Child Neurology Services in Africa

Science.gov (United States)

Wilmshurst, Jo M.; Badoe, Eben; Wammanda, Robinson D.; Mallewa, Macpherson; Kakooza-Mwesige, Angelina; Venter, Andre; Newton, Charles R.

2013-01-01

The first African Child Neurology Association meeting identified key challenges that the continent faces to improve the health of children with neurology disorders. The capacity to diagnose common neurologic conditions and rare disorders is lacking. The burden of neurologic disease on the continent is not known, and this lack of knowledge limits the ability to lobby for better health care provision. Inability to practice in resource-limited settings has led to the migration of skilled professionals away from Africa. Referral systems from primary to tertiary are often unpredictable and chaotic. There is a lack of access to reliable supplies of basic neurology treatments such as antiepileptic drugs. Few countries have nationally accepted guidelines either for the management of epilepsy or status epilepticus. There is a great need to develop better training capacity across Africa in the recognition and management of neurologic conditions in children, from primary health care to the subspecialist level. PMID:22019842

Coping capacities for improving adaptation pathways for flood protection in Can Tho, Vietnam

Science.gov (United States)

Pathirana, A.; Radhakrishnan, M.; Quan, N. H.; Gersonius, B.; Ashley, R.; Zevenbergen, C.

2016-12-01

Studying the evolution of coping and adaptation capacities is a prerequisite for preparing an effective flood management plan for the future, especially in the dynamic and fast changing cities of developing countries. The objectives, requirements, targets, design and performance of flood protection measures will have to be determined after taking into account, or in conjunction with, the coping capacities. A methodology is presented based on adaptation pathways to account for coping capacities and to assess the effect on flood protection measures. The adaptation pathways method determines the point of failure of a particular strategy based on the change in an external driver, a point in time or a socio economic situation where / at which the strategy can no longer meet its objective. Pathways arrived at based on this methodology reflect future reality by considering changing engineering standards along with future uncertainties, risk taking abilities and adaptation capacities. This pathways based methodology determines the Adaptation tipping points (ATP), `time of occurrence of ATP' of flood protection measures after accounting for coping capacities, evaluates the measures and then provides the means to determine the adaptation pathways. Application of this methodology for flood protection measures in Can Tho city in the Mekong delta reveals the effect of coping capacity on the usefulness of flood protection measures and the delay in occurrence of tipping points. Consideration of coping capacity in the system owing to elevated property floor levels lead to the postponement of tipping points and improved the adaptation pathways comprising flood protection measures such as dikes. This information is useful to decision makers for planning and phasing of investments in flood protection.

The determinants of vulnerability and adaptive capacity at the national level and the implications for adaptation

Energy Technology Data Exchange (ETDEWEB)

Brooks, N.; Adger, W.N.; Kelly, P.M. [University of East Anglia, Norwich (United Kingdom). School of Environmental Sciences

2005-07-01

We present a set of indicators of vulnerability and capacity to adapt to climate variability, and by extension climate change, derived using a novel empirical analysis of data aggregated at the national level on a decadal timescale. The analysis is based on a conceptual framework in which risk is viewed in terms of outcome, and is a function of physically defined climate hazards and socially constructed vulnerability. Climate outcomes are represented by mortality from climate-related disasters, using the emergency events database data set, statistical relationships between mortality and a shortlist of potential proxies for vulnerability are used to identify key vulnerability indicators. We find that 11 key indicators exhibit a strong relationship with decadally aggregated mortality associated with climate-related disasters. Validation of indicators, relationships between vulnerability and adaptive capacity, and the sensitivity of subsequent vulnerability assessments to different sets of weightings are explored using expert judgement data, collected through a focus group exercise. The data are used to provide a robust assessment of vulnerability to climate-related mortality at the national level, and represent an entry point to more detailed explorations of vulnerability and adaptive capacity. They indicate that the most vulnerable nations are those situated in sub-Saharan Africa and those that have recently experienced conflict. Adaptive capacity - one element of vulnerability - is associated predominantly with governance, civil and political rights, and literacy. (author)

The determinants of vulnerability and adaptive capacity at the national level and the implications for adaptation

International Nuclear Information System (INIS)

Brooks, N.; Adger, W.N.; Kelly, P.M.

2005-01-01

We present a set of indicators of vulnerability and capacity to adapt to climate variability, and by extension climate change, derived using a novel empirical analysis of data aggregated at the national level on a decadal timescale. The analysis is based on a conceptual framework in which risk is viewed in terms of outcome, and is a function of physically defined climate hazards and socially constructed vulnerability. Climate outcomes are represented by mortality from climate-related disasters, using the emergency events database data set, statistical relationships between mortality and a shortlist of potential proxies for vulnerability are used to identify key vulnerability indicators. We find that 11 key indicators exhibit a strong relationship with decadally aggregated mortality associated with climate-related disasters. Validation of indicators, relationships between vulnerability and adaptive capacity, and the sensitivity of subsequent vulnerability assessments to different sets of weightings are explored using expert judgement data, collected through a focus group exercise. The data are used to provide a robust assessment of vulnerability to climate-related mortality at the national level, and represent an entry point to more detailed explorations of vulnerability and adaptive capacity. They indicate that the most vulnerable nations are those situated in sub-Saharan Africa and those that have recently experienced conflict. Adaptive capacity - one element of vulnerability - is associated predominantly with governance, civil and political rights, and literacy. (author)

The Adaptive Capacity Wheel : a method to assess the inherent characteristics of institutions to enable the adaptive capacity of society

NARCIS (Netherlands)

Gupta, Joyeeta; Termeer, Catrien; Klostermann, Judith; Meijerink, Sander; van den Brink, Margo; Jong, Pieter; Nooteboom, Sibout; Bergsma, Emmy

2010-01-01

Climate change potentially brings continuous and unpredictable changes in weather patterns. Consequently, it calls for institutions that promote the adaptive capacity of society and allow society to modify its institutions at a rate commensurate with the rate of environmental change. Institutions,

The Adaptive Capacity Wheel: a method to assess the inherent characteristics of institutions to enable the adaptive capacity of society

NARCIS (Netherlands)

Gupta, J.; Termeer, C.; Klostermann, J.; Meijerink, S.; van den Brink, M.; de Jong, P.; Nootebooms, S.; Bergsma, E.J.

2010-01-01

Climate change potentially brings continuous and unpredictable changes in weather patterns. Consequently, it calls for institutions that promote the adaptive capacity of society and allow society to modify its institutions at a rate commensurate with the rate of environmental change. Institutions,

Assessing employability capacities and career adaptability in a sample of human resource professionals

Directory of Open Access Journals (Sweden)

Melinde Coetzee

2015-06-01

Full Text Available Orientation: Employers have come to recognise graduates’ employability capacities and their ability to adapt to new work demands as important human capital resources for sustaining a competitive business advantage. Research purpose: The study sought (1 to ascertain whether a significant relationship exists between a set of graduate employability capacities and a set of career adaptability capacities and (2 to identify the variables that contributed the most to this relationship. Motivation for the study: Global competitive markets and technological advances are increasingly driving the demand for graduate knowledge and skills in a wide variety of jobs. Contemporary career theory further emphasises career adaptability across the lifespan as a critical skill for career management agency. Despite the apparent importance attached to employees’ employability and career adaptability, there seems to be a general lack of research investigating the association between these constructs. Research approach, design and method: A cross-sectional, quantitative research design approach was followed. Descriptive statistics, Pearson product-moment correlations and canonical correlation analysis were performed to achieve the objective of the study. The participants (N = 196 were employed in professional positions in the human resource field and were predominantly early career black people and women. Main findings: The results indicated positive multivariate relationships between the variables and showed that lifelong learning capacities and problem solving, decision-making and interactive skills contributed the most to explaining the participants’ career confidence, career curiosity and career control. Practical/managerial implications: The study suggests that developing professional graduates’ employability capacities may strengthen their career adaptability. These capacities were shown to explain graduates’ active engagement in career management

Assessing the components of adaptive capacity to improve conservation and management efforts under global change.

Science.gov (United States)

Nicotra, Adrienne B; Beever, Erik A; Robertson, Amanda L; Hofmann, Gretchen E; O'Leary, John

2015-10-01

Natural-resource managers and other conservation practitioners are under unprecedented pressure to categorize and quantify the vulnerability of natural systems based on assessment of the exposure, sensitivity, and adaptive capacity of species to climate change. Despite the urgent need for these assessments, neither the theoretical basis of adaptive capacity nor the practical issues underlying its quantification has been articulated in a manner that is directly applicable to natural-resource management. Both are critical for researchers, managers, and other conservation practitioners to develop reliable strategies for assessing adaptive capacity. Drawing from principles of classical and contemporary research and examples from terrestrial, marine, plant, and animal systems, we examined broadly the theory behind the concept of adaptive capacity. We then considered how interdisciplinary, trait- and triage-based approaches encompassing the oft-overlooked interactions among components of adaptive capacity can be used to identify species and populations likely to have higher (or lower) adaptive capacity. We identified the challenges and value of such endeavors and argue for a concerted interdisciplinary research approach that combines ecology, ecological genetics, and eco-physiology to reflect the interacting components of adaptive capacity. We aimed to provide a basis for constructive discussion between natural-resource managers and researchers, discussions urgently needed to identify research directions that will deliver answers to real-world questions facing resource managers, other conservation practitioners, and policy makers. Directing research to both seek general patterns and identify ways to facilitate adaptive capacity of key species and populations within species, will enable conservation ecologists and resource managers to maximize returns on research and management investment and arrive at novel and dynamic management and policy decisions. © 2015 Society for

Assessing the components of adaptive capacity to improve conservation and management efforts under global change

Science.gov (United States)

Nicotra, Adrienne; Beever, Erik; Robertson, Amanda; Hofmann, Gretchen; O’Leary, John

2015-01-01

Natural-resource managers and other conservation practitioners are under unprecedented pressure to categorize and quantify the vulnerability of natural systems based on assessment of the exposure, sensitivity, and adaptive capacity of species to climate change. Despite the urgent need for these assessments, neither the theoretical basis of adaptive capacity nor the practical issues underlying its quantification has been articulated in a manner that is directly applicable to natural-resource management. Both are critical for researchers, managers, and other conservation practitioners to develop reliable strategies for assessing adaptive capacity. Drawing from principles of classical and contemporary research and examples from terrestrial, marine, plant, and animal systems, we examined broadly the theory behind the concept of adaptive capacity. We then considered how interdisciplinary, trait- and triage-based approaches encompassing the oft-overlooked interactions among components of adaptive capacity can be used to identify species and populations likely to have higher (or lower) adaptive capacity. We identified the challenges and value of such endeavors and argue for a concerted interdisciplinary research approach that combines ecology, ecological genetics, and eco-physiology to reflect the interacting components of adaptive capacity. We aimed to provide a basis for constructive discussion between natural-resource managers and researchers, discussions urgently needed to identify research directions that will deliver answers to real-world questions facing resource managers, other conservation practitioners, and policy makers. Directing research to both seek general patterns and identify ways to facilitate adaptive capacity of key species and populations within species, will enable conservation ecologists and resource managers to maximize returns on research and management investment and arrive at novel and dynamic management and policy decisions.

Adaptive capacity and human cognition: the process of individual adaptation to climate change

Energy Technology Data Exchange (ETDEWEB)

Grothmann, T. [Potsdam Institute for Climate Impact Research, Potsdam (Germany). Department of Global Change and Social Systems; Patt, A. [Boston University (United States). Department of Geography

2005-10-01

Adaptation has emerged as an important area of research and assessment among climate change scientists. Most scholarly work has identified resource constraints as being the most significant determinants of adaptation. However, empirical research on adaptation has so far mostly not addressed the importance of measurable and alterable psychological factors in determining adaptation. Drawing from the literature in psychology and behavioural economics, we develop a socio-cognitive Model of Private Proactive Adaptation to Climate Change (MPPACC). MPPACC separates out the psychological steps to taking action in response to perception, and allows one to see where the most important bottlenecks occur - including risk perception and perceived adaptive capacity, a factor largely neglected in previous climate change research. We then examine two case studies - one from urban Germany and one from rural Zimbabwe - to explore the validity of MPPACC to explaining adaptation. In the German study, we find that MPPACC provides better statistical power than traditional socio-economic models. In the Zimbabwean case study, we find a qualitative match between MPPACC and adaptive behaviour. Finally, we discuss the important implications of our findings both on vulnerability and adaptation assessments, and on efforts to promote adaptation through outside intervention. (author)

Developing an Instrument to Measure Autonomous Adaptive Capacity to Climate Change among Urban Households

Directory of Open Access Journals (Sweden)

Kathryn R. Selm

2018-02-01

Full Text Available The capacity of households in urban environments to adapt and react to climate change can affect the resilience of the whole community, and instruments for systematically measuring that capacity are needed. We used Raleigh, NC as a case study to explore the dimensions of autonomous adaptive capacity of urban households and to create a scale and associated survey instrument to measure them. Our approach was guided by four capitals that support human livelihoods: social, human, physical, and financial. We surveyed 200 households in Raleigh, NC, and used a principal components analysis to test the scale and survey instrument. Results suggest the scale is a useful and concise tool. Three major dimensions were present among the scale items: financial capital, political awareness, and access to resources. Together, these three dimensions can be used to measure adaptive capacity among different households. These findings are supported by similar work illustrating the value of income inequality and political awareness as indicators of adaptive capacity. Our results also demonstrate that complex relationships among the livelihood capitals may confound our ability to measure financial, physical, and human capitals separately. This framework for assessing adaptive capacity of households, with further refinement and testing, may be used in urban areas to evaluate programs designed to impact resilience to climate change.

Adaptive tele-application for remote neurology diagnosis.

Science.gov (United States)

Garcia, E; Guyennet, H; Lapayre, J-C; Moulin, T

2005-12-01

This paper presents the Collaborative Tele-Neurology (TeNeCi) project which allows practitioners to use telecommunication technologies to provide medical information and services for neurological diseases. Specificities of remote neurology are described and the Cooperative Application Framework (CAliF) multimedia platform on which TeNeCi relies is presented. The technical requirements of such a project in terms of communication and consistency management, audio and video transmissions, and network support, as well as implementation of TeNeCi was evaluated. The software used in this application is composed of several services, such as a Digital Imaging and Communications in Medicine (DICOM) explorer, a DICOM viewer, and a security service. Tests performed on this first TeNeCi release showed good results, and allowed us to explore a larger collaborative experimentation between hospitals in France and Switzerland.

Building Research Capacity to Understand and Adapt to Climate ...

International Development Research Centre (IDRC) Digital Library (Canada)

Building Research Capacity to Understand and Adapt to Climate Change in the Indus Basin ... Eleven world-class research teams set to improve livestock vaccine development ... Building resilience through socially equitable climate action.

The adaptive capacity of smallholder farmers to climate change in the Northern Region of Ghana

Directory of Open Access Journals (Sweden)

Majeed Abdul-Razak

2017-01-01

Full Text Available Climate change is expected to adversely affect agricultural production, particularly in sub-Saharan Africa where the agricultural sector forms the backbone of most countries’ economies. This thus holds true for the agriculture sector of the Northern Region of Ghana which is largely rain-fed and dominated by smallholder farmers with minimal livelihood alternatives. The main research question of this paper is how the adaptive capacity to climate change of smallholder farmers in the Northern Region of Ghana can be characterised? The paper proposes an indicator-based framework for assessing the adaptive capacity of smallholder farmers in the Northern Region of Ghana along six main determinants of adaptive capacity: economic resources, social capital, awareness and training, technology, infrastructure and institutions. Based on a thorough literature review and qualitative interviews with experts for rural livelihoods and agriculture in the study region, the determinants were ranked and three to five indicators per determinant were selected. The results of the expert interviews show that economic resources, awareness and training as well as technological capacities seem most relevant for smallholder farmers’ adaptive capacity while infrastructure, social capital, and institutions were ranked least important. The study operationalized the indicators in a standardized survey questionnaire and tested it in two agrarian communities in the Northern Region of Ghana. The survey results show the aggregate adaptive capacity of respondents is low. However, disparities in adaptive capacity were recorded among respondents in terms of gender and education. Differentiating between the determinants women farmer show significantly lower capacities in fields of economic resources, technology and knowledge and awareness. This paper recommends resilience building interventions in the study area that target individuals with low adaptive capacities, especially women

Determinants of Adaptive Capacity to Climate Change among ...

African Journals Online (AJOL)

Determinants of Adaptive Capacity to Climate Change among Smallholder Rural Households in the Bongo District, Ghana. ... The results of a binary logistic regression model indicates that five predictor variables (education of the household, farming experience, farm size, belief system and training) out of 11 tested ...

Advancing Capacity to Support Climate Change Adaptation : Five ...

International Development Research Centre (IDRC) Digital Library (Canada)

Chargé(e) de projet. Mamadou Moussa Diakhité. Institution. United Nations Institute for Training and Research. Pays d' institution. Switzerland. Site internet. http://www.unitar.org. Extrants. Rapports. Advancing Capacity to Support Climate Change Adaptation (ACCCA) through five pilot actions in Africa : final project report.

Mapping agricultural landscapes and characterizing adaptive capacity in Central America

Science.gov (United States)

Holland, M. B.; Imbach, P. A.; Bouroncle, C.; Donatti, C.; Leguia, E.; Martinez, M.; Medellin, C.; Saborio-Rodriguez, M.; Shamer, S.; Zamora, J.

2013-12-01

One of the key challenges in developing adaptation strategies for smallholder farmers in developing countries is that of a data-poor environment, where spatially-explicit information about where the most vulnerable smallholder communities are located is lacking. Developing countries tend to lack consistent and reliable maps on agricultural land use, and have limited information available on smallholder adaptive capacity. We developed a novel participatory and expert mapping process to overcome these barriers and develop detailed national-scale maps that allow for a characterization of unique agricultural landscapes based on profiles of adaptive capacity for smallholder agriculture in each area. This research focuses specifically on the Central American nations of Costa Rica, Guatemala, and Honduras, where our focus is on coffee and basic grains as the two main cropping systems. Here we present the methodology and results of a series of in-depth interviews and participatory mapping sessions with experts working within the broader agricultural sector in each country. We held individual interviews and mapping sessions with approximately thirty experts from each country, and used a detailed survey instrument for each mapping session to both spatially identify distinct agricultural landscapes, and to further characterize each area based on specific farm practices and social context. The survey also included a series of questions to help us assess the relative adaptive capacity of smallholder agriculture within each landscape. After all expert mapping sessions were completed in each country we convened an expert group to assist in both validating and refining the set of landscapes already defined. We developed a characterization of adaptive capacity by aggregating indicators into main assets-based criteria (e.g. land tenure, access to credit, access to technical assistance, sustainable farm practices) derived from further expert weighting of indicators through an online

Criteria for Determining the Adaptive Capacity of Students of Higher Medical Institutions

Directory of Open Access Journals (Sweden)

M V Yoltukhivskyi

2018-01-01

Full Text Available The article focuses on the importance of the adaptive capacity of students of higher medical institutions in the process of their professional training. The criteria for evaluating the adaptive capacity of students depending on their age were determined. The main mechanisms of forming the adaptive capacity at the organism level were found to be: 1 biochemical mechanisms which manifest themselves in the intracellular processes, e.g. the change in enzyme activity or their number; 2 physiological mechanisms, e.g. increased sweating as the body temperature rises; 3 morphofunctional mechanisms, i.e. the features of body structure and functions which are associated with lifestyle; 4 behavioural mechanisms – e.g. the creation of comfortable living conditions, etc.; 5 ontogenetic mechanisms, i.e. the acceleration of individual development or its slowdown contributing to the survival when conditions change.

Operationalizing analysis of micro-level climate change vulnerability and adaptive capacity

DEFF Research Database (Denmark)

Jiao, Xi; Moinuddin, Hasan

2016-01-01

This paper explores vulnerability and adaptive capacity of rural communities in Southern Laos, where households are highly dependent on climate-sensitive natural resources and vulnerable to seasonal weather fluctuations. The speed and magnitude of climate-induced changes may seriously challenge...... their ability to adapt. Participatory group discussions and 271 household surveys in three villages highlight the current level of vulnerability and adaptive capacity towards climatic variability and risks. This paper visualizes three dimensions of the vulnerability framework at two levels using the Community...... Climate Vulnerability Index and household climate vulnerability cube. Results show that not only poor households are most at risk from climate change challenges, but also those better-off households highly dependent on specialized agricultural production are locally exposed to climate change risks...

ADAPTIVE CAPACITY IN RURAL SOUTH AFRICA Sam Schramski

African Journals Online (AJOL)

sam schramski

2017-02-02

Feb 2, 2017 ... such as the authors of Panarchy, state that adaptive capacity is ―the ... with this definition that the ‗potential' represents a society's response to ... closely linked together in case studies on water and health (Ebi ... water insecurity; weak institutions and governance (Füssel and ...... Stockholm, Sweden, 2005.

The adaptive capacity of institutions in Canada, Argentina, and Chile to droughts and floods

NARCIS (Netherlands)

Hurlbert, M.; Gupta, J.

The increasing evidence of global warming calls on all states to enhance their adaptive capacity to deal with climate change. This paper compares the adaptive capacity of two Canadian provinces, the province of Mendoza, Argentina and the administrative region of Coquimbo, Chile in relation to the

Building Research Capacity to Understand and Adapt to Climate ...

International Development Research Centre (IDRC) Digital Library (Canada)

Building Research Capacity to Understand and Adapt to Climate Change in the Indus Basin ... Site internet ... L'honorable Chrystia Freeland, ministre du Commerce international, a annoncé le lancement d'un nouveau projet financé par le ...

Enhancing Adaptive Capacity in Food Systems: Learning at Farmers' Markets in Sweden

Directory of Open Access Journals (Sweden)

Rebecka Milestad

2010-09-01

Full Text Available This article examines how local food systems in the form of farmers' markets can enhance adaptive capacity and build social-ecological resilience. It does this by exploring the learning potential among farmers and customers. Learning can enable actors to adapt successfully and thus build adaptive capacity. Three forms of learning are investigated: instrumental, communicative, and emancipatory. These forms of learning constitute the foundation for lasting changes of behaviors. Local food systems are characterized by close links and opportunities for face-to-face interactions between consumers and producers of food, and are also institutions where farmers and customers can express and act upon their ethical values concerning food. However, local food systems are still a marginal phenomenon and cannot be accessed by all consumers. Interviews were held with customers and farmers, and the interactions between farmers and customers were observed at two farmers' markets in Sweden. Customers and farmers were found to learn and adapt to each other due to the opportunities offered by the farmers' markets. We found that farmers and customers learned in the instrumental and communicative domains, but could not confirm emancipatory learning. We concluded that the feedback between customers and farmers offers the potential for learning, which in turn contributes to adaptive capacity. This can be a driving force for building resilience in the food system.

Climate Change, Adaptation, and Formal Education: the Role of Schooling for Increasing Societies' Adaptive Capacities in El Salvador and Brazil

Directory of Open Access Journals (Sweden)

Christine Wamsler

2012-06-01

Full Text Available With a worldwide increase in disasters, the effects of climate change are already being felt, and it is the urban poor in developing countries who are most at risk. There is an urgent need to better understand the factors that determine people's capacity to cope with and adapt to adverse climate conditions. This paper examines the influence of formal education in determining the adaptive capacity of the residents of two low-income settlements: Los Manantiales in San Salvador (El Salvador and Rocinha in Rio de Janeiro (Brazil, where climate-related disasters are recurrent. In both case study areas, it was found that the average levels of education were lower for households living at high risk, as opposed to residents of lower risk areas. In this context, the influence of people's level of education was identified to be twofold due to (a its direct effect on aspects that reduce risk, and (b its mitigating effect on aspects that increase risk. The results further suggest that education plays a more determinant role for women than for men in relation to their capacity to adapt. In light of these results, the limited effectiveness of institutional support identified by this study might also relate to the fact that the role of formal education has so far not been sufficiently explored. Promoting (improved access to and quality of formal education as a way to increase people's adaptive capacity is further supported with respect to the negative effects of disasters on people's level of education, which in turn reduce their adaptive capacity, resulting in a vicious circle of increasing risk.

Adaptive dynamic capacity borrowing in road-covering mobile networks

NARCIS (Netherlands)

Ule, A.; Boucherie, Richardus J.; Li, W.; Pan, Y.

2006-01-01

This paper introduces adaptive dynamic capacity borrowing strategies for wireless networks covering a road. In a F/TDMA-based model, road traffic prediction models are used to characterise the movement of hot spots, such as traffic jams, and subsequently to predict the teletraffic load offered to

Ranking the adaptive capacity of nations to climate change when socio-political goals are explicit

International Nuclear Information System (INIS)

Haddad, B.M.

2005-01-01

The typical categories for measuring national adaptive capacity to climate change include a nation's wealth, technology, education, information, skills, infrastructure, access to resources, and management capabilities. Resulting rankings predictably mirror more general rankings of economic development, such as the Human Development Index. This approach is incomplete since it does not consider the normative or motivational context of adaptation. For what purpose or toward what goal does a nation aspire, and in that context, what is its adaptive capacity? This paper posits 11 possible national socio-political goals that fall into the three categories of teleological legitimacy, procedural legitimacy, and norm-based decision rules. A model that sorts nations in terms of adaptive capacity based on national socio-political aspirations is presented. While the aspiration of maximizing summed utility matches typical existing rankings, alternative aspirations, including contractarian liberalism, technocratic management, and dictatorial/religious rule alter the rankings. An example describes how this research can potentially inform how priorities are set for international assistance for climate change adaptation. (author)

Public Sector Reform and Governance for Adaptation: Implications of New Public Management for Adaptive Capacity in Mexico and Norway

Science.gov (United States)

Eakin, Hallie; Eriksen, Siri; Eikeland, Per-Ove; Øyen, Cecilie

2011-03-01

Although many governments are assuming the responsibility of initiating adaptation policy in relation to climate change, the compatibility of "governance-for-adaptation" with the current paradigms of public administration has generally been overlooked. Over the last several decades, countries around the globe have embraced variants of the philosophy of administration broadly called "New Public Management" (NPM) in an effort to improve administrative efficiencies and the provision of public services. Using evidence from a case study of reforms in the building sector in Norway, and a case study of water and flood risk management in central Mexico, we analyze the implications of the adoption of the tenets of NPM for adaptive capacity. Our cases illustrate that some of the key attributes associated with governance for adaptation—namely, technical and financial capacities; institutional memory, learning and knowledge; and participation and accountability—have been eroded by NPM reforms. Despite improvements in specific operational tasks of the public sector in each case, we show that the success of NPM reforms presumes the existence of core elements of governance that have often been found lacking, including solid institutional frameworks and accountability. Our analysis illustrates the importance of considering both longer-term adaptive capacities and short-term efficiency goals in public sector administration reform.

Adaptive capacity based water quality resilience transformation and policy implications in rapidly urbanizing landscapes

International Nuclear Information System (INIS)

Li, Yi; Degener, Jan; Gaudreau, Matthew; Li, Yangfan; Kappas, Martin

2016-01-01

Resilience-based management focuses on specific attributes or drivers of complex social-ecological systems, in order to operationalize and promote guiding principles for water quality management in urban systems. We therefore propose a resilience lens drawing on the theory of adaptive capacity and adaptive cycle to evaluate the urban resilience between water quality and land use type. Our findings show that the resilience of water quality variables, which were calculated based on their adaptive capacities, showed adaptive and sustainable trends with dramatic fluctuation. NH_3-N, Cadmium and Total Phosphorus experienced the most vulnerable shifts in the built-up area, agricultural areas, and on bare land. Our framework provided a consistent and repeatable approach to address uncertainty inherent in the resilience of water quality in different landscapes, as well as an approach to monitor variables over time with respect to national water quality standards. Ultimately, we pointed to the political underpinnings for risk mitigation and managing resilient urban system in a particular coastal urban setting. - Highlights: • Integrated framework to analyze the resilience of urban land-water systems • Addressed the changes of adaptive capacity based resilience and transitions • Applied four transition phases of adaptive cycle to water quality management

Adaptive capacity based water quality resilience transformation and policy implications in rapidly urbanizing landscapes

Energy Technology Data Exchange (ETDEWEB)

Li, Yi, E-mail: ly463526@gmail.com [Department of Cartography, GIS and Remote Sensing, Institute of Geography, Georg-August University of Goettingen, Goettingen 37077 (Germany); Key Laboratory of Coastal and Wetland Ecosystems (Ministry of Education), College of the Environment and Ecology, Xiamen University, Xiamen 361102 (China); Degener, Jan [Department of Cartography, GIS and Remote Sensing, Institute of Geography, Georg-August University of Goettingen, Goettingen 37077 (Germany); Gaudreau, Matthew [Balsillie School of International Affairs, Faculty of Environment, University of Waterloo, 67 Erb Street West, Waterloo, ON N2L 6C2 (Canada); Li, Yangfan, E-mail: yangf@xmu.edu.cn [Key Laboratory of Coastal and Wetland Ecosystems (Ministry of Education), College of the Environment and Ecology, Xiamen University, Xiamen 361102 (China); Kappas, Martin [Department of Cartography, GIS and Remote Sensing, Institute of Geography, Georg-August University of Goettingen, Goettingen 37077 (Germany)

2016-11-01

Resilience-based management focuses on specific attributes or drivers of complex social-ecological systems, in order to operationalize and promote guiding principles for water quality management in urban systems. We therefore propose a resilience lens drawing on the theory of adaptive capacity and adaptive cycle to evaluate the urban resilience between water quality and land use type. Our findings show that the resilience of water quality variables, which were calculated based on their adaptive capacities, showed adaptive and sustainable trends with dramatic fluctuation. NH{sub 3}-N, Cadmium and Total Phosphorus experienced the most vulnerable shifts in the built-up area, agricultural areas, and on bare land. Our framework provided a consistent and repeatable approach to address uncertainty inherent in the resilience of water quality in different landscapes, as well as an approach to monitor variables over time with respect to national water quality standards. Ultimately, we pointed to the political underpinnings for risk mitigation and managing resilient urban system in a particular coastal urban setting. - Highlights: • Integrated framework to analyze the resilience of urban land-water systems • Addressed the changes of adaptive capacity based resilience and transitions • Applied four transition phases of adaptive cycle to water quality management.

Rapid ecosystem change challenges the adaptive capacity of Local Environmental Knowledge.

Science.gov (United States)

Fernández-Llamazares, Álvaro; Díaz-Reviriego, Isabel; Luz, Ana C; Cabeza, Mar; Pyhälä, Aili; Reyes-García, Victoria

2015-03-01

The use of Local Environmental Knowledge has been considered as an important strategy for adaptive management in the face of Global Environmental Change. However, the unprecedented rates at which global change occurs may pose a challenge to the adaptive capacity of local knowledge systems. In this paper, we use the concept of the shifting baseline syndrome to examine the limits in the adaptive capacity of the local knowledge of an indigenous society facing rapid ecosystem change. We conducted semi-structured interviews regarding perceptions of change in wildlife populations and in intergenerational transmission of knowledge amongst the Tsimane', a group of hunter-gatherers of Bolivian Amazonia ( n = 300 adults in 13 villages). We found that the natural baseline against which the Tsimane' measure ecosystem changes might be shifting with every generation as a result of (a) age-related differences in the perception of change and (b) a decrease in the intergenerational sharing of environmental knowledge. Such findings suggest that local knowledge systems might not change at a rate quick enough to adapt to conditions of rapid ecosystem change, hence potentially compromising the adaptive success of the entire social-ecological system. With the current pace of Global Environmental Change, widening the gap between the temporal rates of on-going ecosystem change and the timescale needed for local knowledge systems to adjust to change, efforts to tackle the shifting baseline syndrome are urgent and critical for those who aim to use Local Environmental Knowledge as a tool for adaptive management.

Novelty, Adaptive Capacity, and Resilience

Directory of Open Access Journals (Sweden)

Craig R. Allen

2010-09-01

Full Text Available We present a conceptual framework that explores some of the forces creating innovation and novelty in complex systems. Understanding the sources of variability and novelty may help us better understand complex systems. Understanding complex phenomena such as invasions, migration, and nomadism may provide insight into the structure of ecosystems and other complex systems, and aid our attempts to cope with and mitigate these phenomena, in the case of invasions, and better understand and or predict them. Our model is broadly applicable to ecological theory, including community ecology, resilience, restoration, and policy. Characterizing the link between landscape change and the composition of species communities may help policymakers in their decision-making processes. Understanding how variability is related to system structure, and how that generates novelty, may help us understand how resilience is generated. We suggest that there are three primary opportunities for the generation of novelty into complex systems. These sources of novelty are inherent in the cross-scale structure of complex systems, and are critical for creating adaptive capacity. Novelty originates from the inherent variability present in cross scale structures, within scale reorganization associated with adaptive cycles, and whole-scale transformations resulting from regime shifts. Although speculative, our ideas are grounded in research and observation, and they may provide insight into the evolution of complex systems.

Ranking the adaptive capacity of nations to climate change when socio-political goals are explicit

Energy Technology Data Exchange (ETDEWEB)

Haddad, B.M. [University of California, Santa Cruz, CA (United States)

2005-07-01

The typical categories for measuring national adaptive capacity to climate change include a nation's wealth, technology, education, information, skills, infrastructure, access to resources, and management capabilities. Resulting rankings predictably mirror more general rankings of economic development, such as the Human Development Index. This approach is incomplete since it does not consider the normative or motivational context of adaptation. For what purpose or toward what goal does a nation aspire, and in that context, what is its adaptive capacity? This paper posits 11 possible national socio-political goals that fall into the three categories of teleological legitimacy, procedural legitimacy, and norm-based decision rules. A model that sorts nations in terms of adaptive capacity based on national socio-political aspirations is presented. While the aspiration of maximizing summed utility matches typical existing rankings, alternative aspirations, including contractarian liberalism, technocratic management, and dictatorial/religious rule alter the rankings. An example describes how this research can potentially inform how priorities are set for international assistance for climate change adaptation. (author)

Intermediate Collaborative Adaptive Management Strategies Build Stakeholder Capacity

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Martha C. Monroe

2013-06-01

Full Text Available Efforts to implement collaborative adaptive management (CAM often suffer from challenges, such as an unwillingness of managers to share power, unresolved conflicts between stakeholders, and lack of capacity among stakeholders. Some aspects considered essential to CAM, e.g., trust and stakeholder capacity, may be more usefully viewed as goals for intermediate strategies rather than a set of initial conditions. From this perspective, intermediate steps that focus on social learning and building experience could overcome commonly cited barriers to CAM. An exploration of Springs Basin Working Groups, organized around major clusters of freshwater springs in north Florida, provides a case study of how these intermediate steps enable participants to become more reasonable and engaged. This strategy may be easily implemented by agencies beginning a CAM process.

Subspace based adaptive denoising of surface EMG from neurological injury patients

Science.gov (United States)

Liu, Jie; Ying, Dongwen; Zev Rymer, William; Zhou, Ping

2014-10-01

Objective: After neurological injuries such as spinal cord injury, voluntary surface electromyogram (EMG) signals recorded from affected muscles are often corrupted by interferences, such as spurious involuntary spikes and background noises produced by physiological and extrinsic/accidental origins, imposing difficulties for signal processing. Conventional methods did not well address the problem caused by interferences. It is difficult to mitigate such interferences using conventional methods. The aim of this study was to develop a subspace-based denoising method to suppress involuntary background spikes contaminating voluntary surface EMG recordings. Approach: The Karhunen-Loeve transform was utilized to decompose a noisy signal into a signal subspace and a noise subspace. An optimal estimate of EMG signal is derived from the signal subspace and the noise power. Specifically, this estimator is capable of making a tradeoff between interference reduction and signal distortion. Since the estimator partially relies on the estimate of noise power, an adaptive method was presented to sequentially track the variation of interference power. The proposed method was evaluated using both semi-synthetic and real surface EMG signals. Main results: The experiments confirmed that the proposed method can effectively suppress interferences while keep the distortion of voluntary EMG signal in a low level. The proposed method can greatly facilitate further signal processing, such as onset detection of voluntary muscle activity. Significance: The proposed method can provide a powerful tool for suppressing background spikes and noise contaminating voluntary surface EMG signals of paretic muscles after neurological injuries, which is of great importance for their multi-purpose applications.

Cell-Gazing Into the Future: What Genes, Homo heidelbergensis, and Punishment Tell Us About Our Adaptive Capacity

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Jeffrey Andrews

2013-02-01

Full Text Available If we wish to understand how our species can adapt to the coming tide of environmental change, then understanding how we have adapted throughout the course of evolution is vital. Evolutionary biologists have been exploring these questions in the last forty years, establishing a solid record of evidence that conventional, individual-based models of natural selection are insufficient in explaining social evolution. More recently, this work has supported a growing consensus that our evolution, in which we have expressed extra-ordinary adaptive capacities, can best be explained by “Multi-level Selection”, a theory that includes the influence of both genes and culture to support unique adaptive capacities premised on pro-social behaviours and group selection, not individual-level competition for survival. Applying this scholarship to contemporary concerns about adapting to environmental change may be quite fruitful for identifying sources of vulnerability and adaptive capacity, thereby informing efforts to enhance the likelihood for sustainable futures. Doing so, however, requires that we bridge the gap between evolutionary biology, and the social sciences study of sustainability.

Cross case analysis of institutions and adaptive capacity in The Netherlands: Do institutions for spatial planning, water and nature management in The Netherlands enhance the capacity of society to adapt to climate change?

NARCIS (Netherlands)

Meijerink, S.; Bergsma, E.; Gupta, J.; Jong, P.; Klostermann, J.E.M.; Termeer, C.J.A.M.

2010-01-01

In this working document we aim to answer the following question: Do institutions for spatial planning, water and nature management in the Netherlands enhance the capacity of society to adapt to climate change? To answer this question we have first reviewed the literature on adaptive governance and

Creating an adaptive healing room for neurology patients

NARCIS (Netherlands)

Daemen, E.M.L; Behere, S.; Cuppen, R.P.G.; Facey, J.; Flinsenberg, I.C.M.; Loenen, van E.J.; Rajae-Joordens, R.J.E.

2013-01-01

Informed by the experiences of patients and medical staff, Philips has designed a room for neurology patients that retains a clinical feel when treatment is being carried out, but can flex to create a moretailored, personal ambiende.

Impact of bile salt adaptation of Lactobacillus delbrueckii subsp. lactis 200 on its interaction capacity with the gut.

Science.gov (United States)

Burns, Patricia; Reinheimer, Jorge; Vinderola, Gabriel

2011-10-01

In a previous work, bile-salt-resistant derivatives were obtained from non-intestinal lactobacilli. The aim of this work was to investigate the impact of bile adaptation of Lactobacillus delbrueckii subsp. lactis 200 on morphology, surface properties, in vivo interaction capacity with the gut and ability to activate the gut immune response. Electron microscopy studies, growth kinetics in the presence of bovine and porcine bile, the capacity to deconjugate bile acids, hydrophobicity, autoaggregation and co-aggregation capacities were studied for the parental strain and its bile-resistant derivative in vitro. Additionally, survival in intestinal fluid, the interaction with the gut and the immunomodulating capacities were studied in mice. Bile salt adaptation conferred upon the adapted strain a higher capacity to withstand physiological concentrations of bile salts and greater survival capacity in intestinal fluid. However, bile salt exposure reduced cell hydrophobicity, autoaggregation and adhesion capacities, resulting in reduced persistence in the intestinal lumen and delayed capacity to activate the gut immune response. Insight into the effects of bile salts upon the interaction and immunomodulating capacity of lactobacilli with the gut is provided, relating in vitro and in vivo results. Copyright © 2011 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.

Adaptive Capacity Mapping of Semarang Offshore Territory by the Increasing of Water Level and Climate Change

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Ifan Ridlo Suhelm

2013-07-01

Full Text Available Tidal inundation, flood and land subsidence are the problems faced by Semarang city related to climate change. Intergovernmental Panel on Climate Change (IPCC predicted the increase of sea level rise 18-59 cm during 1990-2100 while the temperature increase 0,6°C to 4°C during the same period. The Semarang coastal city was highly vulnerable to sea level rise and it increased with two factors, topography and land subsidence. The purpose of this study was to map the adaptive capacity of coastal areas in the face of the threat of disasters caused by climate change. The parameters used are Network Number, Employee based educational background, Source Main Livelihoods, Health Facilities, and Infrastructure Road. Adaptive capacity of regions classified into 3 (three classes, namely low, medium and high. The results of the study showed that most of the coastal area of Semarang have adaptive capacities ranging from low to moderate, while the village with low capacity totaling 58 villages (58.62% of the total coastal district in the city of Semarang.

Economic performance of irrigation capacity development to adapt to climate in the American Southwest

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Ward, Frank A.; Crawford, Terry L.

2016-09-01

Growing demands for food security to feed increasing populations worldwide have intensified the search for improved performance of irrigation, the world's largest water user. These challenges are raised in the face of climate variability and from growing environmental demands. Adaptation measures in irrigated agriculture include fallowing land, shifting cropping patterns, increased groundwater pumping, reservoir storage capacity expansion, and increased production of risk-averse crops. Water users in the Gila Basin headwaters of the U.S. Lower Colorado Basin have faced a long history of high water supply fluctuations producing low-valued defensive cropping patterns. To date, little research grade analysis has investigated economically viable measures for irrigation development to adjust to variable climate. This gap has made it hard to inform water resource policy decisions on workable measures to adapt to climate in the world's dry rural areas. This paper's contribution is to illustrate, formulate, develop, and apply a new methodology to examine the economic performance from irrigation capacity improvements in the Gila Basin of the American Southwest. An integrated empirical optimization model using mathematical programming is developed to forecast cropping patterns and farm income under two scenarios (1) status quo without added storage capacity and (2) with added storage capacity in which existing barriers to development of higher valued crops are dissolved. We find that storage capacity development can lead to a higher valued portfolio of irrigation production systems as well as more sustained and higher valued farm livelihoods. Results show that compared to scenario (1), scenario (2) increases regional farm income by 30%, in which some sub regions secure income gains exceeding 900% compared to base levels. Additional storage is most economically productive when institutional and technical constraints facing irrigated agriculture are dissolved. Along with

The capacity to adapt?: communities in a changing climate, environment, and economy on the northern Andaman coast of Thailand

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Nathan J. Bennett

2014-06-01

Full Text Available The health and productivity of marine ecosystems, habitats, and fisheries are deteriorating on the Andaman coast of Thailand. Because of their high dependence on natural resources and proximity to the ocean, coastal communities are particularly vulnerable to climate-induced changes in the marine environment. These communities must also adapt to the impacts of management interventions and conservation initiatives, including marine protected areas, which have livelihood implications. Further, communities on the Andaman coast are also experiencing a range of new economic opportunities associated in particular with tourism and agriculture. These complex and ongoing changes require integrated assessment of, and deliberate planning to increase, the adaptive capacity of communities so that they may respond to: (1 environmental degradation and fisheries declines through effective management interventions or conservation initiatives, (2 new economic opportunities to reduce dependence on fisheries, and (3 the increasing impacts of climate change. Our results are from a mixed methods study, which used surveys and interviews to examine multiple dimensions of the adaptive capacity of seven island communities near marine protected areas on the Andaman coast of Thailand. Results show that communities had low adaptive capacity with respect to environmental degradation and fisheries declines, and to management and conservation interventions, as well as uneven levels of adaptive capacity to economic opportunities. Though communities and households were experiencing the impacts of climate change, especially storm events, changing seasons and weather patterns, and erosion, they were reacting to these changes with limited knowledge of climate change per se. We recommend interventions, in the form of policies, programs, and actions, at multiple scales for increasing the adaptive capacity of Thailand's coastal communities to change. The analytical and methodological

Uneven adaptive capacity among fishers in a sea of change.

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Joshua S Stoll

Full Text Available Fishers worldwide operate in an environment of uncertainty and constant change. Their ability to manage risk associated with such uncertainty and subsequently adapt to change is largely a function of individual circumstances, including their access to different fisheries. However, explicit attention to the heterogeneity of fishers' connections to fisheries at the level of the individual has been largely ignored. We illustrate the ubiquitous nature of these connections by constructing a typology of commercial fishers in the state of Maine based on the different fisheries that fishers rely on to sustain their livelihoods and find that there are over 600 combinations. We evaluate the adaptive potential of each strategy, using a set of attributes identified by fisheries experts in the state, and find that only 12% of fishers can be classified as being well positioned to adapt in the face of changing socioeconomic and ecological conditions. Sensitivity to the uneven and heterogeneous capacity of fishers to manage risk and adapt to change is critical to devising effective management strategies that broadly support fishers. This will require greater attention to the social-ecological connectivity of fishers across different jurisdictions.

[Neurologic vigor of term newborns according to the type of delivery and obstetric maneuvers].

Science.gov (United States)

Riesgo, Rudimar dos Santos; Ohlweiler, Lygia; Winckler, Maria Isabel Bragatti; Ranzan, Josiane; Riesgo, Itamar Dos Santos; Rotta, Newra Tellechea

2009-06-01

to evaluate the effect of delivery type and usual obstetric procedures on the neurologic condition of a sample of consecutive term and healthy neonates, in the first 48 hours of life, using the Neurologic Adaptative Capacity Score (NACS) system. cohort prospective study with 313 neonates, from a neonatology unit: Unidade de Neonatologia e Alojamento Conjunto. The variables analyzed were obstetric variables; clinical outcome: low neurologic vigor phase, evaluated by NACS, at 4, 24 and 48 hours of life. The data have been assessed twice: once with the whole sample and the other comparing the Vigorous Group, whose neonates kept a score of 35 or more during the three evaluations, and the Low Vigor Group, with less than 35 scores during the three consecutive evaluations. Bivariate and multivariate analyses have been done. Possible associations between low neurologic vigor phase and the type of delivery, as well between the low neurologic vigor phase and obstetric variables have been searched. in the bivariate analysis, the delivery type and the obstetric variables were not associated with the low neurologic vigor phase. Nevertheless, the association between the amniotic fluid and the low neurologic vigor phase reached values very close to significance and, then, it was included in the multivariate analysis. In the multivariate analysis, the only variable associated with low neurologic vigor was the presence of meconium stained amniotic fluid, which has shown to be 8.1 times more risky for the neurologic scoring, when Vigorous Group and Low Vigor Group were compared. In the analysis of the whole sample, the same risk was 1.7. neither the delivery type, nor the usual obstetric procedures were associated with low neurologic vigor phase. This is useful information, clinically or legally speaking, mainly for obstetricians. According to this sample data, when the term neonate is healthy, the delivery type and the usual obstetric procedures have no impact in the neurologic

Using a social learning configuration to increase Vietnamese smallholder farmers’ adaptive capacity to respond to climate change

NARCIS (Netherlands)

Phuong, Le Thi Hong; Wals, Arjen; Sen, Le Thi Hoa; Hoa, Nguyen Quoc; Lu, Van Phan; Biesbroek, Robbert

2018-01-01

Social learning is crucial for local smallholder farmers in developing countries to improve their adaptive capacity and to adapt to the current and projected impacts of climate change. While it is widely acknowledged that social learning is a necessary condition for adaptation, few studies have

Community based Adaptation (CBA) as a source of conflict in strengthening local adaptive capacity and resilience in semi-arid regions in sub-Saharan Africa

NARCIS (Netherlands)

Zoomers, E.B.|info:eu-repo/dai/nl/073723592; Soeters, S.R.

2017-01-01

This article, based on fieldwork in Ghana, Burkina Faso and Kenya, provides an overview of different types of climate change adaptation interventions that are currently being implemented to enhance local community’s adaptive capacity and resilience. We show that CBA interventions, whilst measurably

Beyond Vulnerability Assessment: Impact of Developments toward Local Adaptive Capacity in Kemijen City Village, Semarang City

Science.gov (United States)

Jayanimitta, M. E.; Puspasari, D. A.; Widyahantari, R.; Kristina, D.; Ratnaningtyas, T.; Setionurjaya, A.; Anindita, Y. A.

2018-02-01

Vulnerability Assessment is usually used for assessing the ability of an area on facing disaster. In previous studies, the study of Vulnerability Assessment applied only quantitative method to show the vulnerability level. Therefore, this study attempts to add information reviews using qualitative method. Kemijen City Village is one of the administrative areas in the northern part of Semarang City affected by climate change. The residents have to adapt it by renovating and elevating their houses and other infrastructures to avoid floods. There are some development programs held by government, NGOs, and corporations such as Banger Polder Development, PLPBK, etc. It is interesting to know how big the vulnerability level of Kemijen on facing flood disasters, then how the projects can affect local adaptive capacity. To answer it, this research uses mixed-method approach. Vulnerability Assessment uses quantitative method by scoring indicators of Exposure, Sensitivity, and Adaptive Capacity, while the development impact uses qualitative method. The data were collected through interviews and FGD conducted in Joint Studio Course between Diponegoro University and University of Hawaii in October 2016. Non-physical programs such as community empowerment have more positive impacts on local adaptive capacity in Kemijen. Community participation is important for environmental sustainability that can not be done in a short time to educate the people.

Coral bleaching--capacity for acclimatization and adaptation.

Science.gov (United States)

Coles, S L; Brown, Barbara E

2003-01-01

Coral bleaching, i.e., loss of most of the symbiotic zooxanthellae normally found within coral tissue, has occurred with increasing frequency on coral reefs throughout the world in the last 20 years, mostly during periods of El Nino Southern Oscillation (ENSO). Experiments and observations indicate that coral bleaching results primarily from elevated seawater temperatures under high light conditions, which increases rates of biochemical reactions associated with zooxanthellar photosynthesis, producing toxic forms of oxygen that interfere with cellular processes. Published projections of a baseline of increasing ocean temperature resulting from global warming have suggested that annual temperature maxima within 30 years may be at levels that will cause frequent coral bleaching and widespread mortality leading to decline of corals as dominant organisms on reefs. However, these projections have not considered the high variability in bleaching response that occurs among corals both within and among species. There is information that corals and their symbionts may be capable of acclimatization and selective adaptation to elevated temperatures that have already resulted in bleaching resistant coral populations, both locally and regionally, in various areas of the world. There are possible mechanisms that might provide resistance and protection to increased temperature and light. These include inducible heat shock proteins that act in refolding denatured cellular and structural proteins, production of oxidative enzymes that inactivate harmful oxygen radicals, fluorescent coral pigments that both reflect and dissipate light energy, and phenotypic adaptations of zooxanthellae and adaptive shifts in their populations at higher temperatures. Such mechanisms, when considered in conjunction with experimental and observational evidence for coral recovery in areas that have undergone coral bleaching, suggest an as yet undefined capacity in corals and zooxanthellae to adapt to

Complex adaptive strategy to produce capacity-driven financial improvement.

Science.gov (United States)

Capuano, Terry; MacKenzie, Richard; Pintar, Kristi; Halkins, Deborah; Nester, Brian

2009-01-01

Managing capacity in hospitals and emergency departments (EDs) is a global problem. This article demonstrates an efficiency model applied to an acute care hospital facing a budget shortfall as a result of capacity constraints that negatively affected admissions and increased ED diversions. Operating on the hypothesis that reducing inpatient length of stay would allow patients access through all service points and would return the admissions growth rate to budget, a turnaround team was quickly assembled and charged by the chief executive officer to fix the primary cause of financial underperformance--the creeping length of stay--within 60 days. This case study is generalizable to all organizations, regardless of size. Deploying an efficiency model based on the complex adaptive systems approach of "swarmware," the hospital's rapid turnaround efforts produced the results necessary to achieve two established goals: (1) length of stay was decreased to 0.1 days below budget in the 60-day time frame, and (2) all admissions and potential admissions were accepted (saying "yes" to patients) through key points of access in the hospital. Transfer Center denials were reduced to 0 in 19 days, and monthly ED diversions decreased from 110 hours to 20 hours in 60 days. By using a swarmware approach, the hospital created additional bed capacity, allowing for community demand to be accommodated, budgeted admissions target to be exceeded, and market share to be stabilized. This article describes this project's processes and outcomes and the lessons learned and applied, which will assist healthcare leaders who are facing capacity issues in their own organization.

