Improving the oral health status of functionally independent and dependent seniors residing in long-term care facilities through dental hygiene education /

The purpose of this study was to evaluate the oral health status of residents residing in 2 long-term care facilities and determine if dental hygiene education was required in order to improve their current oral health. The oral health status of 6 independent and 4 dependent individuals residing in 2 long-term care facilities was evaluated. In addition, the current oral health and disease prevention practices employed by 4 caregivers who were responsible for providing oral care to dependent residents in the long-term care facilities were evaluated. Furthermore, an evaluation of the oral care practices of independent residents who were responsible for providing their own care was conducted. Finally, the challenges that caregivers and independent residents faced when performing oral care were determined, and methodological changes were proposed. Using a generic qualitative research methodology, data collection was comprised of semi structured interviews, field observations, and documentation. The oral health status of the residents was reevaluated 3 months later. The findings of this study demonstrated an increase in plaque accumulation, gingival inflammation, and unhealthy gingival tissue colour changes among the residents over the 3-month period. The study revealed that poor oral health among the residents was a result of inadequate oral hygiene care techniques, difficulties accessing oral health care, financial limitations, insufficient care staff, insufficient time for personal care duties, lack of professional development, minimal interprofessional collaboration of health disciplines, and lack of perseverance on the part of the caregivers and residents. Overall, oral health is essential, and maintaining optimal oral health requires increased collaboration and communication between health care providers.

Perturbing the impulse activity of a single identified neuron augments the formation of long-term memory in a molluscan semi-intact preparation /

The aim of this study was to investigate the neural correlates of operant conditioning in a semi-intact preparation of the pond snail, Lymnaea stagnalis. Lymnaea learns, via operant conditioning, to reduce its aerial respiratory behaviour in response to an aversive tactile stimulus to its open pneumostome. This thesis demonstrates the successful conditioning of na'ive semiintact preparations to show learning in the dish. Furthermore, these conditioned preparations show long-term memory that persists for at least 18 hours. As the neurons that generate this behaviour have been previously identified I can, for the first time, monitor neural activity during both learning and long-term memory consolidation in the same preparation. In particular, I record from the respiratory neuron Right Pedal Dorsal 1 (RPeD 1) which is part of the respiratory central pattern generator. In this study, I demonstrate that preventing RPeDl impulse activity between training sessions reduces the number of sessions needed to produce long-term memory in the present semi-intact preparation.

The role of molecular, clinical and socioeconomic factors in the long-term survival of axillary node negative breast cancer patients

The overall objective of this study was to investigate factors associated with long-term survival in axillary node negative (ANN) breast cancer patients. Clinical and biological factors included stage, histopathologic grade, p53 mutation, Her-2/neu amplification, estrogen receptor status (ER), progesterone receptor status (PR) and vascular invasion. Census derived socioeconomic (SES) indicators included median individual and household income, proportions of university educated individuals, housing type, "incidence" of low income and an indicator of living in an affluent neighbourhood. The effects of these measures on breast cancer-specific survival and competing cause survival were investigated. A cohort study examining survival among axillary node negative (ANN) breast cancer patients in the greater Toronto area commenced in 1 989. Patients were followed up until death, lost-to-follow up or study termination in 2004. Data were collected from several sources measuring patient demographics, clinical factors, treatment, recurrence of disease and survival. Census level SES data were collected using census geo-coding of patient addresses' at the time of diagnosis. Additional survival data were acquired from the Ontario Cancer Registry to enhance and extend the observation period of the study. Survival patterns were examined using KaplanMeier and life table procedures. Associations were examined using log-rank and Wilcoxon tests of univariate significance. Multivariate survival analyses were perfonned using Cox proportional hazards models. Analyses were stratified into less than and greater than 5 year survival periods to observe whether known markers of short-tenn survival were also associated with reductions in long-tenn survival among breast cancer patients. The 15 year survival probabilities in this cohort were: for breast cancerspecific survival 0.88, competing causes survival 0.89 and for overall survival 0.78. Estrogen receptor (ER) and progesterone receptor (PR) status (Hazard Ratio (HR) ERIPR- versus ER+/PR+, 8.15,95% CI, 4.74, 14.00), p53 mutation (HR, 3.88, 95% CI, 2.00, 7.53) and Her-2 amplification (HR, 2.66, 95% CI, 1.36, 5.19) were associated with significant reductions in short-tenn breast cancer-specific survival «5 years following diagnosis), however, not with long-term survival in univariate analyses. Stage, histopathologic grade and ERiPR status were the clinicallbiologieal factors that were associated with short-term breast cancer specific survival in multivariate results. Living in an affluent neighbourhood (top quintile of median household income compared to the rest of the population) was associated with the largest significant increase in long-tenn breast cancer-specific survival after adjustment for stage, histopathologic grade and treatment (HR, 0.36, 95% CI, 0.12, 0.89).

