Bags

As usual at the beginning of each year, I buy a new messenger bag and it has become part of a regular routine for me. It's not because I like to buy a new bag every year - (Ok I lie; that may be a small part of it!) - but mostly because a lot of the bags don't last longer than a year*.

The Jeep bag I had during sixth form was pretty strong, had a big main compartment/zipped pockets/ seperate orgnaiser and it didn't look to bad either. However after two years it began to look a bit frayed due to the wear and tear. For the beginning of my undergraduate degree, I bought a grey Animal bag. Although it only had one main compartment, it did have numerous zipped pockets and padding which gave it some shape and made it A LOT more comfortable to carry around. The bag lasted longer than a year (three in fact!) and the only reason I stopped using it was because I decided it was time for a change during my clinical placement. In place of it, I went out and bought a light blue Ripcurl bag; again it looked good, had lots of different compartments but it was disappointing however as the bag only made it up to about 6 months before the stitching gave way. With no time to shop around (shocking I know!) I reverted back to my old animal bag.

A new year has begun and again I'm searching for a new bag. Herein lies the problem;

-Bags that I want do NOT exist any longer

-Those bags that do sort of match my checklist are ridiculously over priced.

So after shopping around a bit and a lot of feedback (Twitter's great for that sorta thing), I compiled the following list.

Timbuk2
Heard of these guys from numerous sources and I like the fact you get to design your own bag. However that in turn pushes the price right up and also not many of these bags looked very feminine yet the Aeon bag caught my eye. I thought it was a tad expensive (roughly £50). However after shopping around a bit, I thought why not. I’d heard from various people that they were really good quality bags (Twitters recommendations) and settled on the aeon bag in a gunmetal grey colour with the logo in bright blue. By the time I got round to ordering it, the grey colour had been discontinued and I have no idea why?! Very annoying!

Crumpler
Liked a lot of these designs and also loved the fact that I could order these bags without any hassle (i.e. those countries that do not ship internationally or that have extortionate shipping costs like Timbuk2). I quite like the ‘Cheesytina’ bag and again roughly priced around the £40/£50 mark. The added bonus was that I could actually have a look at some of these bags, as certain stores do stock them. So off I went to TK Maxx to have a look at some samples and I even found the one that I wanted (Cheesytina). It had a good organiser section and it was well padded. The shoulder strap was a bit too big for my liking but it was detachable so I bought the bag. After getting home, I realised that the bag couldn’t quite fit a A4 folder and kept the zip kept snagging when I tried to close it. Unfortunately it had to be returned :( Built
I have to say none of these really appealed in terms of functionality but in terms of deigns and colour, they look fab. A friend of mine at uni who bought a laptop bag, mentioned how although he liked the neoprene material, he hated the fact that it didn’t really retain its’ shape when it was packed full of his books, laptop and other stuff. Pakuma
Recommended by my uncle. I did like some of the designs, specifically the Choroka K3s but felt it was a bit on the small side and felt that the Choroka K2 would be a better size - a cross between the two would be nice. Also the padding for the laptop compartment I thought was a bit in excess perhaps, but I guess it’s better to be cautious sometimes.
Rickshaw
I have NEVER heard of these guys before and I totally love their designs (thank you twitter!). The Med commuter messenger bag is a great size, lots of separate compartments and great designs such as the ‘London Plaid’ which is my favourite design. The only thing holding me back is the price. £50 for a bag was pushing it but double the price at nearly £96 seems to be a little bit too much. I do really like it though :p *The only exception to this would be the grey animal bag that I still have as my 'back up bag' as numerous successors have let me down on more than one occasion.

Dementia

This is just quick overview summarising the current ongoing work in the area of neurosciences, specifically dementia. Dementia (meaning ‘deprived of mind’) is a serious cognitive disorder which affects areas such as memory, attention, language and problem solving. It can be a result of a single brain injury or of a progressive long term illness. As we age, we will all experience some form of change in our cognitive ability which a normal sign of ageing. However it is when these changes seem to increase more than the expected level, that dementia is diagnosed.