Enhancing adaptive capacity for restoring fire-dependent ecosystems: the Fire Learning Network's Prescribed Fire Training Exchanges

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Andrew G. Spencer

2015-09-01

Full Text Available Prescribed fire is a critical tool for promoting restoration and increasing resilience in fire-adapted ecosystems, but there are barriers to its use, including a shortage of personnel with adequate ecological knowledge and operational expertise to implement prescribed fire across multijurisdictional landscapes. In the United States, recognized needs for both professional development and increased use of fire are not being met, often because of institutional limitations. The Fire Learning Network has been characterized as a multiscalar, collaborative network that works to enhance the adaptive capacity of fire management institutions, and this network developed the Prescribed Fire Training Exchanges (TREXs to address persistent challenges in increasing the capacity for prescribed fire implementation. Our research was designed to investigate where fire professionals face professional barriers, how the TREX addresses these, and in what ways the TREX may be contributing to the adaptive capacity of fire management institutions. We evaluated the training model using surveys, interviews, focus groups, and participant observation. We found that, although the training events cannot overcome all institutional barriers, they incorporate the key components of professional development in fire; foster collaboration, learning, and network building; and provide flexible opportunities with an emphasis on local context to train a variety of professionals with disparate needs. The strategy also offers an avenue for overcoming barriers faced by contingent and nonfederal fire professionals in attaining training and operational experience, thereby increasing the variety of actors and resources involved in fire management. Although it is an incremental step, the TREX is contributing to the adaptive capacity of institutions in social-ecological systems in which fire is a critical ecological process.

Leveraging modern climatology to increase adaptive capacity across protected area networks

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Davison, J.E.; Graumlich, L.J.; Rowland, E.L.; Pederson, G.T.; Breshears, D.D.

2012-01-01

Human-driven changes in the global environment pose an increasingly urgent challenge for the management of ecosystems that is made all the more difficult by the uncertain future of both environmental conditions and ecological responses. Land managers need strategies to increase regional adaptive capacity, but relevant and rapid assessment approaches are lacking. To address this need, we developed a method to assess regional protected area networks across biophysically important climatic gradients often linked to biodiversity and ecosystem function. We plot the land of the southwestern United States across axes of historical climate space, and identify landscapes that may serve as strategic additions to current protected area portfolios. Considering climate space is straightforward, and it can be applied using a variety of relevant climate parameters across differing levels of land protection status. The resulting maps identify lands that are climatically distinct from existing protected areas, and may be utilized in combination with other ecological and socio-economic information essential to collaborative landscape-scale decision-making. Alongside other strategies intended to protect species of special concern, natural resources, and other ecosystem services, the methods presented herein provide another important hedging strategy intended to increase the adaptive capacity of protected area networks. ?? 2011 Elsevier Ltd.

Building Adaptive Capacity in Changing Social-Ecological Systems: Integrating Knowledge in Communal Land-Use Planning in the Peruvian Amazon

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Lily O. Rodríguez

2018-02-01

Full Text Available Building resilient sustainable social-ecological systems (SES requires communities to enhance their adaptive capacities. Communal participative land-use planning (Zonificación Participativa Comunal—ZPC is a tool designed for communities to integrating local and scientific knowledge to sustainably organize and manage their SES. Between 2006 and 2011, a ZPC was developed with communities in the buffer zone of Cordillera Azul National Park (Peru, where rapid demographic changes are converting pre-montane seasonally dry forest into agricultural land. Herein, we analyse how the ZPC enhanced adaptive capacity, enabling the SES to cope with environmental, political and economic changes. Based on qualitative, semi-structured interviews, communities are analysed along their capacities in the dimensions social capital, learning, adaptive management and governance. An analysis of yearly high-resolution forest cover data supports our findings. Deforestation activities in biologically sensitive zones decreased rapidly during the time of the ZPC implementation. We find that particularly the long-term presence of the bridging institution and the continuous testing and reflection of the integrated “hybrid knowledge” enabled communities to develop adaptive capacities. The analysis of ZPC our results reveals the enabling conditions for promoting the learning process to develop a sustainable land-use management in the context of migration and rapid changes.

Quality improvement in neurology: AAN Parkinson disease quality measures

Science.gov (United States)

Cheng, E.M.; Tonn, S.; Swain-Eng, R.; Factor, S.A.; Weiner, W.J.; Bever, C.T.

2010-01-01

Background: Measuring the quality of health care is a fundamental step toward improving health care and is increasingly used in pay-for-performance initiatives and maintenance of certification requirements. Measure development to date has focused on primary care and common conditions such as diabetes; thus, the number of measures that apply to neurologic care is limited. The American Academy of Neurology (AAN) identified the need for neurologists to develop measures of neurologic care and to establish a process to accomplish this. Objective: To adapt and test the feasibility of a process for independent development by the AAN of measures for neurologic conditions for national measurement programs. Methods: A process that has been used nationally for measure development was adapted for use by the AAN. Topics for measure development are chosen based upon national priorities, available evidence base from a systematic literature search, gaps in care, and the potential impact for quality improvement. A panel composed of subject matter and measure development methodology experts oversees the development of the measures. Recommendation statements and their corresponding level of evidence are reviewed and considered for development into draft candidate measures. The candidate measures are refined by the expert panel during a 30-day public comment period and by review by the American Medical Association for Current Procedural Terminology (CPT) II codes. All final AAN measures are approved by the AAN Board of Directors. Results: Parkinson disease (PD) was chosen for measure development. A review of the medical literature identified 258 relevant recommendation statements. A 28-member panel approved 10 quality measures for PD that included full specifications and CPT II codes. Conclusion: The AAN has adapted a measure development process that is suitable for national measurement programs and has demonstrated its capability to independently develop quality measures. GLOSSARY

Socio-hydrological modelling of floods: investigating community resilience, adaptation capacity and risk

Science.gov (United States)

Ciullo, Alessio; Viglione, Alberto; Castellarin, Attilio

2016-04-01

Changes in flood risk occur because of changes in climate and hydrology, and in societal exposure and vulnerability. Research on change in flood risk has demonstrated that the mutual interactions and continuous feedbacks between floods and societies has to be taken into account in flood risk management. The present work builds on an existing conceptual model of an hypothetical city located in the proximity of a river, along whose floodplains the community evolves over time. The model reproduces the dynamic co-evolution of four variables: flooding, population density of the flooplain, amount of structural protection measures and memory of floods. These variables are then combined in a way to mimic the temporal change of community resilience, defined as the (inverse of the) amount of time for the community to recover from a shock, and adaptation capacity, defined as ratio between damages due to subsequent events. Also, temporal changing exposure, vulnerability and probability of flooding are also modelled, which results in a dynamically varying flood-risk. Examples are provided that show how factors such as collective memory and risk taking attitude influence the dynamics of community resilience, adaptation capacity and risk.

Spatially Representing Vulnerability to Extreme Rain Events Using Midwestern Farmers' Objective and Perceived Attributes of Adaptive Capacity.

Science.gov (United States)

Gardezi, Maaz; Arbuckle, J Gordon

2017-11-29

Potential climate-change-related impacts to agriculture in the upper Midwest pose serious economic and ecological risks to the U.S. and the global economy. On a local level, farmers are at the forefront of responding to the impacts of climate change. Hence, it is important to understand how farmers and their farm operations may be more or less vulnerable to changes in the climate. A vulnerability index is a tool commonly used by researchers and practitioners to represent the geographical distribution of vulnerability in response to global change. Most vulnerability assessments measure objective adaptive capacity using secondary data collected by governmental agencies. However, other scholarship on human behavior has noted that sociocultural and cognitive factors, such as risk perceptions and perceived capacity, are consequential for modulating people's actual vulnerability. Thus, traditional assessments can potentially overlook people's subjective perceptions of changes in climate and extreme weather events and the extent to which people feel prepared to take necessary steps to cope with and respond to the negative effects of climate change. This article addresses this knowledge gap by: (1) incorporating perceived adaptive capacity into a vulnerability assessment; (2) using spatial smoothing to aggregate individual-level vulnerabilities to the county level; and (3) evaluating the relationships among different dimensions of adaptive capacity to examine whether perceived capacity should be integrated into vulnerability assessments. The result suggests that vulnerability assessments that rely only on objective measures might miss important sociocognitive dimensions of capacity. Vulnerability indices and maps presented in this article can inform engagement strategies for improving environmental sustainability in the region. © 2017 Society for Risk Analysis.

A spatially explicit scenario-driven model of adaptive capacity to global change in Europe

NARCIS (Netherlands)

Acosta, L.; Klein, R.J.T.; Reidsma, P.; Metzger, M.J.; Rounsevell, M.D.A.; Leemans, R.

2013-01-01

Traditional impact models combine exposure in the form of scenarios and sensitivity in the form of parameters, providing potential impacts of global change as model outputs. However, adaptive capacity is rarely addressed in these models. This paper presents the first spatially explicit

Forest management under climatic and social uncertainty: trade-offs between reducing climate change impacts and fostering adaptive capacity.

Science.gov (United States)

Seidl, Rupert; Lexer, Manfred J

2013-01-15

The unabated continuation of anthropogenic greenhouse gas emissions and the lack of an international consensus on a stringent climate change mitigation policy underscore the importance of adaptation for coping with the all but inevitable changes in the climate system. Adaptation measures in forestry have particularly long lead times. A timely implementation is thus crucial for reducing the considerable climate vulnerability of forest ecosystems. However, since future environmental conditions as well as future societal demands on forests are inherently uncertain, a core requirement for adaptation is robustness to a wide variety of possible futures. Here we explicitly address the roles of climatic and social uncertainty in forest management, and tackle the question of robustness of adaptation measures in the context of multi-objective sustainable forest management (SFM). We used the Austrian Federal Forests (AFF) as a case study, and employed a comprehensive vulnerability assessment framework based on ecosystem modeling, multi-criteria decision analysis, and practitioner participation. We explicitly considered climate uncertainty by means of three climate change scenarios, and accounted for uncertainty in future social demands by means of three societal preference scenarios regarding SFM indicators. We found that the effects of climatic and social uncertainty on the projected performance of management were in the same order of magnitude, underlining the notion that climate change adaptation requires an integrated social-ecological perspective. Furthermore, our analysis of adaptation measures revealed considerable trade-offs between reducing adverse impacts of climate change and facilitating adaptive capacity. This finding implies that prioritization between these two general aims of adaptation is necessary in management planning, which we suggest can draw on uncertainty analysis: Where the variation induced by social-ecological uncertainty renders measures aiming to

Socio-ecological Typologies for Understanding Adaptive Capacity of a Region to Natural Disasters

Science.gov (United States)

Surendran Nair, S.; Preston, B. L.; King, A. W.; Mei, R.

2015-12-01

It is expected that the frequency and magnitude of extreme climatic events will increase in coming decades with an anticipated increase in losses from climate hazards. In the Gulf Coastal region of the United States, climate hazards/disasters are common including hurricanes, drought and flooding. However, the capacity to adapt to extreme climatic events varies across the region. This adaptive capacity is linked to the magnitude of the extreme event, exposed infrastructure, and the socio-economic conditions across the region. This study uses hierarchical clustering to quantitatively integrates regional socioeconomic and biophysical factors and develop socio-ecological typologies (SET). The biophysical factors include climatic and topographic variables, and the socio-economic variables include human capital, social capital and man-made resources (infrastructure) of the region. The types of the SET are independent variables in a statistical model of a regional variable of interest. The methodology was applied to US Gulf States to evaluate the social and biophysical determinants of the regional variation in social vulnerability and economic loss to climate hazards. The results show that the SET explains much of the regional variation in social vulnerability, effectively capturing its determinants. In addition, the SET also explains of the variability in economic loss to hazards across of the region. The approach can thus be used to prioritize adaptation strategies to reduce vulnerability and loss across the region.

Adult neurology training during child neurology residency.

Science.gov (United States)

Schor, Nina F

2012-08-21

As it is currently configured, completion of child neurology residency requires performance of 12 months of training in adult neurology. Exploration of whether or not this duration of training in adult neurology is appropriate for what child neurology is today must take into account the initial reasons for this requirement and the goals of adult neurology training during child neurology residency.

Building Adaptive Capacity with the Delphi Method and Mediated Modeling for Water Quality and Climate Change Adaptation in Lake Champlain Basin

Science.gov (United States)

Coleman, S.; Hurley, S.; Koliba, C.; Zia, A.; Exler, S.

2014-12-01

Eutrophication and nutrient pollution of surface waters occur within complex governance, social, hydrologic and biophysical basin contexts. The pervasive and perennial nutrient pollution in Lake Champlain Basin, despite decades of efforts, exemplifies problems found across the world's surface waters. Stakeholders with diverse values, interests, and forms of explicit and tacit knowledge determine water quality impacts through land use, agricultural and water resource decisions. Uncertainty, ambiguity and dynamic feedback further complicate the ability to promote the continual provision of water quality and ecosystem services. Adaptive management of water resources and land use requires mechanisms to allow for learning and integration of new information over time. The transdisciplinary Research on Adaptation to Climate Change (RACC) team is working to build regional adaptive capacity in Lake Champlain Basin while studying and integrating governance, land use, hydrological, and biophysical systems to evaluate implications for adaptive management. The RACC team has engaged stakeholders through mediated modeling workshops, online forums, surveys, focus groups and interviews. In March 2014, CSS2CC.org, an interactive online forum to source and identify adaptive interventions from a group of stakeholders across sectors was launched. The forum, based on the Delphi Method, brings forward the collective wisdom of stakeholders and experts to identify potential interventions and governance designs in response to scientific uncertainty and ambiguity surrounding the effectiveness of any strategy, climate change impacts, and the social and natural systems governing water quality and eutrophication. A Mediated Modeling Workshop followed the forum in May 2014, where participants refined and identified plausible interventions under different governance, policy and resource scenarios. Results from the online forum and workshop can identify emerging consensus across scales and sectors

Identifikasi Gangguan Neurologis Menggunakan Metode Adaptive Neuro Fuzzy Inference System (ANFIS

Directory of Open Access Journals (Sweden)

Jani Kusanti

2015-07-01

Abstract             The use of Adaptive Neuro Fuzzy Inference System (ANFIS methods in the process of identifying one of neurological disorders in the head, known in medical terms ischemic stroke from the ct scan of the head in order to identify the location of ischemic stroke. The steps are performed in the extraction process of identifying, among others, the image of the ct scan of the head by using a histogram. Enhanced image of the intensity histogram image results using Otsu threshold to obtain results pixels rated 1 related to the object while pixel rated 0 associated with the measurement background. The result used for image clustering process, to process image clusters used fuzzy c-mean (FCM clustering result is a row of the cluster center, the results of the data used to construct a fuzzy inference system (FIS. Fuzzy inference system applied is fuzzy inference model of Takagi-Sugeno-Kang. In this study ANFIS is used to optimize the results of the determination of the location of the blockage ischemic stroke. Used recursive least squares estimator (RLSE for learning. RMSE results obtained in the training process of 0.0432053, while in the process of generated test accuracy rate of 98.66%   Keywords— Stroke Ischemik, Global threshold, Fuzzy Inference System model Sugeno, ANFIS, RMSE

Are the French neurology residents satisfied with their training?

Science.gov (United States)

Codron, P; Roux, T; Le Guennec, L; Zuber, M

2015-11-01

There have been dramatic changes in neurology over the past decade; these advances require a constant adaptation of residents' theoretical and practical training. The French Association of Neurology Residents and the College of Neurology Teachers conducted a national survey to assess the French neurology residents' satisfaction about their training. A 16-item questionnaire was sent via e-mail to French neurology residents completing training in 2014. Data were collected and processed anonymously. Of eligible respondents, 126 returned the survey, representing approximately 40% of all the French neurology residents. Most residents (78%) rated their clinical training favorably. Seventy-two percent reported good to excellent quality teaching of neurology courses from their faculty. However, many residents (40%) felt insufficient their doctoral thesis supervision. All residents intended to enter fellowship training after their residency, and most of them (68%) planned to practice in a medical center. French neurology residents seemed satisfied with the structure and quality of their training program. However, efforts are required to improve management of the doctoral thesis and make private practice more attractive and accessible during the residency. In the future, similar surveys should be scheduled to regularly assess neurology residents' satisfaction and the impact of the forthcoming national and European reforms. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

CAPACITY BUILDING FOR CLIMATE CHANGE ADAPTATION: MODULES FOR AGRICULTURAL EXTENSION CURRICULUM DEVELOPMENT

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B.O. Ogunbameru

2013-02-01

Full Text Available Basically, climate change refers to any change in climate overtime, generally caused by natural variability and/or human activities. It has great devastating impact, particularly on agriculture and by extrapolation on farmers and the national economy. The frontline agricultural extension workers are expected to be among the principal stakeholders to teach farmers how to cope with climate change. Consequently, there is a need to develop appropriate teaching package for the training of the frontline agricultural extension workers, based on the myriad of adaptation strategies and practices available in the literature. This paper synthesizes the rationale for capacity building in climate change and the adaptation or coping strategies. The modules (train-the-trainer for teaching agricultural extension workers and farmers are documented in the paper.

Water security and adaptive capacity for climate: Learning lessons from drought decision making in U.S. urban contexts

Science.gov (United States)

Dilling, L.

2017-12-01

Cities in the U.S. have been adapting to drought for many years, implementing a combination of mechanisms to cope with climate and water variability and increasing population. Cities are also at the frontline for making decisions about adaptation to climate change. Are decisions made to cope with drought helping cities to build the adaptive capacity necessary for adapting to climate change? We examined this question by conducting interviews with practitioners involved in drought management at urban water utilities across the U.S. to understand responses to drought and perceptions of their effectiveness. We then drew on established criteria for evaluating successful adaptation (effectiveness, efficiency, equity and legitimacy) to analyze whether these drought policies would build adaptive capacity for climate change. We find that drought responses overall are seen as successful in helping cities balance the demand and supply of water, and maintain system reliability as well as improve water awareness, but can have unintended consequences and shift vulnerability in unexpected ways. For example, even though cities are successful at reducing water use when needed, some are concerned with the increasing difficulty of finding new water savings during a future drought. Secondly, water conservation can affect revenue, impacting the ability of cities to plan for maintenance and capital costs. Third, the social acceptability of policy options is critical and depends on perceived fairness and other factors. Water managers are also challenged by "no fail" expectations that make it difficult to experiment. Moreover some measures can shift vulnerability from one risk, such as running out of water, to another risk, such as water becoming too expensive, lowering quality, or not meeting other key infrastructure design requirements. These findings demonstrate that adaptation measures that seek to reduce exposure to water scarcity can impact aspects of adaptive capacity, and shift

Community capacity to acquire, assess, adapt, and apply research evidence: a survey of Ontario's HIV/AIDS sector

Directory of Open Access Journals (Sweden)

Rourke Sean B

2011-05-01

Full Text Available Abstract Background Community-based organizations (CBOs are important stakeholders in health systems and are increasingly called upon to use research evidence to inform their advocacy, program planning, and service delivery. To better support CBOs to find and use research evidence, we sought to assess the capacity of CBOs in the HIV/AIDS sector to acquire, assess, adapt, and apply research evidence in their work. Methods We invited executive directors of HIV/AIDS CBOs in Ontario, Canada (n = 51 to complete the Canadian Health Services Research Foundation's "Is Research Working for You?" survey. Findings Based on responses from 25 organizations that collectively provide services to approximately 32,000 clients per year with 290 full-time equivalent staff, we found organizational capacity to acquire, assess, adapt, and apply research evidence to be low. CBO strengths include supporting a culture that rewards flexibility and quality improvement, exchanging information within their organization, and ensuring that their decision-making processes have a place for research. However, CBO Executive Directors indicated that they lacked the skills, time, resources, incentives, and links with experts to acquire research, assess its quality and reliability, and summarize it in a user-friendly way. Conclusion Given the limited capacity to find and use research evidence, we recommend a capacity-building strategy for HIV/AIDS CBOs that focuses on providing the tools, resources, and skills needed to more consistently acquire, assess, adapt, and apply research evidence. Such a strategy may be appropriate in other sectors and jurisdictions as well given that CBO Executive Directors in the HIV/AIDS sector in Ontario report low capacity despite being in the enviable position of having stable government infrastructure in place to support them, benefiting from long-standing investment in capacity building, and being part of an active provincial network. CBOs in other

Role of institutional entrepreneurship in building adaptive capacity in community-based healthcare organisations: realist review protocol.

Science.gov (United States)

Iyengar, Sweatha; Katz, Aaron; Durham, Jo

2016-03-24

Over the past 3 decades, there has been a substantial shift to the marketisation of government-funded health services. For organisations traditionally buffered from the competitive pressures of for-profit enterprises, such as community-based organisations, this means developing the capacity to adapt to competitive tendering processes, shifting client expectations, and increasing demands for greater accountability. Drawing on ideas of institutional entrepreneurship, we believe that attempts to build adaptive capacity require the transformation of existing institutional arrangements. Key in this may be identifying and fostering institutional entrepreneurs--actors who take the lead in being the impetus for, and giving direction to, structural change. This study focuses on the strategies used by institutional entrepreneurs to build adaptive capacity in the community-based healthcare sector. The research will use an adapted rapid realist review. The review will find underlying theories that explain the circumstances surrounding the implementation of capacity-building strategies that shape organisational response and generate outcomes by activating causal mechanisms. An early scoping of the literature, and consultations with key stakeholders, will be undertaken to identify an initial programme theory. We will search for relevant journal articles and grey literature. Data will be extracted based on contextual factors, mechanisms and outcomes, and their configurations. The analysis will seek patterns and regularities in these configurations and will focus on confirming, refuting or refining our programme theory. The study does not involve primary research and, therefore, does not require formal ethical approval. However, ethical standards of utility, usefulness, feasibility, propriety, accuracy and accountability will be followed. The results will be written up according to the Realist and Meta-Review Evidence Synthesis: Evolving Standards guidelines. Once completed

Acclimatization and Adaptive Capacity of Marine Species in a Changing Ocean.

Science.gov (United States)

Foo, S A; Byrne, M

To persist in an ocean changing in temperature, pH and other stressors related to climate change, many marine species will likely need to acclimatize or adapt to avoid extinction. If marine populations possess adequate genetic variation in tolerance to climate change stressors, species might be able to adapt to environmental change. Marine climate change research is moving away from single life stage studies where individuals are directly placed into projected scenarios ('future shock' approach), to focus on the adaptive potential of populations in an ocean that will gradually change over coming decades. This review summarizes studies that consider the adaptive potential of marine invertebrates to climate change stressors and the methods that have been applied to this research, including quantitative genetics, laboratory selection studies and trans- and multigenerational experiments. Phenotypic plasticity is likely to contribute to population persistence providing time for genetic adaptation to occur. Transgenerational and epigenetic effects indicate that the environmental and physiological history of the parents can affect offspring performance. There is a need for long-term, multigenerational experiments to determine the influence of phenotypic plasticity, genetic variation and transgenerational effects on species' capacity to persist in a changing ocean. However, multigenerational studies are only practicable for short generation species. Consideration of multiple morphological and physiological traits, including changes in molecular processes (eg, DNA methylation) and long-term studies that facilitate acclimatization will be essential in making informed predictions of how the seascape and marine communities will be altered by climate change. © 2016 Elsevier Ltd. All rights reserved.

[Deficiency, disability, neurology and television series].

Science.gov (United States)

Collado-Vázquez, Susana; Martínez-Martínez, Ariadna; Cano-de-la-Cuerda, Roberto

2015-06-01

The portrayal of neurological disability and deficiency on television has not always been approached in the same way, but has instead tended to reflect the standpoint taken by society with regard to these issues and how they are dealt with according to the prevailing conceptions and values at each particular time. To address the appearance of neurological pathologies in television series and to ponder on the image they have in such contexts. Deficiency and disability of neurological origin have often been depicted on television in series, telefilms and documentaries, and in a wide variety of ways. Here we examine different television series and how they have dealt with neurological pathology, its diagnosis and its treatment, as well as the figure of the healthcare professional and social-familial adaptation. Examples cited include series such as House MD, Glee, American Horror Story, Homeland or Game of Thrones. Television series are a useful tool for making some neurological pathologies better known to the public and for dispelling the myths surrounding others, provided that the pathologies are dealt with in a realistic manner, which is not always the case. More care should be taken with regard to the way in which health professionals are portrayed in television series, as it is not always done correctly and may mislead viewers, who take what they see on the TV as being real.

Do adapted vignettes improve medical decision-making capacity for individuals with Alzheimer's disease?

Science.gov (United States)

Thalén, Liv; Heimann Mühlenbock, Katarina; Almkvist, Ove; Eriksdotter, Maria; Sundström, Erik; Tallberg, Ing-Mari

2017-12-01

Medical decision-making capacity (MDC) is known to decline in individuals with Alzheimer's disease (AD). The vignette method uses hypothetical information as a prerequisite for measuring the capacity to make well-informed decisions to clinical trials. Our aim was to investigate if adapted vignettes can help individuals with mild AD to assimilate information, make decisions and express them in an understandable way, compared to corresponding decisions based on linguistically more demanding vignettes, as measured by the Swedish Linguistic Instrument for Medical Decision-making (LIMD). Two vignettes from LIMD were altered linguistically with the aim to facilitate understanding for individuals with AD. An experimental within-subject design was used to study the influence on MDC of readability (original/adapted vignettes) and content (two different clinical trials). We included 24 patients with mild AD in this prospective study, which read all four vignettes along with a few other tests. This allowed us to investigate the association between MDC and cognitive function. Adapted vignettes did not yield significant differences regarding MDC as compared with original vignettes using a two-way repeated measures analysis of variance. A difference was found between the two clinical trials where LIMD score was significantly higher for Kidney disease than hypertension vignettes. Our results indicate that adapted vignettes may not improve MDC for individuals with mild AD. MDC was affected by which clinical trial the vignettes regarded, which implies that other factors affecting MDC need to be investigated, like length of text and vocabulary used. © 2017 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Neurology and neurologic practice in China.

Science.gov (United States)

Shi, Fu-Dong; Jia, Jian-Ping

2011-11-29

In the wake of dramatic economic success during the past 2 decades, the specialized field of neurology has undergone a significant transformation in China. With an increase in life expectancy, the problems of aging and cognition have grown. Lifestyle alterations have been associated with an epidemiologic transition both in the incidence and etiology of stroke. These changes, together with an array of social issues and institution of health care reform, are creating challenges for practicing neurologists throughout China. Notable problems include overcrowded, decrepit facilities, overloaded physician schedules, deteriorating physician-patient relationships, and an insufficient infrastructure to accommodate patients who need specialized neurologic care. Conversely, with the creation of large and sophisticated neurology centers in many cities across the country, tremendous opportunities exist. Developments in neurologic subspecialties enable delivery of high-quality care. Clinical and translational research based on large patient populations as well as highly sophisticated technologies are emerging in many neurologic centers and pharmaceutical companies. Child neurology and neurorehabilitation will be fast-developing subdisciplines. Given China's extensive population, the growth and progress of its neurology complex, and its ever-improving quality control, it is reasonable to anticipate that Chinese neurologists will contribute notably to unraveling the pathogenic factors causing neurologic diseases and to providing new therapeutic solutions.

City of Iqaluit's climate change impacts, infrastructure risks and adaptive capacity project

International Nuclear Information System (INIS)

Nielsen, D.; Kronenberger, J.

2007-03-01

The City of Iqaluit is an Arctic community that is very susceptible to the stresses of climate change. The city is challenged by increased flooding, coastal erosion and ground instability caused by melting of the permafrost layer. In response, the City of Iqaluit has created policies to reduce greenhouse gases and act on climate change. A project has also been launched to develop adaptation strategies, with particular focus on infrastructure vulnerability given the environmental and climate change in the Canadian Arctic. The purpose of the study is to evaluate the biophysical exposure and hazards on Arctic coasts subject to effects of climate change, identify past and current management strategies used to manage risks in coastal communities which have already experienced environmental change, and to evaluate the adaptive capacity of communities for dealing with coastal hazards throughout the Arctic. This document identified the risks to Iqaluit's infrastructure, including buildings, roads, water supply, wastewater treatment and waste disposal systems. Adaptation options were also developed. These ranged from educational programs and retrofits to policy changes and building standard amendments. refs., tabs., figs

Survey of the professors of child neurology: neurology versus pediatrics home for child neurology.

Science.gov (United States)

Pearl, Phillip L; McConnell, Emily R; Fernandez, Rosamary; Brooks-Kayal, Amy

2014-09-01

The optimal academic home for child neurology programs between adult neurology versus pediatric departments remains an open question. The Professors of Child Neurology, the national organization of child neurology department chairs, division chiefs, and training program directors, was surveyed to evaluate the placement of child neurology programs. Professors of Child Neurology members were surveyed regarding the placement of child neurology programs within adult neurology versus pediatric departments. Questions explored academic versus clinical lines of reporting and factors that may be advantages and disadvantages of these affiliations. Issues also addressed were the current status of board certification and number of clinics expected in academic child neurology departments. Of 120 surveys sent, 95 responses were received (79% response rate). The primary academic affiliation is in neurology in 54% of programs versus 46% in pediatrics, and the primary clinical affiliation is 45% neurology and 55% pediatrics. Advantages versus disadvantages of one's primary affiliation were similar whether the primary affiliation was in neurology or pediatrics. While 61% of respondents are presently board certified in pediatrics, only 2% of those with time-limited certification in general pediatrics plan to be recertified going forward. Typically six to eight half-day clinics per week are anticipated for child neurologists in academic departments without additional funding sources. Overall, leaders of child neurology departments and training programs would not change their affiliation if given the opportunity. Advantages and disadvantages associated with current affiliations did not change whether child neurology was located in neurology or pediatrics. Board certification by the American Board of Psychiatry and Neurology in child neurology is virtually universal, whereas pediatric board certification by the American Board of Pediatrics is being maintained by very few. Most academic

A Comparative Survey of Adaptive Codec Solutions for VoIP over Multirate WLANs: A Capacity versus Quality Performance Trade-Off

Directory of Open Access Journals (Sweden)

Sfairopoulou A

2011-01-01

Full Text Available In multi-rate WLANs, users can suffer transmission rate changes due to the link adaptation mechanism. This results in a variable capacity channel, which is very hostile for VoIP and can cause serious quality of service (QoS degradation in all active calls. Various codec adaptation mechanisms have been proposed as a solution to this, as well as to solve congestion problems on WLAN environments. Here, these solutions are presented, categorized according to the adaptation policy and scenario they implement, and evaluated at call-level in terms of the resulting blocking and dropping probabilities, as well as the perceived voice quality. To define a common performance metric, a new index named VGoS-factor is presented, which, by combining these capacity and quality indicators, can provide an overall view of the capacity versus quality trade-off of the proposed mechanisms and consequently help in choosing the adequate policy for each scenario.

Adaptation in Collaborative Governance Regimes

Science.gov (United States)

Emerson, Kirk; Gerlak, Andrea K.

2014-10-01

Adaptation and the adaptive capacity of human and environmental systems have been of central concern to natural and social science scholars, many of whom characterize and promote the need for collaborative cross-boundary systems that are seen as flexible and adaptive by definition. Researchers who study collaborative governance systems in the public administration, planning and policy literature have paid less attention to adaptive capacity specifically and institutional adaptation in general. This paper bridges the two literatures and finds four common dimensions of capacity, including structural arrangements, leadership, knowledge and learning, and resources. In this paper, we focus on institutional adaptation in the context of collaborative governance regimes and try to clarify and distinguish collaborative capacity from adaptive capacity and their contributions to adaptive action. We posit further that collaborative capacities generate associated adaptive capacities thereby enabling institutional adaptation within collaborative governance regimes. We develop these distinctions and linkages between collaborative and adaptive capacities with the help of an illustrative case study in watershed management within the National Estuary Program.

Prospects for climate change on three Polynesian outliers in Solomon Islands: Exposure, sensitivity and adaptive capacity

DEFF Research Database (Denmark)

Rasmussen, Kjeld; May, Wilhelm; Birk, Thomas Ladegaard Kümmel

2011-01-01

-physical conditions, economic base and social organization – the exposure, sensitivity and adaptation options of island populations are analyzed. It is argued that the three islands are likely to be very differently affected for reasons related to all three categories of characteristics. Local adaptive capacity...... is likely to be insufficient, especially in the case of Ontong Java (which is an atoll), and economic, social, institutional and political factors, external to the islands, will be of increasing importance....

Resilience, Adaptive Capacity, and the "Lock-in Trap" of the Western Australian Agricultural Region

Directory of Open Access Journals (Sweden)

Helen E. Allison

2004-06-01

Full Text Available Using the Western Australian (WA agricultural region as an example of a large-scale social-ecological system (SES, this paper applies a framework based on resilience theory to examine the region's resilience and capacity for change and renewal. Despite numerous policies directed at controlling natural resource degradation in this SES, sustainable natural resource management (NRM has not been achieved. Disparities between the scale and complexity of the problem, the design of management policies, and region's history have all contributed to policy resistance. Historically, when considered as an integrated system, changes may be described by two iterations of the adaptive cycle. These cycles are also synchronous with the third and fourth Kondratiev long-wave economic cycles. The WA agricultural region has experienced sequential periods of growth and accumulation followed by reorganization and renewal, and currently is in the backloop (reorganization to exploitation phases of the adaptive cycle. A region's adaptive capacity is achieved by substituting direct reliance on regional factors with institutional intervention and sophisticated technology, often generated at the global scale. This substitution alters the thresholds of the commodity system and gives the perception of an adaptive system. In contrast, however, if resource depletion, environmental pollution, and population decline, also effects of the commodity system, are included within the model then the region may be considered to be in a "Lock-in" pathological trap. We propose that the dynamics of land-use change between 1900-2003 were driven by macroeconomics at the global scale, mediated by institutions at the national and state scale. Also, the SES, which is composed of relatively fast-moving variables, is largely decoupled from the slow-moving ecological variables.

Primary care perceptions of neurology and neurology services.

Science.gov (United States)

Loftus, Angela M; Wade, Carrie; McCarron, Mark O

2016-06-01

Neurophobia (fear of neural sciences) and evaluation of independent sector contracts in neurology have seldom been examined among general practitioners (GPs). A questionnaire determined GPs' perceptions of neurology compared with other medical specialties. GP experiences of neurology services with independent sector companies and the local National Health Service (NHS) were compared. Areas of potential improvement in NHS neurology services were recorded from thematic analyses. Among 76 GPs neurology was perceived to be as interesting as other medical specialties. GPs reported less knowledge, more difficulty and less confidence in neurology compared with other medical specialties. There was a preference for a local NHS neurology service (pneurology services provided better patient satisfaction. GPs prefer local NHS neurology services to independent sector contracts. GPs' evaluations should inform commissioning of neurology services. Combating neurophobia should be an integral part of responsive commissioning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Bolstering resilience in the coconut kingdom: Improving adaptive capacity to climate change in Vanuatu

International Nuclear Information System (INIS)

Richmond, Noah; Sovacool, Benjamin K.

2012-01-01

This communication discusses climate change adaptation efforts underway in Vanuatu. In particular, it uncovers why community-based approaches to adaptation are more likely to bear fruit than ones driven from the top-down at the national level. The authors make this claim based on early evidence that small-scale projects (a) support community ownership over adaptation, (b) provide ongoing technical learning lessons (c) relieve pressure from capacity constraints at national administrative bodies, and (d) expedite implementation by avoiding cumbersome multilateral procedures. The first section discusses its research methods and presents important characteristics of the Vanuatu economy, people and geography. The communication then moves on to discuss Vanuatu’s vulnerability to the effects of climate change. It specifically investigates on-going efforts to adapt to natural climatic hazards in Vanuatu. Early evidence and analysis reveals lessons salient for energy and climate policy. - Highlights: ► The island state of Vanuatu is especially vulnerable to natural climatic hazards and climate change. ► Community-based approaches to climate change adaptation have unique benefits in Vanuatu. ► This note provides lessons salient for energy and climate policy in Vanuatu.

Modelling and adaptive control of small capacity chillers for HVAC applications

International Nuclear Information System (INIS)

Beghi, A.; Cecchinato, Luca

2011-01-01

An adaptive controller for single and uneven tandem scroll compressor, packaged air-cooled water chillers is described. The designed controller allows to substantially increase the energy performance of the system, as well as to achieve excellent regulation performances in process applications. The controller parameters are adapted on the basis of estimates of the plant thermal load, that are computed by using a Kalman filter. An ad hoc approach is used to define a relay control logic, which is based on a numerical optimization procedure. To support controller design, a detailed simulation environment is developed and validated on an experimental facility. Performance of the algorithm is described with both simulation and experimental data. At low part load ratio values the proposed algorithm grants a 0.6-0.7 K improvement in the regulation performance in terms of supply water temperature standard deviation and mean supply water temperature deviation. The unit energy efficiency improvement with respect to supply water temperature control varies from 7.3% to 3.0% while the experimental seasonal energy efficiency rating improvement is 9.1%. - Research highlights: → Design of an advanced control algorithms for small capacity chillers. → Matlab/Simulink simulation environment development and experimental validation. → Development of an adaptive control algorithm for scroll compressor chillers, which allows to increase both control accuracy and energy performance. → New load estimation scheme based on a Kalman filter.

Milestone-compatible neurology resident assessments: A role for observable practice activities.

Science.gov (United States)

Jones, Lyell K; Dimberg, Elliot L; Boes, Christopher J; Eggers, Scott D Z; Dodick, David W; Cutsforth-Gregory, Jeremy K; Leep Hunderfund, Andrea N; Capobianco, David J

2015-06-02

Beginning in 2014, US neurology residency programs were required to report each trainee's educational progression within 29 neurology Milestone competency domains. Trainee assessment systems will need to be adapted to inform these requirements. The primary aims of this study were to validate neurology resident assessment content using observable practice activities (OPAs) and to develop assessment formats easily translated to the Neurology Milestones. A modified Delphi technique was used to establish consensus perceptions of importance of 73 neurology OPAs among neurology educators and trainees at 3 neurology residency programs. A content validity score (CVS) was derived for each neurology OPA, with scores ≥4.0 determined in advance to indicate sufficient content validity. The mean CVS for all OPAs was 4.4 (range 3.5-5.0). Fifty-seven (78%) OPAs had a CVS ≥4.0, leaving 16 (22%) below the pre-established threshold for content validity. Trainees assigned a higher importance to individual OPAs (mean CVS 4.6) compared to faculty (mean 4.4, p = 0.016), but the effect size was small (η(2) = 0.10). There was no demonstrated effect of length of education experience on perceived importance of neurology OPAs (p = 0.23). Two sample resident assessment formats were developed, one using neurology OPAs alone and another using a combination of neurology OPAs and the Neurology Milestones. This study provides neurology training programs with content validity evidence for items to include in resident assessments, and sample assessment formats that directly translate to the Neurology Milestones. Length of education experience has little effect on perceptions of neurology OPA importance. © 2015 American Academy of Neurology.

Integrated System Design: Promoting the Capacity of Sociotechnical Systems for Adaptation through Extensions of Cognitive Work Analysis.

Science.gov (United States)

Naikar, Neelam; Elix, Ben

2016-01-01

This paper proposes an approach for integrated system design, which has the intent of facilitating high levels of effectiveness in sociotechnical systems by promoting their capacity for adaptation. Building on earlier ideas and empirical observations, this approach recognizes that to create adaptive systems it is necessary to integrate the design of all of the system elements, including the interfaces, teams, training, and automation, such that workers are supported in adapting their behavior as well as their structure, or organization, in a coherent manner. Current approaches for work analysis and design are limited in regard to this fundamental objective, especially in cases when workers are confronted with unforeseen events. A suitable starting point is offered by cognitive work analysis (CWA), but while this framework can support actors in adapting their behavior, it does not necessarily accommodate adaptations in their structure. Moreover, associated design approaches generally focus on individual system elements, and those that consider multiple elements appear limited in their ability to facilitate integration, especially in the manner intended here. The proposed approach puts forward the set of possibilities for work organization in a system as the central mechanism for binding the design of its various elements, so that actors can adapt their structure as well as their behavior-in a unified fashion-to handle both familiar and novel conditions. Accordingly, this paper demonstrates how the set of possibilities for work organization in a system may be demarcated independently of the situation, through extensions of CWA, and how it may be utilized in design. This lynchpin, conceptualized in the form of a diagram of work organization possibilities (WOP), is important for preserving a system's inherent capacity for adaptation. Future research should focus on validating these concepts and establishing the feasibility of implementing them in industrial contexts.

[Deficiency, disability, neurology and cinema].

Science.gov (United States)

Collado-Vázquez, Susana; Cano de la Cuerda, Roberto; Jiménez-Antona, Carmen

2010-12-16

Cinema has been defined in many different ways, but most of them agree that it should be considered both a technique and an art. Although films often depict fantasy stories, in many cases they also reflect day-to-day realities. In its earliest days cinema was already attracted to the world of health and sickness, and frequently addressed topics like medical practice, how patients lived with their illnesses, bioethical issues, the relationship between physician and patient or research. To review the presence of neurological pathologies in the cinema with a view to identifying the main neurological disorders that have been portrayed in films. Likewise it also intends to describe the medical praxis that is employed, the relationship between physician and patient, how the experiences of the patient and the family are represented, the adaptation to social and occupational situations, and the intervention of other health care professionals related with neurological patients. Some of the most significant films that have addressed these topics were reviewed and it was seen that in some of them the illness is dealt with in a very true-to-life manner, whereas others tend to include a greater number of inaccuracies and a larger degree of fiction. Cinema has helped to shape certain ways of thinking about the health care professionals who work with neurological patients, the importance of support from the family and the social role, among other things. This confirms that resorting to cinematographic productions is a fruitful tool for stimulating a critical interest in the past and present of medical practice.

Developing adaptive capacity in times of climate change in central rural Vietnam: exploring smallholders’ learning and governance

NARCIS (Netherlands)

Le, Thi Hong Phuong

2017-01-01

Climate change already affects Vietnam in virtually all sectors. Agriculture in small communities is particularly vulnerable to current and projected climate change impacts. Many of the smallholder farmers in Vietnam have limited adaptive capacity to deal with these impacts. Increasingly social

Locomotor adaptability in persons with unilateral transtibial amputation.

Science.gov (United States)

Darter, Benjamin J; Bastian, Amy J; Wolf, Erik J; Husson, Elizabeth M; Labrecque, Bethany A; Hendershot, Brad D

2017-01-01

Locomotor adaptation enables walkers to modify strategies when faced with challenging walking conditions. While a variety of neurological injuries can impair locomotor adaptability, the effect of a lower extremity amputation on adaptability is poorly understood. Determine if locomotor adaptability is impaired in persons with unilateral transtibial amputation (TTA). The locomotor adaptability of 10 persons with a TTA and 8 persons without an amputation was tested while walking on a split-belt treadmill with the parallel belts running at the same (tied) or different (split) speeds. In the split condition, participants walked for 15 minutes with the respective belts moving at 0.5 m/s and 1.5 m/s. Temporal spatial symmetry measures were used to evaluate reactive accommodations to the perturbation, and the adaptive/de-adaptive response. Persons with TTA and the reference group of persons without amputation both demonstrated highly symmetric walking at baseline. During the split adaptation and tied post-adaptation walking both groups responded with the expected reactive accommodations. Likewise, adaptive and de-adaptive responses were observed. The magnitude and rate of change in the adaptive and de-adaptive responses were similar for persons with TTA and those without an amputation. Furthermore, adaptability was no different based on belt assignment for the prosthetic limb during split adaptation walking. Reactive changes and locomotor adaptation in response to a challenging and novel walking condition were similar in persons with TTA to those without an amputation. Results suggest persons with TTA have the capacity to modify locomotor strategies to meet the demands of most walking conditions despite challenges imposed by an amputation and use of a prosthetic limb.

Visual attention capacity

DEFF Research Database (Denmark)

Habekost, Thomas; Starrfelt, Randi

2009-01-01

Psychophysical studies have identified two distinct limitations of visual attention capacity: processing speed and apprehension span. Using a simple test, these cognitive factors can be analyzed by Bundesen's Theory of Visual Attention (TVA). The method has strong specificity and sensitivity......, and measurements are highly reliable. As the method is theoretically founded, it also has high validity. TVA-based assessment has recently been used to investigate a broad range of neuropsychological and neurological conditions. We present the method, including the experimental paradigm and practical guidelines...... to patient testing, and review existing TVA-based patient studies organized by lesion anatomy. Lesions in three anatomical regions affect visual capacity: The parietal lobes, frontal cortex and basal ganglia, and extrastriate cortex. Visual capacity thus depends on large, bilaterally distributed anatomical...

Closed-form Capacity Expressions for the α-μ Fading Channel with SC Diversity under Different Adaptive Transmission Strategies

Science.gov (United States)

Mohamed, Refaat; Ismail, Mahmoud H.; Newagy, Fatma; Mourad, Heba M.

2013-03-01

Stemming from the fact that the α-μ fading distribution is one of the very general fading models used in the literature to describe the small scale fading phenomenon, in this paper, closed-form expressions for the Shannon capacity of the α-μ fading channel operating under four main adaptive transmission strategies are derived assuming integer values for μ. These expressions are derived for the case of no diversity as well as for selection combining diversity with independent and identically distributed branches. The obtained expressions reduce to those previously derived in the literature for the Weibull as well as the Rayleigh fading cases, which are both special cases of the α-μ channel. Numerical results are presented for the capacity under the four adaptive transmission strategies and the effect of the fading parameter as well as the number of diversity branches is studied.

Adaptive Capacity Management in Bluetooth Networks

DEFF Research Database (Denmark)

Son, L.T.

, such as limited wireless bandwidth operation, routing, scheduling, network control, etc. Currently Bluetooth specification particularly does not describe in details about how to implement Quality of Service and Resource Management in Bluetooth protocol stacks. These issues become significant, when the number...... of Bluetooth devices is increasing, a larger-scale ad hoc network, scatternet, is formed, as well as the booming of Internet has demanded for large bandwidth and low delay mobile access. This dissertation is to address the capacity management issues in Bluetooth networks. The main goals of the network capacity...... capacity allocation, network traffic control, inter-piconet scheduling, and buffer management. First, after a short presentation about Bluetooth technology, and QoS issues, queueing models and a simulation-based buffer management have been constructed. Then by using analysis and simulation, it shows some...

Revisiting Absorptive Capacity

DEFF Research Database (Denmark)

de Araújo, Ana Luiza Lara; Ulhøi, John Parm; Lettl, Christopher

Absorptive capacity has mostly been perceived as a 'passive' outcome of R&D investments. Recently, however, a growing interest into its 'proactive' potentials has emerged. This paper taps into this development and proposes a dynamic model for conceptualizing the determinants of the complementary...... learning processes of absorptive capacity, which comprise combinative and adaptive capabilities. Drawing on survey data (n=169), the study concludes that combinative capabilities primarily enhance transformative and exploratory learning processes, while adaptive capabilities strengthen all three learning...

Challenges to neurology residency education in today's health care environment.

Science.gov (United States)

Bega, Danny; Krainc, Dimitri

2016-09-01

Residency training has had to adapt to higher patient volumes, increased complexity of medical care, and the commercialized system of health care. These changes have led to a concerning culture shift in neurology. We review the relationship between the emerging health care delivery system and residency training, highlighting issues related to duty hours and work-life balance, the changing technological landscape, high patient volumes, and complex service obligations. We propose that the current challenges in health care delivery offer the opportunity to improve neurology residency through faculty development programs, bringing teaching back to the bedside, increasing resident autonomy, utilizing near-peer teaching, and rewarding educators who facilitate an environment of inquiry and scholarship, with the ultimate goal of better alignment between education and patient care. Ann Neurol 2016;80:315-320. © 2016 American Neurological Association.

A High-Capacity Image Data Hiding Scheme Using Adaptive LSB Substitution

Directory of Open Access Journals (Sweden)

H. Yang

2009-12-01

Full Text Available Many existing steganographic methods hide more secret data into edged areas than smooth areas in the host image, which does not differentiate textures from edges and causes serious degradation in actual edge areas. To avoid abrupt changes in image edge areas, as well as to achieve better quality of the stego-image, a novel image data hiding technique by adaptive Least Significant Bits (LSBs substitution is proposed in this paper. The scheme exploits the brightness, edges, and texture masking of the host image to estimate the number k of LSBs for data hiding. Pixels in the noise non-sensitive regions are embedded by a k-bit LSB substitution with a lager value of k than that of the pixels in noise sensitive regions. Moreover, an optimal pixel adjustment process is used to enhance stego-image visual quality obtained by simple LSB substitution method. To ensure that the adaptive number k of LSBs remains unchanged after pixel modification, the LSBs number is computed by the high-order bits rather than all the bits of the image pixel value. The theoretical analyses and experiment results show that the proposed method achieves higher embedding capacity and better stegoimage quality compared with some existing LSB methods.

[The carrier model of neurology in Hungary: a proposal for the solution until 2020].

Science.gov (United States)

Bereczki, Dániel; Csiba, László; Komoly, Sámuel; Vécsei, László; Ajtay, András

2011-11-30

Based on our previous survey on the capacities of neurological services and on the predictable changes in the neurologist workforce in Hungary, we present a proposal for the organization of the structure of neurological services in the future. We discuss the diagnostic groups treated by neurologists, the neurological services and their progressive organization. Using the current capacities as baseline, we propose patient groups to be treated by neurologists in the future, and the levels of services. Based on the tendencies seen in the last years we suggest to consider to allocate acute stroke services exclusively to stroke units in neurological departments, and we identify a few other diagnostic groups where neurology should have a larger share in patient care. We define three levels for inpatient care: university departments, regional/county hospitals, city hospitals. Instead of minimum criteria we assign outpatient and inpatient standards that are functional from the economic point of view as well. University departments cover all areas of neurological services, have a function in graduate and postgraduate training, and on a regional basis they participate in professional quality assurance activities at the county and city hospital levels, and would have a more independent role in residency training. As far as patient care is concerned, the task of the regional/county hospitals would be similar to that of university departments - without the exclusively university functions. A general neurological service would be offered at the city hospital level - the representation of all subspecialties of neurology is not required. Neurorehabilitation would be organized at special units of neurological wards at the city hospital level, at independent neurorehabilitation wards in regional/county hospitals, and also as an outpatient service offered at the patients' home. The most significant organizational change would affect the outpatient neurological services. In addition

Prevalence and Distribution of Neurological Disease in a Neurology ...

African Journals Online (AJOL)

Uche

Annals of Medical and Health Sciences Research – January 2011 – Vol. 1 N0.1. >>>63<<<. Prevalence and Distribution of Neurological Disease in a. Neurology Clinic in Enugu, Nigeria. Onwuekwe IO* and Ezeala-Adikaibe B*. *Neurology Unit, Department of Medicine,. University of Nigeria Teaching Hospital, Enugu, ...

Analysis of farm performance in Europe under different climate and management conditions to improve understanding of adaptive capacity

NARCIS (Netherlands)

Reidsma, P.; Ewert, F.; Oude Lansink, A.

2007-01-01

The aim of this paper is to improve understanding of the adaptive capacity of European agriculture to climate change. Extensive data on farm characteristics of individual farms from the Farm Accountancy Data Network (FADN) have been combined with climatic and socio-economic data to analyze the

Lake eutrophication and environmental change: A viability framework for resilience, vulnerability and adaptive capacity

Science.gov (United States)

Mathias, Jean-Denis; Rougé, Charles; Deffuant, Guillaume

2013-04-01

We present a simple stochastic model of lake eutrophication to demonstrate how the mathematical framework of viability theory fosters operational definitions of resilience, vulnerability and adaptive capacity, and then helps understand which response one should bring to environmental changes. The model represents the phosphorus dynamics, given that high concentrations trigger a regime change from oligotrophic to eutrophic, and causes ecological but also economic losses, for instance from tourism. Phosphorus comes from agricultural inputs upstream of the lake, and we will consider a stochastic input. We consider the system made of both the lake and its upstream region, and explore how to maintain the desirable ecological and economic properties of this system. In the viability framework, we translate these desirable properties into state constraints, then examine how, given the dynamics of the model and the available policy options, the properties can be kept. The set of states for which there exists a policy to keep the properties is called the viability kernel. We extend this framework to both major perturbations and long-term environmental changes. In our model, since the phosphorus inputs and outputs from the lake depend on rainfall, we will focus on extreme rainfall events and long-term changes in the rainfall regime. They can be described as changes in the state of the system, and may displace it outside the viability kernel. Its response can then be described using the concepts of resilience, vulnerability and adaptive capacity. Resilience is the capacity to recover by getting back to the viability kernel where the dynamics keep the system safe, and in this work we assume it to be the first objective of management. Computed for a given trajectory, vulnerability is a measure of the consequence of violating a property. We propose a family of functions from which cost functions and other vulnerability indicators can be derived for any trajectory. There can be

Need for palliative care for neurological diseases.

