Research in Neuroprotection

Research in Neuroprotection A human brain possesses 100 billion nerve cells or neurons. But only about 400,000 of these nerve cells are dopamine nerve cells that can produce dopamine in the substantia nigra. We depend on dopamine neurons for numerous activities such as movement, motivation, reward, punishment, cognition, mood, memory, attention, and sleep. How can so few dopamine neurons do so many things? The answer is dopamine neurons can sprout massive numbers of branches along its axon. This enables the neuron to link up with many other brain cells and modulate numerous biochemical pathways. To support their massive network activity, dopamine neurons depend on their subcellular power stations called mitochondria for the energy. This energy dependence makes dopamine nerve cells vulnerable. Every year, an average of 2,400 dopamine neurons die because of the failure in their power stations. So, half of a healthy adults lifetime supply of dopamine cells is dead by age 80. If 70 percent of dopamine cells in the substantia nigra die, symptoms of PD will kick in. A person will hit this threshold at age 120 just by aging. Some people will hit this threshold earlier, like age 60, due to other sources of cell death. Humans are the only animals to get PD because the life spans of other animals are too short to develop the disease. Because dopamine neurons get sick for many reasons, scientists have come up with several neuroprotective strategies. One idea proposed in 1985 by Walther Birkmayer was to protect dopamine nerve cells from the toxic effect of dopamine itself. Dopamine nerve cells releases dopamine as a neurotransmitter to signal other nerve cells. Once the message is received, the cell needs to clear any leftover dopamine so it doesnt interfere with future transmissions. Some of the dopamine is reabsorbed by the body. The rest is degraded by an enzyme known as monoamine oxidase, or MAO, releasing free radicals that can destroy brain cells, including the dopamine nerve cells in the substantia nigra. Birkmayer thought treating PD patients with the so-called MAO inhibitors early in their PD might slow the progress of the disease. In 1985, Birkmayer conducted a study comparing a control group of 377 PD patients (on L-dopa alone) with 594 patients who received L-dopa plus an MAO inhibitor called slegiline over a nine year period. He found the slegiline group lived on average 15 months longer than the control group. Birkmayer interpreted these findings as evidence that selegiline was preventing the death of substantia nigra neurons in PD. But critics believed the selegiline effect was just symptomatic. Researchers had conducted a series of large, expensive placebo-controlled studies to test the efficacy of selefiline and other MAO inhibitors over the last two decades. The results failed to provide definitive evidence that MAO inhibitors can protect neurons and slow the progression of PD. Meanwhile, scientists have proposed other potential neuroprotection therapies designed to block various disease pathways. Some seek molecule targets that might protect or assist the mitochondria. Others attempt to block calcium channels on the assumption it would help protect the dopamine nerve cells. But these attempts to protect dopamine neurons have been overshadowed by an approach focusing on nourishing dopamine neurons that are damaged but not yet dead. *** In 1991, two scientists at the biotech company Synergen isolated a brain protein that appeared to nourish and protect dopamine neurons. They called this protein glial-cell-line-derived neurotrophic factor, or GDNF. They produced a synthetic form of GDNF and tested it on dopamine neurons in test tubes and in monkeys rendered parkinsonian with MPTP. In the test tubes, GDNF turned sick neurons into healthy ones. In the monkeys, the GDNF reduced their PD symptoms. Amgen was so impressed with the experiment they bought the company. Between 1996 and 1999, Amgen carried out trials on 38 humans. The researchers didnt attempt to reach the striatum, because the available brain catheter was too large. Instead, they delivered the GDNF to the lateral ventricle, hoping the cerebrospinal fluid would carry the GDNF to the striatum. The trial was a failure. The problem, according to the British neurosurgeon Steven Gill, was that the GDNF had not made it to the striatum because of the size and the design of the catheter. Gill designed his own mini-catheter and mounted an in-house open-label study at the Frenchay Hospital involving five moderately advanced PD patients. After one year, Gill reported that all five patients showed dramatic improvements, and there were no serious side effects. This rekindled Amgens interest in GDNF, and the company carried out new animal studies and mounted a blind-placebo-controlled trial. By 2004, Amgens second trial had failed. The company announced that it was halting all clinical use of GDNF around the world. To this day, Gill believes that his approach worked. With funding from the Cure