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- Title
- THE UNITARY CARING LIVED EXPERIENCE OF UNCERTAINTY AMONG FAMILY CAREGIVERS OF PERSONS WITH A STROKE DURING THE HOSPITAL STAY IN SAUDI ARABIA.
- Creator
- Alselami, Seham Eid, Butcher, Howard K., Florida Atlantic University, Christine E. Lynn College of Nursing, Christine E. Lynn College of Nursing
- Abstract/Description
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Stroke is a major health problem in Saudi Arabia that impacts the health outcomes of adults and elderly persons. No matter its severity, stroke is a stressful life event not only for the survivors but their family caregivers as well. Uncertainty is one of the major problems facing family caregivers caring for persons with a stroke. Uncertainty affects overall health outcomes and the quality of life of family caregivers caring for persons with strokes. Current research has not yet identified...
Show moreStroke is a major health problem in Saudi Arabia that impacts the health outcomes of adults and elderly persons. No matter its severity, stroke is a stressful life event not only for the survivors but their family caregivers as well. Uncertainty is one of the major problems facing family caregivers caring for persons with a stroke. Uncertainty affects overall health outcomes and the quality of life of family caregivers caring for persons with strokes. Current research has not yet identified the meaning of the uncertainty of family caregivers of persons with strokes during hospitalization in Saudi Arabia. The purpose of this study was to gain an in-depth understanding of the meaning of uncertainty experienced by family caregivers of persons in the hospital who have survived strokes. This study used a phenomenological design. Data were collected through in-depth face-to-face and online semi-structured interviews with 15 family caregivers using openended questions. Participants were recruited from inpatient medical units and stroke care units in multi acute care hospitals in Saudi Arabia. The interviews were recorded, transcribed verbatim, translated, and analyzed using the hermeneutic phenomenological unitary caring research method. NVivo software (Version 12) was used to manage the qualitative data.
Show less - Date Issued
- 2022
- PURL
- http://purl.flvc.org/fau/fd/FA00014047
- Subject Headings
- Stroke, Caregivers, Nursing, Saudi Arabia
- Format
- Document (PDF)
- Title
- FAMILY CAREGIVING DURING TRANSITIONAL CARE: AN ETHNOGRAPHIC EXPLORATION OF THAI-ISAN FAMILY CAREGIVERS PROVIDING CARE FOR SURVIVING STROKE OLDER ADULTS.
- Creator
- Thiengtham, Supavadee, Chiang-Hanisko, Lenny, Florida Atlantic University, Christine E. Lynn College of Nursing, Christine E. Lynn College of Nursing
- Abstract/Description
-
Providing family caregiving during transitional care of a stroke patient is the most challenging for family caregivers. This is because of the shift in the care environment from a hospital with an organizational culture to a home with a traditional culture. Yet, cultural influences on family caregiving during transitional care are not well studied. This ethnographic study aims to describe the family caregiving of older Thai-Isan stroke survivors through the transition from hospital to home....
Show moreProviding family caregiving during transitional care of a stroke patient is the most challenging for family caregivers. This is because of the shift in the care environment from a hospital with an organizational culture to a home with a traditional culture. Yet, cultural influences on family caregiving during transitional care are not well studied. This ethnographic study aims to describe the family caregiving of older Thai-Isan stroke survivors through the transition from hospital to home. This study employs Lininger's culture care theory (CCT) as the theoretical framework and utilizes the ethnonursing method to discover cultural knowledge. Data was collected through a demographic questionnaire, participant observations, and a semi-structured interview. Data was analyzed using the Four Phases of the Data Analysis Enabler. Fifteen dyads of older stroke patients and their family caregivers were recruited following the inclusion and exclusion criteria. The research settings included Srinagarind Hospital units and key informants’ homes in a Thai-Isan community.
Show less - Date Issued
- 2022
- PURL
- http://purl.flvc.org/fau/fd/FA00014114
- Subject Headings
- Caregivers, Thai ʻĪsān, Stroke, Transcultural nursing
- Format
- Document (PDF)
- Title
- Mechanism of Carbamathione as a therapeutic agent for Stroke.
- Creator
- Modi, Jigar P., Wu, Jang-Yen, Florida Atlantic University, Charles E. Schmidt College of Science, Center for Complex Systems and Brain Sciences
- Abstract/Description
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Stroke is the third leading cause of mortality in the United States, and so far, no clinical interventions have been shown completely effective in stroke treatment. Stroke may result in hypoxia, glutamate release and oxidative stress. One approach for protecting neurons from excitotoxic damage in stroke is to attenuate receptor activity with specific antagonists. Disulfiram requires bio-activation to S-methyl N, N-diethylthiolcarbamate sulfoxide (DETC-MeSO). In vivo, DETC-MeSO is further...