Science.gov (United States)

Provinciali, Leandro; Carlini, Giulia; Tarquini, Daniela; Defanti, Carlo Alberto; Veronese, Simone; Pucci, Eugenio

2016-10-01

The new concept of palliative care supports the idea of palliation as an early approach to patients affected by disabling and life-limiting disease which focuses on the patient's quality of life along the entire course of disease. This model moves beyond the traditional concept of palliation as an approach restricted to the final stage of disease and widens the fields of intervention. There is a growing awareness of the importance of palliative care not only in oncological diseases but also in many other branches of medicine, and it appears particularly evident in the approach to many of the most frequent neurological diseases that are chronic, incurable and autonomy-impairing illnesses. The definition and implementation of palliative goals and procedures in neurology must take into account the specific features of these conditions in terms of the complexity and variability of symptoms, clinical course, disability and prognosis. The realization of an effective palliative approach to neurological diseases requires specific skills and expertise to adapt the concept of palliation to the peculiarities of these diseases; this approach should be realized through the cooperation of different services and the action of a multidisciplinary team in which the neurologist should play a central role to identify and face the patient's needs. In this view, it is paramount for the neurologist to be trained in these issues to promote the integration of palliative care in the care of neurological patients.

The vulnerability of Australian rural communities to climate variability and change: Part II—Integrating impacts with adaptive capacity

NARCIS (Netherlands)

Nelson, R.; Kokic, P.; Crimp, S.; Martin, P.; Meinke, H.B.; Howden, S.M.; DeVoil, P.; McKeon, G.; Nidumolu, U.

2010-01-01

In the first paper in this series [Nelson, R., Kokic, P., Crimp, S., Martin, P., Meinke, H., Howden, S.M. (2010, this issue)], we concluded that hazard/impact modelling needs to be integrated with holistic measures of adaptive capacity in order to provide policy-relevant insights into the multiple

Farmer Health and Adaptive Capacity in the Face of Climate Change and Variability. Part 2: Contexts, Personal Attributes and Behaviors

Directory of Open Access Journals (Sweden)

Helen Berry

2011-10-01

Full Text Available This study extends the emerging body of research on farmer adaptation to climate change, by segmenting farmers on the basis of specific attributes (health, values, belief about climate change, sense of responsibility for climate change, desire to change, social, human and financial capitals and farmer demographics and considering such attributes as critical social aspects of the contextualized capacity to adapt. The segmental analysis was based on a nationally representative sample of 3,993 farmers concerned with farmer adaptation of climate risks. The resulting data were subjected to two-step cluster analysis to identify homogenous groups of farmers based on factors related to climate change adaptation. A three-cluster solution was identified wherein farmers were distinguishable on the basis of belief in climate change, desire for financial assistance and advice, social connectedness, information seeking, and adverse farm conditions. The largest group (Cluster 1: 55% was characterized by farmers who recognized being affected by drought and drying and who were actively engaged in adaptive practices, despite the fact that they had little income and poor farm resources. One third of these farmers reported that their health was a barrier to sustained activity in farming. Cluster 2 (26% was characterized by farmers not readily affected by drying, who enjoyed good incomes, good health and better farming conditions. They expressed little desire to adapt. The smallest cluster (Cluster 3: 19% was also characterized by farmers who recognized that they were affected by drying. However, despite a desire to adapt, they had very little means to do so. They reported the poorest natural resources and the poorest health, despite being younger. The findings suggest that it is the intent to adapt, starting from where people are at, which is a more important indicator of the capacity to work towards sustainable practices than assets tests alone.

Influence of training intensity on adaptations in acid/base transport proteins, muscle buffer capacity, and repeated-sprint ability in active men.

Science.gov (United States)

McGinley, Cian; Bishop, David J

2016-12-01

McGinley C, Bishop DJ. Influence of training intensity on adaptations in acid/base transport proteins, muscle buffer capacity, and repeated-sprint ability in active men. J Appl Physiol 121: 1290-1305, 2016. First published October 14, 2016; doi:10.1152/japplphysiol.00630.2016-This study measured the adaptive response to exercise training for each of the acid-base transport protein families, including providing isoform-specific evidence for the monocarboxylate transporter (MCT)1/4 chaperone protein basigin and for the electrogenic sodium-bicarbonate cotransporter (NBCe)1. We investigated whether 4 wk of work-matched, high-intensity interval training (HIIT), performed either just above the lactate threshold (HIITΔ20; n = 8), or close to peak aerobic power (HIITΔ90; n = 8), influenced adaptations in acid-base transport protein abundance, nonbicarbonate muscle buffer capacity (βm in vitro ), and exercise capacity in active men. Training intensity did not discriminate between adaptations for most proteins measured, with abundance of MCT1, sodium/hydrogen exchanger (NHE) 1, NBCe1, carbonic anhydrase (CA) II, and CAXIV increasing after 4 wk, whereas there was little change in CAIII and CAIV abundance. βm in vitro also did not change. However, MCT4 protein content only increased for HIITΔ20 [effect size (ES): 1.06, 90% confidence limits × / ÷ 0.77], whereas basigin protein content only increased for HIITΔ90 (ES: 1.49, × / ÷ 1.42). Repeated-sprint ability (5 × 6-s sprints; 24 s passive rest) improved similarly for both groups. Power at the lactate threshold only improved for HIITΔ20 (ES: 0.49; 90% confidence limits ± 0.38), whereas peak O 2 uptake did not change for either group. Detraining was characterized by the loss of adaptations for all of the proteins measured and for repeated-sprint ability 6 wk after removing the stimulus of HIIT. In conclusion, 4 wk of HIIT induced improvements in each of the acid-base transport protein families, but, remarkably, a 40

A new battery capacity indicator for nickel-metal hydride battery powered electric vehicles using adaptive neuro-fuzzy inference system

International Nuclear Information System (INIS)

Chau, K.T.; Wu, K.C.; Chan, C.C.; Shen, W.X.

2003-01-01

This paper describes a new approach to estimate accurately the battery residual capacity (BRC) of the nickel-metal hydride (Ni-MH) battery for modern electric vehicles (EVs). The key to this approach is to model the Ni-MH battery in EVs by using the adaptive neuro-fuzzy inference system (ANFIS) with newly defined inputs and output. The inputs are the temperature and the discharged capacity distribution describing the discharge current profile, while the output is the state of available capacity (SOAC) representing the BRC. The estimated SOAC from ANFIS model and the measured SOAC from experiments are compared, and the results confirm that the proposed approach can provide an accurate estimation of the SOAC under variable discharge currents

Farmer Health and Adaptive Capacity in the Face of Climate Change and Variability. Part 1: Health as a Contributor to Adaptive Capacity and as an Outcome from Pressures Coping with Climate Related Adversities

Directory of Open Access Journals (Sweden)

Anne Parkinson

2011-10-01

Full Text Available This paper examines the role farmers’ health plays as an element of adaptive capacity. The study examines which of twenty aspects of adaptation may be related to overall health outcomes, controlling for demographic and on-farm-factors in health problems. The analysis is based on 3,993 farmers’ responses to a national survey of climate risk and adaptation. Hierarchical linear regression modelling was used examine the extent to which, in a multivariate analysis, the use of adaptive practices was predictively associated with self-assessed health, taking into account the farmer’s rating of whether their health was a barrier to undertaking farm work. We present two models, one excluding pre-existing health (model 1 and one including pre-existing health (model 2. The first model accounted for 21% of the variance. In this model better health was most strongly predicted by an absence of on-farm risk, greater financial viability, greater debt pressures, younger age and a desire to continue farming. Social capital (trust and reciprocity was moderately associated with health as was the intention to adopt more sustainable practices. The second model (including the farmers’ health as a barrier to undertaking farm work accounted for 43% of the variance. Better health outcomes were most strongly explained, in order of magnitude, by the absence of pre-existing health problems, greater access to social support, greater financial viability, greater debt pressures, a desire to continue farming and the condition of on-farm resources. Model 2 was a more parsimonious model (only nine predictors, compared with 15 in model 1, and explained twice as much variance in health outcomes. These results suggest that (i pre-existing health problems are a very important factor to consider when designing adaptation programs and policies and (ii these problems may mediate or modify the relationship between adaptation and health.

Hemiparesis is a clinical correlate of general adaptive dysfunction in children and adolescents with Sturge-Weber syndrome.

Science.gov (United States)

Reesman, Jennifer; Gray, Robert; Suskauer, Stacy J; Ferenc, Lisa M; Kossoff, Eric H; Lin, Doris D M; Turin, Elizabeth; Comi, Anne M; Brice, Patrick J; Zabel, T Andrew

2009-06-01

This study sought to identify neurologic correlates of adaptive functioning in individuals with Sturge-Weber syndrome. A total of 18 children, adolescents, and young adults with Sturge-Weber syndrome with brain involvement were recruited from our Sturge-Weber center. All underwent neurologic examination (including review of clinical brain magnetic resonance imaging) and neuropsychological assessment. Neuropsychological assessment included measures of intellectual ability and standardized parent report of adaptive functioning. Overall, Full Scale IQ and ratings of global adaptive functioning were both lower than the population-based norms (P adaptive functioning ratings, clinician ratings of cortical abnormality, and ratings of neurologic status. Hemiparesis (minimal versus prominent) was the only individual component of the rating scales that differentiated between individuals with nonimpaired and impaired adaptive functioning scores. Information obtained during neurological examination of children and adolescents with Sturge-Weber syndrome particularly hemiparetic status is useful for identifying children who may need additional intervention.

Low robustness of increasing reservoir capacity for adaptation to climate change: A case study for an agricultural river basin

Science.gov (United States)

Kim, Daeha; Eum, Hyung-Il

2017-04-01

With growing concerns of the uncertain climate change, investments in water infrastructures are considered as adaptation policies for water managers and stakeholders despite their negative impacts on the environment. Particularly in regions with limited water availability or conflicting demands, building reservoirs and/or augmenting their storage capacity were already adopted for alleviating influences of the climate change. This study provides a probabilistic assessment of climate change impacts on water scarcity in a river system regulated by an agricultural reservoir in South Korea, which already increased its storage capacity for water supply. For the assessment, we developed the climate response functions (CRFs) defined as relationships between bi-decadal system performance indicators (reservoir reliability and vulnerability) and corresponding climatic conditions, using hydrological models with 10,000-year long stochastic generation of daily precipitation and temperatures. The climate change impacts were assessed by plotting 52 downscaled climate projections of general circulation models (GCMs) on the CRFs. Results indicated that augmented reservoir capacity makes the reservoir system more sensitive to changes in long-term averages of precipitation and temperatures despite improved system performances. Increasing reservoir capacity is unlikely to be "no regret" adaptation policy for the river system. On the other hand, converting the planting strategy from transplanting to direct sowing (i.e., a demand control) could be a more robust to bi-decadal climatic changes based on CRFs and thus could be good to be a no-regret policy.

Adaptability: An Important Capacity for Effective Teachers

Science.gov (United States)

Collie, Rebecca J.; Martin, Andrew J.

2016-01-01

A defining feature of teaching work is that it involves novelty, change, and uncertainty on a daily basis. Being able to respond effectively to this change is known as adaptability. In this article, we discuss the importance of adaptability for teachers and their healthy and effective functioning in the workplace. We discuss approaches for…

A focus on adolescence to reduce neurological, mental health and substance-use disability.

Science.gov (United States)

Davidson, Leslie L; Grigorenko, Elena L; Boivin, Michael J; Rapa, Elizabeth; Stein, Alan

2015-11-19

Globally, there is a crucial need to prioritize research directed at reducing neurological, mental health and substance-use disorders in adolescence, which is a pivotal age for the development of self-control and regulation. In adolescence, behaviour optimally advances towards adaptive long-term goals and suppresses conflicting maladaptive short-lived urges to balance impulsivity, exploration and defiance, while establishing effective societal participation. When self-control fails to develop, violence, injury and neurological, mental health and substance-use disorders can result, further challenging the development of self-regulation and impeding the transition to a productive adulthood. Adolescent outcomes, positive and negative, arise from both a life-course perspective and within a socioecological framework. Little is known about the emergence of self-control and regulation in adolescents in low- and middle-income countries where enormous environmental threats are more common (for example, poverty, war, local conflicts, sex trafficking and slavery, early marriage and/or pregnancy, and the absence of adequate access to education) than in high-income countries and can threaten optimal neurodevelopment. Research must develop or adapt appropriate assessments of adolescent ability and disability, social inclusion and exclusion, normative development, and neurological, mental health and substance-use disorders. Socioecological challenges in low- and middle-income countries require innovative strategies to prevent mental health, neurological and substance-use disorders and develop effective interventions for adolescents at risk, especially those already living with these disorders and the consequent disability.

Quantification In Neurology

Directory of Open Access Journals (Sweden)

Netravati M

2005-01-01

Full Text Available There is a distinct shift of emphasis in clinical neurology in the last few decades. A few years ago, it was just sufficient for a clinician to precisely record history, document signs, establish diagnosis and write prescription. In the present context, there has been a significant intrusion of scientific culture in clinical practice. Several criteria have been proposed, refined and redefined to ascertain accurate diagnosis for many neurological disorders. Introduction of the concept of impairment, disability, handicap and quality of life has added new dimension to the measurement of health and disease and neurological disorders are no exception. "Best guess" treatment modalities are no more accepted and evidence based medicine has become an integral component of medical care. Traditional treatments need validation and new therapies require vigorous trials. Thus, proper quantification in neurology has become essential, both in practice and research methodology in neurology. While this aspect is widely acknowledged, there is a limited access to a comprehensive document pertaining to measurements in neurology. This following description is a critical appraisal of various measurements and also provides certain commonly used rating scales/scores in neurological practice.

Adaptive Capacity: An Evolutionary Neuroscience Model Linking Exercise, Cognition, and Brain Health.

Science.gov (United States)

Raichlen, David A; Alexander, Gene E

2017-07-01

The field of cognitive neuroscience was transformed by the discovery that exercise induces neurogenesis in the adult brain, with the potential to improve brain health and stave off the effects of neurodegenerative disease. However, the basic mechanisms underlying exercise-brain connections are not well understood. We use an evolutionary neuroscience approach to develop the adaptive capacity model (ACM), detailing how and why physical activity improves brain function based on an energy-minimizing strategy. Building on studies showing a combined benefit of exercise and cognitive challenge to enhance neuroplasticity, our ACM addresses two fundamental questions: (i) what are the proximate and ultimate mechanisms underlying age-related brain atrophy, and (ii) how do lifestyle changes influence the trajectory of healthy and pathological aging? Copyright © 2017 Elsevier Ltd. All rights reserved.

Institutional perceptions, adaptive capacity and climate change response in a post-conflict country: a case study from Central African Republic

NARCIS (Netherlands)

Brown, H.C.P.; Smit, B.; Somorin, O.A.; Sonwa, D.J.; Ngana, F.

2013-01-01

The Central African Republic (CAR) faces increased vulnerability to climate change because it is a low-income country with low adaptive capacity; a situation that is exacerbated by recent civil conflict. This research analysed the perceptions of decision-makers within, and the response of diverse

Neurologic emergencies in sports.

Science.gov (United States)

Williams, Vernon B

2014-12-01

Sports neurology is an emerging area of subspecialty. Neurologists and non-neurologists evaluating and managing individuals participating in sports will encounter emergencies that directly or indirectly involve the nervous system. Since the primary specialty of sports medicine physicians and other practitioners involved in the delivery of medical care to athletes in emergency situations varies significantly, experience in recognition and management of neurologic emergencies in sports will vary as well. This article provides a review of information and elements essential to neurologic emergencies in sports for the practicing neurologist, although content may be of benefit to readers of varying background and expertise. Both common neurologic emergencies and less common but noteworthy neurologic emergencies are reviewed in this article. Issues that are fairly unique to sports participation are highlighted in this review. General concepts and principles related to treatment of neurologic emergencies that are often encountered unrelated to sports (eg, recognition and treatment of status epilepticus, increased intracranial pressure) are discussed but are not the focus of this article. Neurologic emergencies can involve any region of the nervous system (eg, brain, spine/spinal cord, peripheral nerves, muscles). In addition to neurologic emergencies that represent direct sports-related neurologic complications, indirect (systemic and generalized) sports-related emergencies with significant neurologic consequences can occur and are also discussed in this article. Neurologists and others involved in the care of athletes should consider neurologic emergencies in sports when planning and providing medical care.

Managing small-scale commercial fisheries for adaptive capacity: insights from dynamic social-ecological drivers of change in Monterey Bay.

Science.gov (United States)

Aguilera, Stacy E; Cole, Jennifer; Finkbeiner, Elena M; Le Cornu, Elodie; Ban, Natalie C; Carr, Mark H; Cinner, Joshua E; Crowder, Larry B; Gelcich, Stefan; Hicks, Christina C; Kittinger, John N; Martone, Rebecca; Malone, Daniel; Pomeroy, Carrie; Starr, Richard M; Seram, Sanah; Zuercher, Rachel; Broad, Kenneth

2015-01-01

Globally, small-scale fisheries are influenced by dynamic climate, governance, and market drivers, which present social and ecological challenges and opportunities. It is difficult to manage fisheries adaptively for fluctuating drivers, except to allow participants to shift effort among multiple fisheries. Adapting to changing conditions allows small-scale fishery participants to survive economic and environmental disturbances and benefit from optimal conditions. This study explores the relative influence of large-scale drivers on shifts in effort and outcomes among three closely linked fisheries in Monterey Bay since the Magnuson-Stevens Fisheries Conservation and Management Act of 1976. In this region, Pacific sardine (Sardinops sagax), northern anchovy (Engraulis mordax), and market squid (Loligo opalescens) fisheries comprise a tightly linked system where shifting focus among fisheries is a key element to adaptive capacity and reduced social and ecological vulnerability. Using a cluster analysis of landings, we identify four modes from 1974 to 2012 that are dominated (i.e., a given species accounting for the plurality of landings) by squid, sardine, anchovy, or lack any dominance, and seven points of transition among these periods. This approach enables us to determine which drivers are associated with each mode and each transition. Overall, we show that market and climate drivers are predominantly attributed to dominance transitions. Model selection of external drivers indicates that governance phases, reflected as perceived abundance, dictate long-term outcomes. Our findings suggest that globally, small-scale fishery managers should consider enabling shifts in effort among fisheries and retaining existing flexibility, as adaptive capacity is a critical determinant for social and ecological resilience.

Neurology in Asia.

Science.gov (United States)

Tan, Chong-Tin

2015-02-10

Asia is important as it accounts for more than half of the world population. The majority of Asian countries fall into the middle income category. As for cultural traditions, Asia is highly varied, with many languages spoken. The pattern of neurologic diseases in Asia is largely similar to the West, with some disease features being specific to Asia. Whereas Asia constitutes 60% of the world's population, it contains only 20% of the world's neurologists. This disparity is particularly evident in South and South East Asia. As for neurologic care, it is highly variable depending on whether it is an urban or rural setting, the level of economic development, and the system of health care financing. To help remedy the shortage of neurologists, most counties with larger populations have established training programs in neurology. These programs are diverse, with many areas of concern. There are regional organizations serving as a vehicle for networking in neurology and various subspecialties, as well as an official journal (Neurology Asia). The Asian Epilepsy Academy, with its emphasis on workshops in various locations, EEG certification examination, and fellowships, may provide a template of effective regional networking for improving neurology care in the region. © 2015 American Academy of Neurology.

Why neurology? Factors which influence career choice in neurology.

Science.gov (United States)

Albert, Dara V; Hoyle, Chad; Yin, Han; McCoyd, Matthew; Lukas, Rimas V

2016-01-01

To evaluate the factors which influence the decision to pursue a career in neurology. An anonymous survey was developed using a Likert scale to rate responses. The survey was sent to adult and child neurology faculty, residents and fellows, as well as medical students applying for neurology. Descriptive statistics were used to analyse the factors of influence. Respondents were subsequently categorized into pre-neurology trainees, neurology trainees, child neurologists and adult neurologists, and differences between the groups were analysed using Pearson's chi-square test. One hundred and thirty-three anonymous responses were received. The respondents were neurologists across all levels of training and practice. Across all respondents, the most common factor of high importance was intellectual content of specialty, challenging diagnostic problems, type of patient encountered and interest in helping people. Responses were similar across the groups; however, the earliest trainees cited interest in helping people as most important, while those in neurology training and beyond cite intellectual content of the specialty as most important. As trainees transition from their earliest levels of clinical experience into working as residents and faculty, there is a shift in the cited important factors. Lifestyle and financial factors seem to be the least motivating across all groups. Encouragement from peers, mentors, faculty and practicing physicians is considered high influences in a smaller number of neurologists. This may present an opportunity for practicing neurologists to make connections with medical students early in their education in an effort to encourage and mentor candidates.

Beyond exposure, sensitivity and adaptive capacity: A response based ecological framework to assess species climate change vulnerability

Science.gov (United States)

Fortini, Lucas B.; Schubert, Olivia

2017-01-01

As the impacts of global climate change on species are increasingly evident, there is a clear need to adapt conservation efforts worldwide. Species vulnerability assessments (VAs) are increasingly used to summarize all relevant information to determine a species’ potential vulnerability to climate change and are frequently the first step in informing climate adaptation efforts. VAs commonly integrate multiple sources of information by utilizing a framework that distinguishes factors relevant to species exposure, sensitivity, and adaptive capacity. However, this framework was originally developed for human systems, and its use to evaluate species vulnerability has serious practical and theoretical limitations. By instead defining vulnerability as the degree to which a species is unable to exhibit any of the responses necessary for persistence under climate change (i.e., toleration of projected changes, migration to new climate-compatible areas, enduring in microrefugia, and evolutionary adaptation), we can bring VAs into the realm of ecological science without applying borrowed abstract concepts that have consistently challenged species-centric research and management. This response-based framework to assess species vulnerability to climate change allows better integration of relevant ecological data and past research, yielding results with much clearer implications for conservation and research prioritization.

[Neurology! Adieau? (Part 2)].

Science.gov (United States)

Szirmai, Imre

2010-05-30

The education of neurologists is debilitated worldwide. University professors are engaged in teaching, research and patient-care. This triple challenge is very demanding, and results in permanent insecurity of University employees. To compensate for the insufficient clinical training, some institutes in the USA employ academic staff members exclusively for teaching. The formation of new subspecialties hinders the education and training of general neurologists. At present, four generations of medical doctors are working together in hospitals. The two older generations educate the younger neurologists who have been brought up in the world of limitless network of sterile information. Therefore their manual skills at the bedside and their knowledge of emergency treatment are deficient. Demographics of medical doctors changed drastically. Twice as many women are working in neurology and psychiatry than men. Integrity of neurology is threatened by: (1) Separation of the cerebrovascular diseases from general neurology. Development of "stroke units" was facilitated by the better reimbursement for treatment and by the interest of the pharmaceutical companies. Healthcare politics promoted the split of neurology into two parts. The independent status of "stroke departments" will reduce the rest of clinical neurology to outpatient service. (2) The main argumentation to segregate the rare neurological diseases was that their research will provide benefit for the diseases with high prevalence. This argumentation serves territorial ambitions. The separation of rare diseases interferes with the teaching of differential diagnostics in neurological training. The traditional pragmatic neurology can not be retrieved. The faculty of neurology could retain its integrity by the improvement of diagnostic methods and the ever more effective drugs. Nevertheless, even the progression of neurological sciences induces dissociation of clinical neurology. Neurology shall suffer fragmentation if

Climate Change Perceptions of NY State Farmers: The Role of Risk Perceptions and Adaptive Capacity

Science.gov (United States)

Takahashi, Bruno; Burnham, Morey; Terracina-Hartman, Carol; Sopchak, Amanda R.; Selfa, Theresa

2016-12-01

Climate change is expected to severely impact agricultural practices in many important food-producing regions, including the Northeast United States. Changing climate conditions, such as increases in the amount of rainfall, will require farmers to adapt. Yet, little is known with regard to farmers' perceptions and understandings about climate change, especially in the industrialized country context. This paper aims at overcoming this research limitation, as well as determining the existing contextual, cognitive, and psychological barriers that can prevent adoption of sustainable practices of farmers in New York State. The study is framed within the adaptive capacity and risk perception literature, and is based on a qualitative analysis of in-depth interviews with farmers in 21 farms in two counties in Central New York. The results reveal diverging views about the long-term consequences of climate change. Results also reveal that past experience remains as the most important source of information that influences beliefs and perceptions about climate change, confirming previous research.

Motor adaptation capacity as a function of age in carrying out a repetitive assembly task at imposed work paces.

Science.gov (United States)

Gilles, Martine Annie; Guélin, Jean-Charles; Desbrosses, Kévin; Wild, Pascal

2017-10-01

The working population is getting older. Workers must adapt to changing conditions to respond to the efforts required by the tasks they have to perform. In this laboratory-based study, we investigated the capacities of motor adaptation as a function of age and work pace. Two phases were identified in the task performed: a collection phase, involving dominant use of the lower limbs; and an assembly phase, involving bi-manual motor skills. Results showed that senior workers were mainly limited during the collection phase, whereas they had less difficulty completing the assembly phase. However, senior workers did increase the vertical force applied while assembling parts, whatever the work pace. In younger and middle-aged subjects, vertical force was increased only for the faster pace. Older workers could adapt to perform repetitive tasks under different time constraints, but adaptation required greater effort than for younger workers. These results point towards a higher risk of developing musculoskeletal disorders among seniors. Copyright © 2017 Elsevier Ltd. All rights reserved.

Adapting the capacities and vulnerabilities approach: a gender analysis tool.

Science.gov (United States)

Birks, Lauren; Powell, Christopher; Hatfield, Jennifer

2017-12-01

Gender analysis methodology is increasingly being considered as essential to health research because 'women's social, economic and political status undermine their ability to protect and promote their own physical, emotional and mental health, including their effective use of health information and services' {World Health Organization [Gender Analysis in Health: a review of selected tools. 2003; www.who.int/gender/documents/en/Gender. pdf (20 February 2008, date last accessed)]}. By examining gendered roles, responsibilities and norms through the lens of gender analysis, we can develop an in-depth understanding of social power differentials, and be better able to address gender inequalities and inequities within institutions and between men and women. When conducting gender analysis, tools and frameworks may help to aid community engagement and to provide a framework to ensure that relevant gendered nuances are assessed. The capacities and vulnerabilities approach (CVA) is one such gender analysis framework that critically considers gender and its associated roles, responsibilities and power dynamics in a particular community and seeks to meet a social need of that particular community. Although the original intent of the CVA was to guide humanitarian intervention and disaster preparedness, we adapted this framework to a different context, which focuses on identifying and addressing emerging problems and social issues in a particular community or area that affect their specific needs, such as an infectious disease outbreak or difficulty accessing health information and resources. We provide an example of our CVA adaptation, which served to facilitate a better understanding of how health-related disparities affect Maasai women in a remote, resource-poor setting in Northern Tanzania. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Neurology in a globalizing world: World Congress of Neurology, Vienna, 2013.

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Hachinski, Vladimir

2013-06-11

The World Congress of Neurology (figure 1) theme "Neurology in a Globalizing World" acknowledges that science and increasingly medicine and neurology are becoming globalized. The best way to manage change is to shape it. It is becoming increasingly clear that brain diseases, particularly stroke and dementia, are projected to rise at a rate that could overwhelm our clinics and hospitals. Hence a new emphasis on prevention and the need to work across disciplines beyond our traditional roles. Neurologists are the guardians of the brain and need to take the lead role in advancing new approaches in stemming the tide of neurologic diseases.

Neurological and ocular fascioliasis in humans.

Science.gov (United States)

Mas-Coma, Santiago; Agramunt, Verónica H; Valero, María Adela

2014-01-01

Fascioliasis is a food-borne parasitic disease caused by the trematode species Fasciola hepatica, distributed worldwide, and Fasciola gigantica, restricted to given regions of Africa and Asia. This disease in humans shows an increasing importance, which relies on its recent widespread emergence related to climate and global changes and also on its pathogenicity in the invasive, biliary, and advanced chronic phases in the human endemic areas, mainly of developing countries. In spite of the large neurological affection capacity of Fasciola, this important pathogenic aspect of the disease has been pronouncedly overlooked in the past decades and has not even appear within the numerous reviews on the parasitic diseases of the central nervous system. The aim of this wide retrospective review is an in-depth analysis of the characteristics of neurological and ocular fascioliasis caused by these two fasciolid species. The terms of neurofascioliasis and ophthalmofascioliasis are restricted to cases in which the direct affection of the central nervous system or the eye by a migrant ectopic fasciolid fluke is demonstrated by an aetiological diagnosis of recovered flukes after surgery or spontaneous moving-out of the fluke through the orbit. Cases in which the ectopic fluke is not recovered and the symptoms cannot be explained by an indirect affection at distance may also be included in these terms. Neurofascioliasis and ophthalmofascioliasis cases are reviewed and discussed. With regard to fascioliasis infection giving an indirect rise to neurological affection, the distribution and frequency of cases are analysed according to geography, sex, and age. Minor symptoms and major manifestations are discussed. Three main types of cases are distinguished depending on the characteristics of their manifestations: genuine neurological, meningeal, and psychiatric or neuropsychic. The impressive symptoms and signs appearing in each type of these cases are included. Brain examination

Neurology at the bedside

DEFF Research Database (Denmark)

Kondziella, Daniel; Waldemar, Gunhild

This updated and expanded new edition takes neurology trainees by the hand and guides them through the whole patient encounter - from an efficient neurological history and bedside examination through to differential diagnosis, diagnostic procedures and treatment. At each step the expert authors......, as have new chapters including neurogenetics, neurorehabilitation, neurocritical care and heuristic neurological reasoning. In addition, this second edition now includes more than 100 unique case histories. Neurology at the Bedside, Second Edition is written for neurologists in all stages of training....... Medical students, general practitioners and others with an interest in neurology will also find invaluable information here....

Online Capacity Estimation of Lithium-Ion Batteries Based on Novel Feature Extraction and Adaptive Multi-Kernel Relevance Vector Machine

Directory of Open Access Journals (Sweden)

Yang Zhang

2015-11-01

Full Text Available Prognostics is necessary to ensure the reliability and safety of lithium-ion batteries for hybrid electric vehicles or satellites. This process can be achieved by capacity estimation, which is a direct fading indicator for assessing the state of health of a battery. However, the capacity of a lithium-ion battery onboard is difficult to monitor. This paper presents a data-driven approach for online capacity estimation. First, six novel features are extracted from cyclic charge/discharge cycles and used as indirect health indicators. An adaptive multi-kernel relevance machine (MKRVM based on accelerated particle swarm optimization algorithm is used to determine the optimal parameters of MKRVM and characterize the relationship between extracted features and battery capacity. The overall estimation process comprises offline and online stages. A supervised learning step in the offline stage is established for model verification to ensure the generalizability of MKRVM for online application. Cross-validation is further conducted to validate the performance of the proposed model. Experiment and comparison results show the effectiveness, accuracy, efficiency, and robustness of the proposed approach for online capacity estimation of lithium-ion batteries.

Brief Communication: CATALYST - a multi-regional stakeholder Think Tank for fostering capacity development in disaster risk reduction and climate change adaptation

NARCIS (Netherlands)

Terwisscha van Scheltinga, C.T.H.M.; Hare, M.P.; Bers, van C.; Keur, van der P.

2014-01-01

This brief communication presents the work and objectives of the CATALYST project on "Capacity Development for Hazard Risk Reduction and Adaptation" funded by the European Commission (October 2011–September 2013). CATALYST set up a multi-regional think tank covering four regions (Central America and

Disregard of neurological impairments associated with neglected tropical diseases in Africa

Directory of Open Access Journals (Sweden)

Emmanuel Quansah

2016-06-01

Full Text Available Neglected tropical diseases (NTDs affect people in the bottom billion poorest in the world. These diseases are concentrated in rural areas, conflict zones and urban slums in Africa and other tropical areas. While the World Health Organization recognizes seventeen priority NTDs, the list of conditions present in Africa and elsewhere that are eligible to be classified as NTDs is much longer. Although NTDs are generally marginalized, their associated neurological burden has been almost completely disregarded. However, reports indicate that trichuriasis, schistosomiasis and hookworm infection, among others, cause impairments in memory and cognition, negatively affecting school attendance rates and educational performance particularly among children, as well as agricultural productivity among adults. Consequently, the neurological impairments have substantial influence on education and economic productivity, thus aggravating and perpetuating poverty in affected societies. However, inadequate research, policy and public health attention has been paid to the neurological burdens associated with NTDs. In order to appropriately address these burdens, we recommend the development of policy interventions that focus on the following areas: (i the introduction of training programs to develop the capacity of scientists and clinicians in research, diagnostic and treatment approaches (ii the establishment of competitive research grant schemes to fund cutting-edge research into these neurological impairments, and (iii the development of public health interventions to improve community awareness of the NTD-associated neurological problems, possibly enhancing disease prevention and expediting treatment.

Adapting the neurology area of the Gustavo Fricke Hospital

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Ankelen, A.; González, S.; Aguirre, L.

2007-11-01

Within the framework of the subject Clinical Engineering taught at Hospital Dr. Gustavo Fricke of Viña del Mar Chile, we were assigned to undertake a detailed study on the quality of the electrical power main supply of the Neurology Department, on account of reported malfunctioning of some equipment used in this unit. The study results indicated that the problems occurred only in a device for auditory evoked potentials device and, contrary to what was expected, the problem was unrelated to the quality of the electrical main supply. It was also found that the cause for the problem was electromagnetic interference (EMI) emitted from the system's very own components. To solve the problem, we built a Faraday Cage for the signal-processing unit and increased the separating distance among the various system components. This approach enhanced system performance and significantly improved the recorded signals of patients. The solution adopted from this experience was suggested to others health care centers of our country that had been experiencing similar difficulties with the same type of medical equipment.

The relationship between social determinants of health, and rehabilitation of neurological conditions: a systematic literature review.

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Frier, Amanda; Barnett, Fiona; Devine, Sue

2017-05-01

This systematic literature review aims to explore the relationship between social determinants of health (SDH), and the rehabilitation of neurological conditions. In particular, the review will consider relationships between social determinants and peoples' attendance and sustained adherence to rehabilitation programs, and motivation regarding neurological rehabilitation. A systematic search of peer-reviewed literature from electronic databases; MEDLINE, Scopus, CINAHL and Informit health, was conducted. Papers published between 2004 and 2014 were considered. Eleven quantitative studies met the inclusion criteria. There was a lack of research addressing SDH and neurological rehabilitation simultaneously. Cardiac and cancer rehabilitation studies reported employment and income, social support, transport, housing and food security as the most frequent SDH factors influencing attendance, sustained adherence and motivation. Given this association, a similar relationship between neurological rehabilitation and SDH is plausible. Rehabilitation of neurological conditions can be a long and difficult process. To pursue optimal outcomes, an individual's social circumstances should be considered. Understanding how SDH interact with neurological rehabilitation may enhance service delivery, thus maximizing the possible rehabilitation outcomes for individuals. Future research that considers SDH and rehabilitation of neurological conditions jointly may benefit service providers and those requiring neurological rehabilitation. Implications for Rehabilitation Social determinants of health are important to consider in the rehabilitation of neurological conditions. Understanding the interplay between the social determinants of health and neurological rehabilitation may enhance the possible outcomes for those requiring rehabilitation. Increased awareness and capacity of health care professionals involved in neurological rehabilitation may hasten momentum towards decreased health

Education Research: Neurology resident education

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Mayans, David; Schneider, Logan; Adams, Nellie; Khawaja, Ayaz M.; Engstrom, John

2016-01-01

Objective: To survey US-trained graduating neurology residents who are American Academy of Neurology members, in an effort to trend perceived quality and completeness of graduate neurology education. Methods: An electronic survey was sent to all American Academy of Neurology members graduating from US neurology residency programs in the Spring of 2014. Results: Of 805 eligible respondents, 24% completed the survey. Ninety-three percent of adult neurology residents and 56% of child neurology residents reported plans to pursue fellowship training after residency. Respondents reported a desire for additional training in neurocritical care, neuro-oncology, neuromuscular diseases, botulinum toxin injection, and nerve blocks. There remains a clear deficit in business training of neurology residents, although there was notable improvement in knowledge of coding and office management compared to previous surveys. Discussion: Although there are still areas of perceived weakness in neurology training, graduating neurology residents feel generally well prepared for their chosen careers. However, most still pursue fellowship training for reasons that are little understood. In addition to certain subspecialties and procedures, practice management remains deficient in neurology training and is a point of future insecurity for most residents. Future curriculum changes should consider resident-reported gaps in knowledge, with careful consideration of improving business training. PMID:26976522

Land-based approach to evaluate sustainable land management and adaptive capacity of ecosystems/lands

Science.gov (United States)

Kust, German; Andreeva, Olga

2015-04-01

A number of new concepts and paradigms appeared during last decades, such as sustainable land management (SLM), climate change (CC) adaptation, environmental services, ecosystem health, and others. All of these initiatives still not having the common scientific platform although some agreements in terminology were reached, schemes of links and feedback loops created, and some models developed. Nevertheless, in spite of all these scientific achievements, the land related issues are still not in the focus of CC adaptation and mitigation. The last did not grow much beyond the "greenhouse gases" (GHG) concept, which makes land degradation as the "forgotten side of climate change" The possible decision to integrate concepts of climate and desertification/land degradation could be consideration of the "GHG" approach providing global solution, and "land" approach providing local solution covering other "locally manifesting" issues of global importance (biodiversity conservation, food security, disasters and risks, etc.) to serve as a central concept among those. SLM concept is a land-based approach, which includes the concepts of both ecosystem-based approach (EbA) and community-based approach (CbA). SLM can serve as in integral CC adaptation strategy, being based on the statement "the more healthy and resilient the system is, the less vulnerable and more adaptive it will be to any external changes and forces, including climate" The biggest scientific issue is the methods to evaluate the SLM and results of the SLM investments. We suggest using the approach based on the understanding of the balance or equilibrium of the land and nature components as the major sign of the sustainable system. Prom this point of view it is easier to understand the state of the ecosystem stress, size of the "health", range of adaptive capacity, drivers of degradation and SLM nature, as well as the extended land use, and the concept of environmental land management as the improved SLM approach

History of Neurology in China

Institute of Scientific and Technical Information of China (English)

Wang Xinde

2000-01-01

@@In 1921, the first independent department of neurology was established in Beijing. Before 1949, all over China only 12 professional doctors lectured neurology in medical colleges. Only 30 medically trained personnel were engaged in the neurological departments. The neurological departments contained roughly 200 beds. The thesis on stroke was written by Zhang Shanlei and published in 1922. Author discussed the cerebral stroke on basis of Chinese traditional medicine and European medicine. The first Textbook of Neurology in China was written by Professor Cheng Yu-lin and was published in 1939. In 1952, the Chinese Society of Neurology and Psychiatry of Chinese Medical Association was established. In 1955, the first issue of the Chinese Journal of Neurology and Psychiatry was published.

Getting to value in neurological care: a roadmap for academic neurology.

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Holloway, Robert G; Ringel, Steven P

2011-06-01

Academic neurology is undergoing transformational changes. The public investment in biomedical research and clinical care is enormous and there is a growing perception that the return on this huge investment is insufficient. Hospitals, departments, and individual neurologists should expect more scrutiny as information about their quality of care and financial relationships with industry are increasingly reported to the public. There are unprecedented changes occurring in the financing and delivery of health care and research that will have profound impact on the mission and operation of academic departments of neurology. With the passage of the Patient Protection and Affordable Care Act (PPACA) there will be increasing emphasis on research that demonstrates value and includes the patient's perspective. Here we review neurological investigations of our clinical and research enterprises that focus on quality of care and comparative effectiveness, including cost-effectiveness. By highlighting progress made and the challenges that lie ahead, we hope to create a clinical, educational, and research roadmap for academic departments of neurology to thrive in today's increasingly regulated environment. Copyright © 2011 American Neurological Association.

Neurologic complications of vaccinations.

Science.gov (United States)

Miravalle, Augusto A; Schreiner, Teri

2014-01-01

This chapter reviews the most common neurologic disorders associated with common vaccines, evaluates the data linking the disorder with the vaccine, and discusses the potential mechanism of disease. A literature search was conducted in PubMed using a combination of the following terms: vaccines, vaccination, immunization, and neurologic complications. Data were also gathered from publications of the American Academy of Pediatrics Committee on Infectious Diseases, the World Health Organization, the US Centers for Disease Control and Prevention, and the Vaccine Adverse Event Reporting System. Neurologic complications of vaccination are rare. Many associations have been asserted without objective data to support a causal relationship. Rarely, patients with a neurologic complication will have a poor outcome. However, most patients recover fully from the neurologic complication. Vaccinations have altered the landscape of infectious disease. However, perception of risk associated with vaccinations has limited the success of disease eradication measures. Neurologic complications can be severe, and can provoke fear in potential vaccines. Evaluating whether there is causal link between neurologic disorders and vaccinations, not just temporal association, is critical to addressing public misperception of risk of vaccination. Among the vaccines available today, the cost-benefit analysis of vaccinations and complications strongly argues in favor of vaccination. © 2014 Elsevier B.V. All rights reserved.

New hospital structure in the twenty-first century: the position of level III (tertiary) neurological and stroke care in a changing healthcare system.

Science.gov (United States)

Szentes, Tamás; Kovács, László; Óváry, Csaba

2016-01-01

The determination of the necessary capacity and number of neurology wards of level III progressivity that can be defined in the system of criteria detailed in this article and which possess optimal operating conditions in Hungarian terms. We used the National Health Insurance Company's database to calculate case numbers and capacity for different levels of neurological and stroke care. We also revised the allocation of advanced diagnostic and therapeutic technologies, and proposed changes, based on health insurance data. We also discussed these propositions with clinical experts to test their viability. We determined the adequate number of organisational units capable of providing special neurological healthcare services on the basis of the basic data of the Hungarian healthcare system, specifying this number as 6 instead of the current 11. In our study, we have identified significant bias in the nationwide level of neurological and stroke care organisation, which needs revised allocation of healthcare resources. Naturally, this can only be carried out through the restructuring of the emergency care system and the expansion of pre-hospital care.

The menagerie of neurology

Science.gov (United States)

Beh, Shin C.; Frohman, Teresa; Frohman, Elliot M.

2014-01-01

Summary Neurology is a field known for “eponymophilia.” While eponym use has been a controversial issue in medicine, animal-related metaphoric descriptions continue to flourish in neurologic practice, particularly with the advent of neuroimaging. To provide practicing and trainee neurologists with a useful reference for all these colorful eponyms, we performed a literature review and summarized the various animal eponyms in the practice of neurology (and their etiologic implications) to date. We believe that the ability to recognize animal-like attributes in clinical neurology and neuroradiology may be attributed to a visual phenomenon known as pareidolia. We propose that animal eponyms are a useful method of recognizing clinical and radiologic patterns that aid in the diagnostic process and therefore are effective aidesmémoire and communicative tools that enliven and improve the practice of neurology. PMID:29473555

A hyperacute neurology team - transforming emergency neurological care.

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Nitkunan, Arani; MacDonald, Bridget K; Boodhoo, Ajay; Tomkins, Andrew; Smyth, Caitlin; Southam, Medina; Schon, Fred

2017-07-01

We present the results of an 18-month study of a new model of how to care for emergency neurological admissions. We have established a hyperacute neurology team at a single district general hospital. Key features are a senior acute neurology nurse coordinator, an exclusively consultant-delivered service, acute epilepsy nurses, an acute neurophysiology service supported by neuroradiology and acute physicians and based within the acute medical admissions unit. Key improvements are a major increase in the number of patients seen, the speed with which they are seen and the percentage seen on acute medical unit before going to the general wards. We have shown a reduced length of stay and readmission rates for patients with epilepsy. Epilepsy accounted for 30% of all referrals. The cost implications of running this service are modest. We feel that this model is worthy of widespread consideration. © Royal College of Physicians 2017. All rights reserved.

Residency Training: The need for an integrated diversity curriculum for neurology residency.

Science.gov (United States)

Rosendale, Nicole; Josephson, S Andrew

2017-12-12

Providing culturally responsive care to an increasingly multicultural population is essential and requires formal cultural humility training for residents. We sought to understand the current prevalence and need for this type of training within neurology programs and to pilot an integrated curriculum locally. We surveyed via email all program directors of academic neurology programs nationally regarding the prevalence of and need for formal cultural responsiveness training. Forty-seven program directors (36%) responded to the survey. The majority of respondents did not have a formalized diversity curriculum in their program (65%), but most (85%) believed that training in cultural responsiveness was important. We developed locally an integrated diversity curriculum as a proof of concept. The curriculum covered topics of diversity in language, religion, sexual orientation, gender identity/expression, and socioeconomic status designed to focus on the needs of the local community. Program evaluation included a pre and post survey of the learner attitudes toward cultural diversity. There is an unmet need for cultural responsiveness training within neurology residencies, and integrating this curriculum is both feasible and efficacious. When adapted to address cultural issues of the local community, this curriculum can be generalizable to both academic and community organizations. © 2017 American Academy of Neurology.

The life cycles of six multi-center adaptive clinical trials focused on neurological emergencies developed for the Advancing Regulatory Science initiative of the National Institutes of Health and US Food and Drug Administration: Case studies from the Adaptive Designs Accelerating Promising Treatments Into Trials Project.

Science.gov (United States)

Guetterman, Timothy C; Fetters, Michael D; Mawocha, Samkeliso; Legocki, Laurie J; Barsan, William G; Lewis, Roger J; Berry, Donald A; Meurer, William J

2017-01-01

Clinical trials are complicated, expensive, time-consuming, and frequently do not lead to discoveries that improve the health of patients with disease. Adaptive clinical trials have emerged as a methodology to provide more flexibility in design elements to better answer scientific questions regarding whether new treatments are efficacious. Limited observational data exist that describe the complex process of designing adaptive clinical trials. To address these issues, the Adaptive Designs Accelerating Promising Treatments Into Trials project developed six, tailored, flexible, adaptive, phase-III clinical trials for neurological emergencies, and investigators prospectively monitored and observed the processes. The objective of this work is to describe the adaptive design development process, the final design, and the current status of the adaptive trial designs that were developed. To observe and reflect upon the trial development process, we employed a rich, mixed methods evaluation that combined quantitative data from visual analog scale to assess attitudes about adaptive trials, along with in-depth qualitative data about the development process gathered from observations. The Adaptive Designs Accelerating Promising Treatments Into Trials team developed six adaptive clinical trial designs. Across the six designs, 53 attitude surveys were completed at baseline and after the trial planning process completed. Compared to baseline, the participants believed significantly more strongly that the adaptive designs would be accepted by National Institutes of Health review panels and non-researcher clinicians. In addition, after the trial planning process, the participants more strongly believed that the adaptive design would meet the scientific and medical goals of the studies. Introducing the adaptive design at early conceptualization proved critical to successful adoption and implementation of that trial. Involving key stakeholders from several scientific domains early

William Shakespeare's neurology.

Science.gov (United States)

Paciaroni, Maurizio; Bogousslavsky, Julien

2013-01-01

Many of Shakespeare's plays contain characters who appear to be afflicted by neurological or psychiatric disorders. Shakespeare, in his descriptive analysis of his protagonists, was contributing to the understanding of these disorders. In fact, Charcot frequently used Shakespearean references in his neurological teaching sessions, stressing how acute objective insight is essential to achieving expert clinical diagnosis. Charcot found in Shakespeare the same rigorous observational techniques for which he himself became famous. This chapter describes many of Shakespearean characters suffering from varied neurological disorders, including Parkinsonism, epilepsy, sleeping disturbances, dementia, headache, prion disease, and paralyses. © 2013 Elsevier B.V. All rights reserved.

Grey matter abnormalities in children and adolescents with functional neurological symptom disorder.

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Kozlowska, Kasia; Griffiths, Kristi R; Foster, Sheryl L; Linton, James; Williams, Leanne M; Korgaonkar, Mayuresh S

2017-01-01

Functional neurological symptom disorder refers to the presence of neurological symptoms not explained by neurological disease. Although this disorder is presumed to reflect abnormal function of the brain, recent studies in adults show neuroanatomical abnormalities in brain structure . These structural brain abnormalities have been presumed to reflect long-term adaptations to the disorder, and it is unknown whether child and adolescent patients, with illness that is typically of shorter duration, show similar deficits or have normal brain structure. High-resolution, three-dimensional T1-weighted magnetic resonance images (MRIs) were acquired in 25 patients (aged 10-18 years) and 24 healthy controls. Structure was quantified in terms of grey matter volume using voxel-based morphometry. Post hoc, we examined whether regions of structural difference related to a measure of motor readiness to emotional signals and to clinical measures of illness duration, illness severity, and anxiety/depression. Patients showed greater volumes in the left supplementary motor area (SMA) and right superior temporal gyrus (STG) and dorsomedial prefrontal cortex (DMPFC) (corrected p disorder.

Cardiomyopathy in neurological disorders.

Science.gov (United States)

Finsterer, Josef; Stöllberger, Claudia; Wahbi, Karim

2013-01-01

According to the American Heart Association, cardiomyopathies are classified as primary (solely or predominantly confined to heart muscle), secondary (those showing pathological myocardial involvement as part of a neuromuscular disorder) and those in which cardiomyopathy is the first/predominant manifestation of a neuromuscular disorder. Cardiomyopathies may be further classified as hypertrophic cardiomyopathy, dilated cardiomyopathy, restrictive cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, or unclassified cardiomyopathy (noncompaction, Takotsubo-cardiomyopathy). This review focuses on secondary cardiomyopathies and those in which cardiomyopathy is the predominant manifestation of a myopathy. Any of them may cause neurological disease, and any of them may be a manifestation of a neurological disorder. Neurological disease most frequently caused by cardiomyopathies is ischemic stroke, followed by transitory ischemic attack, syncope, or vertigo. Neurological disease, which most frequently manifests with cardiomyopathies are the neuromuscular disorders. Most commonly associated with cardiomyopathies are muscular dystrophies, myofibrillar myopathies, congenital myopathies and metabolic myopathies. Management of neurological disease caused by cardiomyopathies is not at variance from the same neurological disorders due to other causes. Management of secondary cardiomyopathies is not different from that of cardiomyopathies due to other causes either. Patients with neuromuscular disorders require early cardiologic investigations and close follow-ups, patients with cardiomyopathies require neurological investigation and avoidance of muscle toxic medication if a neuromuscular disorder is diagnosed. Which patients with cardiomyopathy profit most from primary stroke prevention is unsolved and requires further investigations. Copyright © 2013 Elsevier Inc. All rights reserved.

Trends in American Board of Psychiatry and Neurology specialties and neurologic subspecialties

Science.gov (United States)

Faulkner, L.R.; Juul, D.; Pascuzzi, R.M.; Aminoff, M.J.; Crumrine, P.K.; DeKosky, S.T.; Jozefowicz, R.F.; Massey, J.M.; Pirzada, N.; Tilton, A.

2010-01-01

Objective: To review the current status and recent trends in the American Board of Psychiatry and Neurology (ABPN) specialties and neurologic subspecialties and discuss the implications of those trends for subspecialty viability. Methods: Data on numbers of residency and fellowship programs and graduates and ABPN certification candidates and diplomates were drawn from several sources, including ABPN records, Web sites of the Accreditation Council for Graduate Medical Education and the American Medical Association, and the annual medical education issues of the Journal of the American Medical Association. Results: About four-fifths of neurology graduates pursue fellowship training. While most recent neurology and child neurology graduates attempt to become certified by the ABPN, many clinical neurophysiologists elect not to do so. There appears to have been little interest in establishing fellowships in neurodevelopmental disabilities. The pass rate for fellowship graduates is equivalent to that for the “grandfathers” in clinical neurophysiology. Lower percentages of clinical neurophysiologists than specialists participate in maintenance of certification, and maintenance of certification pass rates are high. Conclusion: The initial enthusiastic interest in training and certification in some of the ABPN neurologic subspecialties appears to have slowed, and the long-term viability of those subspecialties will depend upon the answers to a number of complicated social, economic, and political questions in the new health care era. PMID:20855855

Neurological sequelae of bacterial meningitis

NARCIS (Netherlands)

Lucas, Marjolein J.; Brouwer, Matthijs C.; van de Beek, Diederik

2016-01-01

We reported on occurrence and impact of neurological sequelae after bacterial meningitis. We reviewed occurrence of neurological sequelae in children and adults after pneumococcal and meningococcal meningitis. Most frequently reported sequelae are focal neurological deficits, hearing loss, cognitive

[Neurological complications of infective endocarditis in Burkina Faso. Clinical features, management and evolutionary profile].