Parkinsons Trust, Gill is doing a larger study on GDNF. This trial will allow Gill to determine if direct GDNF infusion has potential as a disease-reversing therapy in PD. *** Some neuroscientists argued that a better way to deliver GDNF was to use gene therapy. With gene therapy, you start with a simple common cold virus and replace its gene with the gene of your choice. Here, you can use the gene that encodes the growth factor GDNF or a related cousin called neurturin (NTN). You need to introduce multiple copies of the virus into the patients putamen to infect the neurons with the desired gene. Unlike infusion, gene therapy is a one-shot process. Once the genes are inserted and turned on, they should keep working indefinitely. In 2000, Rush University scientist Jeff Kordower published a paper in Science showing a proof of concept in monkeys. He founded a biotech company in San Diego called Ceregene Inc to undertake a phase I safety trial in humans. Kordower used the NTN gene for the trials because Amgen held the patient on the GDNF gene. After a year, the patients UPDRS motor scores had improved by 40 percent with no serious side effects. In 2008, the results of the phase II double-blind placebo-controlled trial showed no difference between the gene therapy and the placebo groups. Ceregene considered shutting down the NTN gene therapy program. But then two trial patients died of unrelated causes, providing an opportunity to examine their brains. The autopsies revealed that the infusion had fallen short of expectations. Only 15 percent of the putamen expressed the NTN gene; Ceregene researchers had been hoping for 50 percent. With $2.5 million grant from the Michael J. Fox Foundation, Ceregene launched another trial involving 51 patients, infusing four times the viral dose and delivering the NTN to the substantia nigras and putamen. April 2013, after a 15- to 24-month follow-up, the results showed no difference between the treatment group and the placebo group. Key Takeaways A person has a lifetime supply of 400,000 dopamine nerve cells, of which an average of 2,400 die every year. In 1985, Walther Birkmayer attempted to protect dopamine neurons using MAI inhibitors. In the late 1990s, Amgen and Steven Gill attempted to nourish damaged dopamine neurons using the growth factor GDNF. In 2000, Jeff Kordower attempted to use gene therapy to deliver growth factor NTN to nourish damaged dopamine neurons.

The Catwoe Analysis System Health And Social Care Essay

Sweden is the 3rd largest state in Western Europe. It is a comfortable and sophisticated state and provides a criterion of wellness attention that is admired by many international health care suppliers and it has on a regular basis ranked at or near the top of most comparative analyses of international wellness attention systems ( Sweden Association of Local Authorities and Regions, 2005 ) . Sweden is a constitutional monarchy based on a parliamentary democracy. The proprietors of the public wellness system are the state ‘s three democratically elected degrees of authorities. Parliament passes statute law, decides on province gross and outgo and has overall duty for development in wellness attention. Administration is decentralised and the wellness attention bringing system is managed by 21 county councils. Based on geographic locations, the councils are responsible for the wellness of the population in their several countries. This involves non merely the proviso of wellness attention but besides wellness publicity and disease bar ( European Observatory on Health Systems and Policies, 2005 ) . County councils besides regulate private wellness attention ( Mighealth, 2009 ) . The 290 local councils ( urban countries ) are responsible for aged attention and nursing places, including people with physical or psychological disablements. Transformations: Sweden operates a individual remunerator, decentralised, publically owned theoretical account, supplying wellness insurance to every person. Overall 85 % of wellness attention comes from public support. County councils are responsible for the majority of support and operations. Over 90 % of county gross goes to wellness attention, which is funded chiefly from revenue enhancement levies. The municipalities are responsible for the support and bringing of long term attention and societal services. Both the county councils and the municipalities have the right to impose relative income revenue enhancements. Even though persons enjoy cosmopolitan wellness insurance they are still capable to little co-payments and fees for hospital visits, pharmaceuticals and other services. County councils besides regulate private wellness attention. A private wellness attention supplier must hold an understanding in order to be reimbursed by societal insurance, therefore private wellness attention ( with a few exclusions ) is publicly funded in footings of insurance ( Mighealth, 2009 ) . Private insurance is really limited and merely about 2.3 % of persons chose to buy private auxiliary programs ( European