A possible role for intrinsic calcium buffers in the long- term adaptation of crayfish neurons

Increasing the impulse activity of neurons in vivo over 3 or more days causes a reduction in transmitter release that persists for days or weeks (eg. Mercier and Atwood, 1989). This effect is usually accompanied by decreased synaptic fatigue. These two changes involve presynaptic mechanisms and indicate "long-term adaptation" (LTA) of nerve terminals. Previous experiments have shown that LTA requires extracellular calcium and protein synthesis (eg. Hong and Lnenicka, Soc. Neurosci. Abstr. 17:1322) and appears to involve communication between the cell body and the nerve terminals. The present study examines the possibility that the reduction in transmitter release is caused by an -increase in the calcium buffering ability within the nerve terminals. It examines the responses of adapted and control nerve terminals to exogenously applied calcium buffer, BAPTA-AM, which decreases transmitter release (Robitialle and Charlton, 1992). If LTA increases intrinsic Ca2+-buffering, the membrane permeant form of BAPTA should have less effect on adapted nerve terminals than on controls. Experiments are performed on the phasic abdominal extensor motor neurons of the crayfish, Procambarns clarkii. BAPTA-AM decreases excitatory postsynaptic potentials (EPSP's) of the phasic extensor muscles in a dosedependent manner between 5 and 50 JLM. LTA is elicited by in vivo stimulation at 2.5 Hz for 2-4 h per day over 3 days, which reduces EPSP's by over 50%. Experiments indicate that BAPTA-AM produces no significant change in EPSP reduction in adapted neurons when compared to controls. These results do not support the hypothesis that increased daily activity alters rapid intrinsic calcium buffers, that are able to reduce transmitter output in the same manner as BAPTA.

Exploring the Perceptions of Cultural Competence Among Personal Support Workers in an Ontario Long-Term Care Home: A Case Study

Personal Support Workers (PSWs) spend a large amount of time with long-term care (LTC) home residents providing assistance with their activities of daily living. The s limited research on their perceptions of cultural competence presents the need to bridge this knowledge gap. The researcher conducted a qualitative case study at a LTC home in Ontario. Data were collected by conducting a policy document analysis, a key informant interview with the Director of Care (DOC), and two focus groups with PSWs. The five major overarching themes were: The Culture of the LTC Home, Provision of a Supportive Environment, Collaborative Team Approach to Care, Building a Relationship with the Residents, and Maintenance of Staff Morale. The findings illuminated the broad nature of culture, connections to person centered care, and the factors that facilitate or hinder PSWs’ culturally competent care. The ambiguous perception of cultural competence among PSWs suggests further research and education on cultural competence in LTC home settings.