Science.gov (United States)

Yaméogo, N V; Seghda, A; Kagambèga, L J; Diallo, O; Millogo, G R C; Toguyéni, B J Y; Samadoulougou, A K; Niakara, A; Simporé, J; Zabsonré, P

2015-04-01

Neurological complications are the most frequent extracardiac complications of infective endocarditis (IE). This study aimed to describe the epidemiological, clinical and paraclinical aspects, and outcome of neurological complications of infective endocarditis in three hospitals in the city of Ouagadougou in Burkina Faso. From 1 January 2009 to 31 December 2012, we included all patients suffering from IE and selected those in whom a neurological complication was objectified. Neurological involvement was sought on clinical examination but especially CT brain (ischemic infarcts, hemorrhages, aneurysms and abscesses). Blood cultures were systematic. Echocardiography was done for vegetations and characteristics. Among 63 cases of IE, neurological complications were found in 14 patients (22.2%). The average age of patients with neurological complications was 37.4 ± 5.8 years. The sex ratio was 1.3 for women. Neurological damage consisted of nine cases of stroke (64.3%), three cases of hemorrhagic stroke (21.4%) and two cases of brain abscess (14.3%). Neurological complications had already occurred before hospitalization in 4 cases. Blood cultures were positive in 8 cases. Germs found were predominantly Staphylococcus aureus (5 cases) and Streptococcus a- viridans (2 cases). All cases of S. aureus were complicated by stroke. At echocardiography, vegetation was found in all cases. It was found on the mitral in 7 cases, the aorta in 3 cases, the mitral and aortic in 2 cases and the mitral and tricuspid in 2 cases also. The EI had occurred on a native valve in 11 cases, prosthesis in 4 cases (2 mitral and 2 aortic). The vegetations average diameter was 11.2 ± 2.1 mm (6.4 and 1 7.7 mm). Vegetations were mobile in 12 cases. The treatment consisted of antibiotics adapted to the antibiogram, neurological and cardiovascular monitoring. The evolution was marked by seven deaths (50%), including 5 deaths related to cerebral complication (71.4% of deaths). This study shows that

Labor analgesia with ropivacaine added to clonidine: a randomized clinical trial

Directory of Open Access Journals (Sweden)

Giane Nakamura

Full Text Available CONTEXT AND OBJECTIVE: Previous studies have led to speculation that the association between ropivacaine and clonidine might be more effective than ropivacaine alone. We examined the maternal-fetal effects of two pharmacological approaches: a low dose of ropivacaine or a lower dose of ropivacaine plus clonidine for epidural analgesia during labor. DESIGN AND SETTING: Prospective study at Department of Anesthesiology, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista. METHODS: Thirty-two pregnant women in American Society of Anesthesiologists physical status I and II randomly underwent epidural analgesia using 15 ml of ropivacaine 0.125% (R group or 15 ml of ropivacaine 0.0625% plus 75 µg clonidine (RC group. Pain intensity, sensory block level, latency time, motor block intensity, duration of labor analgesia and duration of epidural analgesia were evaluated. The newborns were evaluated using Apgar scores and the Amiel-Tison method (neurological and adaptive capacity score. RESULTS: There were no statistically significant differences between the groups regarding pain score, sensory block level, duration of epidural analgesia or Apgar score. The latency time, duration of labor analgesia and motor block were R group < RC group. The half-hour and two-hour neurological and adaptive capacity scores were higher in the R group. All of the R group newborns and 75% of the RC group newborns were found to be neurologically healthy at the 24-hour examination. RESULTS: There were no statistically significant differences between the groups regarding pain score, sensory block level, duration of epidural analgesia or Apgar score. The latency time, duration of labor analgesia and motor block were R group < RC group. The half-hour and two-hour neurological and adaptive capacity scores were higher in the R group. All of the R group newborns and 75% of the RC group newborns were found to be neurologically healthy at the 24-hour examination

[Neurology and literature].

Science.gov (United States)

Iniesta, I

2010-10-01

Literature complements medical literature in the academic and clinical development of neurologists. The present article explores the contributions of writers of fiction on neurology. Literary works of fiction with particular reference to neurology. A symbiosis between writers of fiction and doctors has been well recognised. From Shakespeare to Cervantes by way of Dickens and Cela to writer - physicians such as Anton Chekhov or António Lobo Antunes have contributed through their medically informed literature to the better understanding of neurology. Some writers like Dostoevsky, Machado de Assis and Margiad Evans have written about their own experiences with disease thus bringing new insights to medicine. Furthermore, some neurological disorders have been largely based on literary descriptions. For instance, Dostoevsky's epilepsy has been retrospectively analysed by famous neurologists including Freud, Alajouanine or Gastaut, whilst his writings and biography have prompted others like Waxman and Geschwind to describe typical behavioural changes in temporal lobe epilepsy, finding their source of inspiration in Dostoevsky. Likewise, Cirignotta et al have named an unusual type of seizure after the Russian novelist. Inspired by Lewis Carroll, Todd introduced the term Alice in Wonderland Syndrome to refer to visual distortions generally associated with migraine. Writers of fiction offer a humanised perception of disease by contributing new insights into the clinical history, informing about the subjective experience of the illness and helping to eradicate the stigma associated to neurological disorders.

A century of Dutch neurology.

Science.gov (United States)

Koehler, P J; Bruyn, G W; Moffie, D

1998-12-01

The Netherlands Society of Neurology evolved from the Society of Psychiatry founded in 1871. The name was changed into Netherlands Society of Psychiatry and Neurology (NSPN) in 1897. In the same year, the word neurology was also added to the name of the journal. The Society steadily blossomed, but in 1909 the first signs of dissatisfaction occurred: the Amsterdam Neurologists Society was founded. A few split-offs would follow. The number of members of the NSPN increased from 205 in 1920 to 585 in 1960. In the early 1960s, the Society was reorganised and would consist of two sections, one for psychiatry and one for neurology. However, this would not last, as a full separation was established in 1974. For several reasons, the name of the journal was changed four times until it assumed its present name in 1974. The 100th volume of CNN was not published, as expected. in 1996, but in 1998, because of two skipped publication years, one during WWII and another in the 1970s. During the last decades of the nineteenth century, teaching of neurology was mostly given within the frame of psychiatry, following the German tradition of 'brainpsychiatry' (organic or biologic psychiatry). The first official chair of psychiatry was founded at Utrecht, 1893 (Winkler). In Amsterdam, private teachers such as Delprat taught 'electro-therapy and nervous diseases' since the 1880s. The first extraordinary chair of neurology and electrotherapy was founded for his successor, Wertheim Salomonson in 1899. The first university clinic for psychiatry and neurology started at the Amsterdam Municipal University, when Winkler became professor of psychiatry and neurology in Amsterdam in 1896. Around the turn of the century, chairs of psychiatry and neurology were also founded in Groningen and Leiden. Separate chairs for neurology and psychiatry appeared in Amsterdam in 1923 and in Utrecht in 1936. Following an initiative of Brouwer, the first neurological university clinic opened its doors in

Working the way up in neurological rehabilitation: the holistic approach of nursing care.

Science.gov (United States)

Portillo, Mari Carmen; Cowley, Sarah

2011-06-01

To provide understanding of the nurses' role in neurological holistic rehabilitation and identify strategies for the enhancement of rehabilitation services. Although acute and chronic neurological patients and relatives experience emotional and social changes, most rehabilitation programmes do not deal with non-physical needs or involve nurses, leading to a poor definition and specialisation of the nursing role. Action research. The project took place in two neurological wards of a highly specialised hospital in Spain and lasted 30 months. An individualised nurse-led social rehabilitation programme was planned, implemented and evaluated. The nursing role and care in rehabilitation were explored with 37 nurses and 40 neurological patients and 40 relatives (convenience sampling). Semi-structured interviews and participant observations were developed. Content (QSR NUDIST Vivo v.2.0) and statistical (SPSS v. 13.0) analyses were run. The lack of time, knowledge and experience, the poor definition of the nursing role and ineffective communication with users limited holistic care in the wards. Some enhancing nursing strategies were proposed and explored: promotion of acceptance/adaptation of the disease through education, reinforcement of the discharge planning and planning of emotional and social choices based on the assessment of individual needs and resources at home. Nursing professionals are in a privileged position to deal with neurological patients' and carers' holistic needs. Several attributes of the advanced nursing role in rehabilitation teams have been proposed to deal with non-physical aspects of care. • Rehabilitation needs of neurological patients and carers at hospital have been described. • Nurses' perceptions of their work and role in rehabilitation have been presented. • Clinical strategies to develop the advanced nursing role in holistic neurological rehabilitation have been highlighted. © 2010 Blackwell Publishing Ltd.

Trends in neurology fellowship training

Institute of Scientific and Technical Information of China (English)

Jordan S.A. Williams; Trent S. Hodgson; Fernando D. Goldenberg; Rimas V. Lukas

2017-01-01

Aim:Aneed for Neurologists exists in the USA.The majority of Neurology residency graduates go on to additional subspecialty training. Methods: Data from the Accreditation Council for Graduate Medical Education from 2001-2014 and the United Council for Neurologic Subspecialties from was analyzed for trends in the number of Neurology subspecialty training programs and their composition. Results: There has been an overall trend of growth in the number of accredited Neurology subspecialty training programs and fellows. These trends vary between specific subspecialties. Conclusion: The authors provide an overview of the contemporary state of Neurology subspecialty training in the USA. A clearer understanding of subspecialty training allows for anticipation of workforce surpluses and deficits.

[The adaptation and validation to Spanish of the questionnaire Aid to Capacity Evaluation (ACE), for the assessment of the ability of patients in medical decision-making].

Science.gov (United States)

Moraleda Barba, Sandra; Ballesta Rodríguez, M Isabel; Delgado Quero, Antonio Luis; Lietor Villajos, Norberto; Moreno Corredor, Andrés; Delgado Rodríguez, Miguel

2015-03-01

To adapt and validate the Spanish version of the Aid to Capacity Evaluation scale, designed to assess the capacity of the adult in medical decision-making, both in diagnosis and treatment processes. Observational study of prospective validation. Primary and hospital care of the basic health area of Jaen. One hundred twenty-nine patients. Questionnaire which included sociodemographic variables, concerning the decision (scope, type of decision, the need for written informed consent), assessment of the capacity to the Aid to Capacity Evaluation scale and other related comorbidity (hearing loss, alcoholism, cognitive level variables with the Mini-Mental State Examination and depression by Goldberg or Yesavage test). The tool is considered viable. The conclusions of the expert panel were favorable. The result of the criteria' validity, comparing the results with the assessment of the experts (forensic and psychiatrist) was very satisfying (P<.001). The intra-observer reliability was low (kappa=0,135). Interobserver reliability remained high (kappa=0.74). The internal consistency was awarded an alpha of Cronbach's 0,645 for the reduced model of 6 items. The Aid to Capacity Evaluation scale was adapted to Spanish, demonstrating adequate internal consistency and construct validity. Its use in clinical practice could contribute to the identification of patients unable to make a particular medical decision and/or to give an informed consent. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Adaptive capacity of the Adjusted Clinical Groups Case-Mix System to the cost of primary healthcare in Catalonia (Spain): a observational study.

Science.gov (United States)

Sicras-Mainar, Antoni; Velasco-Velasco, Soledad; Navarro-Artieda, Ruth; Prados-Torres, Alexandra; Bolibar-Ribas, Buenaventura; Violan-Fors, Concepción

2012-01-01

To describe the adaptive capacity of the Adjusted Clinical Groups (ACG) system to the cost of care in primary healthcare centres in Catalonia (Spain). Retrospective study (multicentres) conducted using computerised medical records. 13 primary care teams in 2008 were included. All patients registered in the study centres who required care between 1 January and 31 December 2008 were finally studied. Patients not registered in the study centres during the study period were excluded. Demographic (age and sex), dependent (cost of care) and case-mix variables were studied. The cost model for each patient was established by differentiating the fixed and variable costs. To evaluate the adaptive capacity of the ACG system, Pearson's coefficient of variation and the percentage of outliers were calculated. To evaluate the explanatory power of the ACG system, the authors used the coefficient of determination (R(2)). The number of patients studied was 227 235 (frequency: 5.9 visits per person per year), with a mean of 4.5 (3.2) episodes and 8.1 (8.2) visits per patient per year. The mean total cost was €654.2. The explanatory power of the ACG system was 36.9% for costs (56.5% without outliers). 10 ACG categories accounted for 60.1% of all cases and 19 for 80.9%. 5 categories represented 71% of poor performance (N=78 887, 34.7%), particularly category 0300-Acute Minor, Age 6+ (N=26 909, 11.8%), which had a coefficient of variation =139% and 6.6% of outliers. The ACG system is an appropriate manner of classifying patients in routine clinical practice in primary healthcare centres in Catalonia, although improvements to the adaptive capacity through disaggregation of some categories according to age groups and, especially, the number of acute episodes in paediatric patients would be necessary to reduce intra-group variation.

History of pediatric neurology in Poland.

Science.gov (United States)

Steinborn, Barbara; Józwiak, Sergiusz

2010-02-01

This review presents the past and the present of pediatric neurology in Poland. Pediatric neurology has its roots in Polish general neurology represented by many outstanding scientists. The founder of Polish school of neurology at the end of 19th century was Edward Flatau, known as the author of Flatau's law. The most famous Polish neurologist was Joseph Babiński, recognized for the first description of pathological plantar reflex. First Polish publication related to child neurology was Brudziński's report on a new meningeal symptom (the flexion of lower limbs during passive neck flexion with pain in neck). Contemporary child neurology in Poland was created by Professor Zofia Majewska after the Second World War. Now 10 academic centers of child neurology exist in Poland fulfilling educational, scientific, and therapeutic roles. Polish Society of Child Neurology was established in 1991 and now there are about 580 members, including 300 child neurologists.

Assessment of policy makers' individual and organizational capacity to acquire, assess, adapt and apply research evidence for maternal and child health policy making in Nigeria: a cross-sectional quantitative survey.

Science.gov (United States)

Uneke, Chigozie Jesse; Sombie, Issiaka; Keita, Namoudou; Lokossou, Virgil; Johnson, Ermel; Ongolo-Zogo, Pierre; Uro-Chukwu, Henry Chukwuemeka

2017-09-01

Throughout the world, there is increasing awareness and acknowledgement of the value of research evidence in the development of effective health policy and in quality health care practice and administration. Among the major challenges associated with the lack of uptake of research evidence into policy and practice in Nigeria is the capacity constraints of policymakers to use research evidence in policy making. To assess the capacity of maternal and child health policy makers to acquire, access, adapt and apply available research evidence. This cross-sectional quantitative survey was conducted at a national maternal, newborn and child health (MNCH) stakeholders' engagement event. An evidence to policy self-assessment questionnaire was used to assess the capacity of forty MNCH policy makers to acquire, assess, adapt and apply research evidence for policy making. Low mean ratings were observed ranging from 2.68-3.53 on a scale of 5 for knowledge about initiating/conducting research and capacity to assess authenticity, validity, reliability, relevance and applicability of research evidence and for organizational capacity for promoting and using of research for policy making. There is need to institute policy makers' capacity development programmes to improve evidence-informed policymaking.

African Journal of Neurological Sciences

African Journals Online (AJOL)

African Journal of Neurological Sciences (AJNS) is owned and controlled by the Pan African Association of Neurological Sciences (PAANS). The AJNS's aim is to publish scientific papers of any aspects of Neurological Sciences. AJNS is published quarterly. Articles submitted exclusively to the AJNS are accepted if neither ...

Neurology and international organizations.

Science.gov (United States)

Mateen, Farrah J

2013-07-23

A growing number of international stakeholders are engaged with neurologic diseases. This article provides a brief overview of important international stakeholders in the practice of neurology, including global disease-specific programs, United Nations agencies, governmental agencies with international influence, nongovernmental organizations, international professional organizations, large private donors, private-public partnerships, commercial interests, armed forces, and universities and colleges. The continued engagement of neurologists is essential for the growing number of international organizations that can and should incorporate neurologic disease into their global agendas.

Neurological abnormalities predict disability

DEFF Research Database (Denmark)

Poggesi, Anna; Gouw, Alida; van der Flier, Wiesje

2014-01-01

To investigate the role of neurological abnormalities and magnetic resonance imaging (MRI) lesions in predicting global functional decline in a cohort of initially independent-living elderly subjects. The Leukoaraiosis And DISability (LADIS) Study, involving 11 European centres, was primarily aimed...... at evaluating age-related white matter changes (ARWMC) as an independent predictor of the transition to disability (according to Instrumental Activities of Daily Living scale) or death in independent elderly subjects that were followed up for 3 years. At baseline, a standardized neurological examination.......0 years, 45 % males), 327 (51.7 %) presented at the initial visit with ≥1 neurological abnormality and 242 (38 %) reached the main study outcome. Cox regression analyses, adjusting for MRI features and other determinants of functional decline, showed that the baseline presence of any neurological...

Bridging neuroanatomy, neuroradiology and neurology: three-dimensional interactive atlas of neurological disorders.

Science.gov (United States)

Nowinski, W L; Chua, B C

2013-06-01

Understanding brain pathology along with the underlying neuroanatomy and the resulting neurological deficits is of vital importance in medical education and clinical practice. To facilitate and expedite this understanding, we created a three-dimensional (3D) interactive atlas of neurological disorders providing the correspondence between a brain lesion and the resulting disorder(s). The atlas contains a 3D highly parcellated atlas of normal neuroanatomy along with a brain pathology database. Normal neuroanatomy is divided into about 2,300 components, including the cerebrum, cerebellum, brainstem, spinal cord, arteries, veins, dural sinuses, tracts, cranial nerves (CN), white matter, deep gray nuclei, ventricles, visual system, muscles, glands and cervical vertebrae (C1-C5). The brain pathology database contains 144 focal and distributed synthesized lesions (70 vascular, 36 CN-related, and 38 regional anatomy-related), each lesion labeled with the resulting disorder and associated signs, symptoms, and/or syndromes compiled from materials reported in the literature. The initial view of each lesion was preset in terms of its location and size, surrounding surface and sectional (magnetic resonance) neuroanatomy, and labeling of lesion and neuroanatomy. In addition, a glossary of neurological disorders was compiled and for each disorder materials from textbooks were included to provide neurological description. This atlas of neurological disorders is potentially useful to a wide variety of users ranging from medical students, residents and nurses to general practitioners, neuroanatomists, neuroradiologists and neurologists, as it contains both normal (surface and sectional) brain anatomy and pathology correlated with neurological disorders presented in a visual and interactive way.

Historical perspective of Indian neurology.

Science.gov (United States)

Mishra, Shrikant; Trikamji, Bhavesh; Singh, Sandeep; Singh, Parampreet; Nair, Rajasekharan

2013-10-01

To chronicle the history of medicine and neurology in India with a focus on its establishment and evolution. THE HISTORY OF NEUROLOGY IN INDIA IS DIVIDED INTO TWO PERIODS: ancient and modern. The ancient period dates back to the mid-second millennium Before Christ (B.C.) during the creation of the Ayurvedic Indian system of Medicine, which detailed descriptions of neurological disorders called Vata Vyadhi. The early 20(th) century witnessed the birth of modern Indian medicine with the onset of formal physician training at the nation's first allopathic medical colleges located in Madras (1835), Calcutta (1835) and Mumbai (1848). Prior to India's independence from Britain in 1947, only 25 medical schools existed in the entire country. Today, there are over 355. In 1951, physicians across the field of neurology and neurosurgery united to create the Neurological Society of India (NSI). Four decades later in 1991, neurologists branched out to establish a separate organization called the Indian Academy of Neurology (IAN). Information was gathered through literature review using PubMed, MD Consult, OVID, primary texts and research at various academic institutions in India. Neurological disorders were first described in ancient India under Ayurveda. The transition to modern medicine occurred more recently through formal training at medical schools beginning in the 1930's. Early pioneers and founders of the NSI (1951) include Dr. Jacob Chandy, Dr. B Ramamurthi, Dr. S. T. Narasimhan and Dr. Baldev Singh. Later, Dr. J. S. Chopra, a prominent neurologist and visionary, recognized the need for primary centers of collaboration and subsequently established the IAN (1991). The future of Neurology in India is growing rapidly. Currently, there are 1100 practicing neurologists and more than 150 post-graduate trainees who join the ranks every year. As the number of neurologists rises across India, there is an increase in the amount of basic, clinical and epidemiological research being

Adaptation of Microplate-based Respirometry for Hippocampal Slices and Analysis of Respiratory Capacity

Science.gov (United States)

Schuh, Rosemary A.; Clerc, Pascaline; Hwang, Hyehyun; Mehrabian, Zara; Bittman, Kevin; Chen, Hegang; Polster, Brian M.

2011-01-01

Multiple neurodegenerative disorders are associated with altered mitochondrial bioenergetics. Although mitochondrial O2 consumption is frequently measured in isolated mitochondria, isolated synaptic nerve terminals (synaptosomes), or cultured cells, the absence of mature brain circuitry is a remaining limitation. Here we describe the development of a method that adapts the Seahorse Extracellular Flux Analyzer (XF24) for the microplate-based measurement of hippocampal slice O2 consumption. As a first evaluation of the technique, we compared whole slice bioenergetics to previous measurements made with synaptosomes or cultured neurons. We found that mitochondrial respiratory capacity and O2 consumption coupled to ATP synthesis could be estimated in cultured or acute hippocampal slices with preserved neural architecture. Mouse organotypic hippocampal slices oxidizing glucose displayed mitochondrial O2 consumption that was well-coupled, as determined by the sensitivity to the ATP synthase inhibitor oligomycin. However stimulation of respiration by uncoupler was modest (<120% of basal respiration) compared to previous measurements in cells or synaptosomes, although enhanced slightly (to ~150% of basal respiration) by the acute addition of the mitochondrial complex I-linked substrate pyruvate. These findings suggest a high basal utilization of respiratory capacity in slices and a limitation of glucose-derived substrate for maximal respiration. The improved throughput of microplate-based hippocampal respirometry over traditional O2 electrode-based methods is conducive to neuroprotective drug screening. When coupled with cell type-specific pharmacology or genetic manipulations, the ability to efficiently measure O2 consumption from whole slices should advance our understanding of mitochondrial roles in physiology and neuropathology. PMID:21520220

THE NEUROLOGICAL FACE OF CELIAC DISEASE.

Science.gov (United States)

Işikay, Sedat; Kocamaz, Halil

2015-01-01

Several neurological disorders have also been widely described in celiac disease patients. The aim of this study was to determine the incidence of accompanying different neurologic manifestations in children with celiac disease at the time of diagnosis and to discuss these manifestations in the light of the recent literature. This prospective cross sectional study included 297 children diagnosed with celiac disease. The medical records of all patients were reviewed. In neurological evaluation, totally 40 (13. 5%) of the 297 celiac patients had a neurological finding including headache, epilepsy, migraine, mental retardation, breath holding spells, ataxia, cerebral palsy, attention deficit hyperactivity disorder, Down syndrome and Turner syndrome in order of frequency. There was not any significant difference between the laboratory data of the patients with and without neurological manifestations. However; type 3a biopsy was statistically significantly more common among patients without neurological manifestations, while type 3b biopsy was statistically significantly more common among patients with neurological manifestations. It is important to keep in mind that in clinical course of celiac disease different neurological manifestations may be reported.

OPRA capacity bounds for selection diversity over generalized fading channels

KAUST Repository

Hanif, Muhammad Fainan

2014-05-01

Channel side information at the transmitter can increase the average capacity by enabling optimal power and rate adaptation. The resulting optimal power and rate adaptation (OPRA) capacity rarely has a closed-form analytic expression. In this paper, lower and upper bounds on OPRA capacity for selection diversity scheme are presented. These bounds hold for variety of fading channels including log-normal and generalized Gamma distributed models and have very simple analytic expressions for easy evaluation even for kth best path selection. Some selected numerical results show that the newly proposed bounds closely approximate the actual OPRA capacity. © 2014 IEEE.

Training Adaptive Decision-Making.

Energy Technology Data Exchange (ETDEWEB)

Abbott, Robert G.; Forsythe, James C.

2014-10-01

Adaptive Thinking has been defined here as the capacity to recognize when a course of action that may have previously been effective is no longer effective and there is need to adjust strategy. Research was undertaken with human test subjects to identify the factors that contribute to adaptive thinking. It was discovered that those most effective in settings that call for adaptive thinking tend to possess a superior capacity to quickly and effectively generate possible courses of action, as measured using the Category Generation test. Software developed for this research has been applied to develop capabilities enabling analysts to identify crucial factors that are predictive of outcomes in fore-on-force simulation exercises.

Adaptive Planning: Understanding Organizational Workload to Capability/ Capacity through Modeling and Simulation

Science.gov (United States)

Hase, Chris

2010-01-01

In August 2003, the Secretary of Defense (SECDEF) established the Adaptive Planning (AP) initiative [1] with an objective of reducing the time necessary to develop and revise Combatant Commander (COCOM) contingency plans and increase SECDEF plan visibility. In addition to reducing the traditional plan development timeline from twenty-four months to less than twelve months (with a goal of six months)[2], AP increased plan visibility to Department of Defense (DoD) leadership through In-Progress Reviews (IPRs). The IPR process, as well as the increased number of campaign and contingency plans COCOMs had to develop, increased the workload while the number of planners remained fixed. Several efforts from collaborative planning tools to streamlined processes were initiated to compensate for the increased workload enabling COCOMS to better meet shorter planning timelines. This paper examines the Joint Strategic Capabilities Plan (JSCP) directed contingency planning and staffing requirements assigned to a combatant commander staff through the lens of modeling and simulation. The dynamics of developing a COCOM plan are captured with an ExtendSim [3] simulation. The resulting analysis provides a quantifiable means by which to measure a combatant commander staffs workload associated with development and staffing JSCP [4] directed contingency plans with COCOM capability/capacity. Modeling and simulation bring significant opportunities in measuring the sensitivity of key variables in the assessment of workload to capability/capacity analysis. Gaining an understanding of the relationship between plan complexity, number of plans, planning processes, and number of planners with time required for plan development provides valuable information to DoD leadership. Through modeling and simulation AP leadership can gain greater insight in making key decisions on knowing where to best allocate scarce resources in an effort to meet DoD planning objectives.

Hippocrates: the forefather of neurology.

Science.gov (United States)

Breitenfeld, T; Jurasic, M J; Breitenfeld, D

2014-09-01

Hippocrates is one of the most influential medical doctors of all times. He started observing and experimenting in times of mysticism and magic. He carried a holistic and humanitarian approach to the patient with examination as the principal approach-inspection, palpation and auscultation are still the most important tools in diagnosing algorithms of today. He had immense experience with the human body most likely due to numerous wound treatments he had performed; some even believe he performed autopsies despite the negative trend at the time. Hippocrates identified the brain as the analyst of the outside world, the interpreter of consciousness and the center of intelligence and willpower. Interestingly, Hippocrates was aware of many valid concepts in neurology; his treatise On the Sacred Disease was the most important for understanding neurology and epilepsy. His other ideas pioneered modern day neurology mentioning neurological diseases like apoplexy, spondylitis, hemiplegia, and paraplegia. Today, 10 % of neurological Pubmed and 7 % of neuroscience Scopus reviews mention Corpus Hippocraticum as one of the sources. Therefore, Hippocrates may be considered as the forefather of neurology.

Wikipedia and neurological disorders.

Science.gov (United States)

Brigo, Francesco; Igwe, Stanley C; Nardone, Raffaele; Lochner, Piergiorgio; Tezzon, Frediano; Otte, Willem M

2015-07-01

Our aim was to evaluate Wikipedia page visits in relation to the most common neurological disorders by determining which factors are related to peaks in Wikipedia searches for these conditions. Millions of people worldwide use the internet daily as a source of health information. Wikipedia is a popular free online encyclopedia used by patients and physicians to search for health-related information. The following Wikipedia articles were considered: Alzheimer's disease; Amyotrophic lateral sclerosis; Dementia; Epilepsy; Epileptic seizure; Migraine; Multiple sclerosis; Parkinson's disease; Stroke; Traumatic brain injury. We analyzed information regarding the total article views for 90 days and the rank of these articles among all those available in Wikipedia. We determined the highest search volume peaks to identify possible relation with online news headlines. No relation between incidence or prevalence of neurological disorders and the search volume for the related articles was found. Seven out of 10 neurological conditions showed relations in search volume peaks and news headlines. Six out of these seven peaks were related to news about famous people suffering from neurological disorders, especially those from showbusiness. Identification of discrepancies between disease burden and health seeking behavior on Wikipedia is useful in the planning of public health campaigns. Celebrities who publicly announce their neurological diagnosis might effectively promote awareness programs, increase public knowledge and reduce stigma related to diagnoses of neurological disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.

Teaching and Learning Resilience: Building Adaptive Capacity for Rural Practice. A Report and Subsequent Analysis of a Workshop Conducted at the Rural Medical Educators Conference, Savannah, Georgia, May 18, 2010

Science.gov (United States)

Longenecker, Randall; Zink, Therese; Florence, Joseph

2012-01-01

Purpose: Resilience, the capacity to endure and overcome hardship, has been suggested as a basic competency for rural medical practice. Unfortunately for physician educators, the medical education literature offers only limited guidance for nurturing this adaptive capacity. We describe the process and subsequent analysis of a daylong curriculum…

Perioperative Management of Neurological Conditions

Directory of Open Access Journals (Sweden)

Manjeet Singh Dhallu

2017-06-01

Full Text Available Perioperative care of the patients with neurological diseases can be challenging. Most important consideration is the management and understanding of pathophysiology of these disorders and evaluation of new neurological changes that occur perioperatively. Perioperative generally refers to 3 phases of surgery: preoperative, intraoperative, and postoperative. We have tried to address few commonly encountered neurological conditions in clinical practice, such as delirium, stroke, epilepsy, myasthenia gravis, and Parkinson disease. In this article, we emphasize on early diagnosis and management strategies of neurological disorders in the perioperative period to minimize morbidity and mortality of patients.

Adaptive steganography

Science.gov (United States)

Chandramouli, Rajarathnam; Li, Grace; Memon, Nasir D.

2002-04-01

Steganalysis techniques attempt to differentiate between stego-objects and cover-objects. In recent work we developed an explicit analytic upper bound for the steganographic capacity of LSB based steganographic techniques for a given false probability of detection. In this paper we look at adaptive steganographic techniques. Adaptive steganographic techniques take explicit steps to escape detection. We explore different techniques that can be used to adapt message embedding to the image content or to a known steganalysis technique. We investigate the advantages of adaptive steganography within an analytical framework. We also give experimental results with a state-of-the-art steganalysis technique demonstrating that adaptive embedding results in a significant number of bits embedded without detection.

Neurology at the bedside

DEFF Research Database (Denmark)

Kondziella, Daniel; Waldemar, Gunhild

, as have new chapters including neurogenetics, neurorehabilitation, neurocritical care and heuristic neurological reasoning. In addition, this second edition now includes more than 100 unique case histories. Neurology at the Bedside, Second Edition is written for neurologists in all stages of training...

Neurological examination in small animals

Directory of Open Access Journals (Sweden)

Viktor Paluš

2014-03-01

Full Text Available This clinical review about the neurological examination in small animals describes the basics about the first steps of investigation when dealing with neurological patients. The knowledge of how to perform the neurological examination is important however more important is how to correctly interpret these performed tests. A step-by-step approach is mandatory and examiners should master the order and the style of performing these tests. Neurological conditions can be sometimes very distressing for owners and for pets that might not be the most cooperating. The role of a veterinary surgeon, as a professional, is therefore to collect the most relevant history, to examine a patient in a professional manner and to give to owners an educated opinion about the further treatment and prognosis. However neurological examinations might look challenging for many. But it is only the clinical application of neuroanatomy and neurophysiology to an every-day situation for practicing veterinarians and it does not require any specific in-to-depth knowledge. This clinical review is aimed not only to provide the information on how to perform the neurological examination but it is also aimed to appeal on veterinarians to challenge their daily routine and to start practicing on neurologically normal patients. This is the best and only way to differentiate between the normal and abnormal in a real situation.

THE NEUROLOGICAL FACE OF CELIAC DISEASE

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Sedat IŞIKAY

2015-09-01

Full Text Available BackgroundSeveral neurological disorders have also been widely described in celiac disease patients.ObjectiveThe aim of this study was to determine the incidence of accompanying different neurologic manifestations in children with celiac disease at the time of diagnosis and to discuss these manifestations in the light of the recent literature.MethodsThis prospective cross sectional study included 297 children diagnosed with celiac disease. The medical records of all patients were reviewed.ResultsIn neurological evaluation, totally 40 (13. 5% of the 297 celiac patients had a neurological finding including headache, epilepsy, migraine, mental retardation, breath holding spells, ataxia, cerebral palsy, attention deficit hyperactivity disorder, Down syndrome and Turner syndrome in order of frequency. There was not any significant difference between the laboratory data of the patients with and without neurological manifestations. However; type 3a biopsy was statistically significantly more common among patients without neurological manifestations, while type 3b biopsy was statistically significantly more common among patients with neurological manifestations.ConclusionIt is important to keep in mind that in clinical course of celiac disease different neurological manifestations may be reported.

Adaptive and non-adaptive data hiding methods for grayscale images based on modulus function

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Najme Maleki

2014-07-01

Full Text Available This paper presents two adaptive and non-adaptive data hiding methods for grayscale images based on modulus function. Our adaptive scheme is based on the concept of human vision sensitivity, so the pixels in edge areas than to smooth areas can tolerate much more changes without making visible distortion for human eyes. In our adaptive scheme, the average differencing value of four neighborhood pixels into a block via a threshold secret key determines whether current block is located in edge or smooth area. Pixels in the edge areas are embedded by Q-bit of secret data with a larger value of Q than that of pixels placed in smooth areas. Also in this scholar, we represent one non-adaptive data hiding algorithm. Our non-adaptive scheme, via an error reduction procedure, produces a high visual quality for stego-image. The proposed schemes present several advantages. 1-of aspects the embedding capacity and visual quality of stego-image are scalable. In other words, the embedding rate as well as the image quality can be scaled for practical applications 2-the high embedding capacity with minimal visual distortion can be achieved, 3-our methods require little memory space for secret data embedding and extracting phases, 4-secret keys have used to protect of the embedded secret data. Thus, level of security is high, 5-the problem of overflow or underflow does not occur. Experimental results indicated that the proposed adaptive scheme significantly is superior to the currently existing scheme, in terms of stego-image visual quality, embedding capacity and level of security and also our non-adaptive method is better than other non-adaptive methods, in view of stego-image quality. Results show which our adaptive algorithm can resist against the RS steganalysis attack.

Historical perspective of Indian neurology

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Shrikant Mishra

2013-01-01

Full Text Available Objective: To chronicle the history of medicine and neurology in India with a focus on its establishment and evolution. Background: The history of neurology in India is divided into two periods: ancient and modern. The ancient period dates back to the mid-second millennium Before Christ (B.C. during the creation of the Ayurvedic Indian system of Medicine, which detailed descriptions of neurological disorders called Vata Vyadhi. The early 20 th century witnessed the birth of modern Indian medicine with the onset of formal physician training at the nation′s first allopathic medical colleges located in Madras (1835, Calcutta (1835 and Mumbai (1848. Prior to India′s independence from Britain in 1947, only 25 medical schools existed in the entire country. Today, there are over 355. In 1951, physicians across the field of neurology and neurosurgery united to create the Neurological Society of India (NSI. Four decades later in 1991, neurologists branched out to establish a separate organization called the Indian Academy of Neurology (IAN. Design/Methods: Information was gathered through literature review using PubMed, MD Consult, OVID, primary texts and research at various academic institutions in India. Results: Neurological disorders were first described in ancient India under Ayurveda. The transition to modern medicine occurred more recently through formal training at medical schools beginning in the 1930′s. Early pioneers and founders of the NSI (1951 include Dr. Jacob Chandy, Dr. B Ramamurthi, Dr. S. T. Narasimhan and Dr. Baldev Singh. Later, Dr. J. S. Chopra, a prominent neurologist and visionary, recognized the need for primary centers of collaboration and subsequently established the IAN (1991. The future of Neurology in India is growing rapidly. Currently, there are 1100 practicing neurologists and more than 150 post-graduate trainees who join the ranks every year. As the number of neurologists rises across India, there is an increase in

Is Walking Capacity in Subjects with Multiple Sclerosis Primarily Related to Muscle Oxidative Capacity or Maximal Muscle Strength? A Pilot Study

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Dominique Hansen

2014-01-01

Full Text Available Background and Purpose. Walking capacity is reduced in subjects with multiple sclerosis (MS. To develop effective exercise interventions to enhance walking capacity, it is important to determine the impact of factors, modifiable by exercise intervention (maximal muscle strength versus muscle oxidative capacity, on walking capacity. The purpose of this pilot study is to discriminate between the impact of maximal muscle strength versus muscle oxidative capacity on walking capacity in subjects with MS. Methods. From 24 patients with MS, muscle oxidative capacity was determined by calculation of exercise-onset oxygen uptake kinetics (mean response time during submaximal exercise bouts. Maximal muscle strength (isometric knee extension and flexion peak torque was assessed on dynamometer. All subjects completed a 6-minute walking test. Relationships between walking capacity (as a percentage of normal value and muscle strength (of knee flexors and extensors versus muscle oxidative capacity were assessed in multivariate regression analyses. Results. The expanded disability status score (EDSS showed a significant univariate correlation (r=-0.70, P<0.004 with walking capacity. In multivariate regression analyses, EDSS and mean response time, but not muscle strength, were independently related to walking capacity (P<0.05. Conclusions. Walking distance is, next to disability level and not taking neurologic symptoms/deficits into account, primarily related to muscle oxidative capacity in subjects with MS. Additional study is needed to further examine/verify these findings.

Water System Adaptation to Hydrological Changes: Module 1, Introduction to Water System Adaptation

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Contemporary water management requires resilience, the ability to meet ever increasing water needs, and capacity to adapt to abrupt or transient changes in water quality and availability. For this purpose, effective adaptation to extreme hydrological events (e.g. intense storms, ...

Influencing adaptation processes on the Australian rangelands for social and ecological resilience

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Nadine A. Marshall

2014-06-01

Full Text Available Resource users require the capacity to cope and adapt to climate changes affecting resource condition if they, and their industries, are to remain viable. Understanding individual-scale responses to a changing climate will be an important component of designing well-targeted, broad-scale strategies and policies. Because of the interdependencies between people and ecosystems, understanding and supporting resilience of resource-dependent people may be as important an aspect of effective resource management as managing the resilience of ecological components. We refer to the northern Australian rangelands as an example of a system that is particularly vulnerable to the impacts of climate change and look for ways to enhance the resilience of the system. Vulnerability of the social system comprises elements of adaptive capacity and sensitivity to change (resource dependency as well as exposure, which is not examined here. We assessed the adaptive capacity of 240 cattle producers, using four established dimensions, and investigated the association between adaptive capacity and climate sensitivity (or resource dependency as measured through 14 established dimensions. We found that occupational identity, employability, networks, strategic approach, environmental awareness, dynamic resource use, and use of technology were all positively correlated with at least one dimension of adaptive capacity and that place attachment was negatively correlated with adaptive capacity. These results suggest that adaptation processes could be influenced by focusing on adaptive capacity and these aspects of climate sensitivity. Managing the resilience of individuals is critical to processes of adaptation at higher levels and needs greater attention if adaptation processes are to be shaped and influenced.

The relevance of a coproductive capacity framework to climate change adaptation: investigating the health and water sectors in Cambodia

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Kathryn J. Bowen

2015-03-01

Full Text Available Multiple active partnerships in the health and water sectors in Cambodia exist to address climate change adaptation, operating beyond typical sectoral and organizational divides. Decisions around national adaptation policy are made predominantly by the relevant lead ministry, contrasting with where funding originates from (i.e., major donors, multilaterals, United Nation agencies. Adaptation policy is thus the result of a process of coproduction by state and nonstate actors. The research we present sought to understand the relationships that exist between knowledge- and decision-makers with respect to climate change adaptation in the health and water sectors in Cambodia, and the factors that enabled or constrained these relationships. Forty-four interviews were conducted with representatives of 32 organizations. We found that coproductive relationships were most effective when there were clearly defined roles and responsibilities, coordination of technical and financial resources, and trust. The two key factors of coproductive capacity that enabled and supported these partnerships were scientific resources and governance capability. Ultimately, the roles and responsibilities given to various actors requires commensurate funding and greater consideration of existing relationships and power dynamics. The reliance on international scientific expertise also needs to be challenged so that local research capabilities can be developed and locally relevant, problem-specific information can be provided. The ongoing funding, codevelopment, and sharing of such knowledge would significantly enhance trust and cooperation.

Guided self-help for mental health disorders in children and young people with chronic neurological conditions: A qualitative evaluation.

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Bennett, Sophie D; Coughtrey, Anna E; Heyman, Isobel; Greally, Suzanna; Clarkson, Harriet; Bhattacharyya, Tuhina; Lewis, Corah; Varadkar, Sophia; Shafran, Roz

2018-03-09

Children with neurological conditions such as epilepsy are at high risk of developing mental health disorders. Guided self-help can be used to increase access to psychological therapies. When developing and evaluating interventions, it is important to obtain the views of service-users about their acceptability. A telephone-guided self-help intervention was used to treat common mental health difficulties in children and young people with neurological conditions. The intervention was not adapted in content to account for chronic illness. This study therefore reports on qualitative interviews with participants to determine the acceptability of the intervention. Semi-structured interviews were conducted with 27 participants (25 parents and 2 young people) who had undertaken a telephone-delivered guided self-help intervention for common mental health difficulties in the context of a paediatric neurological condition. Transcripts were analysed thematically using the framework approach. Thirteen themes were extracted, organised into three main domains, which covered: the practicalities of telephone guided self-help treatment; the outcomes of the intervention; and the extent to which adaptation was needed for chronic illness. Most families found the intervention helpful in working towards their specific goals and noticed changes for the child and/or parents and family. Participants had a positive experience of the intervention and the majority of parents found the standard intervention with individualised goals sufficient to meet the young person's mental health needs. Copyright © 2018 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Gluten sensitivity and neurological manifestations

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Agostino Berio

2015-12-01

Full Text Available The authors report on six cases of gluten-sensitivity, also defined non-celiac gluten sensitivity, characterized by abdominal features (diarrhea, bloating, pain, genetic positivity for predisposition to celiac disease (DQB1* 02 in all cases; DQA1*05 in three; DQA1*02 in two, DQB1*03 in two, negative anti-t-Transglutaminase antibodies, normal mucosa on biopsy in four cases, type 1 of Marsh in one case. The subjects presented frequent central nervous system (CNS symptoms: headache in three patients, somnolence in one, electroencephalogram aspecific alterations in three (in two of them with previous seizures, leptomeningeal cyst in one, intracranial calcification in one, cerebral gliosis in two. After a gluten-free diet, all intestinal and clinical CNS features remitted, but re-appeared after gluten reintroduction. On the basis of the neurological signs, the authors stress the relevance of immune innate system in the pathogenesis of these cases with possible subsequent evolution on immune adaptive system involvement.

Neurology of cardiopulmonary resuscitation.

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Mulder, M; Geocadin, R G

2017-01-01

This chapter aims to provide an up-to-date review of the science and clinical practice pertaining to neurologic injury after successful cardiopulmonary resuscitation. The past two decades have seen a major shift in the science and practice of cardiopulmonary resuscitation, with a major emphasis on postresuscitation neurologic care. This chapter provides a nuanced and thoughtful historic and bench-to-bedside overview of the neurologic aspects of cardiopulmonary resuscitation. A particular emphasis is made on the anatomy and pathophysiology of hypoxic-ischemic encephalopathy, up-to-date management of survivors of cardiopulmonary resuscitation, and a careful discussion on neurologic outcome prediction. Guidance to practice evidence-based clinical care when able and thoughtful, pragmatic suggestions for care where evidence is lacking are also provided. This chapter serves as both a useful clinical guide and an updated, thorough, and state-of-the-art reference on the topic for advanced students and experienced practitioners in the field. © 2017 Elsevier B.V. All rights reserved.

Implementing European climate adaptation policy. How local policymakers react to European policy

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Thomas Hartmann

2015-04-01

Full Text Available EU policy and projects have an increasing influence on policymaking for climate adaptation. This is especially evident in the development of new climate adaptation policies in transnational city networks. Until now, climate adaptation literature has paid little attention to the influence that these EU networks have on the adaptive capacity in cities. This paper uses two Dutch cities as an empirical base to evaluate the influence of two EU climate adaptation projects on both the experience of local public officials and the adaptive capacity in the respective cities. The main conclusion is that EU climate adaptation projects do not automatically lead to an increased adaptive capacity in the cities involved. This is due to the political opportunistic use of EU funding, which hampers the implementation of climate adaptation policies. Furthermore, these EU projects draw attention away from local network building focused on the development and implementation of climate adaptation policies. These factors have a negative cumulative impact on the performance of these transnational policy networks at the adaptive capacity level in the cities involved. Therefore, in order to strengthen the adaptive capacity in today’s European cities, a context-specific, integrative approach in urban planning is needed at all spatial levels. Hence, policy entrepreneurs should aim to create linkage between the issues in the transnational city network and the concerns in local politics and local networks.

Transformational capacity and the influence of place and identity

International Nuclear Information System (INIS)

Marshall, N A; Park, S E; Howden, S M; Adger, W N; Brown, K

2012-01-01

Climate change is altering the productivity of natural resources with far-reaching implications for those who depend on them. Resource-dependent industries and communities need the capacity to adapt to a range of climate risks if they are to remain viable. In some instances, the scale and nature of the likely impacts means that transformations of function or structure will be required. Transformations represent a switch to a distinct new system where a different suite of factors become important in the design and implementation of response strategies. There is a critical gap in knowledge on understanding transformational capacity and its influences. On the basis of current knowledge on adaptive capacity we propose four foundations for measuring transformational capacity: (1) how risks and uncertainty are managed, (2) the extent of skills in planning, learning and reorganizing, (3) the level of financial and psychological flexibility to undertake change and (4) the willingness to undertake change. We test the influence of place attachment and occupational identity on transformational capacity using the Australian peanut industry, which is presently assessing significant structural change in response to predicted climatic changes. Survey data from 88% of peanut farmers in Queensland show a strong negative correlation between transformational capacity and both place attachment and occupational attachment, suggesting that whilst these factors may be important positive influences on the capacity to adapt to incremental change, they act as barriers to transformational change. (letter)

Transformational capacity and the influence of place and identity

Science.gov (United States)

Marshall, N. A.; Park, S. E.; Adger, W. N.; Brown, K.; Howden, S. M.

2012-09-01

Climate change is altering the productivity of natural resources with far-reaching implications for those who depend on them. Resource-dependent industries and communities need the capacity to adapt to a range of climate risks if they are to remain viable. In some instances, the scale and nature of the likely impacts means that transformations of function or structure will be required. Transformations represent a switch to a distinct new system where a different suite of factors become important in the design and implementation of response strategies. There is a critical gap in knowledge on understanding transformational capacity and its influences. On the basis of current knowledge on adaptive capacity we propose four foundations for measuring transformational capacity: (1) how risks and uncertainty are managed, (2) the extent of skills in planning, learning and reorganizing, (3) the level of financial and psychological flexibility to undertake change and (4) the willingness to undertake change. We test the influence of place attachment and occupational identity on transformational capacity using the Australian peanut industry, which is presently assessing significant structural change in response to predicted climatic changes. Survey data from 88% of peanut farmers in Queensland show a strong negative correlation between transformational capacity and both place attachment and occupational attachment, suggesting that whilst these factors may be important positive influences on the capacity to adapt to incremental change, they act as barriers to transformational change.

Neurological Signs and Symptoms in Fibromyalgia

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Watson, Nathaniel F.; Buchwald, Dedra; Goldberg, Jack; Noonan, Carolyn; Ellenbogen, Richard G.

2009-01-01

Objective To determine the type and frequency of neurological signs and symptoms in individuals with fibromyalgia (FM). Methods Persons with FM (n=166) and pain-free controls (n=66) underwent systematic neurological examination by a neurologist blinded to disease status. Neurological symptoms present over the preceding 3 months were assessed with a standard questionnaire. We used logistic regression to evaluate the association of neurological symptoms and examination findings with FM status. Within the FM group we examined the correlation between self-reported symptoms and physical examination findings. Results Compared to the control group, age and gender adjusted estimates revealed the FM group had significantly more neurological abnormalities in multiple categories including: cranial nerves IX and X (42% vs. 8%), sensory (65% vs. 25%), motor (33% vs. 3%), and gait (28% vs. 7%). Similarly, the FM group endorsed significantly more neurological symptoms than the control group in 27 of 29 categories with the biggest differences observed for photophobia (70% vs. 6%), poor balance (63% vs. 4%), and weakness (58% vs. 2%) and tingling (54% vs. 4%) in the arms and legs. Poor balance, coordination, tingling, weakness in the arms and legs, and numbness in any part of body correlated with appropriate neurological exam findings in the FM group. Conclusions This blinded, controlled study demonstrated neurological physical examination findings in persons with FM. The FM group had more neurological symptoms than controls, with moderate correlation between symptoms and signs. These findings have implications for the medical work-up of patients with FM. PMID:19714636

Neurologic signs and symptoms in fibromyalgia.

Science.gov (United States)

Watson, Nathaniel F; Buchwald, Dedra; Goldberg, Jack; Noonan, Carolyn; Ellenbogen, Richard G

2009-09-01

To determine the type and frequency of neurologic signs and symptoms in individuals with fibromyalgia (FM). Persons with FM (n = 166) and pain-free controls (n = 66) underwent systematic neurologic examination by a neurologist blinded to disease status. Neurologic symptoms lasting at least 3 months were assessed with a standard questionnaire. We used logistic regression to evaluate the association of neurologic symptoms and examination findings with FM status. Within the FM group we examined the correlation between self-reported symptoms and physical examination findings. Age- and sex-adjusted estimates revealed that compared with the control group, the FM group had significantly more neurologic abnormalities in multiple categories, including greater dysfunction in cranial nerves IX and X (42% versus 8%) and more sensory (65% versus 25%), motor (33% versus 3%), and gait (28% versus 7%) abnormalities. Similarly, the FM group had significantly more neurologic symptoms than the control group in 27 of 29 categories, with the greatest differences observed for photophobia (70% versus 6%), poor balance (63% versus 4%), and weakness (58% versus 2%) and tingling (54% versus 4%) in the arms or legs. Poor balance or coordination, tingling or weakness in the arms or legs, and numbness in any part of the body correlated with appropriate neurologic examination findings in the FM group. This blinded, controlled study demonstrated neurologic physical examination findings in persons with FM. The FM group had more neurologic symptoms than did the controls, with moderate correlation between symptoms and signs. These findings have implications for the medical evaluation of patients with FM.

[Effects of a physical training program on quantitative neurological indices in mild stage type 2 spinocerebelar ataxia patients].

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Pérez-Avila, I; Fernández-Vieitez, J A; Martínez-Góngora, E; Ochoa-Mastrapa, R; Velázquez-Manresa, M G

Type 2 spinocerebelar ataxia (SCA2) is a neurodegenerative disease with higher prevalence and incidence in Holguín province, Cuba. At present, there is not any drug to counteract the loss of coordinative motor capacities of these patients. Thus physical training seems to be the only way to attenuate the course of disease. To evaluate the effectiveness of a physical training program on quantitative neurological indices in SCA2 patients. A samples of 87 SCA2 patients were studied. All subjects underwent a six month physical exercise program based on coordination, balance and muscular conditioning exercises. Quantitative tests were applied to all patients both before and after the application of the exercise program. Comparisons between pretest versus posttest values were made to evaluate the improvement in neurological indices. All neurological indices both with open eyes and closed eyes significantly improved from pretest to posttest. Static balance, evaluated by Romberg test, also enhanced with training. The exercise training program significantly improved the neurological indices in SCA2 patient with mild stage of disease.

Assessing existing drought monitoring and forecasting capacities, mitigation and adaptation practices in Africa

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Nyabeze, W. R.; Dlamini, L.; Lahlou, O.; Imani, Y.; Alaoui, S. B.; Vermooten, J. S. A.