Observatory on Health Systems and Policies, 2005 ) . Servicess are by and large limited to those non available in the public wellness attention system. Most wellness attention is provided in wellness Centres where the histrions are the people who deliver services are the multidisciplinary squad. Around 25 % of these wellness Centres are in private run endeavors that are commissioned by county councils. There are around 60 infirmaries countrywide with a little figure of them being regional infirmaries that offer extremely specialised attention. The county councils employ the bulk of doctors through a salary or on a capitated rate. Doctors can work outside the public wellness system wholly but patients have to pay the full costs. Swedish wellness attention consumes about one ten percent of the state ‘s entire resources. Therefore it is important that the resources be used sagely and be efficaciously. Environmental restraints faced by Sweden include the two rule factors that are giving rise to increased wellness attention outgo internationally. First there is the demand to equilibrate cost effectivity with increased public demands based on progresss in engineering and intervention. These increased demands equate to lifting wellness attention costs which may be unacceptable to the population who already pay higher revenue enhancements than many other European states. Additionally Sweden, like the remainder of the Western universe has an increasing ageing population. 17 % of its citizens are over 65 old ages of age ( Gennser, 1996 ) . There are two typical schools of idea sing how the addition in the aged population will impact public wellness attention. One position is that the future growing of the aged population will bring forth major additions in wellness outgos which are non likely sustainable given the current administration and support of wellness attention. The contrasting position suggests that wellness attention outgos will increase as a consequence of the growing in the aged population, but most of the growing in wellness attention outgos will be manageable because of some combination of the reallocation of outgos from the immature to the old, attendant additions in productiveness and beginnings ensuing from new engineerings and efficiencies betterments within the wellness attention sector. Whichever position is favoured there is still an increased demand for healthcare intercessions in footings of intervention, attention and bar likewise. Sweden compares favorably in a universe position of wellness attention systems. Whereas in most European states at that place has been an addition in disbursement as a per centum of GDP, Sweden has been the exclusion as it has fallen over a figure of old ages. The last two decennaries have seen many European states set up wellness system reforms aimed at controling the lifting rate of disbursement growing, increase efficiency and widen pick and reactivity and all this at a clip when the sum of attention to be delivered is get downing to transcend the available resources. Sweden has worked at run intoing these purposes whilst still being committed to cosmopolitan entree and equity in service proviso. Part Two: Analyse the key reforms that have been implemented in this wellness system over the past decennary. Although the cardinal construction of the Swedish wellness system has remained reasonably consistent over the last half century, negative tendencies in the economic system which were rendering the system unsustainable in the late 1980 ‘s led to a turning discontent amongst the populace. After three decennaries of rapid economic growing, the economic system was decelerating down. As a consequence of this in the 1990s major reforms evolved in many countries of Sweden, where wellness suppliers experimented with new economic inducements among wellness attention suppliers. These included the debut of the purchaser/provider split, DRG-based reimbursements and extended patient pick. The DRG monetary value mechanism was introduced in 1990 and by basically attaching an official monetary value ticket to every infirmary intervention, authorities budget shapers enabled suppliers both to better their public presentation and to switch the system ‘s focal point to the demands of health- care consumers. In a single-payer theoretical account without monetary values the mission of health-care workers is to make everything possible to handle patients successfully, and people who need intervention be given to drench the system with demand. Funders constricted by budgets so seek to command runaway costs by seting a ceiling on the volume of attention, an action which creates deficits and waiting lists. When compensation beyond the bound is reduced or withdrawn, the production of services slows down and even Michigans. Puting monetary values back into the equation in Sweden changed inducements. Not merely was hospital support improved by the increased production of services, but besides private suppliers were available to execute interventions on an