Mechanisms of long-term modulation of synaptic transmission in crayfish

Please consult the paper edition of this thesis to read. It is available on the 5th Floor of the Library at Call Number: Z 9999 B56 M68 2007

BP BLOGGER: DESCRIPTIVE STUDY OF ELECTRONIC KNOWLEDGE DISSEMINATION IN LONG TERM CARE

Little is known of the uptake and use of knowledge disseminated in electronic formats, especially in Long Term Care (LTC) settings. The purpose of this descriptive study was to examine the dissemination of the BP Bloggers, a series of brief, evidence summaries designed to meet the knowledge needs of LTC staff. Guided by Rogers’ (2003) Diffusion of Innovations theory, the study documents dissemination of the BP Blogger and examines factors affecting dissemination, awareness, perceptions and its use. The survey of BP Blogger recipients was conducted electronically (n=114) online (n=10), by telephone (n=55), and print (n=144). Managers usually received the newsletter electronically while staff in LTC were more likely to receive printed copies. Participants disseminated the newsletter through paper, email, or posting in the workplace. Most participants rated the content, format, and usefulness of the BP Blogger as good or excellent. Time and lack of email access were barriers to dissemination.

The role of retinoic acid in long-term memory formation and synaptic plasticity in the mollusc Lymnaea stagnalis

The active metabolite of vitamin A, retinoic acid (RA), is involved in memory formation and hippocampal plasticity in vertebrates. A similar role for retinoid signaling in learning and memory formation has not previously been examined in an invertebrate species. However, the conservation of retinoid signaling between vertebrates and invertebrates is supported by the presence of retinoid signaling machinery in invertebrates. For example, in the mollusc Lymnaea stagnalis the metabolic enzymes and retinoid receptors have been cloned from the CNS. In this study I demonstrated that impairing retinoid signaling in Lymnaea by either inhibiting RALDH activity or using retinoid receptor antagonists, prevented the formation of long-term memory (LTM). However, learning and intermediate-term memory were not affected. An additional finding was that exposure to constant darkness (due to the light-sensitive nature of RA) itself enhanced memory formation. This memory-promoting effect of darkness was sufficient to overcome the inhibitory effects of RALDH inhibition, but not that of a retinoid receptor antagonist, suggesting that environmental light conditions may influence retinoid signaling. Since RA also influences synaptic plasticity underlying hippocampal-dependent memory formation, I also examined whether RA would act in a trophic manner to influence synapse formation and/or synaptic transmission between invertebrate neurons. However, I found no evidence to support an effect of RA on post-tetanic potentiation of a chemical synapse. Retinoic acid did, however, reduce transmission at electrical synapses in a cell-specific manner. Overall, these studies provide the first evidence for a role of RA in the formation of implicit long-term memories in an invertebrate species and suggest that the role of retinoid signaling in memory formation has an ancient origin.

Personal Support Workers' Experience of Collaboration in a Long-Term Care Facility in Rural Ontario

The growing complexity of healthcare needs of residents living in long-term care necessitates a high level of professional interdependence to deliver quality, individualized care. Personal support workers (PSWs) are the most likely to observe, interpret and respond to resident care plans, yet little is known about how they experience collaboration. This study aimed to describe PSWs’ current experiences with collaboration in long-term care and to understand the factors that influenced their involvement in collaboration. A qualitative approach was used to interview eight PSWs from one long-term care facility in rural Ontario. Thematic analysis revealed three themes: valuing PSWs’ contributions, organizational structure, and individual characteristics and relationships. Collaboration was a difficult process for PSWs who felt largely undervalued and excluded. To improve collaboration, management needs to provide opportunities for PSWs to contribute and support the development of relationships required to collaborate.