2012-04-01

Drought is one of the major natural hazards in many parts of the world, including Africa and some regions in Europe. Drought events have resulted in extensive damages to livelihoods, environment and economy. In 2011, a consortium consisting of 19 organisations from both Africa and Europe started a project (DEWFORA) aimed at developing a framework for the provision of early warning and response through drought impact mitigation for Africa. This framework covers the whole chain from monitoring and vulnerability assessment to forecasting, warning, response and knowledge dissemination. This paper presents the first results of the capacity assessment of drought monitoring and forecasting systems in Africa, the existing institutional frameworks and drought mitigation and adaptation practices. Its focus is particularly on the historical drought mitigation and adaptation actions identified in the North Africa - Maghreb Region (Morocco, Algeria and Tunisia) and in the Southern Africa - Limpopo Basin. This is based on an extensive review of historical drought experiences. From the 1920's to 2009, the study identified 37 drought seasons in the North African - Maghreb Region and 33 drought seasons in the Southern Africa - Limpopo Basin. Existing literature tends to capture the spatial extent of drought at national and administrative scale in great detail. This is driven by the need to map drought impacts (food shortage, communities affected) in order to inform drought relief efforts (short-term drought mitigation measures). However, the mapping of drought at catchment scale (hydrological unit), required for longer-term measures, is not well documented. At regional level, both in North Africa and Southern Africa, two organisations are involved in drought monitoring and forecasting, while at national level 22 organisations are involved in North Africa and 37 in Southern Africa. Regarding drought related mitigation actions, the inventory shows that the most common actions

Current neurology

International Nuclear Information System (INIS)

Appel, S.H.

1988-01-01

The topics covered in this book include: Duchenne muscular dystrophy: DNA diagnosis in practice; Central nervous system magnetic resonance imaging; and Magnetic resonance spectroscopy of neurologic diseases

The French capacity mechanism

International Nuclear Information System (INIS)

2014-01-01

The French capacity mechanism has been design to ensure security of supply in the context of the energy transition. This energy transition challenges the electricity market design with several features: peak load growth, the development of renewables, demand response,... To ensure security of supply in this context, a capacity mechanism is being implemented in France. It is a market wide capacity obligation on electricity suppliers, based on market principles. Suppliers are responsible for forecasting their obligation, which corresponds to their contribution to winter peak load, and must procure enough capacity certificates to meet their obligations. Capacity certificates are granted to capacities through a certification process, which assesses their contribution to security of supply on the basis of availability commitments. This certification process is technology neutral and performance based, associated with controls and penalties in case of non compliance. Demand Side is fully integrated in the market, either through the reduction of suppliers' capacity obligation or direct participation after certification. In addition to the expected benefits in terms of security of supply, the French capacity market will foster the development of demand response. The participation of foreign capacities will require adaptations which are scheduled in a road-map, and could pave the way for further European integration of energy policies. (authors)

Neurological aspects of eclampsia

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Jovanović Dejana

2003-01-01

Full Text Available The difficult types of preeclampsia and eclampsia are presented with the neurological symptoms. The break of cerebral autoregulation mechanism plays the most important role in pathogenesis of cerebral vasospasm. Nevertheless eclampsia isn’t just an ordinary hypertensive encephalopathy because other pathogenic mechanisms are involved in its appearance. The main neuropathologic changes are multifocal vasogenic edema, perivascular multiple microinfarctions and petechial hemorrhages. Neurological clinical manifestations are convulsions, headache, visual disturbances and rarely other discrete focal neurological symptoms. Eclampsia is a high-risk factor for onset of hemorrhagic or ischemic stroke. This is a reason why neurological diagnostic tests are sometimes needed. The method of choice for evaluation of complicated eclampsia is computerized brain topography that shows multiple areas of hypodensity in occipitoparietal regions. These changes are focal vasogenic cerebral edema. For differential diagnosis of eclampsia and stroke other diagnostic methods can be used - fundoscopic exam, magnetic resonance brain imaging, cerebral angiography and cerebrospinal fluid exam. The therapy of eclampsia considers using of magnesium sulfate, antihypertensive, anticonvulsive and antiedematous drugs.

Assessing water resources adaptive capacity to climate change impacts in the Pacific Northwest Region of North America

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A. F. Hamlet

2011-05-01

infrastructure and institutional arrangements provide a reasonably solid foundation for coping with climate change impacts, and that the mandates of existing water resources policy and water resources management institutions are at least consistent with the fundamental objectives of climate change adaptation. A deeper inquiry into the underlying nature of PNW water resources systems, however, reveals significant and persistent obstacles to climate change adaptation, which will need to be overcome if effective use of the region's extensive water resources management capacity can be brought to bear on this problem. Primary obstacles include assumptions of stationarity as the fundamental basis of water resources system design, entrenched use of historical records as the sole basis for planning, problems related to the relatively short time scale of planning, lack of familiarity with climate science and models, downscaling procedures, and hydrologic models, limited access to climate change scenarios and hydrologic products for specific water systems, and rigid water allocation and water resources operating rules that effectively block adaptive response. Institutional barriers include systematic loss of technical capacity in many water resources agencies following the dam building era, jurisdictional fragmentation affecting response to drought, disconnections between water policy and practice, and entrenched bureaucratic resistance to change in many water management agencies. These factors, combined with a federal agenda to block climate change policy in the US during the Bush administration have (with some exceptions contributed to widespread institutional "gridlock" in the PNW over the last decade or so despite a growing awareness of climate change as a significant threat to water management. In the last several years, however, significant progress has been made in surmounting some of these obstacles, and the region's water resources agencies at all levels of governance are making

Assessing water resources adaptive capacity to climate change impacts in the Pacific Northwest Region of North America

Science.gov (United States)

Hamlet, A. F.

2011-05-01

provide a reasonably solid foundation for coping with climate change impacts, and that the mandates of existing water resources policy and water resources management institutions are at least consistent with the fundamental objectives of climate change adaptation. A deeper inquiry into the underlying nature of PNW water resources systems, however, reveals significant and persistent obstacles to climate change adaptation, which will need to be overcome if effective use of the region's extensive water resources management capacity can be brought to bear on this problem. Primary obstacles include assumptions of stationarity as the fundamental basis of water resources system design, entrenched use of historical records as the sole basis for planning, problems related to the relatively short time scale of planning, lack of familiarity with climate science and models, downscaling procedures, and hydrologic models, limited access to climate change scenarios and hydrologic products for specific water systems, and rigid water allocation and water resources operating rules that effectively block adaptive response. Institutional barriers include systematic loss of technical capacity in many water resources agencies following the dam building era, jurisdictional fragmentation affecting response to drought, disconnections between water policy and practice, and entrenched bureaucratic resistance to change in many water management agencies. These factors, combined with a federal agenda to block climate change policy in the US during the Bush administration have (with some exceptions) contributed to widespread institutional "gridlock" in the PNW over the last decade or so despite a growing awareness of climate change as a significant threat to water management. In the last several years, however, significant progress has been made in surmounting some of these obstacles, and the region's water resources agencies at all levels of governance are making progress in addressing the fundamental

[Comorbidity in autism spectrum disorders - II. Genetic syndromes and neurological problems].

Science.gov (United States)

Noterdaeme, Michele A; Hutzelmeyer-Nickels, Anna

2010-07-01

Children with a pervasive developmental disorder show in addition to core symptoms a variety of genetic syndromes as well as neurological problems, which are relevant for the treatment and the course of the disorder. The objective of our study is to analyse the nature and the frequency of these co-morbid somatic disorders in relation to the level of intellectual functioning of the patients. The sample consists of 601 patients with a pervasive developmental disorder diagnosed at the Department of Developmental Disorders at the Heckscher-Klinikum between 1997 and 2007. In addition to genetic syndromes, we also recorded a variety of neurological disorders. 373 of the patients (62%) had at least one additional diagnosis and 121 (20%) had at least two additional diagnoses on Axis IV of the multi-axial classification scheme. Genetic syndromes were found in 6% of the patients (N = 37). Movement disorders (N = 214; 35.6%) and epilepsy (N = 98; 16.3%) were the most frequent neurological disorders. Children with mental retardation showed significantly more somatic diagnoses than children without mental retardation. Children with pervasive developmental disorders show a wide variety of co-morbid somatic problems, which are relevant for the treatment and the course of the disorder. Children with autism and mental retardation show more co-morbid conditions and are more impaired in their psychosocial adaptation than children with autism without mental retardation.

PTSD symptoms and onset of neurologic disease in elderly trauma survivors.

Science.gov (United States)

Grossman, A B; Levin, B E; Katzen, H L; Lechner, S

2004-08-01

In this case study, we present two Holocaust survivors who appeared to have adapted well post-trauma, but developed severe PTSD symptomatology following the onset of neurologic illness in later life. These individuals were referred fro neuropsychological evaluations by their treating neurologists to assess their levels of cognitive functioning. We present the neuropsychological findings, and discuss possible mechanisms for emergence of PTSD symptoms. These case studies demonstrate the need for systematic research to further investigate the potential relationship between aging, degenerative disease, and PTSD symptoms in elderly trauma survivors.

Affective disorders in neurological diseases

DEFF Research Database (Denmark)

Nilsson, F M; Kessing, L V; Sørensen, T M

2003-01-01

OBJECTIVE: To investigate the temporal relationships between a range of neurological diseases and affective disorders. METHOD: Data derived from linkage of the Danish Psychiatric Central Register and the Danish National Hospital Register. Seven cohorts with neurological index diagnoses and two...... of affective disorder was lower than the incidence in the control groups. CONCLUSION: In neurological diseases there seems to be an increased incidence of affective disorders. The elevated incidence was found to be particularly high for dementia and Parkinson's disease (neurodegenerative diseases)....

Enterovirus 71-induced neurological disorders in young gerbils, Meriones unguiculatus: development and application of a neurological disease model.

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Ping-Ping Yao

Full Text Available A reliable disease model mimicking Enterovirus 71 (EV71 infection in humans is essential for understanding pathogenesis and for developing a safe and effective vaccine. Commonly used rodent models including mouse or rat models are not suitable for vaccine evaluation because the rodents are resistant to EV71 infection after they reach the age of 6 days. In this study, 21-day-old gerbils inoculated intraperitoneally (IP with a non mouse-adapted EV71 strain developed neurological lesion-related signs including hind limb paralysis, slowness, ataxia and lethargy similar to those of central nervous system (CNS infection of EV71 in humans. The infected gerbils eventually died of the neurological lesions and EV71 could be isolated from lung, liver, spleen, kidney, heart, spinal cord, brain cortex, brainstem and skeletal muscle. Significantly high virus replication was detected in spinal cord, brainstem and skeletal muscle by cellular analysis, real-time quantitative PCR (RT-PCR and immunohistochemical staining. Histopathologic changes such as neuronal degeneration, neuronal loss and neuronophagia were observed in spinal cord, brain cortex, brainstem, and skeletal muscle along with necrotizing myositis and splenic atrophy. Gerbils that received two doses of inactive whole-virus vaccine showed no EV71-specific symptoms after challenged with EV71. In contrast, gerbils that received mock vaccination died of EV71-induced neuropathology after challenged with EV71. The result indicates that gerbils can serve as a reliable disease model for evaluating safety and efficacy of EV71 vaccine.

Adaptation: Needs, Financing and Institutions

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Klein, Richard J.T.; Kartha, Sivan; Persson, Aasa; Watkiss, Paul; Ackerman, Frank; Downing, Thomas E.; Kjellen, Bo; Schipper, Lisa (Stockholm Environment Institute, Stockholm (SE))

2008-07-01

Regardless of the efforts put into mitigation, some impacts of climate change are already unavoidable. Adaptation to climate change has therefore become a key component of domestic climate policy, along with mitigation. Adaptation has also become key to the success of global climate policy. Without an agreement on supporting adaptation in developing countries, there will be no agreement on mitigation. Strong mitigation efforts make it more likely that adaptation will be effective and affordable. The world cannot rely on adaptation alone: it would eventually lead to a level of climate change to which adaptation is no longer feasible. Government action is needed to create an enabling environment for adaptation. This includes removing existing financial, legal, institutional and knowledge barriers to adaptation, and strengthening the capacity of people and organisations to adapt. The success of adaptation relies on the success of development, and vice versa. Poverty reduction, good governance, education, environmental protection, health and gender equality all contribute to adaptive capacity. Substantially more money is needed to support adaptation in developing countries. Current levels of funding will soon have to be scaled up by two orders of magnitude (from US$ hundreds of million to US$ tens of billion per year). An agreement on adaptation in Copenhagen in 2009 will need to include concrete steps towards a strengthened knowledge base for adaptation, substantially more funding for developing countries, and enhanced adaptation planning and implementation at the national level. Recommendations: Developed countries should accept a transparent, principle-based allocation of responsibility for adaptation funding, resulting in adequate, new and additional money to support adaptation programmes in developing countries. Levies on carbon market transactions and auctioning emission permits are two existing mechanisms of generating new and additional funds consistent with

Neurological complication in HIV patients

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Ritarwan, K.

2018-03-01

Human Immunodeficiency Virus (HIV) is neurotropic and immunotropic, making themassive destruction of both systems. Although their amount has been reduced, there is still neurological presentations and complications of HIV remain common in the era of combination antiretroviral therapy (cART). Neurological opportunistic infections (OI) occur in advanced HIV diseases such as primary cerebral lymphoma, cryptococcal meningitis, cerebral toxoplasmosis, and progressive multifocal encephalopathy. Neurological problem directly related to HIV appear at any stage in the progress of HIV disease, from AIDS-associated dementia to the aseptic meningitis of primary HIV infection observed in subjects with an immune deficiency. The replication of peripheral HIV viral is able to be controlled in the era of effective antiretroviral therapy. Non-HIV-related neurological disease such as stroke increased important as the HIV population ages.

Moroccan Coastal Management : Building Capacity to Adapt to ...

International Development Research Centre (IDRC) Digital Library (Canada)

Impacts from rising sea levels, coastal flooding and storm surges are becoming a challenging policy issue for planners, local authorities and stakeholders in areas such as Morocco's northeastern coast. This project will support capacity building and the development of tools and methods to underpin preparation for and ...

Neurology as career option among postgraduate medical students

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Namit B Gupta

2013-01-01

Full Text Available Background: In the context of inadequacy of neurology workforce in India, it is important to understand factors that post-graduate medical students consider for and against choosing neurology as their career option. Understanding these factors will help in planning strategies to encourage students to pursue a career in neurology. At present, there is a paucity of studies addressing this issue in India. Aims and Objectives: (1 To analyze factors, which post-graduate students consider for and against choosing neurology as a career specialty. (2 To access the level and quality of neurology exposure in the current MBBS and MD curricula. Materials and Methods: Statewide questionnaire based study was conducted in the state of Maharashtra for students eligible to take DM neurology entrance examination (MD Medicine and MD Pediatrics. Results: In this survey, 243 students were enrolled. Factors bringing students to neurology were - intellectual challenge and logical reasoning (72%, inspired by role model teachers (63%, better quality-of-life (51% and scope for independent practice without expensive infrastructure (48%. Factors preventing students from taking neurology were - perception that most neurological diseases are degenerative (78%, neurology is mainly an academic specialty (40%, neurophobia (43% and lack of procedures (57%. Inadequate exposure and resultant lack of self-confidence were common (31%, 70-80%. 84% of the students felt the need for a short term certification course in neurology after MD. Conclusions: To attract more students to neurology, "role model" teachers of neurology could interact and teach students extensively. Neurologists′ efforts to shed their diagnostician′s image and to shift their focus to therapeutics will help change the image of neurology. Out-patient neurology clinics should be incorporated early in the student′s career. Procedures attract students; hence, they should be made conversant with procedures and

Neurologic manifestations of achondroplasia.

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Hecht, Jacqueline T; Bodensteiner, John B; Butler, Ian J

2014-01-01

Achondroplasia is the best described and most common form of the congenital short-limbed dwarfing conditions. Achondroplasia is apparent at birth and has a birth prevalence of 1 in 20000-30000 live-born infants. Achondroplasia is inherited as an autosomal dominant condition, although 80% of cases occur sporadically as new events in their families. Achondroplasia is caused, in virtually all of the cases, by a G380R mutation in fibroblast growth factor receptor 3 (FGFR3). Patients with achondroplasia should be evaluated by a multidisciplinary team of clinicians including geneticists, neurologists, and orthopedists, since there are numerous bony and neurological complications. The most severe complication results from craniocervical stenosis and medullary and upper spinal cord compression, which can have devastating and even lethal sequelae during early childhood. In subsequent decades, including adolescence, spinal cord and nerve compression are more prominent. The neurological complications of achondroplasia have been recognized in adults for more than a century and are attributed to bony defects, connective tissue structures, or both. Similar neurological complications are now appreciated in infants, young children, and teenagers with achondroplasia. Defective connective tissue elements in achondroplasia frequently lead to ligamentous laxity, which can aggravate the complications associated with bony stenosis. Bony abnormalities are known to cause neurological morbidity and lead to a shortened lifespan. Neurological complications associated with achondroplasia are reviewed, including recommendations for the evaluation and management of these clinical problems. © 2014 Elsevier B.V. All rights reserved.

Building Adaptive Capacity of Pathways in Technology Early College High School Stakeholders: A Multiple-Case Study on the Influence of Performance, Leadership, and Organizational Learning

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Michaud-Wells, Amy

2016-01-01

The purpose of this qualitative study was to explore the perceptions and beliefs of Pathways in Technology Early College High School (P-TECH) leaders and stakeholders regarding the personal and professional experiences that contributed to the development of adaptive capacity. This embedded multiple-case study was anchored by the interrelated…

Neurologic sequelae associated with foscarnet therapy.

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Lor, E; Liu, Y Q

1994-09-01

To report three cases of possible foscarnet-induced neurologic sequelae. We report two cases of seizures and one case of hand cramping and finger paresthesia after starting foscarnet therapy with no evidence of predisposing risk factors, such as serum laboratory abnormalities, renal dysfunction, or known central nervous system (CNS) involvement. All three patients had stable laboratory values during therapy and when the neurologic adverse effects occurred. All patients were receiving appropriate dosages of foscarnet. The incidence of seizures in AIDS patients was reviewed. A history of CNS lesions, infections, and/or AIDS per se may increase the risk of a neurologic adverse effect while receiving foscarnet therapy. Acute ionized hypocalcemia may cause these neurologic adverse effects. Ionized hypocalcemia is transitory, is related to the rate of foscarnet infusion, and may not be reflected as a change in total serum calcium concentration. Foscarnet probably contributed to the neurologic adverse effects reported here. Foscarnet may need to be administered at a slower rate than is recommended by the manufacturer. Electrolytes must be monitored closely; however, a neurologic adverse effect may not be foreseen.

Neurological Disorders in Adult Celiac Disease

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Hugh J Freeman

2008-01-01

Full Text Available Celiac disease may initially present as a neurological disorder. Alternatively, celiac disease may be complicated by neurological changes. With impaired nutrient absorption, different deficiency syndromes may occur and these may be manifested clinically with neurological changes. However, in patients with deficiency syndromes, extensive involvement of the small intestine with celiac disease is often evident. There are a number of reports of celiac disease associated with neuropathy, ataxia, dementia and seizure disorder. In these reports, there is no clear relationship with nutrient deficiency and a precise mechanism for the neurological changes has not been defined. A small number of patients have been reported to have responded to vitamin E administration, but most do not. In some, gluten antibodies have also been described, especially in those with ataxia, but a consistent response to a gluten-free diet has not been defined. Screening for celiac disease should be considered in patients with unexplained neurological disorders, including ataxia and dementia. Further studies are needed, however, to determine if a gluten-free diet will lead to improvement in the associated neurological disorder.

Neurological manifestations of dengue viral infection

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Carod-Artal FJ

2014-10-01

Full Text Available Francisco Javier Carod-Artal1,21Neurology Department, Raigmore hospital, Inverness, UK; 2Universitat Internacional de Catalunya (UIC, Barcelona, Spain Abstract: Dengue is the most common mosquito-borne viral infection worldwide. There is increased evidence for dengue virus neurotropism, and neurological manifestations could make part of the clinical picture of dengue virus infection in at least 0.5%–7.4% of symptomatic cases. Neurological complications have been classified into dengue virus encephalopathy, dengue virus encephalitis, immune-mediated syndromes (acute disseminated encephalomyelitis, myelitis, Guillain–Barré syndrome, neuritis brachialis, acute cerebellitis, and others, neuromuscular complications (hypokalemic paralysis, transient benign muscle dysfunction and myositis, and dengue-associated stroke. Common neuro-ophthalmic complications are maculopathy and retinal vasculopathy. Pathogenic mechanisms include systemic complications and metabolic disturbances resulting in encephalopathy, direct effect of the virus provoking encephalitis, and postinfectious immune mechanisms causing immune-mediated syndromes. Dengue viruses should be considered as a cause of neurological disorders in endemic regions. Standardized case definitions for specific neurological complications are still needed. Keywords: encephalitis, encephalopathy, dengue fever, neurological complications

Perception and Interpretation of Climate Change among Quechua Farmers of Bolivia: Indigenous Knowledge as a Resource for Adaptive Capacity

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Sébastien Boillat

2013-12-01

Full Text Available We aim to explore how indigenous peoples observe and ascribe meaning to change. The case study involves two Quechua-speaking farmer communities from mountainous areas near Cochabamba, Bolivia. Taking climate change as a starting point, we found that, first, farmers often associate their observations of climate change with other social and environmental changes, such as value change in the community, population growth, out-migration, urbanization, and land degradation. Second, some of the people interpret change as part of a cycle, which includes a belief in the return of some characteristics of ancient or mythological times. Third, environmental change is also perceived as the expression of "extra-human intentionalities," a reaction of natural or spiritual entities that people consider living beings. On the basis of these interpretations of change and their adaptive strategies, we discuss the importance of indigenous knowledge as a component of adaptive capacity. Even in the context of living with modern science and mass media, indigenous patterns of interpreting phenomena tend to be persistent. Our results support the view that indigenous knowledge must be acknowledged as process, emphasizing ways of observing, discussing, and interpreting new information. In this case, indigenous knowledge can help address complex relationships between phenomena, and help design adaptation strategies based on experimentation and knowledge coproduction.

ESPEN guideline clinical nutrition in neurology.

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Burgos, Rosa; Bretón, Irene; Cereda, Emanuele; Desport, Jean Claude; Dziewas, Rainer; Genton, Laurence; Gomes, Filomena; Jésus, Pierre; Leischker, Andreas; Muscaritoli, Maurizio; Poulia, Kalliopi-Anna; Preiser, Jean Charles; Van der Marck, Marjolein; Wirth, Rainer; Singer, Pierre; Bischoff, Stephan C

2018-02-01

Neurological diseases are frequently associated with swallowing disorders and malnutrition. Moreover, patients with neurological diseases are at increased risk of micronutrient deficiency and dehydration. On the other hand, nutritional factors may be involved in the pathogenesis of neurological diseases. Multiple causes for the development of malnutrition in patients with neurological diseases are known including oropharyngeal dysphagia, impaired consciousness, perception deficits, cognitive dysfunction, and increased needs. The present evidence- and consensus-based guideline addresses clinical questions on best medical nutrition therapy in patients with neurological diseases. Among them, management of oropharyngeal dysphagia plays a pivotal role. The guideline has been written by a multidisciplinary team and offers 88 recommendations for use in clinical practice for amyotrophic lateral sclerosis, Parkinson's disease, stroke and multiple sclerosis. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Perception of pediatric neurology among non-neurologists.

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Jan, Mohammed M S

2004-01-01

Pediatric neurology is considered a relatively new and evolving subspecialty. In Saudi Arabia, neurologic disorders in children are common, and the demand for trained pediatric neurologists is strong. The aim was to study the perception of the pediatric neurology specialty among practicing generalists and their referral practices. Attendees of a symposium on pediatric epilepsy comprehensive review for the generalist were included. A structured 25-item questionnaire was designed to examine their demographics, training, practice, and referral patterns. One hundred nineteen participants attended the symposium, and 90 (76%) questionnaires were returned. Attendees' ages were 22 to 70 years (mean 32 years), with 65.5% female physicians. There were 32% consultants, 51% trainees, and 17% students. Most physicians (67%) were practicing general pediatrics. Only 36% received a structured pediatric neurology rotation during training. Children with neurologic complaints constituted 28.5% of those seen in their practice, and they referred 32.5% of them to pediatric neurology. Only 32% were moderately or highly confident in making the diagnosis or providing the appropriate treatment. Those who received a structured pediatric neurology rotation felt more comfortable in their management (P = .03). Many physicians (38.5%) had no direct access to a pediatric neurologist for referrals. To conclude, pediatric neurologic disorders are common in daily practice. Most generalists did not receive a structured neurology rotation during their training and were not highly confident in diagnosing and treating these children. Given the limited number of pediatric neurologists, I highly recommend that generalists receive appropriate neurologic training.

Neurologic abnormalities in murderers.

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Blake, P Y; Pincus, J H; Buckner, C

1995-09-01

Thirty-one individuals awaiting trial or sentencing for murder or undergoing an appeal process requested a neurologic examination through legal counsel. We attempted in each instance to obtain EEG, MRI or CT, and neuropsychological testing. Neurologic examination revealed evidence of "frontal" dysfunction in 20 (64.5%). There were symptoms or some other evidence of temporal lobe abnormality in nine (29%). We made a specific neurologic diagnosis in 20 individuals (64.5%), including borderline or full mental retardation (9) and cerebral palsy (2), among others. Neuropsychological testing revealed abnormalities in all subjects tested. There were EEG abnormalities in eight of the 20 subjects tested, consisting mainly of bilateral sharp waves with slowing. There were MRI or CT abnormalities in nine of the 19 subjects tested, consisting primarily of atrophy and white matter changes. Psychiatric diagnoses included paranoid schizophrenia (8), dissociative disorder (4), and depression (9). Virtually all subjects had paranoid ideas and misunderstood social situations. There was a documented history of profound, protracted physical abuse in 26 (83.8%) and of sexual abuse in 10 (32.3%). It is likely that prolonged, severe physical abuse, paranoia, and neurologic brain dysfunction interact to form the matrix of violent behavior.

Estimating the Optimal Dosage of Sodium Valproate in Idiopathic Generalized Epilepsy with Adaptive Neuro-Fuzzy Inference System

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Somayyeh Lotfi Noghabi

2012-07-01

Full Text Available Introduction: Epilepsy is a clinical syndrome in which seizures have a tendency to recur. Sodium valproate is the most effective drug in the treatment of all types of generalized seizures. Finding the optimal dosage (the lowest effective dose of sodium valproate is a real challenge to all neurologists. In this study, a new approach based on Adaptive Neuro-Fuzzy Inference System (ANFIS was presented for estimating the optimal dosage of sodium valproate in IGE (Idiopathic Generalized Epilepsy patients. Methods: 40 patients with Idiopathic Generalized Epilepsy, who were referred to the neurology department of Mashhad University of Medical Sciences between the years 2006-2011, were included in this study. The function Adaptive Neuro- Fuzzy Inference System (ANFIS constructs a Fuzzy Inference System (FIS whose membership function parameters are tuned (adjusted using either a back-propagation algorithm alone, or in combination with the least squares type of method (hybrid algorithm. In this study, we used hybrid method for adjusting the parameters. Methods: The R-square of the proposed system was %598 and the Pearson correlation coefficient was significant (P 0.05. Although the accuracy of the model was not high, it wasgood enough to be applied for treating the IGE patients with sodium valproate. Discussion: This paper presented a new application of ANFIS for estimating the optimal dosage of sodium valproate in IGE patients. Fuzzy set theory plays an important role in dealing with uncertainty when making decisions in medical applications. Collectively, it seems that ANFIS has a high capacity to be applied in medical sciences, especially neurology.

Chapter 50: history of tropical neurology.

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Ogunniyi, Adesola

2010-01-01

Tropical neurology began less than two centuries ago. Consumption of dietary toxins predominated at the beginning and gave birth to the geographic entity. The story moved from lathyrism through Jamaican neuropathy to cassava-induced epidemic neuropathy, which was contrasted with Konzo, also associated with cassava. Other tropical diseases enumerated with chronological details include: Chaga's diseases, kwashiorkor, Madras type of motor neuron disease, atlanto-axial dislocation, Burkitt's lymphoma and Kuru, associated with cannibalism among the Fore linguistic group in New Guinea. More recent documentation includes the Cuban neuropathy in 1991 with an epidemic of visual loss and neuropathy, Anaphe venata entomophagy in Nigeria presenting as seasonal ataxia, and neurological aspects of the human immunodeficiency virus infection complete the picture. With time, professional associations were formed and the pioneers were given prominence. The World Federation of Neurology featured Geographic Neurology as a theme in 1977 and Tropical Neurology was given prominence at its 1989 meeting in New Delhi, India. The situation remains unchanged with regards to rare diseases like Meniere's, multiple sclerosis, hereditary disorders. However, with westernization and continued urbanization, changing disease patterns are being observed and tropical neurology may depart from dietary toxins to more western world-type disorders.

Child Neurology Education for Pediatric Residents.

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Albert, Dara V F; Patel, Anup D; Behnam-Terneus, Maria; Sautu, Beatriz Cunill-De; Verbeck, Nicole; McQueen, Alisa; Fromme, H Barrett; Mahan, John D

2017-03-01

The aim of this study was to evaluate whether the current state of child neurology education during pediatric residency provides adequate preparation for pediatric practice. A survey was sent to recent graduates from 3 pediatric residency programs to assess graduate experience, perceived level of competence, and desire for further education in child neurology. Responses from generalists versus subspecialists were compared. The response rate was 32%, half in general pediatric practice. Only 22% feel very confident in approaching patients with neurologic problems. This may represent the best-case scenario as graduates from these programs had required neurology experiences, whereas review of Accreditation Council of Graduate Medical Education-accredited residency curricula revealed that the majority of residencies do not. Pediatric neurologic problems are common, and pediatric residency graduates do encounter such problems in practice. The majority of pediatricians report some degree of confidence; however, some clear areas for improvement are apparent.

Individual differences in explicit and implicit visuomotor learning and working memory capacity.

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Christou, Antonios I; Miall, R Chris; McNab, Fiona; Galea, Joseph M

2016-11-08

The theoretical basis for the association between high working memory capacity (WMC) and enhanced visuomotor adaptation is unknown. Visuomotor adaptation involves interplay between explicit and implicit systems. We examined whether the positive association between adaptation and WMC is specific to the explicit component of adaptation. Experiment 1 replicated the positive correlation between WMC and adaptation, but revealed this was specific to the explicit component of adaptation, and apparently driven by a sub-group of participants who did not show any explicit adaptation in the correct direction. A negative correlation was observed between WMC and implicit learning. Experiments 2 and 3 showed that when the task restricted the development of an explicit strategy, high WMC was no longer associated with enhanced adaptation. This work reveals that the benefit of high WMC is specifically linked to an individual's capacity to use an explicit strategy. It also reveals an important contribution of individual differences in determining how adaptation is performed.

Neurocritical care education during neurology residency

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Drogan, O.; Manno, E.; Geocadin, R.G.; Ziai, W.

2012-01-01

Objective: Limited information is available regarding the current state of neurocritical care education for neurology residents. The goal of our survey was to assess the need and current state of neurocritical care training for neurology residents. Methods: A survey instrument was developed and, with the support of the American Academy of Neurology, distributed to residency program directors of 132 accredited neurology programs in the United States in 2011. Results: A response rate of 74% (98 of 132) was achieved. A dedicated neuroscience intensive care unit (neuro-ICU) existed in 64%. Fifty-six percent of residency programs offer a dedicated rotation in the neuro-ICU, lasting 4 weeks on average. Where available, the neuro-ICU rotation was required in the vast majority (91%) of programs. Neurology residents' exposure to the fundamental principles of neurocritical care was obtained through a variety of mechanisms. Of program directors, 37% indicated that residents would be interested in performing away rotations in a neuro-ICU. From 2005 to 2010, the number of programs sending at least one resident into a neuro-ICU fellowship increased from 14% to 35%. Conclusions: Despite the expansion of neurocritical care, large proportions of US neurology residents have limited exposure to a neuro-ICU and neurointensivists. Formal training in the principles of neurocritical care may be highly variable. The results of this survey suggest a charge to address the variability of resident education and to develop standardized curricula in neurocritical care for neurology residents. PMID:22573636

Neurologic complications in oncology

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Andrea Pace

2010-06-01

Full Text Available Neurologic side effects related to cancer therapy are a common problem in oncology practice. These complications can negatively affect the management of the patient, because they can inhibit treatment and diminish quality of life. Therefore specific skills are required to recognise symptoms and clinical manifestations. This review focuses on the most common neurologic complications to improve physician’s familiarity in determining the aetiology of these symptoms.

Dengue: a new challenge for neurology

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Marzia Puccioni-Sohler

2012-11-01

Full Text Available Dengue infection is a leading cause of illness and death in tropical and subtropical regions of the world. Forty percent of the world’s population currently lives in these areas. The clinical picture resulting from dengue infection can range from relatively minor to catastrophic hemorrhagic fever. Recently, reports have increased of neurological manifestations. Neuropathogenesis seems to be related to direct nervous system viral invasion, autoimmune reaction, metabolic and hemorrhagic disturbance. Neurological manifestations include encephalitis, encephalopathy, meningitis, Guillain-Barré syndrome, myelitis, acute disseminated encephalomyelitis, polyneuropathy, mononeuropathy, and cerebromeningeal hemorrhage. The development of neurological symptoms in patients with positive Immunoglobulin M (IgM dengue serology suggests a means of diagnosing the neurological complications associated with dengue. Viral antigens, specific IgM antibodies, and the intrathecal synthesis of dengue antibodies have been successfully detected in cerebrospinal fluid. However, despite diagnostic advancements, the treatment of neurological dengue is problematic. The launch of a dengue vaccine is expected to be beneficial.

Powerless Spectators, Coping Actors, and Adaptive Co-managers: a Synthesis of the Role of Communities in Ecosystem Management

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Christo Fabricius

2007-06-01

Full Text Available We provide a synthesis of the papers in the Special Issue, the Communities Ecosystems and Livelihoods component of the Millennium Ecosystem Assessment (MA, and other recent publications on the adaptive capacity of communities and their role in ecosystem management. Communities adapt because they face enormous challenges due to policies, conflicts, demographic factors, ecological change, and changes in their livelihood options, but the appropriateness of their responses varies. Based on our synthesis, three broad categories of adaptive communities are identified. "Powerless spectator" communities have a low adaptive capacity and weak capacity to govern, do not have financial or technological options, and lack natural resources, skills, institutions, and networks. "Coping actor" communities have the capacity to adapt, but are not managing social-ecological systems. They lack the capacity for governance because of lack of leadership, of vision, and of motivation, and their responses are typically short term. "Adaptive manager" communities have both adaptive capacity and governance capacity to sustain and internalize this adaptation. They invest in the long-term management of ecosystem services. Such communities are not only aware of the threats, but also take appropriate action for long-term sustainability. Adaptive co-management becomes possible through leadership and vision, the formation of knowledge networks, the existence or development of polycentric institutions, the establishment and maintenance of links between culture and management, the existence of enabling policies, and high levels of motivation in all role players. Adaptive co-managers are empowered, but empowerment is a consequence of the capacity for governance and the capacity to adapt, rather than a starting point. Communities that are able to enhance their adaptive capacity can deal with challenges such as conflicts, make difficult trade-offs between their short- and long

Interobserver variability of the neurological optimality score

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Monincx, W. M.; Smolders-de Haas, H.; Bonsel, G. J.; Zondervan, H. A.

1999-01-01

To assess the interobserver reliability of the neurological optimality score. The neurological optimality score of 21 full term healthy, neurologically normal newborn infants was determined by two well trained observers. The interclass correlation coefficient was 0.31. Kappa for optimality (score of

Education research: neurology training reassessed. The 2011 American Academy of Neurology Resident Survey results.

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Johnson, Nicholas E; Maas, Matthew B; Coleman, Mary; Jozefowicz, Ralph; Engstrom, John

2012-10-23

To assess the strengths and weaknesses of neurology resident education using survey methodology. A 27-question survey was sent to all neurology residents completing residency training in the United States in 2011. Of eligible respondents, 49.8% of residents returned the survey. Most residents believed previously instituted duty hour restrictions had a positive impact on resident quality of life without impacting patient care. Most residents rated their faculty and clinical didactics favorably. However, many residents reported suboptimal preparation in basic neuroscience and practice management issues. Most residents (71%) noted that the Residency In-service Training Examination (RITE) assisted in self-study. A minority of residents (14%) reported that the RITE scores were used for reasons other than self-study. The vast majority (86%) of residents will enter fellowship training following residency and were satisfied with the fellowship offers they received. Graduating residents had largely favorable neurology training experiences. Several common deficiencies include education in basic neuroscience and clinical practice management. Importantly, prior changes to duty hours did not negatively affect the resident perception of neurology residency training.

Neurological complications following bariatric surgery

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Yara Dadalti Fragoso

2012-09-01

Full Text Available OBJECTIVE: It was to report on Brazilian cases of neurological complications from bariatric surgery. The literature on the subject is scarce. METHOD: Cases attended by neurologists in eight different Brazilian cities were collected and described in the present study. RESULTS: Twenty-six cases were collected in this study. Axonal polyneuropathy was the most frequent neurological complication, but cases of central demyelination, Wernicke syndrome, optical neuritis, radiculits, meralgia paresthetica and compressive neuropathies were also identified. Twenty-one patients (80% had partial or no recovery from the neurological signs and symptoms. CONCLUSION: Bariatric surgery, a procedure that is continuously increasing in popularity, is not free of potential neurological complications that should be clearly presented to the individual undergoing this type of surgery. Although a clear cause-effect relation cannot be established for the present cases, the cumulative literature on the subject makes it important to warn the patient of the potential risks of this procedure.

Neurologic disorder and criminal responsibility.

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Yaffe, Gideon

2013-01-01

Sufferers from neurologic and psychiatric disorders are not uncommonly defendants in criminal trials. This chapter surveys a variety of different ways in which neurologic disorder bears on criminal responsibility. It discusses the way in which a neurologic disorder might bear on the questions of whether or not the defendant acted voluntarily; whether or not he or she was in the mental state that is required for guilt for the crime; and whether or not he or she is deserving of an insanity defense. The discussion demonstrates that a just determination of whether a sufferer from a neurologic disorder is diminished in his or her criminal responsibility for harmful conduct requires equal appreciation of the nature of the relevant disorder and its impact on behavior, on the one hand, and of the legal import of facts about the psychologic mechanisms through which behavior is generated, on the other. © 2013 Elsevier B.V. All rights reserved.

Local adaptive capacity as an alternative approach in dealing with hydrometeorological risk at Depok Peri-Urban City

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Fitrinitia, I. S.; Junadi, P.; Sutanto, E.; Nugroho, D. A.; Zubair, A.; Suyanti, E.

2018-03-01

Located in a tropical area, cities in Indonesia are vulnerable to hydrometeorological risks such as flood and landslide and thus become prone to the climate change effects. Moreover, peri-urban cities had double burden as the consequences of main city spill over and also lack of urban facilities in overcoming the disaster. In another perspective, the city has many alternative resources to recover, so its create urban resiliency. Depok city becomes a case study of this research regarding with its development following the impact of Jakarta growth. This research purposes to capture how the local city dwellers could anticipate and adaptive with flood and landslide with their own mitigation version. Through mix method and spatial analysis using GIS techniques, it derives the two comparison approach, the normative and alternative that had been done by the city dwellers. It uses a spatial analysis to have a big picture of Depok and its environmental changing. It also divided into 4 local group of communities as a representative of city dwellers regarding the characteristic of a settlement with their level of risk. The result found type or characteristic of settlement which influenced the local adaptive capacity, from the establishment of infrastructure, health fulfillment and social livelihood with different kind of methods.

Resilience Thinking: Integrating Resilience, Adaptability and Transformability

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Carl Folke

2010-12-01

Full Text Available Resilience thinking addresses the dynamics and development of complex social-ecological systems (SES. Three aspects are central: resilience, adaptability and transformability. These aspects interrelate across multiple scales. Resilience in this context is the capacity of a SES to continually change and adapt yet remain within critical thresholds. Adaptability is part of resilience. It represents the capacity to adjust responses to changing external drivers and internal processes and thereby allow for development along the current trajectory (stability domain. Transformability is the capacity to cross thresholds into new development trajectories. Transformational change at smaller scales enables resilience at larger scales. The capacity to transform at smaller scales draws on resilience from multiple scales, making use of crises as windows of opportunity for novelty and innovation, and recombining sources of experience and knowledge to navigate social-ecological transitions. Society must seriously consider ways to foster resilience of smaller more manageable SESs that contribute to Earth System resilience and to explore options for deliberate transformation of SESs that threaten Earth System resilience.

Standards in Neurological Rehabilitation, June 1997

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Michael P. Barnes

1997-01-01

Full Text Available The European Federation of Neurological Societies (EFNS Scientific Panel on Neurorehabilitation established a Task Force on standards in neurological rehabilitation in June 1996. The remit for the Task Force was to: (1 produce a report on the state of neurological rehabilitation across Europe; and (2 recommend standards for the provision of neurological services for disabled people. The main conclusions of the Task Force were as follows: (1 A questionnaire circulated to each European member country has indicated a significant lack of adequate neurological rehabilitation facilities across Europe. Very few countries have any established network of neurological rehabilitation centres. Few countries have adequately trained neurological rehabilitation physicians, therapists or nurses. Such poor facilities should be seen in the context of the large numbers and increasing prevalence of people with neurological disabilities. (2 The Task Force has summarized the significant benefits that can follow from the establishment of a dedicated and cost effective neurological rehabilitation service including functional improvement, reduction of unnecessary complications, better coordination and use of limited resources, improved opportunities for education, training and research and a clear point of contact for the disabled person. (3 The Task Force recommends minimum standards for the prevention of neurological disability including access to health education, genetic counselling and emergency resources. The Task Force also encourages governments to invest in improved legislation for accident prevention. (4 The Task Force has outlined some minimum standards for the staffing of a neurological rehabilitation service including improved training both for neurologists and rehabilitation physicians. Such training could include a cross-national training programme both for physicians and other health care staff. (5 The Task Force supports a two-tier system of

Paediatric Neurological Conditions Seen at the Physiotherapy ...

African Journals Online (AJOL)

Paediatric neurological conditions constitute a major cause of disability in childhood. However there seems to be an apparent dearth of published works on the patterns of neurological conditions seen in Nigerian physiotherapy clinics of rural locations. This study aimed at describing the spectrum of neurological conditions ...

Climate Change Adaptation Research and Capacity Development in ...

International Development Research Centre (IDRC) Digital Library (Canada)

This project aims to improve the quality of research, teaching and learning in climate change science at the University of Ghana. It will do so by building staff and ... La gestion de l'eau dans les milieux urbains et ruraux, élément fondamental des villes qui savent s'adapter aux changements climatiques. Les changements ...

Status of neurology medical school education

Science.gov (United States)

Ali, Imran I.; Isaacson, Richard S.; Safdieh, Joseph E.; Finney, Glen R.; Sowell, Michael K.; Sam, Maria C.; Anderson, Heather S.; Shin, Robert K.; Kraakevik, Jeff A.; Coleman, Mary; Drogan, Oksana

2014-01-01

Objective: To survey all US medical school clerkship directors (CDs) in neurology and to compare results from a similar survey in 2005. Methods: A survey was developed by a work group of the American Academy of Neurology Undergraduate Education Subcommittee, and sent to all neurology CDs listed in the American Academy of Neurology database. Comparisons were made to a similar 2005 survey. Results: Survey response rate was 73%. Neurology was required in 93% of responding schools. Duration of clerkships was 4 weeks in 74% and 3 weeks in 11%. Clerkships were taken in the third year in 56%, third or fourth year in 19%, and fourth year in 12%. Clerkship duration in 2012 was slightly shorter than in 2005 (fewer clerkships of ≥4 weeks, p = 0.125), but more clerkships have moved into the third year (fewer neurology clerkships during the fourth year, p = 0.051). Simulation training in lumbar punctures was available at 44% of schools, but only 2% of students attempted lumbar punctures on patients. CDs averaged 20% protected time, but reported that they needed at least 32%. Secretarial full-time equivalent was 0.50 or less in 71% of clerkships. Eighty-five percent of CDs were “very satisfied” or “somewhat satisfied,” but more than half experienced “burnout” and 35% had considered relinquishing their role. Conclusion: Trends in neurology undergraduate education since 2005 include shorter clerkships, migration into the third year, and increasing use of technology. CDs are generally satisfied, but report stressors, including inadequate protected time and departmental support. PMID:25305155

Climate Change Adaptation in a Mediterranean Semi-Arid Catchment: Testing Managed Aquifer Recharge and Increased Surface Reservoir Capacity

Directory of Open Access Journals (Sweden)

Nicolas Guyennon

2017-09-01

Full Text Available Among different uses of freshwater, irrigation is the most impacting groundwater resource, leading to water table depletion and possible seawater intrusion. The unbalance between the availability of water resources and demand is currently exacerbated and could become worse in the near future in accordance with climate change observations and scenarios provided by Intergovernmental Panel on Climate Change (IPCC. In this context, Increasing Maximum Capacity of the surface reservoir (IMC and Managed Aquifer Recharge (MAR are adaptation measures that have the potential to enhance water supply systems resiliency. In this paper, a multiple-users and multiple-resources-Water Supply System (WSS model is implemented to evaluate the effectiveness of these two adaptation strategies in a context of overexploited groundwater under the RCP 4.5 and the RCP 8.5 IPCC scenarios. The presented a case study that is located in the Puglia, a semi-arid region of South Italy characterized by a conspicuous water demand for irrigation. We observed that, although no significant long-term trend affects the proposed precipitation scenarios, the expected temperature increase highly impacts the WSS resources due to the associated increase of water demand for irrigation purposes. Under the RCP 4.5 the MAR scenario results are more effective than the IMC during long term wet periods (typically 5 years and successfully compensates the impact on the groundwater resources. Differently, under RCP 8.5, due to more persistent dry periods, both adaptation scenarios fail and groundwater resource become exposed to massive sea water intrusion during the second half of the century. We conclude that the MAR scenario is a suitable adaptation strategy to face the expected future changes in climate, although mitigation actions to reduce green-house gases are strongly required.

A randomised controlled trial investigating the benefits of adaptive working memory training for working memory capacity and attentional control in high worriers.

Science.gov (United States)

Hotton, Matthew; Derakshan, Nazanin; Fox, Elaine

2018-01-01

The process of worry has been associated with reductions in working memory capacity and availability of resources necessary for efficient attentional control. This, in turn, can lead to escalating worry. Recent investigations into working memory training have shown improvements in attentional control and cognitive performance in high trait-anxious individuals and individuals with sub-clinical depression. The current randomised controlled trial investigated the effects of 15 days of adaptive n-back working memory training, or an active control task, on working memory capacity, attentional control and worry in a sample of high worriers. Pre-training, post-training and one-month follow-up measures of working memory capacity were assessed using a Change Detection task, while a Flanker task was used to assess attentional control. A breathing focus task was used as a behavioural measure of worry in addition to a number of self-report assessments of worry and anxiety. Overall there was no difference between the active training and the active control condition with both groups demonstrating similar improvements in working memory capacity and worry, post-training and at follow-up. However, training-related improvements on the n-back task were associated with gains in working memory capacity and reductions in worry symptoms in the active training condition. These results highlight the need for further research investigating the role of individual differences in working memory training. Copyright © 2017. Published by Elsevier Ltd.

Neurological Manifestations of Dengue Infection

Directory of Open Access Journals (Sweden)

Guo-Hong Li

2017-10-01

Full Text Available Dengue counts among the most commonly encountered arboviral diseases, representing the fastest spreading tropical illness in the world. It is prevalent in 128 countries, and each year >2.5 billion people are at risk of dengue virus infection worldwide. Neurological signs of dengue infection are increasingly reported. In this review, the main neurological complications of dengue virus infection, such as central nervous system (CNS, peripheral nervous system, and ophthalmic complications were discussed according to clinical features, treatment and possible pathogenesis. In addition, neurological complications in children were assessed due to their atypical clinical features. Finally, dengue infection and Japanese encephalitis were compared for pathogenesis and main clinical manifestations.

The endogenous regenerative capacity of the damaged newborn brain: boosting neurogenesis with mesenchymal stem cell treatment

OpenAIRE

Donega, Vanessa; van Velthoven, Cindy TJ; Nijboer, Cora H; Kavelaars, Annemieke; Heijnen, Cobi J

2013-01-01

Neurogenesis continues throughout adulthood. The neurogenic capacity of the brain increases after injury by, e.g., hypoxia–ischemia. However, it is well known that in many cases brain damage does not resolve spontaneously, indicating that the endogenous regenerative capacity of the brain is insufficient. Neonatal encephalopathy leads to high mortality rates and long-term neurologic deficits in babies worldwide. Therefore, there is an urgent need to develop more efficient therapeutic strategie...

African Journal of Neurological Sciences: Editorial Policies

African Journals Online (AJOL)

African Journal of Neurological Sciences (AJNS) is owned and controlled by the Pan African Association of Neurological Sciences (PAANS). The AJNS's aim is to publish scientific papers of any aspects of Neurological Sciences. AJNS is published quarterly. Articles submitted exclusively to the AJNS are accepted if neither ...

Water Governance in Chile and Canada: a Comparison of Adaptive Characteristics

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Margot A. Hurlbert

2013-12-01

Full Text Available We compare the structures and adaptive capacities of water governance regimes that respond to water scarcity or drought in the South Saskatchewan River Basin (SSRB of western Canada and the Elqui River Basin (EB in Chile. Both regions anticipate climate change that will result in more extreme weather events including increasing droughts. The SSRB and the EB represent two large, regional, dryland water basins with significant irrigated agricultural production but with significantly different governance structures. The Canadian governance situation is characterized as decentralized multilevel governance with assigned water licenses; the Chilean is characterized as centralized governance with privatized water rights. Both countries have action at all levels in relation to water scarcity or drought. This structural comparison is based on studies carried out in each region assessing the adaptive capacity of each region to climate variability in the respective communities and applicable governance institutions through semistructured qualitative interviews. Based on this comparison, conclusions are drawn on the adaptive capacity of the respective water governance regimes based on four dimensions of adaptive governance that include: responsiveness, learning, capacity, including information, leadership, and equity. The result of the assessment allows discussion of the significant differences in terms of ability of distinct governance structures to foster adaptive capacity in the rural sector, highlights the need for a better understanding of the relationship of adaptive governance and good governance, and the need for more conceptual work on the interconnections of the dimensions of adaptive governance.

Visual attention capacity: a review of TVA-based patient studies.

Science.gov (United States)

Habekost, Thomas; Starrfelt, Randi

2009-02-01

Psychophysical studies have identified two distinct limitations of visual attention capacity: processing speed and apprehension span. Using a simple test, these cognitive factors can be analyzed by Bundesen's Theory of Visual Attention (TVA). The method has strong specificity and sensitivity, and measurements are highly reliable. As the method is theoretically founded, it also has high validity. TVA-based assessment has recently been used to investigate a broad range of neuropsychological and neurological conditions. We present the method, including the experimental paradigm and practical guidelines to patient testing, and review existing TVA-based patient studies organized by lesion anatomy. Lesions in three anatomical regions affect visual capacity: The parietal lobes, frontal cortex and basal ganglia, and extrastriate cortex. Visual capacity thus depends on large, bilaterally distributed anatomical networks that include several regions outside the visual system. The two visual capacity parameters are functionally separable, but seem to rely on largely overlapping brain areas.

Developing Personalized Sensorimotor Adaptability Countermeasures for Spaceflight

Science.gov (United States)

Mulavara, A. P.; Seidler, R. D.; Peters, B.; Cohen, H. S.; Wood, S.; Bloomberg, J. J.