equal footing. This stimulation to productiveness required that reimbursement degrees be transparent, stable and dependable. The fairness implicit in the DRG pricing system and the information it conveyed enabled buyers to be s plit from suppliers within publically funded health care ( Hjertqvist, 2002 ) . Patient rights were besides really much in focal point during the 1890ss, there were alterations in waiting list warrants both in 1992 and 1997 and as the Patients ‘ Rights Reform came approximately in 1999, although there were alterations to the latter some old ages subsequently. They have shown a turning committedness towards wellness publicity. Preventive attention potentially offers a cost-efficient alternate to high-cost engineering and medical attention. Part Three: Explain how one of these chief reforms could be applied within the Maltese system in order to either contain public outgo or increase quality and efficiency. Mental ailment wellness is noted as one of the largest public wellness jobs in Sweden. It excessively is an country that has been capable to the purchaser/provider attack. Dr Thomas Flodin, a board member of the Swedish Medical Association, said he did non hold any expostulation to increased usage of the private sector. â€Å" What is of import is non who provides the attention, but that it remains available to everyone. † And this seems to be one of the underlying features of the Swedish system ( cited by Triggle, 2005 ) . Presently in Malta private mental wellness service suppliers are limited to Consultant Psychiatrists who although seeing patients in private, finally rely on public services for attention and intervention or likewise para-professional such as psychologists. With merely one psychiatric infirmary and centrally managed para-services there is a monopoly on mental sick wellness service proviso. If this theoretical account was to be adopted so market inducements could be introduced into a system that is presently publically managed. The production of services would go the exclusive concern of supplier organic structures. This may non needfully mention to ‘new ‘ suppliers but may besides include infirmaries, nursing places and community wellness Centres, who would no longer keep a budget and make up one's mind how it should be spent. Cardinal budgets are a tool to cut down costs during times of economic diminution. Servicess are reduced and activity slows down ( e.g. deficiency of community mental wellness services, bed barricading due to deficiency of services to ease flow of patients ) . Alternatively, gross would depend on contracts from buyers. Buyers would non be consumers or patients, but buying governments established to purchase ( but non bring forth ) wellness services. The buying governments would be commissioned to procure betterments in wellness for defined populations ( people with mental sick wellness ) , and do so by measuring their population ‘s wellness attention demands, finding the most cost-efficient agencies of run intoing these demands, and undertaking suppliers to provide the services required. Cardinal to the purchaser/provider separation is the procedure of competitory tendering, or catching, designed to promote competition among suppliers. Introducing competition would add pluralism to what is now a set, restricted group of services. Having estimated which and how many services are needed, the buying authorization would ask for suppliers to subject stamps for contracts to provide them. These contracts would include stipulate the type and sum of attention to be supplied, the quality of the service, and the contractual period. Once these were awarded, suppliers would be able to concentrate on the proficient facets of proviso, taking to carry through their contractual duties at lowest cost. Competitive tendering forces suppliers to continually seek to better the efficiency of their productive procedures. The more efficient will win more contracts by being able to subject lower commands than their rivals. They will besides be able to spread out into new countries of service bringing. The buying authorization would be good placed to change the mix of services available by moving in the involvements of their populations and exerting their purchasing power. Released from the influence of suppliers, buying governments are able to replace traditional attention attacks with advanced services and guarantee that services are received in their most appropriate scenes, and contract for cost effectual signifiers of proviso. Furthermore, given their duty to procure mensurable wellness betterments it is in their involvement to guarantee a greater co-ordination of attention for single users. Suppliers will ever appreciate that efficiency will ever be better paid than inefficiency. This would hold a monolithic impact on patients who at nowadays have to accept attention and intervention that is normally generalized and to a great extent based on tradition and administered in a grossly paternalistic civilization of the adviser ever