Show moreStroke is the third leading cause of mortality in the United States, and so far, no clinical interventions have been shown completely effective in stroke treatment. Stroke may result in hypoxia, glutamate release and oxidative stress. One approach for protecting neurons from excitotoxic damage in stroke is to attenuate receptor activity with specific antagonists. Disulfiram requires bio-activation to S-methyl N, N-diethylthiolcarbamate sulfoxide (DETC-MeSO). In vivo, DETC-MeSO is further oxidized to the sulfone which is carbamoylated forming Carbamathione, a glutathione adducts. Carbamathione proved to be useful as a pharmacological agent in the treatment of cocaine dependence with the advantage that it lacks ALDH2 inhibitory activity. Carbamathione is a partial NMDA glutamate antagonist. The purpose of this dissertation study is to evaluate the neuroprotective effects of Carbamathione drug on PC-12 cell line and to understand the protective mechanisms underlying in three stroke-related models: excessive glutamate, hypoxia/reoxygenation and bilateral carotid artery occlusion (BCAO). Carbamathione was administered 14 mg/kg subcutaneously for 4 days with the first injection occurring 30 min after occlusion in the mouse BCAO stroke model. Mice were subjected to the locomotor test, and the brain was analyzed for infarct size. Heat shock proteins, key proteins involved in apoptosis and endoplasmic reticulum (ER) stress, were analyzed by immunoblotting. Carbamathione reduced both cell death following hypoxia/reoxygenation and brain infarct size. It improved performance on the locomotor test. The level of pro-apoptotic proteins declined, and anti-apoptotic, P-AKT and HSP27 protein expressions were markedly increased. We found that Carbamathione suppresses the up- regulation of Caspase-12, Caspase-3 and significantly declined ER stress protein markers GRP 78, ATF4, XBP-1, and CHOP. Carbamathione can down- regulate ATF 4 and XBP1 expression, indicating that Carbamathione inhibits the ER stress induced by hypoxia/reoxygenation through suppressing PERK and IRE1 pathways. Carbamathione elicits neuroprotection through the preservation of ER resulting in reduction of apoptosis by increase of anti-apoptotic proteins and decrease of pro-apoptotic proteins. Carbamathione can suppress the activation of both PERK and IRE1 pathways in PC-12 cell cultures and has no inhibitory effect on ATF6 pathway. These findings provide promising and rational strategies for stroke therapy.
Show less - Date Issued
- 2017
- PURL
- http://purl.flvc.org/fau/fd/FA00004979, http://purl.flvc.org/fau/fd/FA00004969
- Subject Headings
- Dissertations, Academic -- Florida Atlantic University, Stroke., Stroke--drug therapy., Carbamathione
- Format
- Document (PDF)
- Title
- cGMP/PKG-regulated mechanisms of protection from low oxygen and oxidative stress.
- Creator
- Mahneva, Olena, Milton, Sarah L., Dawson-Scully, Ken, Florida Atlantic University, Charles E. Schmidt College of Science, Department of Biological Sciences
- Abstract/Description
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Stroke is one of the leading causes of human death in the United States. The debilitating effects of an ischemic stroke are due to the fact that mammalian neurons are highly susceptible to hypoxia and subsequent oxygen reperfusion. From studies in Drosophila melanogaster, cGMP-dependent Protein Kinase (PKG) enzyme is thought to affect anoxia tolerance by modifying the electrical current through potassium ion channels. In this research, two animal models were employed: Drosophila melanogaster...
