonprofit interaction, the continuing tension between cooperation and identity maintenance, and simultaneous global lesson sharing and an emphasis on local-level problem-solving, where nonprofits are viewed as a means to maintaining continuity and redefining community. The article situates our understanding of government,nonprofit relations in a comparative perspective that accounts for dominant global paradigms, increasing interdependence among actors and nations, and evolving models of governance at all levels. Copyright 2002 John Wiley & Sons, Ltd. [source]

Switching atypical antipsychotics: a review

Pierre Chue
Background:, Atypical antipsychotics are increasingly used in the treatment of diverse psychiatric disorders; however, there is little information on the ,why, when, and how' of switching between the different atypical antipsychotics currently available. Objective:, To review the data on switching and atypical antipsychotics. Methods:, A literature search was initially conducted using the key words followed by a search of relevant articles including conference abstracts; relevant pharmaceutical companies were also contacted. Results:, Clinical trial data are limited in terms of parameters measured, and case reports describe specific problems. Few studies are based on real world populations of psychiatric patients over the long-term. Careful patient and drug selections matched to a carefully supervised and appropriate cross titration based upon the pharmacodynamic and pharmacokinetic properties of all of the drugs involved is important to avoid potential complications such as re-emergence or worsening of psychosis and withdrawal, rebound, and emergent phenomena including new or uncovered side-effects. Psychoeducation and involvement of patients and caregivers in the process are also necessary for a successful switch. Conclusion:, Despite the prevalence of switching in real world clinical practice, there is a paucity of data to guide clinicians with respect to effective and safe strategies. There are no criteria defining a successful switch. With the increasing range and formulations of atypical antipsychotics available, there is a rationale for their early use to avoid the practical problems associated with switching from conventional antipsychotics as well as the opportunity to maintain patients on an optimal atypical antipsychotic monotherapy. [source]