Long-term effects of sports concussion

Questions : Cette thèse visait à répondre à deux questions fondamentales : 1) Est-ce que les athlètes qui présentent un historique de commotions cérébrales du sport en conservent des effets délétères à long terme? ; et 2) Est-ce que les effets néfastes des commotions cérébrales récurrentes sur le fonctionnement tant cognitif que moteur sont cumulatifs? Devis expérimental : À l’aide d’un plan d’investigation double-cohorte réalisé avec un groupe d’athlètes évoluant au niveau universitaire et un autre formé d’anciens athlètes universitaires testés plus de trois décennies plus tard, les quatre études qui composent cette thèse ont employé des méthodes raffinées d’investigation des fonctions cognitives et motrices pour en déceler des atteintes persistantes. Méthodologie : Les potentiels évoqués cognitifs ainsi que les tests neuropsychologiques ont permis de sonder le fonctionnement cognitif de ces athlètes alors que la stimulation magnétique transcrânienne, une plateforme de force permettant de mesurer la stabilité posturale ainsi qu’un système d’enregistrement tridimensionnel des mouvements rapides alternatifs ont servi à l’évaluation de l’intégrité du système moteur. Résultats : Cette thèse a permis de déceler des altérations persistentes et cumulatives des fonctions cognitives et motrices. De plus, ces subtiles atteintes observées chez les jeunes athlètes, affectant essentiellement des marqueurs neurophysiologiques sous-cliniques du fonctionnement cognitif et moteur, s’étaient accentuées chez les anciens athlètes universitaires qui montraient un déclin quantifiable tant des fonctions cognitives que motrices. Discussion : Ces résultats suggèrent d’une part que les commotions cérébrales du sport entraînent des altérations cognitives et motrices chroniques qui s’accentuent en fonction du nombre de commotions cérébrales subies. D’autre part, les effets délétères des commotions cérébrales du sport sur le fonctionnement cognitif et moteur combinés à ceux associés au processus de vieillissement entraînent un déclin cognitif et moteur quantifiable en comparaison aux anciens athlètes n’ayant jamais subi de commotions cérébrales.

Mechanisms of translation regulation in long-term synaptic plasticity

Les souvenirs sont encodés dans le cerveau grâce aux configurations uniques de vastes réseaux neuronaux. Chaque connexion dans ces circuits est apte à être modifiée. Ces changements durables s’opèrent au niveau des synapses grâce à une synthèse de protéines de novo et génèrent ce qu’on nomme des traces mnésiques. Plusieurs preuves indiquent que, dans certaines formes de plasticité synaptique à long terme, cette synthèse a lieu dans les dendrites près des synapses activées plutôt que dans le corps cellulaire. Cependant, les mécanismes qui régulent cette traduction de protéines demeurent encore nébuleux. La phase d’initiation de la traduction est une étape limitante et hautement régulée qui, selon plusieurs chercheurs, constitue la cible principale des mécanismes de régulation de la traduction dans la plasticité synaptique à long terme. Le présent projet de recherche infirme cette hypothèse dans une certaine forme de plasticité synaptique, la dépression à long terme dépendante des récepteurs métabotropiques du glutamate (mGluR-LTD). À l’aide d’enregistrements électrophysiologiques de neurones hippocampiques en culture couplés à des inhibiteurs pharmacologiques, nous montrons que la régulation de la traduction implique les étapes de l’élongation et de la terminaison et non celle de l’initiation. De plus, nous démontrons grâce à des stratégies de knockdown d’expression d’ARN que la protéine de liaison d’ARNm Staufen 2 joue un rôle déterminant dans la mGluR-LTD induite en cultures. Dans leur ensemble, les résultats de la présente étude viennent appuyer un modèle de régulation de la traduction locale de protéines qui est indépendante de l’initiation.