Show moreStroke is one of the leading causes of human death in the United States. The debilitating effects of an ischemic stroke are due to the fact that mammalian neurons are highly susceptible to hypoxia and subsequent oxygen reperfusion. From studies in Drosophila melanogaster, cGMP-dependent Protein Kinase (PKG) enzyme is thought to affect anoxia tolerance by modifying the electrical current through potassium ion channels. In this research, two animal models were employed: Drosophila melanogaster and mammalian neurons exposed to stroke-like conditions. First, in vivo studies using Drosophila were performed to further our knowledge about the differences between the naturally occurring variants of the Drosophila foraging gene, which shows different protein levels of PKG. Mitochondrial density and metabolic activity between two fly genotypes exposed to anoxia and reoxygenation were compared. It was found that flies with less enzyme potentially showed mitochondrial biogenesis and higher metabolic rates upon reoxygenation. Next, in vivo studies where PKG enzyme was activated pharmacologically were performed; it was found that the activation of the cGMP/PKG pathway led to neuroprotection upon anoxia and reoxygenation. Furthermore, this model was translated into the in vitro model using Drosophila cells. Instead of anoxia and reoxygenation, hypoxia mimetics and hydrogen peroxide were used to induce cellular injury. After showing the cGMP/PKG pathway activation-induced cell protection, the potential downstream targets of the molecular signaling as well as underlying biochemical changes were assessed. It was found that mitochondrial potassium ion channels were involved in the protective signaling and the signaling modulated metabolic function. Furthermore, it was found that acidosis protected Drosophila cells from cell death, metabolic disruption, and oxidative stress. Finally, this research was translated to a mammalian in vitro model of neuronal damage upon stroke-like conditions; there, it was demonstrated that the cGMP/PKG pathway activation in rat primary cortical neurons and human cortical neurons was protective from low oxygen and acute oxidative stress. The results of this study lead to a better understanding of molecular mechanisms taking place during low oxygen and oxidative stresses. Consequently, this knowledge may be used to identify potential therapeutic targets and treatments that may prevent detrimental neurological effects of an ischemic stroke in humans.
Show less - Date Issued
- 2018
- PURL
- http://purl.flvc.org/fau/fd/FA00013013
- Subject Headings
- Stroke, Cyclic GMP-Dependent Protein Kinases, Oxidative Stress
- Format
- Document (PDF)
- Title
- Stroke Prevention in a Neighborhood with a High Incidence of Stroke: Exploring a Community’s Understanding.
- Creator
- Sessa, Joy, Keller, Kathryn, Florida Atlantic University, Christine E. Lynn College of Nursing
- Abstract/Description
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Stroke continues to plague the United States, affecting 795,000 people annually. Although stroke mortality has decreased, the overall incidence of stroke appears essentially unchanged. With a population that is projected to increase in age and stroke risk over the next 10-15 years, this is concerning. Current stroke prevention education may not be adequately tailored to community learning needs. Analyzing existing demographic data within electronic medical records may allow healthcare systems...
Show moreStroke continues to plague the United States, affecting 795,000 people annually. Although stroke mortality has decreased, the overall incidence of stroke appears essentially unchanged. With a population that is projected to increase in age and stroke risk over the next 10-15 years, this is concerning. Current stroke prevention education may not be adequately tailored to community learning needs. Analyzing existing demographic data within electronic medical records may allow healthcare systems to identify high-risk neighborhoods by geocoding stroke diagnoses and then completing a qualitative analysis within the target community of specific stroke knowledge deficits. That information may then inform stroke prevention education for that neighborhood. A descriptive, exploratory approach was used to identify a community with a high incidence of stroke using geocoded demographic data from patients coding out with a stroke diagnosis. Qualitative interviews conducted within the community yielded the following themes: fragmented knowledge of stroke causes and risk factors, unawareness of hypertension and diabetes as significant risk factors for stroke, knowing but experiencing challenges to engaging in healthy practices—specifically, diet and exercise, and financial barriers to healthcare resources. While most of the participants had adequate healthcare coverage and reported regular interactions with a primary healthcare provider, this community continued to experience a higher incidence of stroke than surrounding neighborhoods. The findings of this study highlighted specific challenges to stroke prevention that may inform future stroke prevention initiatives. Future research in other communities using this approach may provide additional insights into the specific knowledge deficits unique to communities, as well as revealing patterns and trends in stroke prevention knowledge. Approaching stroke prevention education using only data obtained from large registries may provide a broad overview of knowledge deficits, but lack the specificity necessary to effectively address stroke knowledge needs at the community level. Recognizing the challenges inherent with behavior modification for implementing lifestyle changes should also be considered when designing future stroke education. Harnessing technology in the form of web applications, text messaging, and email for maintaining communication with patients may improve effectiveness of stroke prevention interventions. Implementing a comprehensive health promotion program that addresses specific community needs with tailored health education and behavioral support may lead to decreased incidence of cerebrovascular disease in this community and provide a model for managing other preventable diseases.
Show less - Date Issued
- 2019
- PURL
- http://purl.flvc.org/fau/fd/FA00013261
- Subject Headings
- Stroke prevention & control, Patient Education--methods, Commnunity, Neighborhoods
- Format
- Document (PDF)
- Title
- EFFECT OF G-CSF GENE THERAPY IN A MICROGLIA MODEL OF STROKE.