2016-01-01

Astronauts experience sensorimotor disturbances during their initial exposure to microgravity and during the re-adaptation phase following a return to an Earth-gravitational environment. Interestingly, astronauts who return from spaceflight show substantial differences in their abilities to readapt to a gravitational environment. The ability to predict the manner and degree to which individual astronauts would be affected would improve the effectiveness of countermeasure training programs designed to enhance sensorimotor adaptability. In this paper we will be presenting results from our ground-based study that show how behavioral, brain imaging and genomic data may be used to predict individual differences in sensorimotor adaptability to novel sensorimotor environments. This approach will allow us to better design and implement sensorimotor adaptability training countermeasures against decrements in post-mission adaptive capability that are customized for each crewmember's sensory biases, adaptive capacity, brain structure, functional capacities, and genetic predispositions. The ability to customize adaptability training will allow more efficient use of crew time during training and will optimize training prescriptions for astronauts to ensure expected outcomes.

Neurologic Complications of Transplantation.

Science.gov (United States)

Dhar, Rajat

2018-02-01

Neurologic disturbances including encephalopathy, seizures, and focal deficits complicate the course 10-30% of patients undergoing organ or stem cell transplantation. While much or this morbidity is multifactorial and often associated with extra-cerebral dysfunction (e.g., graft dysfunction, metabolic derangements), immunosuppressive drugs also contribute significantly. This can either be through direct toxicity (e.g., posterior reversible encephalopathy syndrome from calcineurin inhibitors such as tacrolimus in the acute postoperative period) or by facilitating opportunistic infections in the months after transplantation. Other neurologic syndromes such as akinetic mutism and osmotic demyelination may also occur. While much of this neurologic dysfunction may be reversible if related to metabolic factors or drug toxicity (and the etiology is recognized and reversed), cases of multifocal cerebral infarction, hemorrhage, or infection may have poor outcomes. As transplant patients survive longer, delayed infections (such as progressive multifocal leukoencephalopathy) and post-transplant malignancies are increasingly reported.

Adapting to climate change by water management organisations: Enablers and barriers

Science.gov (United States)

Azhoni, Adani; Jude, Simon; Holman, Ian

2018-04-01

Climate change will be particularly experienced though the medium of water. Water organisations, that are managing societal and ecological needs for water, are therefore likely to experience the impact the most. This study reviews the current literature regarding adaptation to climate change by water management organisations and associated barriers. Literature on adaptive capacity is growing and a general consensus is emerging on the determinants of adaptive capacity, although variations exist regarding how it is to be evaluated, enhanced and applied to policy making due to its dynamic, contextual and latent nature. Since adaptive capacity is hard to measure and successful adaptation difficult to define, some studies focus on the existence of adaptation attributes of organisations. Studies reporting successful adaptation are minimal and barriers of adaptation are being discovered as adaptation research transitions into implementation. But the root causes of these barriers are often overlooked and the interconnectedness of the barriers is poorly addressed. Increasingly, combining top-down and bottom-up approaches to adaptation is being recommended due to the limitations of each. However, knowledge regarding how organisations operating at different scales can enhance adaptive capacity of other organisations operating at another scale is lacking due to the few studies of inter-organisational networks across scales. Social networks among actors are recognised as a key factor to enable adaptation. However, network studies generally focus on individual actors and rarely between public agencies/organisations. Moreover, the current literature is inadequate to understand the relationship between adaptation enabling characteristics, barriers and adaptation manifestation. The review demonstrates that research on understanding the emergence and sustenance of barriers is urgently required. Addressing these knowledge gaps will help to improve the design of adaptation strategies

Neurology and the Internet: a review.

Science.gov (United States)

Moccia, Marcello; Brigo, Francesco; Tedeschi, Gioacchino; Bonavita, Simona; Lavorgna, Luigi

2018-06-01

Nowadays, the Internet is the major source to obtain information about diseases and their treatments. The Internet is gaining relevance in the neurological setting, considering the possibility of timely social interaction, contributing to general public awareness on otherwise less-well-known neurological conditions, promoting health equity and improving the health-related coping. Neurological patients can easily find several online opportunities for peer interactions and learning. On the other hand, neurologist can analyze user-generated data to better understand patient needs and to run epidemiological studies. Indeed, analyses of queries from Internet search engines on certain neurological diseases have shown a strict temporal and spatial correlation with the "real world." In this narrative review, we will discuss how the Internet is radically affecting the healthcare of people with neurological disorders and, most importantly, is shifting the paradigm of care from the hands of those who deliver care, into the hands of those who receive it. Besides, we will review possible limitations, such as safety concerns, financial issues, and the need for easy-to-access platforms.

Capacity to adapt to environmental change: evidence from a network of organizations concerned with increasing wildfire risk

Directory of Open Access Journals (Sweden)

A. Paige. Fischer

2017-03-01

Full Text Available Because wildfire size and frequency are expected to increase in many forested areas in the United States, organizations involved in forest and wildfire management could arguably benefit from working together and sharing information to develop strategies for how to adapt to this increasing risk. Social capital theory suggests that actors in cohesive networks are positioned to build trust and mutual understanding of problems and act collectively to address these problems, and that actors engaged with diverse partners are positioned to access new information and resources that are important for innovation and complex problem solving. We investigated the patterns of interaction within a network of organizations involved in forest and wildfire management in Oregon, USA, for evidence of structural conditions that create opportunities for collective action and learning. We used descriptive statistical analysis of social network data gathered through interviews to characterize the structure of the network and exponential random graph modeling to identify key factors in the formation of network ties. We interpreted our findings through the lens of social capital theory to identify implications for the network's capacity to engage in collective action and complex problem-solving about how to adapt to environmental change. We found that tendencies to associate with others with similar management goals, geographic emphases, and attitudes toward wildfire were strong mechanisms shaping network structure, potentially constraining interactions among organizations with diverse information and resources and limiting opportunities for learning and complex problem-solving needed for adaptation. In particular, we found that organizations with fire protection and forest restoration goals comprised distinct networks despite sharing concern about the problem of increasing wildfire risk.

Chapter 44: history of neurology in Italy.

Science.gov (United States)

Bentivoglio, Marina; Mazzarello, Paolo

2010-01-01

The chapter starts from the Renaissance (although the origins of Italian neurology can be traced back to the Middle Ages), when treatises of nervous system physiopathology still followed Hippocratic and Galenic "humoral" theories. In Italy, as elsewhere in Europe, the concepts of humoral pathology were abandoned in the 18th century, when neurology was influenced by novel trends. Neurology acquired the status of clinical discipline (as "clinic of mental diseases") after national reunification (declared in 1861 but completed much later). At the end of the 19th and first decades of the 20th century, eminent Italian "neuropsychiatrists" (including, among many others, Ugo Cerletti, who introduced electroconvulsive shock therapy in 1938) stimulated novel knowledge and approaches, "centers of excellence" flourished, and "Neurological Institutes" were founded. In the first half of the 20th century, the history of Italian neurology was dominated by World Wars I and II (which stimulated studies on the wounded) and the fascist regime in-between the Wars (when the flow of information was instead very limited). Italy became a republic in 1946, and modern neurology and its distinction from psychiatry were finally promoted. The chapter also provides detailed accounts of scientific societies and journals dedicated to the neurological sciences in Italy.

Uplink capacity of multi-class IEEE 802.16j relay networks with adaptive modulation and coding

DEFF Research Database (Denmark)

Wang, Hua; Xiong, C; Iversen, Villy Bæk

2009-01-01

The emerging IEEE 802.16j mobile multi-hop relay (MMR) network is currently being developed to increase the user throughput and extend the service coverage as an enhancement of existing 802.16e standard. In 802.16j, the intermediate relay stations (RSs) help the base station (BS) communicate...... with those mobile stations (MSs) that are either too far away from the BS or placed in an area where direct communication with BS experiences unsatisfactory level of service. In this paper, we investigate the uplink Erlang capacity of a two-hop 802.16j relay system supporting both voice and data traffics...... with adaptive modulation and coding (AMC) scheme applied in the physical layer. We first develop analytical models to calculate the blocking probability in the access zone and the outage probability in the relay zone, respectively. Then a joint algorithm is proposed to determine the bandwidth distribution...

Resilience thinking: integrating resilience, adaptability and transformability

Science.gov (United States)

Carl Folke; Stephen R. Carpenter; Brian Walker; Marten Scheffer; Terry Chapin; Johan. Rockstrom

2010-01-01

Resilience thinking addresses the dynamics and development of complex social-ecological systems (SES). Three aspects are central: resilience, adaptability and transformability. These aspects interrelate across multiple scales. Resilience in this context is the capacity of a SES to continually change and adapt yet remain within critical thresholds. Adaptability is part...

Education Research: Neurology training reassessed

Science.gov (United States)

Maas, Matthew B.; Coleman, Mary; Jozefowicz, Ralph; Engstrom, John

2012-01-01

Objective: To assess the strengths and weaknesses of neurology resident education using survey methodology. Methods: A 27-question survey was sent to all neurology residents completing residency training in the United States in 2011. Results: Of eligible respondents, 49.8% of residents returned the survey. Most residents believed previously instituted duty hour restrictions had a positive impact on resident quality of life without impacting patient care. Most residents rated their faculty and clinical didactics favorably. However, many residents reported suboptimal preparation in basic neuroscience and practice management issues. Most residents (71%) noted that the Residency In-service Training Examination (RITE) assisted in self-study. A minority of residents (14%) reported that the RITE scores were used for reasons other than self-study. The vast majority (86%) of residents will enter fellowship training following residency and were satisfied with the fellowship offers they received. Conclusions: Graduating residents had largely favorable neurology training experiences. Several common deficiencies include education in basic neuroscience and clinical practice management. Importantly, prior changes to duty hours did not negatively affect the resident perception of neurology residency training. PMID:23091077

Hypnosis as therapy for functional neurologic disorders.

Science.gov (United States)

Deeley, Q

2016-01-01

treatment approaches, such as cognitive-behavioral, rehabilitative, or psychodynamic therapy. Suggestions are generally symptom-focused (designed to resolve a symptom) or exploratory (using methods such as revivification or age regression to explore experiences associated with symptom onset). The evidence base is dominated by case studies and series, with a paucity of randomized controlled trials. Future evaluation studies should allow for the fact that suggestion with or without hypnosis is a component of broader treatment interventions adapted to a wide range of symptoms and presentations. An important role of the concept of suggestion in the management of functional neurologic symptoms is to raise awareness of how interactions with clinicians and wider clinical contexts can alter expectancies and beliefs of patients in ways that influence the onset, course, and remission of symptoms. © 2016 Elsevier B.V. All rights reserved.

International electives in neurology training

Science.gov (United States)

Lyons, Jennifer L.; Coleman, Mary E.; Engstrom, John W.

2014-01-01

Objective: To ascertain the current status of global health training and humanitarian relief opportunities in US and Canadian postgraduate neurology programs. Background: There is a growing interest among North American trainees to pursue medical electives in low- and middle-income countries. Such training opportunities provide many educational and humanitarian benefits but also pose several challenges related to organization, human resources, funding, and trainee and patient safety. The current support and engagement of neurology postgraduate training programs for trainees to pursue international rotations is unknown. Methods: A survey was distributed to all program directors in the United States and Canada (December 2012–February 2013) through the American Academy of Neurology to assess the training opportunities, institutional partnerships, and support available for international neurology electives. Results: Approximately half of responding programs (53%) allow residents to pursue global health–related electives, and 11% reported that at least 1 trainee participated in humanitarian relief during training (survey response rate 61%, 143/234 program directors). Canadian programs were more likely to allow residents to pursue international electives than US programs (10/11, 91% vs 65/129, 50%, p = 0.023). The number of trainees participating in international electives was low: 0%–9% of residents (55% of programs) and 10%–19% of residents (21% of programs). Lack of funding was the most commonly cited reason for residents not participating in global health electives. If funding was available, 93% of program directors stated there would be time for residents to participate. Most program directors (75%) were interested in further information on global health electives. Conclusions: In spite of high perceived interest, only half of US neurology training programs include international electives, mostly due to a reported lack of funding. By contrast, the majority

Assessing Capacity for Sustainability of Effective Programs and Policies in Local Health Departments.

Science.gov (United States)

Tabak, Rachel G; Duggan, Katie; Smith, Carson; Aisaka, Kristelle; Moreland-Russell, Sarah; Brownson, Ross C

2016-01-01

Sustainability has been defined as the existence of structures and processes that allow a program to leverage resources to effectively implement and maintain evidence-based public health and is important in local health departments (LHDs) to retain the benefits of effective programs. Explore the applicability of the Program Sustainability Framework in high- and low-capacity LHDs as defined by national performance standards. Case study interviews from June to July 2013. Standard qualitative methodology was used to code transcripts; codes were developed inductively and deductively. Six geographically diverse LHD's (selected from 3 of high and 3 of low capacity) : 35 LHD practitioners. Thematic reports explored the 8 domains (Organizational Capacity, Program Adaptation, Program Evaluation, Communications, Strategic Planning, Funding Stability, Environmental Support, and Partnerships) of the Program Sustainability Framework. High-capacity LHDs described having environmental support, while low-capacity LHDs reported this was lacking. Both high- and low-capacity LHDs described limited funding; however, high-capacity LHDs reported greater funding flexibility. Partnerships were important to high- and low-capacity LHDs, and both described building partnerships to sustain programming. Regarding organizational capacity, high-capacity LHDs reported better access to and support for adequate staff and staff training when compared with low-capacity LHDs. While high-capacity LHDs described integration of program evaluation into implementation and sustainability, low-capacity LHDs reported limited capacity for measurement specifically and evaluation generally. When high-capacity LHDs described program adoption, they discussed an opportunity to adapt and evaluate. Low-capacity LHDs struggled with programs requiring adaptation. High-capacity LHDs described higher quality communication than low-capacity LHDs. High- and low-capacity LHDs described strategic planning, but high-capacity

Assessing capacity for sustainability of effective programs and policies in local health departments

Science.gov (United States)

Tabak, Rachel G.; Duggan, Katie; Smith, Carson; Aisaka, Kristelle; Moreland-Russell, Sarah; Brownson, Ross C.

2015-01-01

Context Sustainability has been defined as the existence of structures and processes that allow a program to leverage resources to effectively implement and maintain evidence-based public health and is important in local health departments (LHDs) to retain the benefits of effective programs. Objective Explore the applicability of the Program Sustainability Framework in high- and low-capacity LHDs as defined by national performance standards. Design Case study interviews from June-July 2013. Standard qualitative methodology was used to code transcripts; codes were developed inductively and deductively. Setting Six geographically diverse LHD’s (selected from three high- and three low-capacity) Participants 35 LHD practitioners Main Outcome Measures Thematic reports explored the eight domains (Organizational Capacity, Program Adaptation, Program Evaluation, Communications, Strategic Planning, Funding Stability, Environmental Support, and Partnerships) of the Program Sustainability Framework. Results High-capacity LHDs described having environmental support, while low-capacity LHDs reported this was lacking. Both high- and low-capacity LHDs described limited funding; however, high-capacity LHDs reported greater funding flexibility. Partnerships were important to high- and low-capacity LHDs, and both described building partnerships to sustain programming. Regarding organizational capacity, high-capacity LHDs reported better access to and support for adequate staff and staff training compared to low-capacity LHDs. While high-capacity LHDs described integration of program evaluation into implementation and sustainability, low-capacity LHDs reported limited capacity for measurement specifically and evaluation generally. When high-capacity LHDs described program adoption, they discussed an opportunity to adapt and evaluate. Low-capacity LHDs struggled with programs requiring adaptation. High-capacity LHDs described higher quality communication than low-capacity LHDs. High

The adaptive capacity of smallholder mixed-farming systems to the impact of climate change: The case of KwaZulu-Natal in South Africa

OpenAIRE

Nonhlanzeko N. Mthembu; Elliot M. Zwane

2017-01-01

Climate change poses a serious threat to efforts by developing countries to ensure food security and poverty reduction. The National Development goals of South Africa envisage the agricultural sector as a key driver for job creation and economic growth. This article seeks to investigate the adaptive capacity of the Ncunjane farming community in Msinga, KwaZulu-Natal in response to drought spells of 2010 and 2014. This article draws on data collected using both qualitative and quantitative met...

Cervical spinal canal narrowing and cervical neurologi-cal injuries

Directory of Open Access Journals (Sweden)

ZHANG Ling

2012-04-01

Full Text Available 【Abstract】Cervical spinal canal narrowing can lead to injury of the spinal cord and neurological symptoms in-cluding neck pain, headache, weakness and parasthesisas. According to previous and recent clinical researches, we investigated the geometric parameters of normal cervical spinal canal including the sagittal and transverse diameters as well as Torg ratio. The mean sagittal diameter of cervical spinal canal at C 1 to C 7 ranges from 15.33 mm to 20.46 mm, the mean transverse diameter at the same levels ranges from 24.45 mm to 27.00 mm and the mean value of Torg ratio is 0.96. With respect to narrow cervical spinal canal, the following charaterstics are found: firstly, extension of the cervical spine results in statistically significant stenosis as compared with the flexed or neutral positions; secondly, females sustain cervical spinal canal narrowing more easily than males; finally, the consistent narrowest cervical canal level is at C 4 for all ethnicity, but there is a slight variation in the sagittal diameter of cervical spinal stenosis (≤14 mm in Whites, ≤ 12 mm in Japanese, ≤13.7 mm in Chinese. Narrow sagittal cervical canal diameter brings about an increased risk of neurological injuries in traumatic, degenerative and inflam-matory conditions and is related with extension of cervical spine, gender, as well as ethnicity. It is hoped that this re-view will be helpful in diagnosing spinal cord and neuro-logical injuries with the geometric parameters of cervical spine in the future. Key words: Spinal cord injuries; Spinal stenosis; Trauma, nervous system

Cochlear implantation in children with congenital cytomegalovirus infection accompanied by psycho-neurological disorders.

Science.gov (United States)

Yamazaki, Hiroshi; Yamamoto, Rinko; Moroto, Saburo; Yamazaki, Tomoko; Fujiwara, Keizo; Nakai, Masako; Ito, Juichi; Naito, Yasushi

2012-04-01

Cochlear implantation was effective for deaf children with congenital cytomegalovirus (CMV) infection, but their cochlear implant (CI) outcomes were often impaired, depending on the types of CMV-associated psycho-neurological disorders. Evaluation of cognitive development and autistic tendency of implantees might be useful to predict their CI outcomes. To reveal the influence of CMV-associated psycho-neurological disorders on CI outcomes. This was a retrospective evaluation of 11 implantees with congenital CMV infection (CMV-CIs) and 14 implantees with autosomal recessive hearing loss (genetic-CIs). Nine of 11 CMV-CIs suffered from psycho-neurological disorders; one from attention deficit hyperactivity disorder, two from pervasive developmental disorder, and six from mental retardation. Aided hearing thresholds with CIs in the two groups did not differ, but two autistic and two mentally retarded CMV-CIs showed significantly low scores in speech discrimination tests. Language-Social (L-S) developmental quotients (DQs) evaluated by the Kyoto Scale of Psychological development were improved after the implantation in both groups, but the postoperative increase of L-S DQs was significantly smaller in the CMV-CIs than that of genetic-CIs. Interestingly, the postoperative L-S and Cognitive-Adaptive (C-A) DQs showed statistically significant correlation in all cases except for two autistic CMV-CIs whose L-S DQs were much lower than those expected from their C-A DQs.

Condições mais frequentes em um ambulatório de perícia neurológica The most common disorders in neurological clinic for medico-legal assessment of labour capacity at the Brazilian Social Security System (INSS in Florianópolis - SC, Brazil

Directory of Open Access Journals (Sweden)

Paulo Cesar Trevisol-Bittencourt

2001-06-01

Full Text Available OBJETIVO: Apresentar as condições nosológicas vistas em perícia neurológica em um ambulatório de referência estadual do Instituto Nacional de Seguridade Social (INSS, Florianópolis, Santa Catarina, Brasil, durante o período de outubro de 97 a maio de 98. MÉTODO: Revisão dos relatórios especializados das perícias solicitadas ao especialista em neurologia, com identificação dos diagnósticos finais dos 108 pacientes encaminhados para avaliação. RESULTADOS: Os diagnósticos mais comuns em ordem decrescente de frequência foram: epilepsia, doenças reumatológicas, distúrbios psiquiátricos, alterações neurológicas associadas a alcoolismo crônico, síndrome pós TCE e doença vascular cerebral. CONCLUSÕES: Doenças neurológicas podem determinar importante grau de incapacidade no trabalhador catarinense. Contudo, existe um subestimado potencial de recuperação funcional. Além disso, diversas condições não genuinamente neurológicas são encaminhadas para avaliação especializada.OBJECTIVE: To present the most frequent diagnosis among patients refered for neurological evaluation to estimate their labour capacities at the unit of National Institute of Social Security (INSS, Florianópolis-SC, southern Brazil. METHOD: Review of all medical records of 108 patients evaluated between October 97 and May 98. The sample was submited to judicious medico-legal assessment to define their final diagnosis. RESULTS: Neurological evaluation disclosed as the commonest disorders, in decreasing order of frequency: epilepsy, rheumatic diseases, psychiatric illnesses, neurological disorders related to chronic alcoholism, head trauma syndrome and cerebrovascular diseases. CONCLUSION: Neurological disorders may be responsible for important disability among workers in our society. However, the potential for social rehabilitation, often underestimated, must be considered. Moreover, diverse non-neurological conditions used to be sent for

Neurological aspects of acute radiation injuries

International Nuclear Information System (INIS)

Torubarov, F.S.; Bushmanov, A.Yu.

1999-01-01

Results of the most important clinical studies of human nervous system reactions to acute radiation, carried out at Neurology Clinic of the State Research Center of Russia - Institute of Biophysics are presented. Clinical picture of changes in the nervous system in acute radiation disease caused by homologous and heterologous external irradiation is described. Main neurological syndrome of extremely severe acute radiation disease: acute radiation encephalopathy, radiation toxic encephalopathy, and hemorrhagic syndrome of the central nervous system is distinguished. Relationship between neurological disorders and the geometry of exposure are considered [ru

Vegetative status characteristics in children with neurological pathology on the background of undifferentiated connective tissue dysplasia

Directory of Open Access Journals (Sweden)

Tyazka O.V.

2016-03-01

influence of one or another of the divisions of the ANS, which served as the basis for determining the severity of the impact of the components of autonomic regulation. Autonomic reactivity was assessed on the basis of reflex of samples Danin-Aschner and Chermak-Goering in statistical analysis for Galu. Support for the activities was set according to clinortotation samples. UNDCT diagnosis and severity was Dagestanis on the basis of criteria proposed by T. Milkovsky-Dimitrova (1985 in modification of L. N. Abakumova. Results. Therefore, children with neurological pathology on the background of undifferentiated connective tissue dysplasia have a deeper down-the vegetative, the severity of which correlates with the degree of NDCT (P<0.05. The prevalence parasympathicotonia and low sympathetic reactivity in children with UDCT, perhaps due to metabolic disorders: increased average potassium-calcium ratio, which serves as one of the criteria the predominance of vagotonia, and lower levels of total calcium and inorganic phosphorus, which point to insufficient provision of vitamin D. Inadequate functioning of the sympathetic division of ANS leads to decrease of adaptive&trophic processes in situations requiring intense mental activity, and hence the adaptive capacity of the organism. Patients with insufficient vegetative support amid NDCT form a group of psychological risk, which is characterized by reduced subjective assessment of their own capabilities, emotional instability, and repressive conformism. Conclusion. Deficit vegetative maintenance in children with NDCT is potentially dangerous during physical paranavitana in the untrained conditions, dysplastic modified myocytes, including cardiomyocytes, which may poyasnite ciselements (deficiency of vitamin D3, hypocalcaemia and gphotospace, which, in turn, contributes to a violation of biochemically-colloidal processes and bioenergetic reactions in children and more severe manifestations of the UNDCT. Given the above, children

Psychological assessment of malingering in psychogenic neurological disorders and non-psychogenic neurological disorders : relationship to psychopathology levels

NARCIS (Netherlands)

van Beilen, M.; Griffioen, B. T.; Gross, A.; Leenders, K. L.

2009-01-01

Background and purpose: It remains unknown whether psychological distress causes malingering in patients with psychogenic symptoms. Methods: We studied 26 patients with psychogenic neurological disorders on psychopathology and malingering in comparison with 26 patients with various neurological

Institutional adaptation to drought: the case of Fars Agricultural Organization.

Science.gov (United States)

Keshavarz, Marzieh; Karami, Ezatollah

2013-09-30

Recurrent droughts in arid and semi-arid regions are already rendering agricultural production, mainstay of subsistence livelihoods, uncertain. In order to mitigate the impact of drought, agricultural organizations must increase their capacity to adapt. Institutional adaptation refers to the creation of an effective, long-term government institution or set of institutions in charge of planning and policy, and its capacity to develop, revise, and execute drought policies. Using the Fars Agricultural Organization in Iran, as a case study, this paper explores the institutional capacities and capabilities, necessary to adapt to the drought conditions. The STAIR model was used as a conceptual tool, and the Bayesian network and Partial Least Squares (PLS) path modeling was applied to explain the mechanisms by which organizational capacities influence drought management. A survey of 309 randomly selected managers and specialists indicated serious weaknesses in the ability of the organization to apply adaptation strategies effectively. Analysis of the causal models illustrated that organizational culture and resources and infrastructure significantly influenced drought management performance. Moreover, managers and specialists perceived human resources and strategy, goals, and action plan, respectively, as the main drivers of institutional adaptation to drought conditions. Recommendations and implications for drought management policy are offered to increase organizational adaptation to drought and reduce the subsequent sufferings. Copyright © 2013 Elsevier Ltd. All rights reserved.

Using ECC DRAM to Adaptively Increase Memory Capacity

OpenAIRE

Luo, Yixin; Ghose, Saugata; Li, Tianshi; Govindan, Sriram; Sharma, Bikash; Kelly, Bryan; Boroumand, Amirali; Mutlu, Onur

2017-01-01

Modern DRAM modules are often equipped with hardware error correction capabilities, especially for DRAM deployed in large-scale data centers, as process technology scaling has increased the susceptibility of these devices to errors. To provide fast error detection and correction, error-correcting codes (ECC) are placed on an additional DRAM chip in a DRAM module. This additional chip expands the raw capacity of a DRAM module by 12.5%, but the applications are unable to use any of this extra c...

Community-Acquired Pneumonia Hospitalization among Children with Neurologic Disorders.

Science.gov (United States)

Millman, Alexander J; Finelli, Lyn; Bramley, Anna M; Peacock, Georgina; Williams, Derek J; Arnold, Sandra R; Grijalva, Carlos G; Anderson, Evan J; McCullers, Jonathan A; Ampofo, Krow; Pavia, Andrew T; Edwards, Kathryn M; Jain, Seema

2016-06-01

To describe and compare the clinical characteristics, outcomes, and etiology of pneumonia among children hospitalized with community-acquired pneumonia (CAP) with neurologic disorders, non-neurologic underlying conditions, and no underlying conditions. Children children's hospitals. Neurologic disorders included cerebral palsy, developmental delay, Down syndrome, epilepsy, non-Down syndrome chromosomal abnormalities, and spinal cord abnormalities. We compared the epidemiology, etiology, and clinical outcomes of CAP in children with neurologic disorders with those with non-neurologic underlying conditions, and those with no underlying conditions using bivariate, age-stratified, and multivariate logistic regression analyses. From January 2010-June 2012, 2358 children with radiographically confirmed CAP were enrolled; 280 (11.9%) had a neurologic disorder (52.1% of these individuals also had non-neurologic underlying conditions), 934 (39.6%) had non-neurologic underlying conditions only, and 1144 (48.5%) had no underlying conditions. Children with neurologic disorders were older and more likely to require intensive care unit (ICU) admission than children with non-neurologic underlying conditions and children with no underlying conditions; similar proportions were mechanically ventilated. In age-stratified analysis, children with neurologic disorders were less likely to have a pathogen detected than children with non-neurologic underlying conditions. In multivariate analysis, having a neurologic disorder was associated with ICU admission for children ≥2 years of age. Children with neurologic disorders hospitalized with CAP were less likely to have a pathogen detected and more likely to be admitted to the ICU than children without neurologic disorders. Published by Elsevier Inc.

Neurological sequelae in survivors of cerebral malaria | Oluwayemi ...

African Journals Online (AJOL)

Introduction: Cerebral malaria is a common cause of neurological sequelae and death in childhood. Information on persistent neurological sequelae post hospital discharge and their predisposing factors are scarce. Methods: This is a prospective study describing persisting neurological impairments post discharge among ...

Comparative audit of clinical research in pediatric neurology.

Science.gov (United States)

Al-Futaisi, Amna; Shevell, Michael

2004-11-01

Clinical research involves direct observation or data collection on human subjects. This study was conducted to evaluate the profile of pediatric neurology clinical research over a decade. Trends in pediatric neurology clinical research were documented through a systematic comparative review of articles published in selected journals. Eleven journals (five pediatric neurology, three general neurology, three general pediatrics) were systematically reviewed for articles involving a majority of human subjects less than 18 years of age for the years 1990 and 2000. Three hundred thirty-five clinical research articles in pediatric neurology were identified in the 11 journals for 1990 and 398 for 2000, a 19% increase. A statistically significant increase in analytic design (21.8% vs 39.5%; P = .01), statistical support (6% vs 16.6%; P neurology over a decade. Trends apparently suggest a more rigorous approach to study design and investigation in this field.

Protective Effects of Ginseng on Neurological Disorders

Directory of Open Access Journals (Sweden)

Wei-Yi eOng

2015-07-01

Full Text Available Ginseng (Order: Apiales, Family: Araliaceae, Genus: Panax has been used as a traditional herbal medicine for over 2000 years, and is recorded to have antianxiety, antidepressant and cognition enhancing properties. The protective effect of ginseng on neurological disorders is discussed in this review. Ginseng species and ginsenosides, and their intestinal metabolism and bioavailability are briefly introduced. This is followed by molecular mechanisms of effects of ginseng on the brain, including glutamatergic transmission, monoamine transmission, estrogen signaling, nitric oxide production, the Keap1/Nrf2 adaptive cellular stress pathway, neuronal survival, apoptosis, neural stem cells and neuroregeneration, microglia, astrocytes, oligodendrocytes and cerebral microvessels. The molecular mechanisms of the neuroprotective effects of ginseng in Alzheimer’s disease including Aβ formation, tau hyperphosphorylation and oxidative stress, major depression, stroke, Parkinson’s disease and multiple sclerosis / experimental allergic encephalitis are then presented. It is hoped that this discussion will stimulate more studies on the use of ginseng in these disorders.

Convergence Performance of Adaptive Algorithms of L-Filters

Directory of Open Access Journals (Sweden)

Robert Hudec

2003-01-01

Full Text Available This paper deals with convergence parameters determination of adaptive algorithms, which are used in adaptive L-filters design. Firstly the stability of adaptation process, convergence rate or adaptation time, and behaviour of convergence curve belong among basic properties of adaptive algorithms. L-filters with variety of adaptive algorithms were used to their determination. Convergence performances finding of adaptive filters is important mainly for their hardware applications, where filtration in real time or adaptation of coefficient filter with low capacity of input data are required.

Rare Neurological Complications After Sleeve Gastrectomy.

Science.gov (United States)

Tabbara, Malek; Carandina, Sergio; Bossi, Manuela; Polliand, Claude; Genser, Laurent; Barrat, Christophe

2016-12-01

Bariatric surgery is considered to be the most effective treatment of morbid obesity and improvement of obesity-related comorbidities, such as type II diabetes. However, both peripheral and central neurological complications can occur after bariatric surgery. Such complications tend to occur more frequently after bypass surgery than after sleeve gastrectomy (SG). The objective of this study was to identify the patients that presented post-operative neurological complications after undergoing SG and describe the incidence, presentation, and management of these complications. This was a retrospective study of 592 cases of SG performed between 2009 and 2014 with a special focus on patients who presented neurological complications. Of the 592 SG cases, only seven (1.18 %) patients presented neurological complications. All patients had uneventful post-operative course, but all reported feeding difficulties, accompanied by severe dysphagia, and rapid weight loss, with a mean weight loss of 35 kg (30-40 kg) 3 months after SG. All patients were readmitted owing to neurological symptoms that included paresthesia, abolition of deep tendon reflexes of the lower limbs, muscle pain, and motor and sensitive deficits in some cases. There were two cases of Wernicke's encephalopathy. All patients were treated for neuropathy secondary to vitamin B1 deficiency and had a significant improvement and/or resolution of their symptoms. Neurological complications after SG are rare and are often preceded by gastrointestinal symptoms, rapid weight loss, and lack of post-operative vitamin supplementation. Re-hospitalization and multidisciplinary team management are crucial to establish the diagnosis and initiate treatment.

[Sir William Richard Gowers: author of the "bible of neurology"].

Science.gov (United States)

Hirose, Genjiro

2014-11-01

William Richard Gowers is one of the great pioneers in neurology and the author of the well-known neurology textbook, "A Manual of Diseases of the Nervous System." His concepts of neurology are based on meticulously and carefully accumulated knowledge of history, observations, and neurological examinations of patients with various neurological diseases. He is not only a great neurologist but also a great teacher who loves teaching students and physicians through well-prepared lectures. We can glean the essence of the field of neurology through his life story and numerous writings concerning neurological diseases.

Neurology check list. 5. rev. and enl. ed.

International Nuclear Information System (INIS)

Grehl, Holger; Reinhardt, Frank

2013-01-01

The neurology check list covers the following issues, organized in four parts: Grey part - diagnostic fundamentals, therapeutic principles: clinical neurological examination, liquor puncture, specific laboratory diagnostics, neurophysical diagnostics, imaging techniques, therapeutic principles, legal aspects, neurological assessment. Green Part - leading syndromes and leading symptoms. Blue part - neurological disease appearance: pains in head and face, pain syndrome, congenital and development disturbances, liquor circulation disturbances, ZNS hemorrhages, tumors and neoplasm, paraneoplastic syndromes, inflammatory diseases of the nervous system, dementia diseases, metabolic and other encephalopathy, cerebellum diseases and system surmounting processes, movement degeneration, basal ganglion diseases, epilepsy, non-epileptic attacks, medulla diseases, brain nerve diseases, plexus lesions, radicular lesions, peripheric neuropathy, neuromuscular transfer disturbances, muscular diseases. Red part: neurological intensive medicine.

Program Director Survey: Attitudes Regarding Child Neurology Training and Testing.

Science.gov (United States)

Valencia, Ignacio; Feist, Terri B; Gilbert, Donald L

2016-04-01

As a result of major clinical and scientific advances and changes in clinical practice, the role of adult neurology training for Child Neurology and Neurodevelopmental Disability (NDD) certification has become controversial. The most recently approved requirements for board eligibility for child neurology and neurodevelopmental disability residents still include 12 months in adult neurology rotations. The objective of this study was to assess United States child neurology and neurodevelopmental disability residency program directors' opinions regarding optimal residency training. The authors developed an 18-item questionnaire and contacted all 80 child neurology and neurodevelopmental disability program directors via e-mail, using SurveyMonkey. A total of 44 program directors responded (55%), representing programs that train 78 categorical and 94 total resident positions, approximately 70% of those filled in the match. Respondents identified multiple areas where child neurology residents need more training, including genetics and neuromuscular disease. A substantial majority (73%) believed child neurology and neurodevelopmental disability residents need less than 12 adult neurology training months; however, most (75%) also believed adult hospital service and man-power needs (55%) and finances (34%) would pose barriers to reducing adult neurology. Most (70%) believed reductions in adult neurology training should be program flexible. A majority believed the written initial certification examination should be modified with more child neurology and fewer basic neuroscience questions. Nearly all (91%) felt the views of child neurology and neurodevelopmental disability program directors are under-represented within the Accreditation Council for Graduate Medical Education Residency Review Committee. The requirement for 12 adult neurology months for Child Neurology and Neurodevelopmental Disability certification is not consistent with the views of the majority of program

[Assessment of sociocognitive functions in neurological patients Presentation of a French adaptation of two tools and implementation in frontal dementia].

Science.gov (United States)

Ehrlé, Nathalie; Henry, Audrey; Pesa, Audrey; Bakchine, Serge

2011-03-01

This paper presents a French battery designed to assess emotional and sociocognitive abilities in neurological patients in clinical practice. The first part of this battery includes subtests assessing emotions: a recognition task of primary facial emotions, a discrimination task of facial emotions, a task of expressive intensity judgment, a task of gender identification, a recognition task of musical emotions. The second part intends to assess some sociocognitive abilities, that is mainly theory of mind (attribution tasks of mental states to others: false believe tasks of first and second order, faux-pas task) and social norms (moral/conventional distinction task, social situations task) but also abstract language and humour. We present a general description of the battery with special attention to specific methodological constraints for the assessment of neurological patients. After a brief introduction to moral and conventional judgments (definition and current theoretical basis), the French version of the social norm task from RJR Blair (Blair and Cipolotti, 2000) is developed. The relevance of these tasks in frontal variant of frontotemporal dementia (fvFTD is illustrated by the report of the results of a study conducted in 18 patients by the Cambridge group and by the personal study of a patient with early stage of vfFTD. The relevance of the diagnostic of sociocognitive impairment in neurological patients is discussed.

Capacity for teaching climate change adaptation in the university ...

African Journals Online (AJOL)

The teaching materials employed included textbooks (83.3%), journal (78.3%), conference proceedings (66.7%), articles on Climate Change and agricultural adaptation (80.8%) and lectures/teaching notes (44.2%). The major teaching methods used to communicate climate change concepts were lecture (63.3%) and field ...

Palliative care and neurology

Science.gov (United States)

Boersma, Isabel; Miyasaki, Janis; Kutner, Jean

2014-01-01

Palliative care is an approach to the care of patients and families facing progressive and chronic illnesses that focuses on the relief of suffering due to physical symptoms, psychosocial issues, and spiritual distress. As neurologists care for patients with chronic, progressive, life-limiting, and disabling conditions, it is important that they understand and learn to apply the principles of palliative medicine. In this article, we aim to provide a practical starting point in palliative medicine for neurologists by answering the following questions: (1) What is palliative care and what is hospice care? (2) What are the palliative care needs of neurology patients? (3) Do neurology patients have unique palliative care needs? and (4) How can palliative care be integrated into neurology practice? We cover several fundamental palliative care skills relevant to neurologists, including communication of bad news, symptom assessment and management, advance care planning, caregiver assessment, and appropriate referral to hospice and other palliative care services. We conclude by suggesting areas for future educational efforts and research. PMID:24991027

The tablet device in hospital neurology and in neurology graduate medical education: a preliminary study.

Science.gov (United States)

George, Pravin; Newey, Christopher R; Bhimraj, Adarsh

2015-01-01

There is limited literature on tablet devices for neurohospitalists and in neurological graduate medical education. This study evaluated utilization, benefits, and limitations of customized tablets on inpatient neurology practice and resident education. The hypothesis was the perception of the tablet would be positive, given their portability, convenience to accessing point-of-care reference, and accessibility to the electronic medical record. Second-generation iPads with neurology-specific applications and literature were provided to our in-hospital general, stroke, and consult neurology teams. After 1 year, residents on these teams were surveyed on demographic data, familiarity, and utilization of the iPad and their perceptions of the device. All 27 residents responded to the survey. Most participants (23 of 27) used a tablet while on inpatient service. Twelve regularly utilized the neurology-specific apps and/or accessed scientific articles. Technologically savvy residents felt significantly more comfortable using tablets and were more quickly acquainted with the features. Thirteen respondents wanted a formal orientation on the advanced features of the tablet independent of their familiarity with the device or level of technological comfort. Overall, the perception was that the tablet was beneficial for inpatient clinical care and as an educational reference. Participants became easily familiarized with the device features quickly, regardless of whether they owned one previously or not. Most physicians indicated interest in advanced features of tablets; however, a formal orientation may be beneficial for optimal utilization. A reliable network connection is essential to in-hospital use of tablet devices. Additional research pertaining to patient outcomes, objective educational benefit, and cost-effectiveness is necessary.

Diverse Neurological Manifestations of Lead Encephalopathy ...

African Journals Online (AJOL)

Three patients with lead encephalopathy due to industrial poisoning are presented. They all showed a wide spectrum of neurological manifestations, which mimic other neurological presentations. It is emphasised that lead poisoning still occurs in industry, despite efforts at prevention. S. Afr. Med. J., 48, 1721 (1974) ...

Neurological complications following adult lung transplantation

NARCIS (Netherlands)

Mateen, F. J.; Dierkhising, R. A.; Rabinstein, A. A.; van de Beek, D.; Wijdicks, E. F. M.

2010-01-01

The full spectrum of neurologic complications and their impact on survival in lung recipients has not been reported. A retrospective cohort review of the Mayo Clinic Lung Transplant Registry (1988-2008) was performed to determine the range of neurologic complications in a cohort of adult lung

Late neurologic and cognitive sequelae of inflicted traumatic brain injury in infancy.

Science.gov (United States)

Barlow, Karen M; Thomson, Elaine; Johnson, David; Minns, Robert A

2005-08-01

There is limited information regarding the long-term outcome of inflicted traumatic brain injury (TBI), including shaken infant syndrome. The purpose of this study was to describe the long-term neurologic, behavioral, and cognitive sequelae seen in this population. A cross-sectional and prospective longitudinal study was conducted of 25 children with inflicted TBI in Scotland between 1980 and 1999. After consent was obtained, neurologic and cognitive examinations were performed on all participants and sequentially in the prospective cohort. Two global outcome measures were used: Glasgow Outcome Score (GOS) and Seshia's outcome score. Cognitive outcome was assessed using the Bayley Scales of Infant Development, British Ability Scales, and the Vineland Adaptive Behavior Scales. The mean length of follow-up was 59 months. A total of 68% of survivors were abnormal on follow-up, 36% had severe difficulties and were totally dependant, 16% had moderate difficulties, and 16% had mild difficulties on follow-up. A wide range of neurologic sequelae were seen, including motor deficits (60%), visual deficits (48%), epilepsy (20%), speech and language abnormalities (64%), and behavioral problems (52%). There was a wide range of cognitive abilities: the mean psychomotor index, 69.9 (SD: +/-25.73); and mean mental development index, 74.53 (SD: +/-28.55). Adaptive functioning showed a wide range of difficulties across all domains: communication domain (mean: 76.1; SD: +/-25.4), Daily living skills domain (mean: 76.9; SD: +/-24.3), and socialization domain (mean: 79.1; SD: +/-23.1). Outcome was found to correlate with the Pediatric Trauma Score and the Glasgow Coma Score but did not correlate with age at injury or mechanism of injury. Inflicted TBI has a very poor prognosis and correlates with severity of injury. Extended follow-up is necessary so as not to underestimate problems such as specific learning difficulties and attentional and memory problems that may become apparent only

[Cinema and neurology: early educational applications].

Science.gov (United States)

Collado-Vázquez, Susana; Carrillo, Jesús M

2015-03-01

Since its earliest days, cinema has been used in the teaching of neurology both to illustrate the professor's explanations and to make learning easier for students. To analyse some of the first applications of cinema to the teaching and learning of neurology. Shortly after the birth of the film projector it became apparent that it could be a valuable aid in teaching medicine, and especially neurology. Initially, actual recordings made by doctors themselves were used, and later documentaries, short films and feature films were employed as means of showing diagnostic and therapeutic methods, as well as different pathological signs, such as movement disorders. The intention was not to replace other methodologies but instead to complement them and to make the process of acquiring knowledge easier. Applying cinema in teaching is a useful way to portray the contents of different subjects, especially in the field of neurology, and to favour the acquisition of both specific and cross-disciplinary competences, with very positive results being obtained among students.

Repetitive Transcranial Magnetic Stimulation for Clinical Applications in Neurological and Psychiatric Disorders: An Overview

Science.gov (United States)

Machado, Sergio; Arias-Carrión, Oscar; Paes, Flávia; Vieira, Renata Teles; Caixeta, Leonardo; Novaes, Felipe; Marinho, Tamires; Almada, Leonardo Ferreira; Silva, Adriana Cardoso; Nardi, Antonio Egidio

2013-01-01

Neurological and psychiatric disorders are characterized by several disabling symptoms for which effective, mechanism-based treatments remain elusive. Consequently, more advanced non-invasive therapeutic methods are required. A method that may modulate brain activity and be viable for use in clinical practice is repetitive transcranial magnetic stimulation (rTMS). It is a non-invasive procedure whereby a pulsed magnetic field stimulates electrical activity in the brain. Here, we focus on the basic foundation of rTMS, the main stimulation parametters, the factors that influence individual responses to rTMS and the experimental advances of rTMS that may become a viable clinical application to treat neurological and psychiatric disorders. The findings showed that rTMS can improve some symptoms associated with these conditions and might be useful for promoting cortical plasticity in patients with neurological and psychiatric disorders. However, these changes are transient and it is premature to propose these applications as realistic therapeutic options, even though the rTMS technique has been evidenced as a potential modulator of sensorimotor integration and neuroplasticity. Functional imaging of the region of interest could highlight the capacity of rTMS to bring about plastic changes of the cortical circuitry and hint at future novel clinical interventions. Thus, we recommend that further studies clearly determine the role of rTMS in the treatment of these conditions. Finally, we must remember that however exciting the neurobiological mechanisms might be, the clinical usefulness of rTMS will be determined by its ability to provide patients with neurological and psychiatric disorders with safe, long-lasting and substantial improvements in quality of life. PMID:25610279

Strengthening Local Capacity for Adaptation to Climate Change in ...

International Development Research Centre (IDRC) Digital Library (Canada)

Researchers will then couple these scenarios with hydrological models and projected trends in land use and agriculture to identify the areas and populations most vulnerable to water-related climate change. The government of the province of Oruro has expressed an interest in pioneering adaptation plans and has already ...

The assessment of minor neurological dysfunction in infancy using the Touwen Infant Neurological Examination : strengths and limitations

NARCIS (Netherlands)

Hadders-Algra, Mijna; Heineman, Kirsten R.; Bos, Arend F.; Middelburg, Karin J.

Aim Little is known of minor neurological dysfunction (MND) in infancy. This study aimed to evaluate the inter-assessor reliability of the assessment of MND with the Touwen Infant Neurological Examination (TINE) and the construct and predictive validity of MND in infancy. Method Inter-assessor

Flood risk perception and adaptation capacity: a contribution to the socio-hydrology debate

Directory of Open Access Journals (Sweden)

S. Fuchs

2017-06-01

Full Text Available Dealing with flood hazard and risk requires approaches rooted in both natural and social sciences, which provided the nexus for the ongoing debate on socio-hydrology. Various combinations of non-structural and structural flood risk reduction options are available to communities. Focusing on flood risk and the information associated with it, developing risk management plans is required but often overlooks public perception of a threat. The perception of risk varies in many different ways, especially between the authorities and the affected public. It is because of this disconnection that many risk management plans concerning floods have failed in the past. This paper examines the private adaptation capacity and willingness with respect to flooding in two different catchments in Greece prone to multiple flood events during the last 20 years. Two studies (East Attica and Evros were carried out, comprised of a survey questionnaire of 155 and 157 individuals, from a peri-urban (East Attica and a rural (Evros area, respectively, and they focused on those vulnerable to periodic (rural area and flash floods (peri-urban area. Based on the comparisons drawn from these responses, and identifying key issues to be addressed when flood risk management plans are implemented, improvements are being recommended for the social dimension surrounding such implementation. As such, the paper contributes to the ongoing discussion on human–environment interaction in socio-hydrology.

Flood risk perception and adaptation capacity: a contribution to the socio-hydrology debate

Science.gov (United States)

Fuchs, Sven; Karagiorgos, Konstantinos; Kitikidou, Kyriaki; Maris, Fotios; Paparrizos, Spyridon; Thaler, Thomas

2017-06-01

Dealing with flood hazard and risk requires approaches rooted in both natural and social sciences, which provided the nexus for the ongoing debate on socio-hydrology. Various combinations of non-structural and structural flood risk reduction options are available to communities. Focusing on flood risk and the information associated with it, developing risk management plans is required but often overlooks public perception of a threat. The perception of risk varies in many different ways, especially between the authorities and the affected public. It is because of this disconnection that many risk management plans concerning floods have failed in the past. This paper examines the private adaptation capacity and willingness with respect to flooding in two different catchments in Greece prone to multiple flood events during the last 20 years. Two studies (East Attica and Evros) were carried out, comprised of a survey questionnaire of 155 and 157 individuals, from a peri-urban (East Attica) and a rural (Evros) area, respectively, and they focused on those vulnerable to periodic (rural area) and flash floods (peri-urban area). Based on the comparisons drawn from these responses, and identifying key issues to be addressed when flood risk management plans are implemented, improvements are being recommended for the social dimension surrounding such implementation. As such, the paper contributes to the ongoing discussion on human-environment interaction in socio-hydrology.

Adding Behavioural Science Capacity to Document Deterrents and ...

International Development Research Centre (IDRC) Digital Library (Canada)

... psychosocial barriers and motivators to participation and retention in HIV vaccine research ... -promoting government capacity to advocate, support ethical research, ... IWRA/IDRC webinar on climate change and adaptive water management.

Neuroscience-related research in Ghana: a systematic evaluation of direction and capacity.

Science.gov (United States)

Quansah, Emmanuel; Karikari, Thomas K

2016-02-01

Neurological and neuropsychiatric diseases account for considerable healthcare, economic and social burdens in Ghana. In order to effectively address these burdens, appropriately-trained scientists who conduct high-impact neuroscience research will be needed. Additionally, research directions should be aligned with national research priorities. However, to provide information about current neuroscience research productivity and direction, the existing capacity and focus need to be identified. This would allow opportunities for collaborative research and training to be properly explored and developmental interventions to be better targeted. In this study, we sought to evaluate the existing capacity and direction of neuroscience-related research in Ghana. To do this, we examined publications reporting research investigations authored by scientists affiliated with Ghanaian institutions in specific areas of neuroscience over the last two decades (1995-2015). 127 articles that met our inclusion criteria were systematically evaluated in terms of research foci, annual publication trends and author affiliations. The most actively-researched areas identified include neurocognitive impairments in non-nervous system disorders, depression and suicide, epilepsy and seizures, neurological impact of substance misuse, and neurological disorders. These studies were mostly hospital and community-based surveys. About 60% of these articles were published in the last seven years, suggesting a recent increase in research productivity. However, data on experimental and clinical research outcomes were particularly lacking. We suggest that future investigations should focus on the following specific areas where information was lacking: large-scale disease epidemiology, effectiveness of diagnostic platforms and therapeutic treatments, and the genetic, genomic and molecular bases of diseases.

Severe neurological complication following adjustable gastric banding.

Science.gov (United States)

Martines, G; Musa, N; Aquilino, F; Capuano, P

2018-01-01

In the last years with the increase of bariatric surgery, first of all as a result of new indications, a rise in the incidence of nutrient-related complications has been observed. Currently little is known about the impact of post-bariatric malnutrition and neurological complications. Wernicke's encephalopathy is a severe neurological syndrome which occurs as a result of thiamine deficiency. Wernicke-Korsakoff syndrome must be considered a serious neurological complication of bariatric surgery with significant morbidity and mortality, with rapidly progressing neurological symptoms, and must be treated immediately. We report the case of a 35 years-old male patient, affected by morbid obesity, anxious-depressive syndrome and alcohol use disorder, who after adjustable gastric banding implanted in another hospital developed a severe malnutrition and neurological syndrome. The patient showed poor adherence to the follow-up and to the dietary indications and after all, we needed to place a PEG for enteral nutrition in order to resolve the malnutrition condition and the neurological syndrome. Our experience emphasizes that preoperative selection and assessment of a patient's nutritional status according to guidelines, is required to identify potential problems, and that bariatric surgeons or physicians caring for patient who have undergone bariatric surgery should be familiar with the constellation of nutritional and neurological disorder that may occur after surgery. We want to remark the importance of preoperative selection of the patients, the follow-up and the cooperation between patient and physician in order to obtain the best result and avoid severe complications.

Clinical trials in neurology: design, conduct, analysis

National Research Council Canada - National Science Library

Ravina, Bernard

2012-01-01

.... Clinical Trials in Neurology aims to improve the efficiency of clinical trials and the development of interventions in order to enhance the development of new treatments for neurologic diseases...

Multidrug-resistant typhoid fever with neurologic findings on the Malawi-Mozambique border.