Neurological disorders including dementia are set to rise in the future due to an ageing population.

Types:
The type of dementia is dependent on the pathophysiology. The different forms can be dependent on;
- Age (often the same illness can be given different names as they arise in different age groups)
- Gender (some types of dementia seem to be higher in women than in men)
- Pathology (the change in size and shape of the cells i.e. plaques, neurofibrillary tangles, lesions and the location of the changed area i.e. frontal lobe, temporal lobe.
Consequently the pathology in turn determines the symptoms that characterise the illness.

Diagnosis:
When a person is suffering from dementia, the clinician will usually take a clinical history to see if there is a familial link within the family. This will involve enquiring about the patient’s diet, sleep patterns, medications and a history recent illnesses such as stroke, heart disease, cholesterol, blood pressure and diabetes. A mini-mental state examination (MMSE) is also carried out to test the level of cognitive impairment in combination with other clinical diagnostic tests.

It is common practice to also conduct psychological tests and blood tests to exclude other possible causes. The clinical tests may involve scans and neuroimaging techniques (MRI, CAT) as well as an electroencephalography (EEG), analysis of the cerebrospinal fluid (CSF), tissue biopsies, genetic testing. When all other possible clinical causes have been eliminated then further testing of the cognitive domain is conducted to determine the type of dementia.

There are a number of different scales and assessment methods used to test the cognitive domain however used on their own they are not sufficient, as there is large variation between guidelines and thus the potential for misdiagnosis is possible. Often the histological examination of the brain post mortem is used confirm the diagnosis.

Treatment:
Something to bear in mind is that certain types of dementia are multifactorial meaning that they have numerous causes. For this section if we look specifically at Alzheimer’s and the treatments associated with this disease.

Prevention:
Prevention is the best course of treatment and a number of risk factors have been identified for Alzheimer’s disease;
- A diet that is healthy, low fat, rich in B vitamins and avoidance of alcohol and smoking
- Cognitive fitness - maintaining intellectual and physical activity is a protective risk factor against cognitive decline
- Reducing cardiovascular risk factors is beneficial i.e. hypercholesterolemia, hypertension, hyperhomocysteinemia, dietary saturate fats, cholesterol, antioxidants,diabetes mellitus, cardiovascular disease and cerebrovascular disease.
- the presence of the ε4 allele of the apolipoprotein E (apoE) gene has been identified as a strong genetic risk factor

Pharmaceutiacal:
Although there is no actual cure as this moment in time, there drugs avaliable to help alleviate the symptoms.
- Cardiovascular risk factors can be controlled by the use of antiplatelet drugs such as aspirin to decrease platelet aggregation and statins such as Atorvastatin to reduce serum cholesterol.
- The use of acetylcholinesterase inhibitors such as galantamine, donepezil and rivastigmine. It is thought that the degradation of acetylcholine is a contributing factor and so these drugs slow down the degradation, allowing levels to remain elevated and prevent further neuronal damage.
- Other drugs include the regulation of neurotransmitters using glutamate, NSAIDS and statins.
- Pharmaceutical intervention such as antidepressants, neuroleptics and mood-stabilizers help alleviate the behavioral changes.

The future:
There are numerous groups working on different theories and possible treatments; selections of which are described below.
- Improvements in diagnostic criteria to allow earlier detection thus leading to more positive outcomes.
- Numerous pharmaceutical drugs such as Protollin, Dimebon, Rember are currently undergoing clinical trials.
- Recent work at the University of Manchester has shown that the herpes simplex virus (usually found in cold sores) may be linked to the build of plaques associated with Alzheimer’s. If this is the case then anti viral agents may be used to treat Alzheimer’s.
- To reduced the levels of amyloid protein that cause plaques by using immunotherapy or the development of a vaccine.
- Using the brain’s own neuroprotective strategies to protect against possible causes such as stroke. This novel approach is called ischemic ‘postconditioning’ that involves the activation of the protein kinase Akt, may go onto to produce a suitable treatment.
- the role of metals such as aluminium and spices such as tumeric have also been highlighted in recent work.

