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As the human population continues to age, an increasing number of people will exhibit significant deficits in cognitive function and dementia. It is now recognized that cerebrovascular, metabolic and neurodegenerative diseases all play major roles in the evolution of cognitive impairment and dementia. Thus with our more recent recognition of these relationships and our need to understand and more positively impact on this world health problem, "The Leo and Anne Albert Charitable Trust" (Gene Pranzo, Trustee with significant support from Susan Brogan, Meeting Planner) provided generous support for this inaugural international workshop that was held from April 13-16, 2015 at the beautiful Ritz Carlton Golf Resort in North Naples, Florida. Researchers from SUNY Downstate Medical Center, Brooklyn, NY organized the event by selecting the present group of translationally inclined preclinical, clinical and population scientists focused on cerebrovascular disease (CVD) risk and its progression to vascular cognitive impairment (VCI) and dementia. Participants at the workshop addressed important issues related to aging, cognition and dementia by: (1) sharing new data, information and perspectives that intersect vascular, metabolic and neurodegenerative diseases, (2) discussing gaps in translating population risk, clinical and preclinical information to the progression of cognitive loss, and (3) debating new approaches and methods to fill these gaps that can translate into future therapeutic interventions. Participants agreed on topics for group discussion prior to the meeting and focused on specific translational goals that included promoting better understanding of dementia mechanisms, the identification of potential therapeutic targets for intervention, and discussed/debated the potential utility of diagnostic/prognostic markers. Below summarizes the new data-presentations, concepts, novel directions and specific discussion topics addressed by this international translational team at our "First Leo and Anne Albert Charitable Trust 'Think Tank' VCI workshop".

Objectives Training healthcare professionals in emergency maternal healthcare is a critical component of improving overall maternal health in developing countries like Rwanda. This paper explored the challenges that healthcare professionals who participated in a Continuing Professional Development (CPD) program on Advanced Life Support in Obstetrics® (ALSO) face in putting the learned knowledge and skills into practice in hospitals of Rwanda. Methods This study used a mixed methods approach to understand the challenges/barriers to applying new knowledge and skills in the hospitals of Rwanda. We conducted thirteen purposive in-depth interviews with ALSO® trainees (nurses, midwives and physicians) complemented with a cross-sectional survey on staff turnover in eight of the nine hospitals in the Eastern province of Rwanda. Results Our study found that trainees do not get enough opportunity to apply the new knowledge and skills in their hospitals and expand to health centers. In part because they are frequently rotating to different departments of the hospital and are not getting the opportunity to train their colleagues to share the learned knowledge and skills. The lack of refresher trainings/mentorship and the high personnel turnover were also reported as a barrier to applying new knowledge and skills. Reasons for staff turnover included pursuing further studies, a better opportunity (job/remuneration), low morale, and family related motives including joining a spouse or better schools for children. Conclusions for Practice Expanding and formalizing CPD training to all the healthcare professionals involved in providing maternal care services would improve the provision of emergency maternal healthcare in Rwanda., Author(s): Germaine Tuyisenge [sup.1] [sup.2] , Celestin Hategeka [sup.3] [sup.4] , Isaac Luginaah [sup.2] , Yolanda Babenko-Mould [sup.5] , David Cechetto [sup.6] , Stephen Rulisa [sup.7] [sup.8] Author Affiliations: (Aff1) [...]

Background: Maternal near-miss refers to women who survive death from life-threatening obstetric complications and has various social, financial, physical, and psychological impacts on families. Objective: To explore male partners' perceptions of maternal near-miss experienced by their female partners and the associated psychosocial impacts on their families in Rwanda. Methods: This was a qualitative study involving 27 semi-structured in-depth interviews with male partners whose spouses experienced a maternal near-miss event. Data were analyzed using a thematic coding to generate themes from participants' responses. Results: Six key themes that emerged were: male partner's support during wife's pregnancy and during maternal near-miss hospitalization, getting the initial information about the spouse's near-miss event, psychosocial impacts of spouse's near-miss, socio-economic impact of spouse's near-miss, post- maternal near-miss family dynamics, and perceived strategies to minimize the impacts of near-miss. Male partners reported emotional, social, and economic impacts as a result of their traumatic experiences. Conclusions: The impact of maternal near-miss among families in Rwanda remains an area that needs healthcare attention. The residual emotional, financial, and social consequences not only affect females, but also their male partners and their relatives. Male partners should be involved and be well-informed about their partners' conditions and the expected long-term effects of near-miss. Also, medical and psychological follow-up for both spouses is necessary for the enhancement of the health and well-being of affected households. [ABSTRACT FROM AUTHOR]

Research was conducted to identify the receptors in the lateral hypothalamic area (LHA) that influence insular cortex (IC) sympathetic responses. IC stimulation was performed on 27 Wistar rats before and after glutamate and other receptor antagonists were administered into the LHA. The rats were tested for renal nerve activity, heart rate and arterial pressure. Results indicate that the IC autonomic afferents that project to the LHA involve N-methyl-D-aspartic acid glutamatergic receptors.

Interaction of neuropeptides and neurotransmitters in anesthetized male wistar rats is investigated. The investigation reveals that the processes for peptide interaction with primary neurotransmitters in the parabranchial nucleus requires the postsynaptic action of the primary neurotransmitters.

Measurements of the acute variations in heart rate (HR), arterial pressure (AP) and renal nerve sympathetic activity (RSNA) during lidocaine (LID) and D,L-homocysteic acid (DLH) pressure injection into the insular cortex (IC) of conscious and anesthetized spontaneously hypertensive rats (SHR) and Wistar rats help study the autonomic responses of (IC) in these animals. LID and DHL stimulation of IC increases mean AP and lowers RSNA and HR in anesthetized Wistar rats, while the conscious rats exhibit a pressor response without HR change. Anesthetized SHR activation with DHL and LID does not alter mean AP but lowers the HR.

The changes in response of thalamic neuronal activity evoked by vagal stimulation before and after neurotransmiter antagonist injections into the parabrachial nucleus (PB) were recorded and the putative neurotransmitter in ascending visceral pathways were investigated. The blood pressure and heart rate of male Wistar rats anesthetized with chloral hydrate and alpha-chloralose were monitored continuously. The changes in visceral thalamus during single and multiunit activity were studied by stimulating the cervical vagus nerve. alpha2 and GABA(sub A) receptors were effective in tonic activity of ventral basal thalamic neurons receiving visceral input and the NMDA receptors mediated the relay of visceral afferent sensory information through the PB.

Excitatory amino acid (EAA) and cholinergic neurotransmission receptor regulate tonic renal sympathetic nerve functions after spinal cord damage. EAA and the receptor maintain the renal nerve discharges that are significantly lowered by intrathecally injected atropine and kynurenate. Renal sympathetic function does not influence major changes in arterial pressure even though the nerral discharges cause transient increase in arterial pressure.

The effects of neuropeptides on the conduction of visceral sensory input from the parabrachial plexus to the thalamus were examined by monitoring neural activity of the thalamus induced by vagal stimulation. Blood pressure and heart rate were monitored after calcitonin gene-related peptide, substance P, somatostatin (SOM), cholecystokinin and neurotensin were injected into the parabrachial plexus of prepared rats. Test results indicate that SOM inhibits tonic activity and greatly increased the response-to background ratio of thalamic visceral stimulation.