being right and hence the exclusive writer of th eir intervention bundle. Making a market environment breaks up traditional beaurocratic attacks. In Sweden many former public service employees became enterprisers by choosing to run as private suppliers and working conditions of wellness attention employees and improved as they ‘voted with their pess ‘ . This excessively would be possible in Malta. Cardinal authorities need non play a major portion in the twenty-four hours to twenty-four hours running of the wellness system. After set uping regulative maps, and apportioning population weighted budgets to buying governments, the market can be left to itself, with the cardinal authorities curtailing itself to the fiscal and public presentation audit of buyers. Government sections may publish guidelines and directives to accomplish a grade of consistence in buying determinations, and to guarantee that the wellness system contributes to national aims and precedences. Government can concentrate on stand foring the population by explicating a vision for mental wellness in Malta. Implementing such a wellness attention reform in Malta addition handiness, competition and patient pick.MentionsEuropean Observatory on Health Systems and Policies ( 2005 ) Health Systems in Transition. Hit Drumhead: Sweden. Writer. Gennser, M. ( 1996 ) Sweden ‘s Health Care System: Swedish attitudes about wellness attention. In Healthy Incentives: Canadian Health Reform in an International Context. Edited by: McArthur W, Ramsay C and Walker M. Vancouver. The Fraser Institute. Hjertqvist, J. ( 2002 ) Health Care Treatment Prices In Swedish Hospitals: DRGs are a cardinal to performance-based wellness reform. Available from hypertext transfer protocol: //www.fcpp.org/pdf/Policy % 20Frontiers % 206 % 20- % 20DRG % 20Prices % 20in % 20Sweden % 20including % 20appendix % 20final.PDF Mighealth ( 2009 ) Introduction to Swedish Health Care. Available from hypertext transfer protocol: //mighealth.net.se/index.php Swedish Association of Local Authorities and Regions ( 2005 ) Swedish Health Care in an International Context – a comparing of attention demands, costs, and outcomes. Available from hypertext transfer protocol: //www.swedishhealthcare.se/swedenshealthcaresystem.html Triggle, N. ( 2005 ) Keeping Healthy, the Swedish manner. Available from hypertext transfer protocol: //news.bbc, co.uk/go/pr/fr/-/2/hi/health/4461098.stm

A Long Way Gone Questionair - Free Essay Example

Sample details Pages: 1 Words: 320 Downloads: 4 Date added: 2017/09/19 Category Environment Essay Type Argumentative essay Tags: Problems Essay Did you like this example? Caitlin Spradlin Period 1 1. A long way gone: Memoirs of a boy soldier, Ishmael Beah 218 Pages 2. The external conflicts in this story include person vs. person and person vs. society. The reason person vs. person is included, because Ishmael has many problems with the rebels he must join in the cruel war that is of Sierra Leone. Not only did these very soldiers burn down his town and take away and later murder his parents, but they also bring horror and death to everyone who gets in their path, for reasons Ishmael could never discern. He must fight next to those that have destroyed the ones he loves, and the country he has grown to call his own. Person vs. society comes into play throughout the entire book. Ishmael and everyone who grew to be apart of this country must watch their whole community burn down, and see the horrors of death and destruction. They run for their lives and the lives of their loved ones, only to starve or get caught, beaten, and even killed with li ttle help from anyone. 3. The internal conflict of this story is individual vs. self. Ishmael is a young innocent boy who has to hear that his community, friends, and parents have all went down in flames. I imagine the emotional toll to be horrendous. He must also join the war that did so much wrong to him and continue on to be ordered to kill and torture others. For a boy who has probably never seen a gun, this is huge! He has to close himself down (emotionally) and try to strive like that. After the war he has to move to a different country alone, move in with strangers and continue to put back as many pieces to his puzzle as he can. He ends up being very successful but the emotional impacts of the war has scared him for forever. 4. Passage One: â€Å" Don’t waste time! Our writers will create an original "A Long Way Gone Questionair" essay for you Create order

What Are Holistic Admissions When Applying to College