Science.gov (United States)

Lutterloh, Emily; Likaka, Andrew; Sejvar, James; Manda, Robert; Naiene, Jeremias; Monroe, Stephan S; Khaila, Tadala; Chilima, Benson; Mallewa, Macpherson; Kampondeni, Sam D; Lowther, Sara A; Capewell, Linda; Date, Kashmira; Townes, David; Redwood, Yanique; Schier, Joshua G; Nygren, Benjamin; Tippett Barr, Beth; Demby, Austin; Phiri, Abel; Lungu, Rudia; Kaphiyo, James; Humphrys, Michael; Talkington, Deborah; Joyce, Kevin; Stockman, Lauren J; Armstrong, Gregory L; Mintz, Eric

2012-04-01

Salmonella enterica serovar Typhi causes an estimated 22 million cases of typhoid fever and 216 000 deaths annually worldwide. We investigated an outbreak of unexplained febrile illnesses with neurologic findings, determined to be typhoid fever, along the Malawi-Mozambique border. The investigation included active surveillance, interviews, examinations of ill and convalescent persons, medical chart reviews, and laboratory testing. Classification as a suspected case required fever and ≥1 other finding (eg, headache or abdominal pain); a probable case required fever and a positive rapid immunoglobulin M antibody test for typhoid (TUBEX TF); a confirmed case required isolation of Salmonella Typhi from blood or stool. Isolates underwent antimicrobial susceptibility testing and subtyping by pulsed-field gel electrophoresis (PFGE). We identified 303 cases from 18 villages with onset during March-November 2009; 214 were suspected, 43 were probable, and 46 were confirmed cases. Forty patients presented with focal neurologic abnormalities, including a constellation of upper motor neuron signs (n = 19), ataxia (n = 22), and parkinsonism (n = 8). Eleven patients died. All 42 isolates tested were resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole; 4 were also resistant to nalidixic acid. Thirty-five of 42 isolates were indistinguishable by PFGE. The unusual neurologic manifestations posed a diagnostic challenge that was resolved through rapid typhoid antibody testing in the field and subsequent blood culture confirmation in the Malawi national reference laboratory. Extending laboratory diagnostic capacity, including blood culture, to populations at risk for typhoid fever in Africa will improve outbreak detection, response, and clinical treatment.

[Neurology in medieval regimina sanitatis].

Science.gov (United States)

de Frutos González, V; Guerrero Peral, A L

2011-09-01

In medical medieval literature some works about dietetics stand out. Dietetics, as a separate branch of medicine, includes not only food or drinks, but other environmental factors influencing on health. They are known as regimina sanitatis or salutis, and specially developed in the Christian west. They generally consisted of a balance between the Galenic "six non-natural things"; factors regulating health and its protection: environment, exercise, food, sleep, bowel movements and emotions. After reviewing the sources and defining the different stages of this genre, we have considered three of the most out-standing medieval regimina, the anonymous Regimen sanitatis salernitanum, Arnaldo de Vilanova's Regimen sanitatis ad regem aragonum and Bernardo de Gordon's Tractatus of conservatione vite humane. In them we review references to neurological disease. Though not independently considered, there is a significant presence of neurological diseases in the regimina. Dietetics measures are proposed to preserve memory, nerves, or hearing, as well as for the treatment of migraine, epilepsy, stroke or dizziness. Regimina are quiet representative among medical medieval literature, and they show medieval physicians vision of neurological diseases. Dietetics was considered useful to preserve health, and therapeutics was based on natural remedies. 2010 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

[Neurology of hysteria (conversion disorder)].

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Sonoo, Masahiro

2014-07-01

Hysteria has served as an important driving force in the development of both neurology and psychiatry. Jean Martin Charcot's devotion to mesmerism for treating hysterical patients evoked the invention of psychoanalysis by Sigmund Freud. Meanwhile, Joseph Babinski took over the challenge to discriminate between organic and hysterical patients from Charcot and found Babinski's sign, the greatest milestone in modern neurological symptomatology. Nowadays, the usage of the term hysteria is avoided. However, new terms and new classifications are complicated and inconsistent between the two representative taxonomies, the DSM-IV and ICD-10. In the ICD-10, even the alternative term conversion disorder, which was becoming familiar to neurologists, has also disappeared as a group name. The diagnosis of hysteria remains important in clinical neurology. Extensive exclusive diagnoses and over investigation, including various imaging studies, should be avoided because they may prolong the disease course and fix their symptoms. Psychological reasons that seem to explain the conversion are not considered reliable. Positive neurological signs suggesting nonorganic etiologies are the most reliable measures for diagnosing hysteria, as Babinski first argued. Hysterical paresis has several characteristics, such as giving-way weakness or peculiar distributions of weakness. Signs to uncover nonorganic paresis utilizing synergy include Hoover's test and the Sonoo abductor test.

The neurological basis of occupation.

Science.gov (United States)

Gutman, Sharon A; Schindler, Victoria P

2007-01-01

The purpose of the present paper was to survey the literature about the neurological basis of human activity and its relationship to occupation and health. Activities related to neurological function were organized into three categories: those that activate the brain's reward system; those that promote the relaxation response; and those that preserve cognitive function into old age. The results from the literature review correlating neurological evidence and activities showed that purposeful and meaningful activities could counter the effects of stress-related diseases and reduce the risk for dementia. Specifically, it was found that music, drawing, meditation, reading, arts and crafts, and home repairs, for example, can stimulate the neurogical system and enhance health and well-being, Prospective research studies are needed to examine the effects of purposeful activities on reducing stress and slowing the rate of cognitive decline.

Canadian Paediatric Neurology Workforce Survey and Consensus Statement.

Science.gov (United States)

Doja, Asif; Orr, Serena L; McMillan, Hugh J; Kirton, Adam; Brna, Paula; Esser, Michael; Tang-Wai, Richard; Major, Philippe; Poulin, Chantal; Prasad, Narayan; Selby, Kathryn; Weiss, Shelly K; Yeh, E Ann; Callen, David Ja

2016-05-01

Little knowledge exists on the availability of academic and community paediatric neurology positions. This knowledge is crucial for making workforce decisions. Our study aimed to: 1) obtain information regarding the availability of positions for paediatric neurologists in academic centres; 2) survey paediatric neurology trainees regarding their perceptions of employment issues and career plans; 3) survey practicing community paediatric neurologists 4) convene a group of paediatric neurologists to develop consensus regarding how to address these workforce issues. Surveys addressing workforce issues regarding paediatric neurology in Canada were sent to: 1) all paediatric neurology program directors in Canada (n=9) who then solicited information from division heads and from paediatric neurologists in surrounding areas; 2) paediatric neurology trainees in Canada (n=57) and; 3) community paediatric neurologists (n=27). A meeting was held with relevant stakeholders to develop a consensus on how to approach employment issues. The response rate was 100% from program directors, 57.9% from residents and 44% from community paediatric neurologists. We found that the number of projected positions in academic paediatric neurology is fewer than the number of paediatric neurologists that are being trained over the next five to ten years, despite a clinical need for paediatric neurologists. Paediatric neurology residents are concerned about job availability and desire more career counselling. There is a current and projected clinical demand for paediatric neurologists despite a lack of academic positions. Training programs should focus on community neurology as a viable career option.

African Journal of Neurological Sciences: Journal Sponsorship

African Journals Online (AJOL)

African Journal of Neurological Sciences: Journal Sponsorship. Journal Home > About the Journal > African Journal of Neurological Sciences: Journal Sponsorship. Log in or Register to get access to full text downloads.

Neurologic deficit after resection of the sacrum.

Science.gov (United States)

Biagini, R; Ruggieri, P; Mercuri, M; Capanna, R; Briccoli, A; Perin, S; Orsini, U; Demitri, S; Arlecchini, S

1997-01-01

The authors describe neurologic deficit (sensory, motor, and sphincteral) resulting from sacrifice of the sacral nerve roots removed during resection of the sacrum. The anatomical and functional bases of sphincteral continence and the amount of neurologic deficit are discussed based on level of sacral resection. A large review of the literature on the subject is reported and discussed. The authors emphasize how the neurophysiological bases of sphincteral continence (rectum and bladder) and of sexual ability are still not well known, and how the literature reveals disagreement on the subject. A score system is proposed to evaluate neurologic deficit. The clinical model of neurologic deficit caused by resection of the sacrum may be extended to an evaluation of post-traumatic deficit.

Molecular imaging in neurology and neuroscience

International Nuclear Information System (INIS)

Schreckenberger, M.

2007-01-01

Molecular imaging in neurology and neuroscience is a suspenseful and fast developing tool in order to quantitatively image genomics and proteomics by means of direct and indirect markers. Because of its high-sensitive tracer principle, nuclear medicine imaging has the pioneering task for the methodical progression of molecular imaging. The current development of molecular imaging in neurology changes from the use of indirect markers of gene and protein expression to the direct imaging of the molecular mechanisms. It is the aim of this article to give a short review on the status quo of molecular imaging in neurology with emphasis on clinically relevant aspects. (orig.)

The beginnings of the Southern Child/Pediatric Neurology Society.

Science.gov (United States)

Dyken, Paul Richard; Bodensteiner, John B

2015-04-01

The founding and early development of the Southern Pediatric Neurology Society was in many ways parallel to that of the Child Neurology Society. The organization started out as the Southern Child Neurology Society but the name was changed at the time of incorporation so as to avoid confusion of identity and purpose with the larger Child Neurology Society. Although there are archives of early days and the later development of the Southern Pediatric Neurology Society, the details have never been set down in a narrative explaining the events that led to the development of the organization. In this paper, we try to produce a written record of the history of the founding and early development of the Southern Pediatric Neurology Society. © The Author(s) 2014.

Working Memory Capacity as a Dynamic Process

Science.gov (United States)

Simmering, Vanessa R.; Perone, Sammy

2013-01-01

A well-known characteristic of working memory (WM) is its limited capacity. The source of such limitations, however, is a continued point of debate. Developmental research is positioned to address this debate by jointly identifying the source(s) of limitations and the mechanism(s) underlying capacity increases. Here we provide a cross-domain survey of studies and theories of WM capacity development, which reveals a complex picture: dozens of studies from 50 papers show nearly universal increases in capacity estimates with age, but marked variation across studies, tasks, and domains. We argue that the full pattern of performance cannot be captured through traditional approaches emphasizing single causes, or even multiple separable causes, underlying capacity development. Rather, we consider WM capacity as a dynamic process that emerges from a unified cognitive system flexibly adapting to the context and demands of each task. We conclude by enumerating specific challenges for researchers and theorists that will need to be met in order to move our understanding forward. PMID:23335902

The Role of Magnesium in Neurological Disorders

Directory of Open Access Journals (Sweden)

Anna E. Kirkland

2018-06-01

Full Text Available Magnesium is well known for its diverse actions within the human body. From a neurological standpoint, magnesium plays an essential role in nerve transmission and neuromuscular conduction. It also functions in a protective role against excessive excitation that can lead to neuronal cell death (excitotoxicity, and has been implicated in multiple neurological disorders. Due to these important functions within the nervous system, magnesium is a mineral of intense interest for the potential prevention and treatment of neurological disorders. Current literature is reviewed for migraine, chronic pain, epilepsy, Alzheimer’s, Parkinson’s, and stroke, as well as the commonly comorbid conditions of anxiety and depression. Previous reviews and meta-analyses are used to set the scene for magnesium research across neurological conditions, while current research is reviewed in greater detail to update the literature and demonstrate the progress (or lack thereof in the field. There is strong data to suggest a role for magnesium in migraine and depression, and emerging data to suggest a protective effect of magnesium for chronic pain, anxiety, and stroke. More research is needed on magnesium as an adjunct treatment in epilepsy, and to further clarify its role in Alzheimer’s and Parkinson’s. Overall, the mechanistic attributes of magnesium in neurological diseases connote the macromineral as a potential target for neurological disease prevention and treatment.

[Neurological syndromes associated with homocystein dismetabolism].

Science.gov (United States)

Shirokov, E A; Leonova, S F

2006-01-01

The article summarizes the results of clinical, neurological, and laboratory examination of patients with hyperhomocysteinemia. The data obtained suggest the existence of common pathobiochemical mechanisms of homocystein, cholesterol, and myelin dysmetabolism. The authors demonstrate that neurological manifestations of hyperhomocysteinemia are associated with the processes of demyelinization in the central and peripheral nervous systems.

Old wine in new bottles: The adaptive capacity of the hydraulic mission in Ecuador

Directory of Open Access Journals (Sweden)

Jeroen F. Warner

2017-06-01

Full Text Available Despite a widely embraced ecological turn and strident critique of megastructures in the 1990s, construction of large infrastructure has been reignited worldwide. While Integrated Water Resources Management (IWRM and River Basin Management (RBM have at least discursively held sway as the dominant paradigm in water management since the late 1990s, we argue that the 'hydraulic mission' never really went away and has in some places energetically re-emerged. The development discourse that justified many dams in the past is now supplemented by a new set of appealing justifiers. With the help of the case of Ecuador we show that the hegemonic project of the hydraulic mission has a great discursive adaptive capacity and a new set of allies. The rise of the BRICS (especially China, South-South cooperation and private investors provides non-traditional sources of funding, making the construction of hydraulic infrastructure less dependent on Western conditionalities. The resulting governance picture highlights the disconnect between the still widely embraced policy discourse of IWRM/RBM and the drivers and practices of the hydraulic mission; questioning what value international calls for 'good water governance' have in the midst of new discourses, broader transnational political projects and the powerful dam-building alliances that underlie them.

Capacities for population-genetic variation and ecological adaptations

Directory of Open Access Journals (Sweden)

Marinković Dragoslav

2007-01-01

Full Text Available In contemporary science of population genetics it is equally complex and important to visualize how adaptive limits of individual variation are determined, as well as to describe the amount and sort of this variation. Almost all century the scientists devoted their efforts to explain the principles and structure of biological variation (genetic, developmental, environmental, interactive, etc., basing its maintenance within existing limits mostly on equilibria proclaimed by Hardy-Weinberg rules. Among numerous model-organisms that have been used to prove these rules and demonstrate new variants within mentioned concepts, Drosophila melanogaster is a kind of queen that is used in thousands of experiments for almost exactly 100 years (CARPENTER 1905, with which numerous discoveries and principles were determined that later turned out to be applicable to all other organisms. It is both, in nature and in laboratory, that Drosophilids were used to demonstrate the basic principles of population-genetic variation that was later applied to other species of animals. In ecological-genetic variation their richness in different environments could be used as an exact indicator of the status of a determined habitat, and its population-genetic structure may definitely point out to a possibility that specific resources of the environment start to be in danger to deteriorate, or to disappear in the near future. This paper shows clear-cut differences among environmental habitats, when populations of Drosophilidae are quantitatively observed in different wild, semi-domestic and domestic environments, demonstrating a highly expressed mutual dependence of these two parameters. A crucial approach is how to estimate the causes that determine the limits of biological, i.e. of individual and population-genetic variation. The realized, i.e. adaptive variation, is much lesser than a total possible variation of a polygenic trait, and in this study, using a moderately

Cultivating Institutional Capacities for Learning Analytics

Science.gov (United States)

Lonn, Steven; McKay, Timothy A.; Teasley, Stephanie D.

2017-01-01

This chapter details the process the University of Michigan developed to build institutional capacity for learning analytics. A symposium series, faculty task force, fellows program, research grants, and other initiatives are discussed, with lessons learned for future efforts and how other institutions might adapt such efforts to spur cultural…

Neurological eponyms--who gets the credit? Essay review.

Science.gov (United States)

Okun, Michael S

2003-03-01

The recent publication of Neurological Eponyms by Peter Koehler and colleagues has revived the interest in neurological eponyms and raised important questions about their use. Many investigators have contributed to the body of knowledge that defines the specialty of neurology. We honor them by associating their names with neurological diseases. The history of neurological eponyms provides us with an opportunity to reexamine the important question of who gets the credit. Additional issues have surfaced including why certain eponyms tend to stick in the literature and others disappear, as well as the important realization that lengthy modern descriptions may require name eponyms for simplification. Eponyms can be confusing as to whether they refer to a disease or a syndrome and this confusion can impact the diagnosis and treatment of patients. There is an inevitable evolution of certain eponyms as our understanding of entities expands. This paper provides an overview of neurological eponyms with the explanation of the potential reasons why names were associated with neurological diseases. These included first case reports, relating isolated cases, years of observation, defining neuroanatomy, physician sufferer, new physical examination maneuvers, academic climate, the advent of a new procedure, fame, and competition amongst investigators. Important issues have surfaced regarding sharing credit amongst investigators, name priority, crediting the wrong investigator, and lack of a defined system to award credit. Since eponym use is based on a peer dependent system, each neurologist must make a more critical appraisal of who gets the credit and understand the differences between diseases and syndromes in order to better preserve neurological history.

Neurologic signs and symptoms frequently manifest in acute HIV infection

Science.gov (United States)

Fletcher, James L.K.; Valcour, Victor; Kroon, Eugène; Ananworanich, Jintanat; Intasan, Jintana; Lerdlum, Sukalaya; Narvid, Jared; Pothisri, Mantana; Allen, Isabel; Krebs, Shelly J.; Slike, Bonnie; Prueksakaew, Peeriya; Jagodzinski, Linda L.; Puttamaswin, Suwanna; Phanuphak, Nittaya; Spudich, Serena

2016-01-01

Objective: To determine the incidence, timing, and severity of neurologic findings in acute HIV infection (pre–antibody seroconversion), as well as persistence with combination antiretroviral therapy (cART). Methods: Participants identified with acute HIV were enrolled, underwent structured neurologic evaluations, immediately initiated cART, and were followed with neurologic evaluations at 4 and 12 weeks. Concurrent brain MRIs and both viral and inflammatory markers in plasma and CSF were obtained. Results: Median estimated HIV infection duration was 19 days (range 3–56) at study entry for the 139 participants evaluated. Seventy-three participants (53%) experienced one or more neurologic findings in the 12 weeks after diagnosis, with one developing a fulminant neurologic manifestation (Guillain-Barré syndrome). A total of 245 neurologic findings were noted, reflecting cognitive symptoms (33%), motor findings (34%), and neuropathy (11%). Nearly half of the neurologic findings (n = 121, 49%) occurred at diagnosis, prior to cART initiation, and most of these (n = 110, 90%) remitted concurrent with 1 month on treatment. Only 9% of neurologic findings (n = 22) persisted at 24 weeks on cART. Nearly all neurologic findings (n = 236, 96%) were categorized as mild in severity. No structural neuroimaging abnormalities were observed. Participants with neurologic findings had a higher mean plasma log10 HIV RNA at diagnosis compared to those without neurologic findings (5.9 vs 5.4; p = 0.006). Conclusions: Acute HIV infection is commonly associated with mild neurologic findings that largely remit while on treatment, and may be mediated by direct viral factors. Severe neurologic manifestations are infrequent in treated acute HIV. PMID:27287217

Problematic psychosocial adaptation and executive dysfunction in women and men with myelomeningocele.

Science.gov (United States)

Stubberud, Jan; Riemer, Gunnar

2012-01-01

Myelomeningocele (MMC) is caused by incomplete neural tube development, affecting physical, cognitive and adaptive functioning. The aim of this study was to characterize women and men with problematic psychosocial adaptation with respect to cognitive functions and psychological symptoms. It was expected that cognitive functions, especially the executive functions, were mostly impaired. In addition, the clinical history, the neurological and the psychological functioning was investigated. Twelve participants (six men, six women; age range 24-41 years) with MMC were recruited from TRS National Resource Centre for Rare Disorders. Inclusion criteria were (1) uncompleted upper secondary school, (2) unemployment and (3) lack of social relationships. The participants underwent a systematic clinical history, a clinical neurological examination, a neuropsychological assessment and questionnaires regarding cognitive and psychological functioning. All participants had major neurological deficits and most of them had hydrocephalus and Chiari-II malformation. Cognitive deficits were present in a range of domains, especially the executive functions. The neuropsychological findings showed no obvious difference between men and women. Symptoms of psychopathology were more pronounced in women. The men were less capable to structure daily living. The neuropsychological findings disclosed that the executive functions were most impaired. Future research should be directed towards cognitive rehabilitation.

[Online survey of the organizational structures of emergency neurology in Germany].

Science.gov (United States)

Topka, H; Pfefferkorn, T; Andres, F; Kastrup, A; Klein, M; Niesen, W; Poppert, H

2017-06-01

In 2007, the first poll among neurologists provided some insight into the organizational structures of emergency neurology in Germany. Given that emergency neurology as well as emergency medicine in general have undergone substantial changes during the last decade, the subcommittee Neurological Emergency Medicine of the German Neurological Society conducted a follow-up study to explore current structures supporting neurological emergency medicine in German neurological hospitals. Between July and September 2016, an online questionnaire was e‑mailed to 675 neurologists in institutions participating in in-patient neurological care. Of these, some 32% (university hospitals 49%) answered. Neurological patients represent 12-16% and hence a significant proportion of emergency patients. The fraction of in-patients admitted to hospitals via emergency departments amounted to 78% (median) in general hospitals and 52% in university hospitals. Most emergency departments are organized as an interdisciplinary structure combining conservative with surgical disciplines frequently led by an independent department head. Neurology departments employ rather diverse strategies to organize neurological emergency care. Also, the way emergency patients are assigned to different disciplines varied largely. Currently, neurological patients represent a rather growing fraction of patients in emergency departments. An increasing proportion of neurology in-patients enter the hospital via emergency departments. Neurology departments in Germany face increasing challenges to cope with large numbers of neurological emergency patients. While most of the participating neurologists indicated suffering predominantly from scarce personal resources both in neurology and neuroradiology, an independent neurological emergency department was not considered an option.

The Profile of Neurology Patients Evaluated in the Emergency Department

Directory of Open Access Journals (Sweden)

Ufuk Emre

2009-09-01

Full Text Available OBJECTIVE: Early, rapid, and multidisciplinary approaches are very important in the diagnosis of neurological disorders in emergency departments. The present study aimed to investigate the features of patients that presented for neurology consultation in the emergency department. METHODS: The present study included 780 patients. Patient demographic features, reasons for emergent treatment and neurological consultation, neurological diagnosis by the neurologist, and laboratory (total blood count, serum glucose level, urea, creatine, erythrocyte sedimentation rate, and D-dimer levels and imaging findings were retrospectively evaluated based on patient charts. RESULTS: Impaired consciousness was the most frequent reason for neurological consultation (19.7%. Among these patients, ischemic stroke was diagnosed in 27.9%, hypoxic encephalopathy in 18.2%, cerebral hemorrhage in 9.1%, and 11% had no neurological diagnosis. Other common reasons for neurological consultation were vertigo, headache, seizure, and stroke. Clinical findings were related to other systemic causes in 43.7% of the study group. Focal neurological findings were present, especially in patients that presented with ischemic and hemorrhagic stroke, epilepsy, and hypoxic encephalopathy. CONCLUSION: In emergency departments, metabolic causes should be ruled out in patients with impaired consciousness and the absence of focal neurological signs. Intracranial structural disorders must be evaluated when focal neurological signs are present. Cautiously prepared algorithms and neurological examination training will help improve the accuracy of emergency department diagnoses

The Adaptation Finance Gap Report

DEFF Research Database (Denmark)

UNEP’s Adaptation Gap Report series focuses on Finance, Technology and Knowledge gaps in climate change adaptation. It compliments the Emissions Gap Report series, and explores the implications of failing to close the emissions gap. The report builds on a 2014 assessment by the United Nations...... Environment Programme (UNEP), which laid out the concept of ‘adaptation gaps’ and outlined three such gaps: technology, finance and knowledge. The 2016 Adaptation Gap Report assesses the difference between the financial costs of adapting to climate change in developing countries and the amount of money...... actually available to meet these costs – a difference known as the “adaptation finance gap”. Like the 2014 report, the 2016 report focuses on developing countries, where adaptation capacity is often the lowest and needs the highest, and concentrates on the period up to 2050. The report identifies trends...

Mind-body interventions: applications in neurology.

Science.gov (United States)

Wahbeh, Helané; Elsas, Siegward-M; Oken, Barry S

2008-06-10

Half of the adults in the United States use complementary and alternative medicine with mind-body therapy being the most commonly used form. Neurology patients often turn to their physicians for insight into the effectiveness of the therapies and resources to integrate them into their care. The objective of this article is to give a clinical overview of mind-body interventions and their applications in neurology. Medline and PsychInfo were searched on mind-body therapies and neurologic disease search terms for clinical trials and reviews and published evidence was graded. Meditation, relaxation, and breathing techniques, yoga, tai chi, and qigong, hypnosis, and biofeedback are described. Mind-body therapy application to general pain, back and neck pain, carpal tunnel syndrome, headaches, fibromyalgia, multiple sclerosis, epilepsy, muscular dysfunction, stroke, aging, Parkinson disease, stroke, and attention deficit-hyperactivity disorder are reviewed. There are several conditions where the evidence for mind-body therapies is quite strong such as migraine headache. Mind-body therapies for other neurology applications have limited evidence due mostly to small clinical trials and inadequate control groups.

Neurological disorders in children with autism

Directory of Open Access Journals (Sweden)

N. N. Zavadenko

2015-01-01

Full Text Available During a clinical examination of children with autistic spectrum disorders, attention should be drawn to both their major clinical manifestations and neurological comorbidities. The paper considers the mechanisms of autism-induced neurological disorders, the spectrum of which may include manifestations, such as retarded and disharmonic early psychomotor development; the specific features of sensory perception/processing; rigidity and monotony of motor and psychic reactions; motor disinhibition and hyperexcitability; motor stereotypies; uncoordinated movements; developmental coordination disorders (dyspraxia; impaired expressive motor skills; speech and articulation disorders; tics; epilepsy. It describes the specific features of neurological symptoms in Asperger’s syndrome, particularly in semantic-pragmatic language disorders, higher incidence rates of hyperlexia, motor and vocal tics. The incidence rate of epilepsy in autistic spectrum disorders is emphasized to be greater than the average population one. At the same time, the risk of epilepsy is higher in mentally retarded patients with autism. Identification of neurological disorders is of great importance in determining the tactics of complex care for patients with autistic spectrum disorders. 

[Anesthesia for patients with neurological diseases].

Science.gov (United States)

Kimura, Masafumi; Saito, Shigeru

2010-09-01

Several surgical treatments can be employed for the patients with neurological disorders, such as multiple sclerosis, Guillain-Barré syndrome, Parkinson's disease, amyotrophic lateral sclerosis, Alzheimer disease and spinal cord injury. It is possible that anesthesia related complications are induced in these neurologically complicated patients in the perioperative period. Respiratory dysfunction and autonomic nervous system dysfunction are most common in this population. Respiratory muscle weakness and bulbar palsy may cause aspiration pneumonia. Sometimes, postoperative ventilatory support is mandatory in these patients. Autonomic nervous system dysfunction may cause hypotension secondary to postural changes, blood loss, or positive airway pressure. Some therapeutic agents prescribed for neurological symptoms have drug interaction with anesthetic agents. Patients with motor neuron disease should be considered to be vulnerable to hyperkalemia in response to a depolarizing muscle relaxant. Although perioperative treatment guideline for most neurologic disorders has not been reported to lessen perioperative morbidity, knowledge of the clinical features and the interaction of common anesthetics with the drug therapy is important in planning intraoperative and postoperative management.

Functional capacity and mental state of patients undergoing cardiac surgery

Directory of Open Access Journals (Sweden)

Bruna Corrêa

Full Text Available Abstract Introduction: Cardiovascular diseases are a serious public health problem in Brazil. Myocardial revascularization surgery (MRS as well as cardiac valve replacement and repair are procedures indicated to treat them. Thus, extracorporeal circulation (ECC is still widely used in these surgeries, in which patients with long ECC times may have greater neurological deficits. Neurological damage resulting from MRS can have devastating consequences such as loss of independence and worsening of quality of life. Objective: To assess the effect of cardiac surgery on a patient’s mental state and functional capacity in both the pre- and postoperative periods. Methods: We conducted a cross-sectional study with convenience sampling of subjects undergoing MRS and valve replacement. Participants were administered the Mini-Mental State Exam (MMSE and the Duke Activity Status Index (DASI in the pre- and postoperative periods, as well as before their hospital discharge. Results: This study assessed nine patients (eight males aged 62.4 ± 6.3 years with a BMI of 29.5 ± 2.3 kg/m2. There was a significant decrease in DASI scores and VO2 from preoperative to postoperative status (p = 0.003 and p = 0.003, respectively. Conclusion: This study revealed a loss of cognitive and exercise capacity after cardiac surgery. A larger sample however is needed to consolidate these findings.

Plant adaptation to temperature and photoperiod

Directory of Open Access Journals (Sweden)

O. JUNTTILA

2008-12-01

Full Text Available Plants respond to environmental conditions both by adaptation and by acclimation. The ability of the plants to grow, reproduce and survive under changing climatic conditions depends on the efficiency of adaptation and acclimation. The adaptation of developmental processes in plants to temperature and photoperiod is briefly reviewed. In annual plants this adaptation is related to growth capacity and to the timing of reproduction. In perennial plants growing under northern conditions, adaptation of the annual growth cycle to the local climatic cycle is of primary importance. Examples of the role of photothermal conditions in regulation of these phenological processes are given and discussed. The genetic and physiological bases for climatic adaptation in plants are briefly examined.;

Teacher' Interpersonal Self-Efficacy: Evaluation and Predictive Capacity of Teacher Burnout

Science.gov (United States)

García-Ros, Rafael; Fuentes, María C.; Fernández, Basilio

2015-01-01

Introduction: This study analyzed the predictive capacity and incremental validity of teachers' interpersonal self-efficacy on their levels of burnout. First, it presents the validation process of a Spanish adaptation of the Teacher Interpersonal Self-Efficacy Scale--TISES--(Browers & Tomic, 1999, 2001). Second, the predictive capacity of…

The effects of neurologic assessment E-learning in nurses.

Science.gov (United States)

Shin, Ji Yeon; Issenberg, S Barry; Roh, Young Sook

2017-10-01

A firm understanding of the preliminary assessment of a patient with neurological disorders is needed for ensuring optimal patient outcomes. The purpose of this study is to evaluate the effects of using e-learning on neurologic assessment knowledge, ability, and self-confidence among nurses. This study used a non-equivalent control group pretest-posttest design. Nurses working in the neurology and neurosurgery wards, Republic of Korea PARTICIPANTS: A convenience sample of 50 nurses was assigned to either the experimental group (n=24) or the control group (n=26). The experimental group participated in the self-directed e-learning program related to neurologic assessment, and control group underwent self-directed learning with handout. Knowledge, ability, and self-confidence were measured at pretest and posttest. There were no significant differences in knowledge (U=270, p=0.399) and self-confidence (U=241.5, p=0.171) between the two groups. Nurses in the experimental group showed higher neurologic assessment ability compared with those in the control group (U=199, p=0.028). Self-directed neurologic assessment e-learning induced improvement in the neurologic assessment ability among nurses. Self-directed e-learning can be applied for improving competencies in neurologic assessment. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Neurologic aspects of vibration syndrome].

Science.gov (United States)

Langauer-Lewowicka, H; Zajac-Nedza, M

1997-01-01

The authors present divergent opinions on the pathogenesis of vibratory syndrome, and primarily on its angio-neurological form, i.e. vascular, neurogenic and immunological theory. In the light of these concepts the clinical manifestations of vibratory syndrome are discussed in view of both systemic and local developments. The issues concerning neurological diagnostics with reference to the usefulness of electrophysiological methods are thoroughly analysed. Difficulties in early diagnosis and identification of symptoms that distinguish vibratory syndrome from other syndromes with similar manifestations are highlighted.

Problem neurology residents: a national survey.

Science.gov (United States)

Tabby, David S; Majeed, Muhammed H; Schwartzman, Robert J

2011-06-14

Problem residents are found across most medical specialties at a prevalence of about 10%. This study was designed to explore the prevalence and causes of problem neurology residents and to compare neurology programs' responses and outcomes. Directors of 126 US neurology residency programs were sent an electronic survey. We collected data on demographics, first and all "identifiers" of problem residents, and year of training in which the problem was found. We asked about observable signs, etiology, and who performed remediation. We asked what resources were used and what outcomes occurred. Ninety-five program directors completed surveys (75% response rate). Almost all neurology programs have problem residents (81%). Age, sex, marital status, being a US native, or attending a US medical school had no effect on problem status. Being a parent carried a lower likelihood of problems (32%). Most commonly the problem is acted on during the first year of training. Faculty members without defined educational roles were the most frequent first identifiers. Program directors were the most common remediators. The most common remediation techniques were increasing supervision and assigning a faculty mentor. Graduate medical education office and psychiatric or psychological counseling services were most often used. Eleven percent of problem residents required a program for impaired physicians and 14% required a leave of absence. Sixteen percent were dismissed from their programs. The prevalence of problem residents in neurology is similar to other disciplines, and various resources are available to remediate them.

Strengthening Environmental Economics Capacity in Research on ...

International Development Research Centre (IDRC) Digital Library (Canada)

Strengthening Environmental Economics Capacity in Research on Climate Change Adaptation ... They will develop environmental economics methods to address specific climate change challenges caused by extreme weather stressors. ... Initiative Villes ciblées : gestion des déchets urbains à Cochabamba, en Bolivie.

Material and Social Construction: A Framework for the Adaptation of Buildings

Directory of Open Access Journals (Sweden)

Jesse M. Keenan

2014-12-01

Full Text Available This article is a formulation of a framework for understanding the nature of change, particularly climate change, as it applies to the scale of a building. Through an exploration of various scientific and social scientific literutre, the article positions the concept of adaptation as the appropriate mode for understanding and managing change. Through the classification of a duality of material and social construction in the ontological composition of a building, various lines of thought relating to adaptive capacity and adaptive cycling within systems theory are appropriated within an integrated framework for adaptation. Specifically, it is theorized that as buildings as objects are developing greater capacities for intergrated operations and management through artificial intelligence, they will possess an ex ante capacity to autonomously adapt in dynamic relation to and with the ex post adaptation of owners and operators. It is argued that this top-down and bottom-up confluence of multi-scalar dynamic change is consistent with the prevailing theory of Panarchy applied in social-ecological systems theory. The article concludes with normative perspectives on the limitations of systems theory in architecture, future directions for research and an alternative positioning of professional practices.

Neurology referrals to a liaison psychiatry service.

LENUS (Irish Health Repository)

Fitzgerald, P

2012-02-03

The objective of the present study was to assess the activity of the Liaison Psychiatry service of Cork University Hospital in relation to all in-patient neurology referrals over a 12-month period. Of 1685 neurology admissions, 106 (6%) were referred to liaison psychiatry for assessment. 91 referrals (86%) met criteria for a psychiatric disorder according to DSM-IV, the commonest being major depression (24%) and somatoform disorder (23%). Patients with multiple sclerosis or epilepsy comprised nearly half of all referrals (48 cases; 45%). Approximately 20% of M.S. in-patients (21 cases) were referred for psychiatric assessment, with the corresponding figure in epilepsy being 25% (18 cases). Although only 106 (6%) neurology in-patients were referred to liaison psychiatry, psychiatric diagnoses were documented in 327 (20%) discharge forms, presumably reflecting previous diagnosis. The above findings indicate that psychiatric illness is common among neurology inpatients screened by liaison psychiatry yet referral rates are relatively low in terms of the overall number of neurology in-patients. Psychiatric disorders were diagnosed in 86% of referrals indicating high concordance between neurologists and liaison psychiatry regarding the presence of a psychiatric disorder.

Feeding problems in children with neurological disorders.

Science.gov (United States)

Jamroz, Ewa; Głuszkiewicz, Ewa; Grzybowska-Chlebowczyk, Urszula; Woś, Halina

2012-01-01

The aim of this study was to evaluate the prevalence of selected risk factors of weight deficiency in children with chronic metabolic diseases. The study group involved 160 children, from 2 months to 15 years (mean age 3.14 years), with diseases of the nervous system and body weight deficiency. According to the type of neurological disease the following groups of patients were separated: static encephalopathies, progressive encephalopathies, disorders of mental development of undetermined etiology, genetically determined diseases. As the exponent of malnutrition, z-score of weight-for-age standards was used. An inclusion criterion for the study group was z-score of weight-for-age children, neurological disorders, oral motor dysfunction, diseases of other organs, gastrointestinal motility disorders (oral cavity, esophagus, intestines) and type of nutritional therapy. The most advanced malnutrition was in children with progressive encephalopathies and genetically determined diseases. Seizures and muscular hypotonia were most common neurological disorders. Oral motor dysfunctions were observed in 40% of patients. Malnutrition in children with neurological disorders is associated mainly with neurological deficits. In this group of children monitoring of somatic development and early nutritional intervention are necessary.

LEARNERS SATISFACTION FACTORS IN NEUROLOGY RELATED MOOCs

Directory of Open Access Journals (Sweden)

Ionela MANIU

2017-12-01

Full Text Available The aim of this article is to investigate the factors that are influencing student satisfaction in case of neurology related massive open online courses (MOOCs. We analyzed data collected from learners enrolled in 40 neurology related MOOCs, by manually looking for information in these courses reviews. The main identified satisfaction factors can be grouped into the following categories: content related factors: course content, additional materials, assignments, external research and teaching - learning related factors (teacher presentation techniques / style: engaging, clear, coherent, knowledgeable, sharing / explanation, interactive, excitement, considering student’s needs, inspiring, sense of humor. Competences, skills and objectives pursued by neurology related MOOCs are also discussed. Analyzing these factors can be useful in new courses management (design and implementation and also in understanding the needs (motivation, behaviors, perception of 21st century learners interested in neurology related fields.

Evaluation of a nurse-led social rehabilitation programme for neurological patients and carers: an action research study.

Science.gov (United States)

Portillo, Mari Carmen; Corchón, Silvia; López-Dicastillo, Olga; Cowley, Sarah

2009-02-01

Very few neurological rehabilitation programmes have successfully dealt with patients' and relatives' social needs. Furthermore, the nurses' contribution in those programmes is poor or unclear. To determine the rationale, effectiveness and adequacy of a nurse-led social rehabilitation programme implemented with neurological patients and their carers. In this action research study Hart and Bond's experimental and professionalizing typologies were applied through Lewinian cycles. A social rehabilitation programme was planned, based on the results of an in-depth baseline assessment of the context and individual needs. The programme focused on increasing the level of acceptance/adaptation of the disease through verbal and written education, easing the discharge planning, and offering social choices based on the social assessment of individual needs and possibilities at home. Two neurological wards of a hospital in Spain. The programme evaluation included 27 nurses, and two groups of patients and relatives (control group=18 patients and 19 relatives, intervention group=17 patients and 16 relatives). The two groups of patients and relatives were compared before and after discharge to determine the effectiveness of the programme. Socio-demographic forms, semi-structured interviews, participant observations, and validated scales to measure activities of daily living and social life were used, and data were analysed using content (QSR Nudist Vivo, v.2.0) and statistical (SPSS v. 13.0) analyses. The new programme resulted in social care being integrated in daily practice and developed knowledge about social rehabilitation. This had a positive impact on nurses' attitudes. Patients and relatives had more realistic expectations and positive attitudes towards social life, and developed a wider variety of choices for social changes. Better adaptation, and more coping skills and satisfaction were achieved. This rehabilitation programme was feasible and effective. Patients and

Neurological legal disability

Directory of Open Access Journals (Sweden)

Radhakrishna H

2006-01-01

Full Text Available Neurological disorders with a prolonged course, either remediable or otherwise are being seen increasingly in clinical practice and many such patients are young and are part of some organization or other wherein their services are needed if they were healthy and fit. The neurologists who are on the panel of these organizations are asked to certify whether these subjects are fit to work or how long they should be given leave. These certificates may be produced in the court of law and may be subjected to verification by another neurologist or a medical board. At present there are no standard guidelines in our country to effect such certification unlike in orthopedic specialty or in ophthalmology. The following is a beginning, based on which the neurologist can certify the neurological disability of such subjects and convey the same meaning to all neurologists across the country.

Benefit of adaptive FEC in shared backup path protected elastic optical network.

Science.gov (United States)

Guo, Hong; Dai, Hua; Wang, Chao; Li, Yongcheng; Bose, Sanjay K; Shen, Gangxiang

2015-07-27

We apply an adaptive forward error correction (FEC) allocation strategy to an Elastic Optical Network (EON) operated with shared backup path protection (SBPP). To maximize the protected network capacity that can be carried, an Integer Linear Programing (ILP) model and a spectrum window plane (SWP)-based heuristic algorithm are developed. Simulation results show that the FEC coding overhead required by the adaptive FEC scheme is significantly lower than that needed by a fixed FEC allocation strategy resulting in higher network capacity for the adaptive strategy. The adaptive FEC allocation strategy can also significantly outperform the fixed FEC allocation strategy both in terms of the spare capacity redundancy and the average FEC coding overhead needed per optical channel. The proposed heuristic algorithm is efficient and not only performs closer to the ILP model but also does much better than the shortest-path algorithm.

Education Research: Neurology resident education: Trending skills, confidence, and professional preparation.

Science.gov (United States)

Jordan, Justin T; Mayans, David; Schneider, Logan; Adams, Nellie; Khawaja, Ayaz M; Engstrom, John

2016-03-15

To survey US-trained graduating neurology residents who are American Academy of Neurology members, in an effort to trend perceived quality and completeness of graduate neurology education. An electronic survey was sent to all American Academy of Neurology members graduating from US neurology residency programs in the Spring of 2014. Of 805 eligible respondents, 24% completed the survey. Ninety-three percent of adult neurology residents and 56% of child neurology residents reported plans to pursue fellowship training after residency. Respondents reported a desire for additional training in neurocritical care, neuro-oncology, neuromuscular diseases, botulinum toxin injection, and nerve blocks. There remains a clear deficit in business training of neurology residents, although there was notable improvement in knowledge of coding and office management compared to previous surveys. Although there are still areas of perceived weakness in neurology training, graduating neurology residents feel generally well prepared for their chosen careers. However, most still pursue fellowship training for reasons that are little understood. In addition to certain subspecialties and procedures, practice management remains deficient in neurology training and is a point of future insecurity for most residents. Future curriculum changes should consider resident-reported gaps in knowledge, with careful consideration of improving business training. © 2016 American Academy of Neurology.

Autism spectrum symptoms in children with neurological disorders.

Science.gov (United States)

Ryland, Hilde K; Hysing, Mari; Posserud, Maj-Britt; Gillberg, Christopher; Lundervold, Astri J

2012-11-12

The aims of the present study were to assess symptoms associated with an autism spectrum disorder (ASD) in children with neurological disorders as reported by parents and teachers on the Autism Spectrum Screening Questionnaire (ASSQ), as well as the level of agreement between informants for each child. The ASSQ was completed by parents and teachers of the 5781 children (11-13 years) who participated in the second wave of the Bergen Child Study (BCS), an on-going longitudinal population-based study. Out of these children, 496 were reported to have a chronic illness, including 99 whom had a neurological disorder. The neurological disorder group included children both with and without intellectual disabilities. Children with neurological disorders obtained significantly higher parent and teacher reported ASSQ scores than did non-chronically ill children and those with other chronic illnesses (pchildren with neurological disorders was moderate to high for the total score and for three sub scores generated from a factor analysis, and low to moderate for single items. The ASSQ identifies a high rate of ASD symptoms in children with neurological disorders, and a large number of children screened in the positive range for ASD. Although a firm conclusion awaits further clinical studies, the present results suggest that health care professionals should be aware of potential ASD related problems in children with neurological disorders, and should consider inclusion of the ASSQ or similar screening instruments as part of their routine assessment of this group of children.

Post dengue neurological complication

Directory of Open Access Journals (Sweden)

Hizlinda Tohid

2015-12-01

Full Text Available Dengue infection is highly endemic in many tropical countries including Malaysia. However, neurological complications arising from dengue infection is not common; Gullain–Barre syndrome (GBS is one of these infrequent complications. In this paper, we have reported a case in which a 39-year-old woman presented with a neurological complication of dengue infection without typical symptoms and signs of dengue fever. She had a history of acute gastroenteritis (AGE followed by an upper respiratory tract infection (URTI weeks prior to her presentation rendering GBS secondary to the post viral URTI and AGE as the most likely diagnosis. Presence of thrombocytopenia was the only clue for dengue in this case.

Vaccination and neurological disorders

Directory of Open Access Journals (Sweden)

Anastasia Gkampeta

2015-12-01

Full Text Available Active immunization of children has been proven very effective in elimination of life threatening complications of many infectious diseases in developed countries. However, as vaccination-preventable infectious diseases and their complications have become rare, the interest focuses on immunization-related adverse reactions. Unfortunately, fear of vaccination-related adverse effects can led to decreased vaccination coverage and subsequent epidemics of infectious diseases. This review includes reports about possible side effects following vaccinations in children with neurological disorders and also published recommendations about vaccinating children with neurological disorders. From all international published data anyone can conclude that vaccines are safer than ever before, but the challenge remains to convey this message to society.

Effect of a care plan based on Roy adaptation model biological dimension on stroke patients' physiologic adaptation level.

Science.gov (United States)

Alimohammadi, Nasrollah; Maleki, Bibi; Shahriari, Mohsen; Chitsaz, Ahmad

2015-01-01

Stroke is a stressful event with several functional, physical, psychological, social, and economic problems that affect individuals' different living balances. With coping strategies, patients try to control these problems and return to their natural life. The aim of this study is to investigate the effect of a care plan based on Roy adaptation model biological dimension on stroke patients' physiologic adaptation level. This study is a clinical trial in which 50 patients, affected by brain stroke and being admitted in the neurology ward of Kashani and Alzahra hospitals, were randomly assigned to control and study groups in Isfahan in 2013. Roy adaptation model care plan was administered in biological dimension in the form of four sessions and phone call follow-ups for 1 month. The forms related to Roy adaptation model were completed before and after intervention in the two groups. Chi-square test and t-test were used to analyze the data through SPSS 18. There was a significant difference in mean score of adaptation in physiological dimension in the study group after intervention (P adaptation in the patients affected by brain stroke in the study and control groups showed a significant increase in physiological dimension in the study group by 47.30 after intervention (P adaptation model biological dimension care plan can result in an increase in adaptation in patients with stroke in physiological dimension. Nurses can use this model for increasing patients' adaptation.

Management of male neurologic patients with infertility

DEFF Research Database (Denmark)

Fode, Mikkel; Sønksen, Jens

2015-01-01

Many aspects of fertility rely on intact neurologic function and thus neurologic diseases can result in infertility. While research into general female fertility and alterations in male semen quality is limited, we have an abundance of knowledge regarding ejaculatory dysfunction following nerve...

Neurologic emergencies in HIV-negative immunosuppressed patients.

Science.gov (United States)

Guzmán-De-Villoria, J A; Fernández-García, P; Borrego-Ruiz, P J

HIV-negative immunosuppressed patients comprise a heterogeneous group including transplant patients, patients undergoing treatment with immunosuppressors, uremic patients, alcoholics, undernourished patients, diabetics, patients on dialysis, elderly patients, and those diagnosed with severe or neoplastic processes. Epileptic seizures, focal neurologic signs, and meningoencephalitis are neurologic syndromes that require urgent action. In most of these situations, neuroimaging tests are necessary, but the findings can be different from those observed in immunocompetent patients in function of the inflammatory response. Infectious disease is the first diagnostic suspicion, and the identification of an opportunistic pathogen should be oriented in function of the type and degree of immunosuppression. Other neurologic emergencies include ischemic stroke, cerebral hemorrhage, neoplastic processes, and pharmacological neurotoxicity. This article reviews the role of neuroimaging in HIV-negative immunodepressed patients with a neurologic complication that requires urgent management. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

Thyroid-related neurological disorders and complications in children.

Science.gov (United States)

Nandi-Munshi, Debika; Taplin, Craig E

2015-04-01

Thyroid hormones exert critical roles throughout the body and play an important and permissive role in neuroendocrine, neurological, and neuromuscular function. We performed a PubMed search through June 2014 with search terms including "hypothyroidism," "hyperthyroidism," "neurological complications," "neuropathy," "myopathy," "congenital hypothyroidism," and "encephalopathy." Relevant publications reviewed included case series, individual case reports, systematic reviews, retrospective analyses, and randomized controlled trials. The neurological outcomes of congenital hypothyroidism were reviewed, along with the clinical features of associated neuromuscular syndromes of both hypothyroidism and hyperthyroidism, including other autoimmune conditions. Evidence for, and pathophysiological controversies surrounding, Hashimoto encephalopathy was also reviewed. The establishment of widespread newborn screening programs has been highly successful in attenuating or preventing early and irreversible neurological harm resulting from congenital thyroid hormone deficiency, but some children continue to display neuromuscular, sensory, and cognitive defects in later life. Acquired disorders of thyroid function such as Hashimoto thyroiditis and Graves' disease are associated with a spectrum of central nervous system and/or neuromuscular dysfunction. However, considerable variation in clinical phenotype is described, and much of our knowledge of the role of thyroid disease in childhood neurological disorders is derived from adult case series. Early and aggressive normalization of thyroxine levels in newborn infants with congenital hypothyroidism is important in minimizing neurological sequelae, but maternal thyroid hormone sources are also critically important to the early developing brain. A spectrum of neurological disorders has been reported in older children with acquired thyroid disease, but the frequency with which these occur remains poorly defined in the literature, and

Qualification of the adaptive capacities of livestock farming systems

Directory of Open Access Journals (Sweden)

Benoît Dedieu

2009-07-01

Full Text Available This paper aims at exploring what is covered by « adapting to last » with a farming systems approach. Long term dynamics can be analysed as adaptive cycles, the system being permanently exposed to disturbances and shocks. Mobilizing the concept of resilience, we analyse the factors that differentiate the principles for long term action the livestock farmers have, principles which give consistency to the family - farms trajectories. With the concept of operational flexibilty, we qualify the sources of flexibility the livestock farmers maintain to cope with hazards. They are internal, related to the production process regulation properties, to the technical (adaptive or rigid specifications, to the sales policies, or external related to the information and commercial networks. Understanding the production process regulation properties require livestock farming systems models (i.e. combining decisional and biological sub-systems that can simulate how herd dynamics operate under fluctuant rules or productive parameters. It also require to evaluate the room for manoeuvre the work organization let to the farmer. All these aspects are illsutrated with on farm studies in herbivore systems (sheep, dairy, beef.Este artigo busca explorar "adaptações a mudanças" sob a ótica de sistemas de produção animal. Dinâmicas de longo prazo podem ser analisadas como ciclos adaptativos, sendo o sistema permanentemente exposto a distúrbios e choques. Utilizando o conceito de resiliência, analisam-se os fatores que diferenciam os princípios para ações de longo prazo tomadas por produtores rurais, princípios estes que dão consistência à família - trajetórias da propriedade rural. Com o conceito de flexibilidade operacional, qualificam-se as fontes de flexibilidade que os produtores mantêm para lidar com riscos. Eles são internos, relacionados a propriedades de regulação do processo produtivo, a especificações técnicas (adaptáveis ou rígidas, a

Policy Learning and Organizational Capacities in Innovation Policies

DEFF Research Database (Denmark)

Borrás, Susana

2011-01-01

Bengt-Åke Lundvall’s work has underlined the importance of policy learning for inducing innovation systems’ adaptability. In spite of his efforts and of the general interest in this topic, studies of policy learning in innovation policy continue to be scarce. Elaborating from recent theoretical...... advances, the paper identifies three levels of policy learning and argues that their effects on innovation systems are related to specific capacities of the relevant organizations implementing change. This analytical framework is used in the study of trans-national policy learning in Europe in the area...... of science–industry relations, showing the importance of capacities (or lack thereof). This calls for the practical need of addressing organizational capacity-building, in particular of analytical capacity, for truly strategic innovation policy-making....

Morbidity and Mortality Patterns among Neurological Patients in the ...

African Journals Online (AJOL)

Background/Objective: The morbidity and mortality of neurological patients managed in the intensive care unit reflect the causes of neurological disorders and the effectiveness of management. Method: The morbidity and mortality patterns of neurological patients admitted into the intensive care unit of the University of Benin ...

Profile of Neurological admissions at the University of Nigeria ...

African Journals Online (AJOL)

Background: The burden of Neurological diseases may be on the increase especially in developing countries. Improved outcome in these settings may require appreciation of the spectrum of Neurological diseases and the impediments to their management. We aim to determine the profile of neurological admissions and ...