Regulation of GABA(A) and glutamate receptor expression, synaptic facilitation and long-term potentiation in the hippocampus of prion mutant mice

Background: Prionopathies are characterized by spongiform brain degeneration, myoclonia, dementia, and periodic electroencephalographic (EEG) disturbances. The hallmark of prioniopathies is the presence of an abnormal conformational isoform (PrP(sc)) of the natural cellular prion protein (PrP(c)) encoded by the Prnp gene. Although several roles have been attributed to PrP(c), its putative functions in neuronal excitability are unknown. Although early studies of the behavior of Prnp knockout mice described minor changes, later studies report altered behavior. To date, most functional PrP(c) studies on synaptic plasticity have been performed in vitro. To our knowledge, only one electrophysiological study has been performed in vivo in anesthetized mice, by Curtis and coworkers. They reported no significant differences in paired-pulse facilitation or LTP in the CA1 region after Schaffer collateral/commissural pathway stimulation. Principal Findings: Here we explore the role of PrP(c) expression in neurotransmission and neural excitability using wild-type, Prnp -/- and PrP(c)-overexpressing mice (Tg20 strain). By correlating histopathology with electrophysiology in living behaving mice, we demonstrate that both Prnp -/- mice but, more relevantly Tg20 mice show increased susceptibility to KA, leading to significant cell death in the hippocampus. This finding correlates with enhanced synaptic facilitation in paired-pulse experiments and hippocampal LTP in living behaving mutant mice. Gene expression profiling using Illumina microarrays and Ingenuity pathways analysis showed that 129 genes involved in canonical pathways such as Ubiquitination or Neurotransmission were co-regulated in Prnp -/- and Tg20 mice. Lastly, RT-qPCR of neurotransmission-related genes indicated that subunits of GABA(A) and AMPA-kainate receptors are co-regulated in both Prnp -/- and Tg20 mice. Conclusions/Significance: Present results demonstrate that PrP(c) is necessary for the proper homeostatic functioning of hippocampal circuits, because of its relationships with GABA(A) and AMPA-Kainate neurotransmission. New PrP(c) functions have recently been described, which point to PrP(c) as a target for putative therapies in Alzheimer's disease. However, our results indicate that a "gain of function" strategy in Alzheimer's disease, or a "loss of function" in prionopathies, may impair PrP(c) function, with devastating effects. In conclusion, we believe that present data should be taken into account in the development of future therapies.

Long term trends of seasonal and monthly rainfall in different intensity ranges over Indian subcontinent

In general Indian summer monsoon rainfall did not show any significant trend in all Indian summer monsoon rainfall series, however, it was reported that the ISMR is subjected to spatial trends. This paper made an attempt to bring out long term trends of different intensity classes of summer monsoon rainfall in different regions of Indian subcontinent. The long term trend of seasonal and monthly rainfall were also made using the India Meteorological Department gridded daily rainfall data with a spatial resolution of 1° × 1° latitude-longitude grid for the period from 1st January, 1901 to 31st December, 2003. The summer monsoon rainfall shows an increasing trend in southeast, northwest and northeast regions, whereas decreasing trend in the central and west coastal regions. In monthly scale, July rainfall shows decreasing trend over west coastal and central Indian regions and significant increasing trend over northeast region at 0.1% significant level. During the month August, decreasing trend is observed in the west coastal stations at 10% significant level. In most of the stations, mean daily rainfall shows an increasing trend for low and very high intense rainfall. For the moderate rainfall, the trend is different for different regions. In the central and southern regions the trend of moderate and moderately high classes show increasing trend. And for the high and very high intensity classes, the trend is decreasing significantly. In the northeastern regions, above 10 mm/day rainfall shows significantly increasing trend with 0.1% significant level.

Prion Protein is Expressed on Long-term Repopulating Hematopoietic Stem Cells and is Necessary for their Self-renewal

We show that the prion protein (PrP) is expressed on the surface of bone marrow cell populations enriched in long-term repopulating hematopoietic stem cells. Affinity purification of the PrP-positive and PrP-negative fractions from these populations, followed by competitive reconstitution assays, show that all long-term repopulating hematopoietic stem cells express PrP. Hematopoietic stem cells from PrP null bone marrow exhibit impaired self-renewal in serial competitive transplantation experiments, and premature exhaustion when exposed to cell cycle-specific myelotoxic injury. Therefore, PrP is a novel marker for hematopoietic stem cells and regulates their self-renewal.