Most selective colleges and universities in the United States have holistic admissions. Grades and test scores matter (often a lot), but the school wants to get to know you as a whole person. The final admission decision will be based on a combination of numerical and non-numerical information. Key Takeaways: Holistic Admissions A school with a holistic admissions policy considers the whole applicant, not just numerical measures such as grades and test scores.Extracurricular activities, the rigor of your courses, letters of recommendation, demonstrated interest, college interviews and demonstrated interest can all play a role in holistic admissions.Good grades and standardized test scores are still extremely important at schools with holistic admissions. What Are Holistic Admissions? Youll frequently hear admissions folks talk about how their admission process is holistic, but what exactly does this mean for an applicant? Holistic can be defined as an emphasis on the whole person, not just select pieces that make up the whole person. If a college has holistic admissions, the schools admissions officers consider the whole applicant, not just empirical data like ones GPA or SAT scores. Colleges with a holistic admissions policy are not simply looking for students with good grades. They want to admit interesting students who will contribute to the campus community in meaningful ways. Under a holistic admissions policy, a student with a 3.8 GPA might be turned down while an award-winning trumpet player with a 3.0 GPA might get accepted. The student who wrote a stellar essay might get preference over the student who had higher ACT scores but a bland essay. In general, holistic admissions take into account a students interests, passions, special talents and personality. For example, the admissions folks at the University of Maine at Farmington describe their holistic policy well: Were far more interested in who you are and what you can bring to our campus community than how you happened to score on a high-pressure, high-stakes standardized test. We look at your high school achievements, your extracurricular activities, your work and life experiences, community service activities, artistic and creative talents, and more. All the unique, personal traits that make you ... you. When we review your application we take the time and care to get to know you as an individual, not as a number on a score sheet. Factors Considered Under Holistic Admissions Most of us would agree that its preferable to be treated as a person rather than a number. The challenge, of course, is conveying to a college what it is that makes you ... you. At a college with holistic admissions, all of the following are most likely important: A strong academic record with challenging courses. Your record should show that youre the type of student who takes on a challenge rather than shies away from it. Your GPA tells only part of the story. Have you taken advantage of AP, IB, Honors, and/or dual enrollment courses when they were an option for you?Glowing letters of recommendation. What do your teachers and mentors say about you? What do they see as your defining characteristics? Often a teacher can describe your potential in a way that is useful to colleges considering admitting you.Interesting extracurricular activities. It doesnt matter so much what you do, but that you have a passion for something outside of the classroom. Depth and leadership in an extracurricular area will be more impressive than a smattering of involvement in numerous activities.A winning application essay. Make sure your essay presents your personality, your sharp mind, and your writing skills. If you are asked to write supplemental essays, make su re they are carefully tailored for the school, not generic.Demonstrated interest. Not all schools take this into consideration, but in general, colleges want to admit students who will accept the offer of admission. Campus visits, applying early, and crafting supplemental essays thoughtfully can all play into demonstrated interest.A strong college interview. Try to do an interview even if it is optional. The interview is one of the best ways for the college to get to know you as a person. There are also a few holistic measures that are not under your control. Most colleges work to enroll a group of students whose diversity will enrich the campus community. Diversity here is defined in broad terms: socio-economic background, race, religion, gender identity, nationality, geographic location, and so on. Its not unusual, for example, for a Northeast college to admit a student from Wyoming or Hawaii over an equally qualified student from Massachusetts in an effort to diversify the student body. Legacy status can also play a role in the admissions process, and you clearly have no control over whether or not your parents or a sibling attended a school to which you are applying. A Final Word About Holistic Admissions Keep in mind that even with holistic admissions, colleges will admit just those students who they think will succeed academically. Your grades in college preparatory classes will be the most important piece of your application at nearly every college. No extracurricular activities or essay will make up for an academic record that fails to show that you are prepared for college-level work. The SAT and ACT are typically a bit less important than your academic record, but there also it will be hard to gain admission to the countrys top colleges if your scores are significantly below the norm.