- Creator
- Velasquez Saldarriaga, Esteban, Wu, Jang-Yen, Florida Atlantic University, Department of Biomedical Science, Charles E. Schmidt College of Medicine
- Abstract/Description
-
Cerebrovascular events (stroke) are a significant cause of morbidity and mortality worldwide. Ischemic stroke accounts for ~85% of all strokes and is caused by the blockade of blood flow to a certain area of the brain, resulting in oxygen and nutrient deprivation and ultimately cell death. Cerebral ischemia induces a strong neuroinflammatory response that contributes to tissue damage and is driven by changes in the gene expression profile and phenotype of brain cells including neurons,...
Show moreCerebrovascular events (stroke) are a significant cause of morbidity and mortality worldwide. Ischemic stroke accounts for ~85% of all strokes and is caused by the blockade of blood flow to a certain area of the brain, resulting in oxygen and nutrient deprivation and ultimately cell death. Cerebral ischemia induces a strong neuroinflammatory response that contributes to tissue damage and is driven by changes in the gene expression profile and phenotype of brain cells including neurons, astrocytes, and microglia. Microglia are the resident immune and phagocytic cells of the central nervous system. They rapidly respond to ischemia by migrating to the site of injury and modulating the inflammatory response there. Although microglia may play a deleterious role in the acute phase of stroke, evidence suggests that they play an important role in the reduction of excitotoxic injury as well as in neurogenesis during the tissue regeneration phase. Granulocyte-colony stimulating factor (G-CSF) is a hematopoietic growth factor that has shown beneficial effects in models of ischemic stroke. G-CSF exerts its neuroprotective effects through different mechanisms including mobilization of haemopoietic stem cells, angiogenesis, neurogenesis, anti-inflammation, and anti-apoptosis. However, its effect on microglia is not well understood yet. The main objective of this project was to evaluate the protective and anti-inflammatory effect of G-CSF gene therapy against glutamate cytotoxicity in the human microglial clone 3 cell line (HMC3). Our results show that although G-CSF gene therapy did not significantly protect HMC3 cells against glutamate induced cell death, it reduced the expression levels of pro-inflammatory proteins NF-κB p65, IL-1β and IL-6, while increasing the phosphorylation of Akt, a regulator of cell survival and proliferation.
Show less - Date Issued
- 2021
- PURL
- http://purl.flvc.org/fau/fd/FA00013821
- Subject Headings
- Stroke, Granulocyte Colony-Stimulating Factor, Cerebrovascular disease, Microglia
- Format
- Document (PDF)
- Title
- G-CSF GENE THERAPY FOR BRAIN DISEASES AND/OR SICKLE CELL ANEMIA.
- Creator
- Basilio, Stefan, Prentice, Howard, Florida Atlantic University, Department of Biomedical Science, Charles E. Schmidt College of Medicine
- Abstract/Description
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Ischemic stroke is defined as a blockage or reduced flow of blood to select areas of brain tissue due to either plaque formation or buildup of blood clots in the small blood vessels. A characteristic of sickle cell anemic patients is the potential for them to experience a similar type of blockage due to the sticky nature of the sickled red blood cells as well as defective oxygen delivery to the brain. Because of this similarity, sickle cell anemia may represent a good animal research model...
Show moreIschemic stroke is defined as a blockage or reduced flow of blood to select areas of brain tissue due to either plaque formation or buildup of blood clots in the small blood vessels. A characteristic of sickle cell anemic patients is the potential for them to experience a similar type of blockage due to the sticky nature of the sickled red blood cells as well as defective oxygen delivery to the brain. Because of this similarity, sickle cell anemia may represent a good animal research model for therapeutic intervention based on stroke models. In recent studies, Granulocyte-Colony Stimulating Factor (GCSF), has been shown to exhibit a robust range of neuroprotective properties against neurological disorders including ischemic stroke through preservation of the endoplasmic reticulum (ER) by modulating various ER stress pathways. Through cognitive deficit analysis in the form of behavioral and locomotor experiments in addition to in situ biomarker analysis by way of western blotting and immunohistochemistry, we found that G-CSF gene therapy exhibited neurogenic and neuroprotective effects in ischemic mouse models and could possibly serve as a good therapy for other diseases that share similar pathology to stroke.
Show less - Date Issued
- 2021
- PURL
- http://purl.flvc.org/fau/fd/FA00013787
- Subject Headings
- Sickle cell anemia, Stroke, Granulocyte Colony-Stimulating Factor, Gene therapy
- Format
- Document (PDF)
