The quality of life for 46 stroke survivors under the age of 65 years in a stroke register was studied 4 years after their first stroke. A questionnaire covering four domains of life (working conditions, activities at home, family relationships, and leisure time activities) was used for investigation of the quality of life. The results showed that in spite of a good recovery in terms of discharge from the hospital, activities of daily living, and return to work, the quality of life of most patients (83%) had not been restored to the prestroke level. Deterioration among the several domains of life ranged from 39% to 80%, the lowest being in the domain of activities at home and the highest in the domain of leisure time activities. Hemispheral localization of the lesion, paresis, coordination disturbances, and especially subjective tendency to depression were highly correlated with a deterioration in the quality of life. Dependence in activities of daily living and an inability to return to work were also associated with the lack of restoration. Our results suggest that much more attention should be paid to the quality of life of stroke patients. (Stroke 1988;19:1101-1107)S troke is a major, chronically disabling neurologic disease that often radically and permanently changes the lives of its victims. Medical treatment and occupational and physical therapy have been used to help stroke patients. Discharge from the hospital and the degree of independence achieved in activities of daily living (ADL) have been the usual criteria 1 -5 used to measure the success of rehabilitation. Although many studies 6 -8 have shown that stroke rehabilitation can help a patient to regain and maintain functional abilities, the efficacy of therapeutic interventions has been questioned. However, little attention has been given to the quality of life following expensive, often long treatment. As Feigenson 9 points out, "unless this factor is considered, any statistics used in analysing the benefits of treatment are incomplete and misleading."Although the concept has been only loosely defined, there is agreement that quality of life refers to a person's subjective well-being and life satisfaction and that it includes mental and physical health, material well-being, interpersonal relationships within and outside the family, work and other activities in the community, personal development and fulfillment, and active recreation.10 -13 Despite the fact that the basic definition of quality of life From the Department of Neurology, University of Helsinki, Helsinki, Finland.Supported by the Finnish Heart Association. Address for correspondence: Marja-Liisa Niemi, MA, Department of Neurology, University of Helsinki, Haartmaninkatu 4, 00290 Helsinki, Finland. Received November 12, 1987; accepted April 26, 1988. seems to apply to most people, there is a need to focus its evaluation directly on the problems created by illness and disability. 911 The aim of our study was to investigate the quality of life in relation to recovery from stroke. Sub...

The recovery from stroke of 154 survivors out of 255 stroke patients was analyzed. The outcomes documented were: discharge from hospital, activities of daily living (ADL) and return to work. A clear improvement in neurological and neuropsychological deficits was seen from the acute stage to three months, and this continued to twelve months, but to a lesser degree. 69% and 78% respectively, of the patients were at home three and twelve months after stroke. Independence in ADL increased from 32% acutely to 62% and 68% by three and twelve months, respectively. Of those gainfully employed prior to stroke, 55% had returned to work after twelve months. As a group, SAH patients seemed to recover better, but, for those that could be age-matched with infarction patients, there was no difference in outcome. Old age, acute stage hemiparesis, impairment of intelligence and memory, visuoperceptual deficits, nonadequate emotional reactions, and living alone all had a major negative influence on outcome. This study suggests that neurological and neuropsychological deficits, as well as emotional reactions, influence the outcomes after stroke, and all should be taken into consideration in prognosis.

BackgroundSeveral molecular and population genetic studies have focused on the native sheep breeds of Finland. In this work, we investigated their ancestral sheep populations from Iron Age, Medieval and Post-Medieval periods by sequencing a partial mitochondrial DNA D-loop and the 5’-promoter region of the SRY gene. We compared the maternal (mitochondrial DNA haplotypes) and paternal (SNP oY1) genetic diversity of ancient sheep in Finland with modern domestic sheep populations in Europe and Asia to study temporal changes in genetic variation and affinities between ancient and modern populations.ResultsA 523-bp mitochondrial DNA sequence was successfully amplified for 26 of 36 sheep ancient samples i.e. five, seven and 14 samples representative of Iron Age, Medieval and Post-Medieval sheep, respectively. Genetic diversity was analyzed within the cohorts. This ancient dataset was compared with present-day data consisting of 94 animals from 10 contemporary European breeds and with GenBank DNA sequence data to carry out a haplotype sharing analysis. Among the 18 ancient mitochondrial DNA haplotypes identified, 14 were present in the modern breeds. Ancient haplotypes were assigned to the highly divergent ovine haplogroups A and B, haplogroup B being the major lineage within the cohorts. Only two haplotypes were detected in the Iron Age samples, while the genetic diversity of the Medieval and Post-Medieval cohorts was higher. For three of the ancient DNA samples, Y-chromosome SRY gene sequences were amplified indicating that they originated from rams. The SRY gene of these three ancient ram samples contained SNP G-oY1, which is frequent in modern north-European sheep breeds.ConclusionsOur study did not reveal any sign of major population replacement of native sheep in Finland since the Iron Age. Variations in the availability of archaeological remains may explain differences in genetic diversity estimates and patterns within the cohorts rather than demographic events that occurred in the past. Our ancient DNA results fit well with the genetic context of domestic sheep as determined by analyses of modern north-European sheep breeds.

Sheep were among the first domesticated animals to appear in Estonia in the late Neolithic and became one of the most widespread livestock species in the region from the Late Bronze Age onwards. However, the origin and historical expansion of local sheep populations in Estonia remain poorly understood. Here, we analysed fragments of the hypervariable D-loop of mitochondrial DNA (mtDNA; 213 bp) and the Y-chromosome SRY gene (130 bp) extracted from 31 archaeological sheep bones dated from approximately 800 BC to 1700 AD. The ancient DNA data of sheep from Estonia were compared with ancient sheep from Finland as well as a set of contemporary sheep breeds from across Eurasia in order to place them in a wider phylogeographical context. The analysis shows that: (i) 24 successfully amplified and analysed mtDNA sequences of ancient sheep cluster into two haplogroups, A and B, of which B is predominant; (ii) four of the ancient mtDNA haplotypes are novel; (iii) higher mtDNA haplotype diversity occurred during the Middle Ages as compared to other periods, a fact concordant with the historical context of expanding international trade during the Middle Ages; (iv) the proportion of rarer haplotypes declined during the expansion of sheep from the Near Eastern domestication centre to the northern European region; (v) three male samples showed the presence of the characteristic northern European haplotype, SNP G-oY1 of the Y-chromosome, and represent the earliest occurrence of this haplotype. Our results provide the first insight into the genetic diversity and phylogeographical background of ancient sheep in Estonia and provide basis for further studies on the temporal fluctuations of ancient sheep populations.