Rather than give up on life as so many dementia patients do, I discovered that a few people I know, regularly keep journals throughout their illness. The purpose of this is sort of two fold; firstly it helps the person keep track of their thoughts thus giving their mental capacity a workout and secondly it may help give carers an insight into how the patient is feeling and try and solve some of the problems that they may be facing. During my research, I also found that quite a few people who suffer from dementia or have loved ones living with this illness have set up online blogs.

This I feel is a great idea because for the sufferers it is a way to maintain their intellectual ability as I mentioned before and for the carers it is a way to release some of those feelings of frustration and helplessness. The fact that their journals are online mean that anyone can read them and know that they are not alone with this illness, that they have someone to share their thoughts and feelings with. Personally from the patients that I've seen that is one of the key things; the fear/feeling of isolation and to alleviate some of those fears can only be a positive step forward.

The death of a brain

Due to my area of interest, I read a lot of articles linked to most aspects of brain neurology – anatomy, function, biochemistry, as all of it adds to the overall picture. The brain is clearly as important organ and can make everything go haywire if the slightest thing goes wrong. Stating the obvious I know. Independent of my past research project in dementia, I’ve recently seen an increase in the number of articles focussing on cognitive function.

During my clinical placement, I saw what memory loss can do to a patient and the effects it can have on family and friends. It really is a terrible thing to be stripped of all your memories and I can only imagine what a terrifying experience it must be. Have you ever had those sort of dreams where you are transported to some place you don’t recognise and have no recollection of how you got there? It makes your heart race just a little bit faster, the anxiety kicks in and you begin to feel restless and uncomfortable. Now imagine having that same feeling in real life where you are fully awake and you have to deal with all those emotions on a daily basis. Actually scratch that, imagine having to deal with that situation every 30 or so minutes because that’s how long your brain can retain such information. Just think of the sheer exhaustion your body goes through when the adrenaline kicks every half hour or so – physically tired as well as mentally. Sounds like a horrifying situation doesn’t it?

It’s one of the reasons why so much research time and effort is directed towards manipulation of brain functions. So how can we solve this problem? Perhaps we should have some sort of external method of storing our thoughts. Although this is veering a little towards the bionic side and science fiction, I remember the film ‘6th Day’ in which people could have a new body made should their old one get damaged and have their thoughts transferred over to their new clone. An interesting transition and something that perhaps may be used in the future, one way or another. There is also talk of an artificial brain being developed that is only 10 years away. An article in Medscape magazine raises the issue of who decides when a brain has fulfilled it's lifespan? Also who is it that will make that key decision? As it is an organ, surely is has the capacity to be regenerated? A jolt of electricity would be sufficient to kick start the neuronal activity again and resume normal brain wave patterns surely? Furthermore researchers in the USA are also looking at ways of editing memories. On the whole, it all sounds rather exciting doesn’t it?

So why in the back of my mind is there this niggling feeling? I agree something should be done but why does the idea of a researcher/scientist editing my memory scream ‘lobotomy’ to me? The thought that someone else other than me will have the power to decide which memories I should or shouldn’t keep. I told a friend of mine about this article and she stated that without any control over what your own thoughts what difference is there between you and someone with dementia? I don’t think she fully understood the concept but she did raise an important issue – control. Whether it was a manipulation of stored memories or the implantation of a ‘new’ brain, it all boils down to an individual wanting some control over their life; that is the key thing to bear in mind. Just wanted to end with this final article in which David Blunkett has promised to donate his brain to research after his death. The donation of healthy organs is something which would help tremedously and I agree with Dr Chris Morris on how a lot more time, money and effort is required in this area of research.