Working memory capacity as a dynamic process

Directory of Open Access Journals (Sweden)

Vanessa R Simmering

2013-01-01

Full Text Available A well-known characteristic of working memory is its limited capacity. The source of such limitations, however, is a continued point of debate. Developmental research is positioned to address this debate by jointly identifying the source(s of limitations and the mechanism(s underlying capacity increases. Here we provide a cross-domain survey of studies and theories of working memory capacity development, which reveals a complex picture: dozens of studies from 50 papers show nearly universal increases in capacity estimates with age, but marked variation across studies, tasks, and domains. We argue that the full pattern of performance cannot be captured through traditional approaches emphasizing single causes, or even multiple separable causes, underlying capacity development. Rather, we consider working memory capacity as a dynamic process that emerges from a unified cognitive system flexibly adapting to the context and demands of each task. We conclude by enumerating specific challenges for researchers and theorists that will need to be met in order to move our understanding forward.

Individual differences in response conflict adaptations

Directory of Open Access Journals (Sweden)

Doris eKeye

2013-12-01

Full Text Available Conflict-monitoring theory argues for a general cognitive mechanism that monitors for con-flicts in information-processing. If that mechanism detects conflict, it engages cognitive con-trol to resolve it. A slow-down in response to incongruent trials (conflict effect, and a modu-lation of the conflict effect by the congruence of the preceding trial (Gratton or context effect have been taken as indicators of such a monitoring system. The present study (N = 157 investigated individual differences in the conflict and the context effect in a horizontal and a vertical Simon task, and their correlation with working memory capacity. Strength of conflict was varied by proportion of congruent trials. Coherent factors could be formed representing individual differences in speeded performance, conflict adaptation, and context adaptation. Conflict and context factors were not associated with each other. Contrary to theories assuming a close relation between working memory and cognitive control, working memory capacity showed no relation with any factors representing adaptation to conflict.

Suspecting Neurological Dysfunction From E Mail Messages ...

African Journals Online (AJOL)

A non medical person suspected and confirmed neurological dysfunction in an individual, based only on e mail messages sent by the individual. With email communication becoming rampant “peculiar” email messages may raise the suspicion of neurological dysfunction. Organic pathology explaining the abnormal email ...

Neurological manifestations in Fabry's disease

DEFF Research Database (Denmark)

Møller, Anette Torvin; Jensen, Troels Staehelin

2007-01-01

. Neurological symptoms, such as burning sensations (occasionally accompanied by acroparesthesia) and stroke, are among the first to appear, and occur in both male and female patients. A delay in establishing the diagnosis of Fabry's disease can cause unnecessary problems, especially now that enzyme replacement...... treatment is available to prevent irreversible organ damage. Females with Fabry's disease who present with pain have often been ignored and misdiagnosed because of the disorder's X-linked inheritance. This Review will stress the importance of recognizing neurological symptoms for the diagnosis of Fabry...

Neurological manifestation of colonic adenocarcinoma

Directory of Open Access Journals (Sweden)

Uzair Chaudhary

2012-04-01

Full Text Available Paraneoplastic neurologic disorders are extremely rare in cancer patients and are most commonly associated with certain tumors, such as ovarian cancer, small cell lung cancer, and breast cancer. We report here a paraneoplastic neurological syndrome in a 53-year-old man with colonic adenocarcinoma with a solitary liver metastasis. His paraneoplastic syndrome was successfully treated by methylprednisolone and primary oncologic therapies including neoadjuvant chemotherapy and definitive surgery. This is also the first documented case of simultaneous manifestation of a sensory neuropathy and limbic encephalitis with colon cancer.

Neurological manifestations of snake bite in Sri Lanka.

Directory of Open Access Journals (Sweden)

Seneviratne U

2002-10-01

Full Text Available BACKGROUND AND AIMS: Snake bite is an important cause of mortality and morbidity in certain parts of Sri Lanka. This study was designed to determine the offending snakes, neurological manifestations, disease course, and outcome in neurotoxic envenomation. METHODS AND MATERIAL: Fifty six consecutive patients admitted with neurological manifestations following snake bite were studied prospectively. Data were obtained regarding the offending snakes, neurological symptoms, time taken for onset of symptoms, neurological signs, and time taken for recovery. RESULTS: The offending snake was Russell′s viper in 27(48.2%, common and Sri Lankan krait in 19(33.9%, cobra in 3(5.4%, and unidentified in 7(12.5%. Ptosis was the commonest neurological manifestation seen in 48(85.7% followed by ophthalmoplegia (75%, limb weakness (26.8%, respiratory failure (17.9%, palatal weakness (10.7%, neck muscle weakness (7.1%, and delayed sensory neuropathy (1.8%. Neurological symptoms were experienced usually within 6 hours after the bite. Following administration of antivenom, the signs of recovery became evident within a few hours to several days. The duration for complete recovery ranged from four hours to two weeks. CONCLUSIONS: Complete recovery of neuromuscular weakness was observed in all patients except for one who died with intracerebral haemorrhage shortly after admission.

The Spectrum of Neurological Manifestations Associated with Gaucher Disease

Directory of Open Access Journals (Sweden)

Tamanna Roshan Lal

2017-03-01

Full Text Available Gaucher disease, the most common lysosomal storage disorder, is due to a deficiency in the enzyme glucocerebrosidase. This leads to the accumulation of its normal substrate, glucocerebroside, in tissue macrophages, affecting the hematological, visceral, bone and neurologic systems. Gaucher disease is classified into three broad phenotypes based upon the presence or absence of neurological involvement: type 1 (non-neuronopathic, type 2 (acute neuronopathic, and type 3 (subacute neuronopathic. Phenotypically, there is a wide spectrum of visceral and neurological manifestations. Enzyme replacement is effective in managing the visceral disease; however, treating the neurological manifestations has proved to be more challenging. This review discusses the various neurological manifestations encountered in Gaucher disease, and provides a brief overview regarding the treatment and ongoing research challenges.

[Problems in the individual adaptation of working women].

Science.gov (United States)

Grebeneva, O V; Balaeva, E A

2008-01-01

The mechanisms of development of dysadaptive changes were revealed in factory workers in relation to congenital personality traits and the schemes of individual adaptation strategies were defined. At the same time increased anxiety leading to the accelerated rates of aging preceded impaired adaptive processes. The differences in the female adaptive patterns were determined by both the degree of emotional stability and the baseline energy capacities of the cardiorespiratory system and the involvement of a mental component in adaptation.

Building Capacity to Adapt to Climate Change in Southeast Asia ...

International Development Research Centre (IDRC) Digital Library (Canada)

This project will endeavor to meet this need by measuring vulnerability to climate change in selected communities; mapping each community's vulnerability to climate change; analyzing the social vulnerability of local communities to climate change; identifying locally appropriate adaptation options; conducting an economic ...

Breastfeeding and neurological outcome at 42 months

NARCIS (Netherlands)

Patandin, S; Weisglas-Kuperus, N; Touwen, BCL; Boersma, ER

1998-01-01

This study investigated the effect of early feeding mode on the neurological condition at 42 months. For this purpose, healthy pregnant women were recruited in Groningen and Rotterdam, The Netherlands. Children were healthy and born at term. At 42 months, the children were neurologically examined by

Microbiota and neurologic diseases: potential effects of probiotics.

Science.gov (United States)

Umbrello, Giulia; Esposito, Susanna

2016-10-19

The microbiota colonizing the gastrointestinal tract have been associated with both gastrointestinal and extra-gastrointestinal diseases. In recent years, considerable interest has been devoted to their role in the development of neurologic diseases, as many studies have described bidirectional communication between the central nervous system and the gut, the so-called "microbiota-gut-brain axis". Considering the ability of probiotics (i.e., live non-pathogenic microorganisms) to restore the normal microbial population and produce benefits for the host, their potential effects have been investigated in the context of neurologic diseases. The main aims of this review are to analyse the relationship between the gut microbiota and brain disorders and to evaluate the current evidence for the use of probiotics in the treatment and prevention of neurologic conditions. Overall, trials involving animal models and adults have reported encouraging results, suggesting that the administration of probiotic strains may exert some prophylactic and therapeutic effects in a wide range of neurologic conditions. Studies involving children have mainly focused on autism spectrum disorder and have shown that probiotics seem to improve neuro behavioural symptoms. However, the available data are incomplete and far from conclusive. The potential usefulness of probiotics in preventing or treating neurologic diseases is becoming a topic of great interest. However, deeper studies are needed to understand which formulation, dosage and timing might represent the optimal regimen for each specific neurologic disease and what populations can benefit. Moreover, future trials should also consider the tolerability and safety of probiotics in patients with neurologic diseases.

Boxers--computed tomography, EEG, and neurological evaluation

International Nuclear Information System (INIS)

Ross, R.J.; Cole, M.; Thompson, J.S.; Kim, K.H.

1983-01-01

During the last three years, 40 ex-boxers were examined to determine the effects of boxing in regard to their neurological status and the computed tomographic (CT) appearance of the brain. Thirty-eight of these patients had a CT scan of the brain, and 24 had a complete neurological examination including an EEG. The results demonstrate a significant relationship between the number of bouts fought and CT changes indicating cerebral atrophy. Positive neurological findings were not significantly correlated with the number of bouts. Electroencephalographic abnormalities were significantly correlated with the number of bouts fought. Computed tomography and EEG of the brain should be considered as part of a regular neurological examination for active boxers and, if possible, before and after each match, to detect not only the effects of acute life-threatening brain trauma such as subdural hematomas and brain hemorrhages, but the more subtle and debilitating long-term changes of cerebral atrophy

The Profile of Neurology Patients Evaluated in the Emergency Department

OpenAIRE

Ufuk Emre; Ayşe Semra Demir; Esra Acıman; Nejla Çabuk; Sibel Kıran; Aysun Ünal

2009-01-01

OBJECTIVE: Early, rapid, and multidisciplinary approaches are very important in the diagnosis of neurological disorders in emergency departments. The present study aimed to investigate the features of patients that presented for neurology consultation in the emergency department. METHODS: The present study included 780 patients. Patient demographic features, reasons for emergent treatment and neurological consultation, neurological diagnosis by the neurologist, and laboratory (total blood...

Neurologic disorders

International Nuclear Information System (INIS)

Chakeres, D.W.

1987-01-01

There is a wide range of indications for radiographic evaluation of possible cerebrovascular disease, since a wide range of neurologic symptoms can be encountered secondary to ischemia. Frequently the diagnosis of cerebrovascular disease is clear on clinical grounds, but radiographic evaluation is essential both to quantify the extent of disease and establish the underlying cause (e.g., vasculitis, embolus) while excluding other causes so that the proper therapy can follow

Long-term fat diet adaptation effects on performance, training capacity, and fat utilization

DEFF Research Database (Denmark)

Helge, Jørn Wulff

2002-01-01

It is well known that adaptation to a fat-rich carbohydrate-poor diet results in lower resting muscle glycogen content and a higher rate of fat oxidation during exercise when compared with a carbohydrate-rich diet. The net effect of such an adaptation could potentially be a sparing of muscle...... glycogen, and because muscle glycogen storage is coupled to endurance performance, it is possible that adaptation to a high-fat diet potentially could enhance endurance performance. Therefore, the first issue in this review is to critically evaluate the available evidence for a potential endurance...... performance enhancement after long-term fat-rich diet adaptation. Attainment of optimal performance is among other factors dependent also on the quality and quantity of the training performed. When exercise intensity is increased, there is an increased need for carbohydrates. On the other hand, consumption...

Adapting Community-Based Water Supply in Central America to a ...

International Development Research Centre (IDRC) Digital Library (Canada)

This research project will study the effects of climate change on water ... They will also: -assess how water suppliers can adapt their practices to ... to help prioritize climate change adaptation investments -build local capacities ... focus on assessing the costs and benefits of different adaptation measures. ... Related content ...

Interest in neurology during medical clerkship in three Nigerian medical schools

Directory of Open Access Journals (Sweden)

Olanrewaju Timothy O

2010-05-01

Full Text Available Abstract Background This study sought to ascertain perception of Nigerian medical students of neurology in comparison with 7 other major medical specialties. To also determine whether neurology was the specialty students consider most difficult and the reasons for this and to appraise their opinion on how neurosciences and neurology were taught in their different universities. Methods Self-administered questionnaires were used to obtain information from randomly selected clinical students from 3 medical colleges in Nigeria (University of Ibadan, Ibadan; University of Ilorin, Ilorin; Ladoke Akintola University of Technology, Osogbo. Results Of 320 questionnaires sent out, 302 were returned given 94% response rate. Students felt they knew neurology least of all the 8 medical specialties, and were not confident of making neurological diagnoses. About 82% of the students indicated they learnt neurology best from bedside teaching, followed by use of medical textbooks. Close to 15% found online resources very useful for learning neurology and 6% indicated that group discussion was quite useful in the acquisition of knowledge on neurology. Histology and biochemistry were the preclinical subjects participants opined were least useful in learning neurology. The most frequent reasons students felt neurology was difficult were problems with understanding neuroanatomy (49%, insufficient exposure to neurological cases (41%, too many complex diagnoses (32% and inadequate neurology teachers (32%. Conclusions Nigerian medical students perceived neurology as the most difficult medical specialty and are not interested in specializing in it. Neurology education could be improved upon by provision of more bedside tutorials and increased availability of online resources to enhance learning. There is need to emphasize increased frequency of small group discussions amongst students so that they will be used to teamwork after graduation.

Neurology Research in Saudi Arabia: Urgent call for action.

Science.gov (United States)

Algahtani, Hussein; Shirah, Bader; Boker, Faisal; Algamdi, Albaraa; Alkahtani, Abdulah

2017-08-01

Research activities in Saudi Arabia are promoted at the governmental and institutional levels. However, the output and quality of research conducted in the field of neurology has not yet been measured quantitatively. This study therefore aimed to analyse neurology-related publications from Saudi Arabia. This study was conducted in January 2016. A systematic search using the PubMed ® search engine (National Library of Medicine, Bethesda, Maryland, USA) was conducted to identify all neurology-related articles published from Saudi Arabia between January 1996 and December 2015. A total of 1,292 neurology-related publications were identified. Neurology research increased linearly with time, with most publications originating from Riyadh (67%) and the university sector (≈47%). However, most neurology-related articles were published in journals which had an impact factor of Saudi Arabia has increased substantially over the last 20 years. However, as most articles were published in low-impact journals, the quality of research remains inadequate and should be improved. It is important that an official research culture be established in both governmental and private universities as well as colleges and health institutions in Saudi Arabia. The formation of clinical academic departments staffed by research experts is recommended to ensure the quality of neurology research output.

Task analysis in neurosciences programme design - neurological ...

African Journals Online (AJOL)

Defining educational objectives is the key to achieving the goal of professional competence in students. The technique of task analysis was selected to determine components of competence in clinical neurology appropriate to the needs of primary care. A survey of neurological problems in general practice revealed that ...

Residual neurologic sequelae after childhood cerebral malaria

NARCIS (Netherlands)

van Hensbroek, M. B.; Palmer, A.; Jaffar, S.; Schneider, G.; Kwiatkowski, D.

1997-01-01

Cerebral malaria is an important cause of pediatric hospital admissions in the tropics. It commonly leads to neurologic sequelae, but the risk factors for this remain unclear and the long-term outcome unknown. The purpose of this study was to identify the common forms of neurologic sequelae that

Risk of neurological diseases among survivors of electric shocks

DEFF Research Database (Denmark)

Grell, Kathrine; Meersohn, Andrea; Schüz, Joachim

2012-01-01

Several studies suggest a link between electric injuries and neurological diseases, where electric shocks may explain elevated risks for neuronal degeneration and, subsequently, neurological diseases. We conducted a retrospective cohort study on the risk of neurological diseases among people...... in Denmark who had survived an electric accident in 1968-2008. The cohort included 3,133 people and occurrences of neurological diseases were determined by linkage to the nationwide population-based Danish National Register of Patients. The numbers of cases observed at first hospital contact in the cohort...... were compared with the respective rates of first hospital contacts for neurological diseases in the general population. We observed significantly increased risks for peripheral nerve diseases (standardized hospitalization ratio (SHR), 1.66; 95% confidence interval (CI), 1.22-2.22), for migraine (SHR, 1...

Cognitive, emotional, and neural benefits of musical leisure activities in aging and neurological rehabilitation: A critical review.

Science.gov (United States)

Särkämö, Teppo

2017-04-28

Music has the capacity to engage auditory, cognitive, motor, and emotional functions across cortical and subcortical brain regions and is relatively preserved in aging and dementia. Thus, music is a promising tool in the rehabilitation of aging-related neurological illnesses, such as stroke and Alzheimer disease. As the population ages and the incidence and prevalence of these illnesses rapidly increases, music-based interventions that are enjoyable and effective in the everyday care of the patients are needed. In addition to formal music therapy, musical leisure activities, such as music listening and singing, which patients can do on their own or with a caregiver, are a promising way to support psychological well-being during aging and in neurological rehabilitation. This review article provides an overview of current evidence on the cognitive, emotional, and neural effects of musical leisure activities both during normal aging and in the rehabilitation and care of stroke patients and people with dementia. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Strengthening threatened communities through adaptation: insights from coastal Mozambique

Directory of Open Access Journals (Sweden)

Jessica L. Blythe

2014-06-01

Full Text Available Change is a defining characteristic of coastal social-ecological systems, yet the magnitude and speed of contemporary change is challenging the adaptive capacity of even the most robust coastal communities. In the context of multiple drivers of change, it has become increasingly important to identify how threatened communities adapt to livelihood stressors. We investigate how adaptation is negotiated in two coastal fishing communities by documenting livelihood stressors, household assets, adaptive strategies, and factors that facilitate or inhibit adaptation. Declining catch is the most common stressor being experienced in both communities, however, socioeconomic, e.g., disease or theft, and ecological, e.g., severe storms and drought, changes are also creating livelihood stress. We find that specialized fishers' with higher investment in fishing gear and government support are adapting by intensifying their fishing efforts, whereas poorer fishers with more livelihood options are adapting through diversification. Adaptation is facilitated by fishers' groups, occupational pride, and family networks. It is inhibited by limited assets, competition over declining resources, and pervasive poverty. Our data suggest that adaptation is a heterogeneous process that is influenced by multiple factors. Understanding the complexity of fishers' responses to livelihood stressors is critical for fostering adaptive capacity in coastal communities, for strengthening fisheries management, and for improving the livelihoods of fishing dependent communities.

Neurologic Evaluation and Management of Perioperative Nerve Injury.

Science.gov (United States)

Watson, James C; Huntoon, Marc A

2015-01-01

Neurologic injury after regional anesthesia or pain medicine procedures is rare. Postprocedural neurologic deficits may create high levels of anxiety for the patient and practitioner, although most deficits are limited in severity and can be expected to fully resolve with time. Postoperative anesthesia-related neuraxial and peripheral nerve injuries are reviewed to define an efficient, structured approach to these complications. Emphasis is placed on acutely stratifying the urgency and scope of diagnostic testing or consultation necessity, initiating appropriate definitive treatments, and defining appropriate out-of-hospital follow-up and symptom management. Studies pertinent to the recognition, evaluation, and treatment of neurologic assessment of perioperative nerve injury and published since the last advisory on the topic are reviewed and a new structured algorithmic approach is proposed. The evolving literature on postoperative inflammatory neuropathies is reviewed to help define the clinical criteria and to identify patients who would benefit from early neurological evaluation. New sections review potential acute interventions to improve neurologic outcome and long-term management of neuropathic pain resulting from perioperative nerve injury.

Cotard syndrome in neurological and psychiatric patients.

Science.gov (United States)

Ramirez-Bermudez, Jesus; Aguilar-Venegas, Luis C; Crail-Melendez, Daniel; Espinola-Nadurille, Mariana; Nente, Francisco; Mendez, Mario F

2010-01-01

The authors describe the frequency and characteristics of Cotard syndrome among neurological and psychiatric inpatients at a tertiary referral center. All inpatients from the National Institute of Neurology of Mexico (March 2007-May 2009) requiring neuropsychiatric consultation were reviewed. Among 1,321 inpatient consultations, 63.7% had neurological disease and one (0.11%) had viral encephalitis and Cotard syndrome. Of inpatients, 36.2% had pure psychiatric disorders and three (0.62%) had Cotard syndrome, associated with psychotic depression, depersonalization, and penile retraction (koro syndrome). This review discusses potential mechanisms for Cotard syndrome, including the role of a perceptual-emotional dissociation in self-misattribution in the deliré des negations.

The practice of neurology: Looking ahead by looking back.

Science.gov (United States)

Ringel, Steven P

2015-05-19

Over the last 50 years, there have been many improvements in therapy for individuals with neurologic disorders. Simultaneously, the complexity and cost of care have increased. The delivery of neurologic services is inefficient. The needs of both patients and neurologists are not being optimally addressed. Although greater attention is on the quality, safety, and value of the care, there remains a need for fundamental redesign in the way neurologic services are provided. The future practice of neurology will likely be interdisciplinary and provide both easy access and efficient coordination of services. No matter what changes in financing of health care are adopted, focus needs to be on reducing health care costs. Patients seeking neurologic care will expect seamless, innovative, and cost-effective services and to be active participants in their care. The proposed modifications address current demands and advocate for prospective innovative solutions. The changes proposed to improve care for patients will simultaneously make the careers of neurologists more gratifying and less stressful. © 2015 American Academy of Neurology.

Neurological manifestations in HIV positive patients in Tehran, Iran

Directory of Open Access Journals (Sweden)

Minoo Mohraz

2014-02-01

Full Text Available Objective: To evaluate the neurological complications among Iranian HIV-positive patients. Methods: This cross-sectional study was conducted among 428 patients diagnosed with HIV infection between 2006 and 2009 at Imam Khomeini hospital, Tehran, Iran. Demographic and clinical variables as well as laboratory tests were extracted and analyzed. Also, another 100 patients refereed to Voluntary Counseling and Testing center of the hospital were visited and evaluated for neurological complications. Results: Among the patients, neurologic manifestations were observed in 34 (7.94% patients. Twenty three percent of the patients received antiretroviral therapy. Identified causes included brain toxoplasmosis (14.7%, progressive multi-focal leuko encephalopathy (5.9%, HIV encephalopathy (5.9%, TB meningitis (5% and unknown etiologies (11.8%. Also, among 100 patients who were admitted and visited at the Voluntary Counseling and Testing center, no one was diagnosed for any neurological manifestations. Conclusions: According to our results, toxoplasmosis is the most frequent cause of neurological conditions among Iranian HIV infected patients and should be considered in any HIV/AIDS patient with neurological manifestations.

Neurological Findings in Myeloproliferative Neoplasms

Directory of Open Access Journals (Sweden)

Semra Paydas

2013-04-01

Full Text Available Myeloproliferative neoplasms (MPN arise from genetic deficiencies at the level of pluripotent stem cells. Each of these neoplasms is a clonal stem cell disorder with specific phenotypic, genetic and clinical properties. Age is one of the most important factors in the development of symptoms and complications associated with MPNs.High white blood cell counts in chronic myelocytic leukemia also known as leukocytosis may lead to central nervous system findings. Tumors developing outside the bone marrow named as extramedullary myeloid tumors (EMMT could be detected at the initial diagnosis or during the prognosis of the disease, which may cause neurological symptoms due to pressure of leukemic cell mass on various tissues along with spinal cord. Central nervous system involvement and thrombocytopenic hemorrhage may lead to diverse neurological symptoms and findings.Transient ischemic attack and thrombotic stroke are the most common symptoms in polycythemia vera. Besides thrombosis and hemorrage, transformation to acute leukemia can cause neurological symptoms and findings. Transient ischemic attack, thrombotic stroke and specifically hemorrage can give rise to neurological symptoms similar to MPN in essential thrombocytosis.Extramedullary hematopoiesis refers to hematopoietic centers arise in organ/tissues other than bone marrow in myelofibrosis. Extramedullar hematopoietic centers may cause intracranial involvement, spinal cord compression, seizures and hydrocephalia. Though rare, extramedullary hematopoiesis can be detected in cranial/spinal meninges, paraspinal tissue and intracerebral regions. Extramedullary hematopoiesis has been reported in peripheral neurons, choroid plexus, pituitary, orbits, orbital and lacrimal fossa and in sphenoidal sinuses. [Cukurova Med J 2013; 38(2.000: 157-169

Chapter 17: cognitive assessment in neurology.

Science.gov (United States)

Henderson, Victor W

2010-01-01

Modern interests in cognitive assessment began with Franz Gall's early 19th century theory of mental organology and Paul Broca's reports in the 1860s on patients with focal brain injury and aphemia. These workers spurred interest in assessing delimited mental abilities in relation to discrete cerebral areas. With roots in experimental and educational psychology, the intelligence testing movement added assessment tools that could be applied to neurological patients. Early- to mid-20th-century landmarks were Alfred Binet and Theodore Simon's intelligence scale, Howard Knox's nonverbal performance tests, and the intelligence quotient conceived by Lewis Terman and refined by David Wechsler. Also developed during this era were Henry Head's Serial Tests for aphasic patients and Kurt Goldstein's tests for brain-injured patients with impairments in "abstract attitude" and concept formation. Other investigators have contributed procedures for the evaluation of language functions, memory, visuospatial and visuoconstructive skills, praxis, and executive functions. A further milestone was the development of short standardized cognitive instruments for dementia assessment. Within a neurological arena, the historical emphasis has been on a flexible, process-driven approach to the service of neurological diagnosis and syndrome identification. Advances in clinical psychology, neurology, and the cognate clinical neurosciences continue to enrich assessment options.

Neurological complications of Zika virus infection.

Science.gov (United States)

Carod-Artal, Francisco Javier

2018-04-26

Zika virus (ZIKV) disease is a vector-borne infectious disease transmitted by Aedes mosquitoes. Recently, ZIKV has caused outbreaks in most American countries. Areas covered: Publications about neurological complications of ZIKV infection retrieved from pubmed searchers were reviewed, and reference lists and relevant articles from review articles were also examined. Vertical/intrauterine transmission leads to congenital infection and causes microcephaly and congenital ZIKV syndrome. ZIKV preferentially infects human neural progenitor cells and triggers cell apoptosis. ZIKV RNA has been identified in foetal brain tissue and brains of microcephalic infants who died; amniotic fluid and placentas of pregnant mothers; and umbilical cord, cerebro-spinal fluid and meninges of newborns. The increase in the number of Guillain-Barre syndrome (GBS) cases during the ZIKV outbreak in the Americas provides epidemiological evidence for the link between ZIKV infection and GBS. Less frequently reported ZIKV neurological complications include encephalitis/meningoencephalitis, acute disseminated encephalomyelitis, myelitis, cerebrovascular complications (ischemic infarction; vasculopathy), seizures and encephalopathy, sensory polyneuropathy and sensory neuronopathy. Analysis of GBS incidence could serve as an epidemiological 'marker' or sentinel for ZIKV disease and other neurological complications associated to ZIKV. Expert commentary: An expanding spectrum of neurological complications associated with ZIKV infection is being recognised.

Neurological status in severely jaundiced Zimbabwean neonates

NARCIS (Netherlands)

Wolf, M. J.; Beunen, G.; Casaer, P.; Wolf, B.

1998-01-01

Neurological status was studied in 50 jaundiced infants with a total serum bilirubin of > 400 mumol/l (23.4 mg/dl). Infants were assessed in the neonatal period with the Neonatal Neurological Examination and 4 months of age with the Infant Motor Screen. Twenty-six (52 per cent) infants were

Autism spectrum symptoms in children with neurological disorders

Directory of Open Access Journals (Sweden)

Ryland Hilde K

2012-11-01

Full Text Available Abstract Background The aims of the present study were to assess symptoms associated with an autism spectrum disorder (ASD in children with neurological disorders as reported by parents and teachers on the Autism Spectrum Screening Questionnaire (ASSQ, as well as the level of agreement between informants for each child. Methods The ASSQ was completed by parents and teachers of the 5781 children (11–13 years who participated in the second wave of the Bergen Child Study (BCS, an on-going longitudinal population-based study. Out of these children, 496 were reported to have a chronic illness, including 99 whom had a neurological disorder. The neurological disorder group included children both with and without intellectual disabilities. Results Children with neurological disorders obtained significantly higher parent and teacher reported ASSQ scores than did non-chronically ill children and those with other chronic illnesses (p Conclusions The ASSQ identifies a high rate of ASD symptoms in children with neurological disorders, and a large number of children screened in the positive range for ASD. Although a firm conclusion awaits further clinical studies, the present results suggest that health care professionals should be aware of potential ASD related problems in children with neurological disorders, and should consider inclusion of the ASSQ or similar screening instruments as part of their routine assessment of this group of children.

A national neurological excellence centers network.

Science.gov (United States)

Pazzi, S; Cristiani, P; Cavallini, A

1998-02-01

The most relevant problems related to the management of neurological disorders are (i) the frequent hospitalization in nonspecialist departments, with the need for neurological consultation, and (ii) the frequent requests of GPs for highly specialized investigations that are very expensive and of little value in arriving at a correct diagnosis. In 1996, the Consorzio di Bioingegneria e Informatica Medica in Italy realized the CISNet project (in collaboration with the Consorzio Istituti Scientifici Neuroscienze e Tecnologie Biomediche and funded by the Centro Studi of the National Public Health Council) for the implementation of a national neurological excellence centers network (CISNet). In the CISNet project, neurologists will be able to give on-line interactive consultation and off-line consulting services identifying correct diagnostic/therapeutic procedures, evaluating the need for both examination in specialist centers and admission to specialized centers, and identifying the most appropriate ones.

Perinatal pharmacology: applications for neonatal neurology.

Science.gov (United States)

Smits, Anne; Allegaert, Karel

2011-11-01

The principles of clinical pharmacology also apply to neonates, but their characteristics warrant a tailored approach. We focus on aspects of both developmental pharmacokinetics (concentration/time relationship) and developmental pharmacodynamics (concentration/effect relationship) in neonates. We hereby aimed to link concepts used in clinical pharmacology with compound-specific observations (anti-epileptics, analgosedatives) in the field of neonatal neurology. Although in part anecdotal, we subsequently illustrate the relevance of developmental pharmacology in the field of neonatal neurology by a specific intervention (e.g. whole body cooling), specific clinical presentations (e.g. short and long term outcome following fetal exposure to antidepressive agents, the development of new biomarkers for fetal alcohol syndrome) and specific clinical needs (e.g. analgosedation in neonates, excitocytosis versus neuro-apoptosis/impaired synaptogenesis). Copyright © 2011 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Intervertebral Disc Characteristic on Progressive Neurological Deficit

Directory of Open Access Journals (Sweden)

Farid Yudoyono

2017-09-01

Full Text Available Objective: To examine the intervertebral disc characteristic on magnetic resonance imaging (MRI in lumbar herniated disc (LHD patients with progressive neurological deficit. Methods: Patients were collected retrospectively from Dr. Hasan Sadikin General Hospital Database from 2011–2013 with LHD, had neurological deficit such as radiculopathy and cauda equine syndrome for less than four weeks with a positive sign confirmed by neurological examination and confirmatory with MRI examination. Results: A total of 14 patients with lumbar herniated disc disease (10 males, 4 females suffered from progressive neurological deficit with an average age of (52.07±10.9 years old. Early disc height was 9.38±0.5 mm and progressive neurological deficit state disc height was 4.03±0.53 mm, which were significantly different statisticaly (p<0.01. Symptoms of radiculopathy were seen in 11 patients and cauda equine syndrome in three patients. Modic changes grade 1 was found in five patients, grade 2 in eight patients,grade 3 in one patient, Pfirmman grade 2 in eleven patients and grade 3 in three patients. Thecal sac compression 1/3 compression was seen in four patients and 2/3 compression in ten patients. Conclusions: Neurosurgeon should raise concerns on the characteristic changes of intervertebral disc in magnetic resonance imaging examination to avoid further neural injury in lumbar herniated disc patients.

Opinion and Special Articles: Neurology education at US osteopathic medical schools.

Science.gov (United States)

Freedman, Daniel A; Albert, Dara V F

2017-12-12

Osteopathic medical schools have a longstanding tradition of training primary care physicians (PCP). Neurologic symptoms are common in the PCP's office and there is an undersupply of neurologists in the United States. It is therefore crucial for osteopathic medical students to have a strong foundation in clinical neurology. Despite the importance, a mere 6% of osteopathic medical schools have required neurology clerkships. Furthermore, exposure to neurology in medical school through required clerkships has been correlated with matching into neurology residency. As osteopathic medical schools continue to expand, it will become increasingly important to emphasize the American Academy Neurology's published guidelines for a core clerkship curriculum. Practicing neurologists should take an active role in encouraging osteopathic medical schools to adopt these guidelines. © 2017 American Academy of Neurology.

Improving conservation outcomes with a new paradigm for understanding species’ fundamental and realized adaptive capacity

Science.gov (United States)

Beever, Erik; O’Leary, John; Mengelt, Claudia; West, Jordan M.; Julius, Susan; Green, Nancy; Magness, Dawn; Petes, Laura E.; Stein, Bruce A.; Nicotra, Adrienne B; Hellmann, Jessica J; Robertson, Amanda L; Staudinger, Michelle D.; Rosenberg, Andrew A.; Babij, Eleanora; Brennan, Jean; Schuurman, Gregor W.; Hofmann, Gretchen E

2016-01-01

Worldwide, many species are responding to ongoing climate change with shifts in distribution, abundance, phenology, or behavior. Consequently, natural-resource managers face increasingly urgent conservation questions related to biodiversity loss, expansion of invasive species, and deteriorating ecosystem services. We argue that our ability to address these questions is hampered by the lack of explicit consideration of species’ adaptive capacity (AC). AC is the ability of a species or population to cope with climatic changes and is characterized by three fundamental components: phenotypic plasticity, dispersal ability, and genetic diversity. However, few studies simultaneously address all elements; often, AC is confused with sensitivity or omitted altogether from climate-change vulnerability assessments. Improved understanding, consistent definition, and comprehensive evaluations of AC are needed. Using classic ecological-niche theory as an analogy, we propose a new paradigm that considers fundamental and realized AC: the former reflects aspects inherent to species, whereas the latter denotes how extrinsic factors constrain AC to what is actually expressed or observed. Through this conceptualization, we identify ecological attributes contributing to AC, outline areas of research necessary to advance understanding of AC, and provide examples demonstrating how the inclusion of AC can better inform conservation and natural-resource management.

Neurologic Manifestations of Enterovirus 71 Infection in Korea.

Science.gov (United States)

Lee, Kyung Yeon; Lee, Myoung Sook; Kim, Dong Bin

2016-04-01

Enterovirus 71 frequently involves the central nervous system and may present with a variety of neurologic manifestations. Here, we aimed to describe the clinical features, magnetic resonance imaging (MRI) findings, and cerebrospinal fluid (CSF) profiles of patients presenting with neurologic complications of enterovirus 71 infection. We retrospectively reviewed the records of 31 pediatric patients hospitalized with acute neurologic manifestations accompanied by confirmed enterovirus 71 infection at Ulsan University Hospital between 2010 and 2014. The patients' mean age was 2.9 ± 5.5 years (range, 18 days to 12 years), and 80.6% of patients were less than 4 years old. Based on their clinical features, the patients were classified into 4 clinical groups: brainstem encephalitis (n = 21), meningitis (n = 7), encephalitis (n = 2), and acute flaccid paralysis (n = 1). The common neurologic symptoms included myoclonus (58.1%), lethargy (54.8%), irritability (54.8%), vomiting (48.4%), ataxia (38.7%), and tremor (35.5%). Twenty-five patients underwent an MRI scan; of these, 14 (56.0%) revealed the characteristic increased T2 signal intensity in the posterior region of the brainstem and bilateral cerebellar dentate nuclei. Twenty-six of 30 patients (86.7%) showed CSF pleocytosis. Thirty patients (96.8%) recovered completely without any neurologic deficits; one patient (3.2%) died due to pulmonary hemorrhage and shock. In the present study, brainstem encephalitis was the most common neurologic manifestation of enterovirus 71 infection. The characteristic clinical symptoms such as myoclonus, ataxia, and tremor in conjunction with CSF pleocytosis and brainstem lesions on MR images are pathognomonic for diagnosis of neurologic involvement by enterovirus 71 infection.

The Adaptation Gap Report. Towards Global Assessment

DEFF Research Database (Denmark)

2017-01-01

The Paris Agreement, adopted in 2015, established the global goal on adaptation of enhancing adaptive capacity, strengthening resilience and reducing vulnerability to climate change, with a view to contributing to sustainable development and ensuring an adequate adaptation response in the context...... Change (UNFCCC) to prepare for the implementation of the Paris Agreement. In contrast to previous Adaptation Gap Reports, the 2017 report focuses on issues relating to frameworks, comprising concepts, methodologies and data, rather than on assessing a particular dimension of the adaptation gap. Future...... extensive external review. The Paris Agreement’s global goal on adaptation provides a new starting point and impetus for assessing progress on adaptation at the global level, but additional information is required for assessing such progress. The global goal on adaptation provides a collective vision...

[Prevalence of neurological disorders among children with Down syndrome].

Science.gov (United States)

Gaete, Beatriz; Mellado, Cecilia; Hernández, Marta

2012-02-01

Neurological disturbances are common problems in children with Down Syndrome (DS). To determine the prevalence of neurological disorders affecting children with Down Syndrome. Review of medical records of 253 children aged from 1 day to 23 years affected with DS, attended at a public hospital and a University clinic. The overall prevalence of neurological disorders was 38.7%. The most common problems were ocular motor disorders in 26% of cases and epilepsy in 12%. Neurological disorders are more common in children with DS than in the general population. Motor ocular disorders and epilepsy are the predominant disturbances detected.

Suicide and patients with neurologic diseases. Methodologic problems

DEFF Research Database (Denmark)

Stenager, E N; Stenager, Egon

1992-01-01

OBJECTIVE: The suicide risk in patients with many neurologic diseases has been reported to be greater than that in the general population. Studies on the subject are, however, often encumbered with methodologic problems. We appraised these problems and, based on an evaluation, reappraised knowledge...... of the suicide risk in patients with specific neurologic diseases. DATA SOURCE: Using the computerized database MEDLINE, we identified all published reports with the key words suicide, attempted suicide, and neurologic diseases. STUDY SELECTION: We assessed and reviewed studies concerning the most common...... of the studies, the methods used gave rise to uncertainty about the conclusion presented. CONCLUSION: An increased suicide risk was found in patients suffering from multiple sclerosis and spinal cord lesions as well as in selected groups of patients with epilepsy. In other neurologic diseases, the suicide risk...

Localized scleroderma en coup de sabre in the Neurology Clinic.

Science.gov (United States)

Pinho, João; Rocha, João; Sousa, Filipa; Macedo, Cristiana; Soares-Fernandes, João; Cerqueira, João; Maré, Ricardo; Lourenço, Esmeralda; Pereira, João

2016-07-01

Localized scleroderma en coup de sabre (LScs) is a form of localized scleroderma thought to be an autoimmune disorder. Central nervous system involvement is not rare and neurological manifestations include seizures, focal neurological deficits, headache and neuropsychiatric changes. Patients attending the Neurology Clinic with the final diagnosis of LScs with neurological manifestations were identified and clinical and imagiological records reviewed. Five patients (0.024%) had LScs with neurological involvement, presenting with transient focal neurologic deficits, seizures, headache or migraine with aura. Neuroimaging studies confirmed localized skin depression and showed bone thinning, white matter lesions, brain calcifications, sulcal effacement and meningeal enhancement. Three patients experienced clinical improvement after immunosuppressive therapy, and in two of these patients neuroimaging findings also improved. Recognizing typical dermatologic changes is keystone for the diagnosis of LScs with neurological involvement. It is a diagnosis of exclusion and extensive etiological diagnostic evaluation should be performed. Treatment options, including conservative follow-up or immunosuppressive therapy, should be carefully considered. Copyright © 2016 Elsevier B.V. All rights reserved.

Neurology Research in Saudi Arabia : Urgent call for action

Directory of Open Access Journals (Sweden)

Hussein Algahtani

2017-08-01

Full Text Available Objectives: Research activities in Saudi Arabia are promoted at the governmental and institutional levels. However, the output and quality of research conducted in the field of neurology has not yet been measured quantitatively. This study therefore aimed to analyse neurology-related publications from Saudi Arabia. Methods: This study was conducted in January 2016. A systematic search using the PubMed® search engine (National Library of Medicine, Bethesda, Maryland, USA was conducted to identify all neurology-related articles published from Saudi Arabia between January 1996 and December 2015. Results: A total of 1,292 neurologyrelated publications were identified. Neurology research increased linearly with time, with most publications originating from Riyadh (67% and the university sector (≈47%. However, most neurology-related articles were published in journals which had an impact factor of <1 (55%. Conclusion: Neurology research in Saudi Arabia has increased substantially over the last 20 years. However, as most articles were published in low-impact journals, the quality of research remains inadequate and should be improved. It is important that an official research culture be established in both governmental and private universities as well as colleges and health institutions in Saudi Arabia. The formation of clinical academic departments staffed by research experts is recommended to ensure the quality of neurology research output.

Linking African Researchers with Adaptation Policy Spaces | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

Linking African Researchers with Adaptation Policy Spaces. Poor understanding of policy processes tends to reduce the value of research results and the ability of researchers to influence policy. One of the main goals of IDRC's Climate Change Adaptation in Africa (CCAA) program is to build the capacity of researchers to ...

Neurologic Outcomes of Complex Adult Spinal Deformity Surgery

DEFF Research Database (Denmark)

Lenke, Lawrence G; Fehlings, Michael G; Shaffrey, Christopher I

2016-01-01

STUDY DESIGN: Prospective, multicenter, international observational study. OBJECTIVE: To evaluate motor neurologic outcomes in patients undergoing surgery for complex adult spinal deformity (ASD). SUMMARY OF BACKGROUND DATA: The neurologic outcomes after surgical correction for ASD have been...... and 16.42% showed an improvement. At 6 months, 10.82% patients showed a decline in preoperative LEMS, 20.52% improvement, and 68.66% maintenance. This was a significant change compared with 6 weeks and at discharge. CONCLUSION: Although complex ASD surgery can restore neurologic function in patients...

Differences in characteristics among new pediatric neurology patients: the effect of a newly established private pediatric neurology practice.

Science.gov (United States)

Van Cleave, Jeanne; Woodruff, Brian; Freed, Gary L

2008-01-01

To investigate changes in volume and characteristics of new patients referred when a private pediatric neurology practice (PP) opened in 2004 in an area served primarily by an academic medical center's (AMC) pediatric neurology practice. Retrospective analysis of medical and billing records to examine changes in volume, diagnosis, and sociodemographic factors of new patients at the AMC from July 2004 to June 2005; the PP during the same period; and the AMC during the year before. One year after the PP opened, 40% more new pediatric neurology patients were seen in this area than the year before. Compared with the AMC, PP saw a greater proportion of seizures (34% vs 26%, P 20 miles from the practice (32% vs 64%, P pediatric neurology patients in this area. After the PP opened, the AMC continued to care for most patients with rare diseases and fewer financial resources. Future research should examine whether the increase in volume reflects relief of pent-up demand or increased referral rates due to eased access, and should elucidate how differences in patient populations at academic and private subspecialty practices relate to access to subspecialty care and financial well-being of academic practices.

Predominance of neurologic diseases in international aeromedical transportation.

Science.gov (United States)

Chen, Wan-Lin; Lin, Yu-Ming; Ma, Hong-Ping; Chiu, Wen-Ta; Tsai, Shin-Han

2009-12-01

International travel industry in Taiwan is expanding. The number of people traveling abroad was approximately 480,000 people in 1980; 2,940,000 in 1990; 7,320,000 in 2000, and in 2007, it has reached 8,960,000, which was more than one third of total population. Air medical transportation will be necessary when local medical facilities do not approximate the international standards. No previous study on epidemiology in Taiwan on patients received international medical repatriation. This is the first report to discuss the epidemiology of Taiwan's international aeromedical transportation and its focus on neurologic diseases. Retrospective analysis of all international aeromedical transports on Taiwanese patients from October 2005 to September 2007 was performed. All materials were collected from the databank of International SOS, Taipei. The data were analyzed with Microsoft Excel and SPSS v. 11.0 software (SPSS, Chicago, Ill). A total of 416 patients were transported. Excluding expatriates transported outbound and 2-stage inbound transports, the Taiwanese patient number with international aeromedical transport was 379; 51 by air ambulance and 328 commercially. There were 271 male (72%) and 108 female patients (18%). Of the 379 patients, 178 (47%) were neurologic diseases. Two hundred ninety-five (78%) patients were transported from China. Patient transports peaked in autumn by 105 (28%). Of all 33 ventilated patients, 12 (36%) were neurologic diseases. In-flight complications occurred in 10% of neurologic and 2% of nonneurologic cases. No in-flight mortality occurred in both groups. Neurologic diseases comprise most of the Taiwanese patients that requires medical transportation. With relatively suboptimal medical standard and high medical expenses in China, patients with neurologic conditions need timely and safe aeromedical transport than those with other diseases. Transport of patients with neurologic diseases, either by air ambulance or commercial flights, can

Support Fund for Local Adaptation Strategies | IDRC - International ...

International Development Research Centre (IDRC) Digital Library (Canada)

This project seeks to strengthen the leadership and technical and organizational capacity of grassroots communities in the area of adaptation to climate change. It will do so by putting in place a process for selecting pilot projects, identifying team needs in terms of capacity building, contracting providers of (public or private) ...

Adult phenylketonuria presenting with subacute severe neurologic symptoms.

Science.gov (United States)

Seki, M; Takizawa, T; Suzuki, S; Shimizu, T; Shibata, H; Ishii, T; Hasegawa, T; Suzuki, N

2015-08-01

We report a 48-year-old Japanese woman with phenylketonuria (PKU) who presented with severe neurological symptoms more than 30 years after discontinuation of dietary treatment. She was diagnosed with PKU at 6-years-old and was treated with a phenylalanine restricted diet until she was 15 years old. When she was 48-years-old she started having difficulty walking. After several months, she presented with severe disturbance of consciousness and was admitted. She was diagnosed as having neurological complications associated with PKU. We observed temporal changes in her laboratory data, brain MRI and single-photon emission computed tomography (SPECT) scan findings. Brain MRI on T2-weighted, fluid-attenuated inversion recovery and diffusion-weighted images revealed high intensity lesions in her bilateral frontal lobes and 123I-IMP SPECT showed marked and diffuse hypoperfusion in the bilateral cerebrum and cerebellum. After the resumption of dietary treatment, serum phenylalanine concentrations immediately decreased to the normal range. However, her neurological symptoms took longer to improve. We also found no clear temporal association between MRI findings and clinical severity. SPECT abnormalities showed marked improvement after treatment. It is well known that PKU patients who discontinue the dietary restriction from their childhood develop minor neurological impairments. However, PKU patients with late-onset severe neurological symptoms are very rare. To our knowledge, this is the first report regarding SPECT findings of PKU patients with late-onset severe neurological deterioration. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Current emergency medicine for neurological disorders in children].

Science.gov (United States)

Osamura, Toshio

2010-01-01

In 2006, the number of pediatric outpatients consulting our hospital during non-practice hours increased by 218.1% of that in 1996. The number of pediatric inpatients during non-practice hours in 2006 increased by 71.3% of that in 1996. In 2006, the number of patients who were admitted with neurological disorders in children during non-practice hours increased to 213.3% of that in 1996. The proportion of these pediatric patients among those who were admitted during non-practice hours was 16.6% in our hospital, suggesting the importance of neurological disorders in pediatric emergency medicine. More than 60% of inpatients with neurological disorders in children were 3 years old or younger. The most common neurological symptoms observed at admission included convulsion (81.6%) and disturbance of consciousness (8.5%). The disorders were mainly febrile seizure (41.4%) and epilepsy (29.0%). Most patients with severe disorders requiring emergency medicine, such as head bruise, acute encephalitis/encephalopathy, purulent meningitis, and head trauma, were admitted during non-practice hours. The prognoses of most neurological disorders in children were favorable. However, patients with sequelae (especially, hypoxic encephalopathy, acute encephalitis/encephalopathy) showed an unfavorable neurological prognosis. Early rehabilitation during admission was useful as a support method for their families. In the future, a comprehensive rehabilitation program for children with acquired brain injury should be established and laws to promote home care must be passed.

Children's sleep disturbance scale in differentiating neurological disorders.

Science.gov (United States)

Cohen, Rony; Halevy, Ayelet; Shuper, Avinoam

2013-12-01

We use the Sleep Disturbance Scale for Children (SDSC) routinely as a tool for evaluating children's sleep quality in our pediatric neurology clinic. We analyzed at its ability to detect sleep disturbances distinctive to selected neurological disorders. One-hundred and eighty-six children (age range 2-18 years) who were evaluated by the SDSC questionnaire were divided into three groups according to their principal diagnosis: epilepsy, attention deficit hyperactivity disorder, or others. Their responses were analyzed. The average frequency of abnormal total sleep score was 26.9%. The most frequent sleep disorders were excessive somnolence (25.3%), initiating and maintaining sleep (24.7%), and arousal/nightmares (23.1%). There were no significant group differences for total scores or sleep disorder-specific scores; although a sleep-wake transition disorder was more frequent among children with epilepsy (31%). A literature search revealed that the frequency of abnormal total scores in several neurological disorders (e.g., epilepsy, cerebral palsy) ranges between 20% and 30%. The mechanism underlying sleep disturbances in many neurological disorders may be unrelated to that of the primary disease but rather originate from nonspecific or environmental factors (e.g., familial/social customs and habits, temperament, psychological parameters). Although the SDSC is noninformative for studying the effect of a specific neurological disorder on sleep, we still recommend its implementation for screening for sleep disturbances in children with neurological abnormalities. Copyright © 2013 Elsevier Inc. All rights reserved.

Neurological disorders in HIV-infected children in India.

Science.gov (United States)

Gupta, S; Shah, D M; Shah, I

2009-09-01

There are few studies of HIV-related neurological disorders from centres in low-income countries where facilities are available for detailed investigation. Records of all patients attending the paediatric HIV outpatient department at B. J. Wadia Hospital for Children, Mumbai between April 2000 and March 2008 were reviewed. Of 668 HIV-infected patients, 48 (7.2%) had neurological manifestations and are included in this study. Twenty-six (54.2%) children had HIV encephalopathy. Other causes of neurological manifestations include febrile convulsion in five (10.4%), bacterial meningitis in three (6.3%), epilepsy in two (4.2%), tuberculous meningitis and progressive multi-focal encephalopathy in two (4.2%) each and toxoplasmosis, vasculitis, acute demyelinating encephalomyelitis, anti-phospholipid antibody syndrome, Down's syndrome, birth asphyxia, herpes simplex encephalopathy and mitochondrial encephalopathy in one (2.1%) each. Mean (SD) age at presentation was 4.36 (3.38) years with a range of 2 months to 15 years. The common subtle neurological manifestations were abnormal deep tendon reflexes and extensor plantar reflexes. The common symptomatic manifestations were delayed milestones in 21 children (43.8%) and seizures in 19 (39.6%). Seizures were more common in males (54%) than in females (25%) (p=0.038). In children neurological deficits were more common in older children. Of the 13 children who received HAART, nine (60.23%) improved. Early diagnosis of neurological disorders in HIV-infected children is important for appropriate investigation and management, especially the introduction of HAART.

Adaptation funding and development assistance: some FAQs

Energy Technology Data Exchange (ETDEWEB)

Ayers, Jessica; Huq, Saleemul

2008-11-15

It's becoming ever clearer that development and climate change are intertwined issues. Unsustainable development drives climate change; sustainable development can reduce vulnerability to it. Development issues can constrain capacity to adapt to climate change; climate impacts can be a barrier to development. So adaptation to climate impacts is increasingly seen as part of good development practice – and development to improve the lives and resource access of people facing climate challenges is viewed as a prerequisite for successful adaptation. But when it comes to adaptation funding, confusion and contention remain over the role development institutions play.

Chapter 20: neurological illustration from photography to cinematography.

Science.gov (United States)

Aubert, Geneviève

2010-01-01

This chapter explores iconography in neurology from the birth of photography up to the early medical applications of cinematography before 1914. The important visual part of neurological diagnosis explains why these techniques were adopted very early by neurologists. Duchenne published the first medical book illustrated with photographs of patients. The first and most famous photographic laboratory was created in Charcot's department, at the Salpêtrière in Paris, under the direction of Albert Londe. Londe published the first book dedicated to medical photography. The physiologist Marey and the photographer Muybridge, in association with neurologists, played key roles in the development of chronophotography and cinematography. Germany was the first country to welcome cinematography in a neurology department. Independently, neurologists began to film patients in other countries in Europe and in America. In 1905, Arthur Van Gehuchten (1861-1914), Belgian anatomist and neurologist, began systematically to film neurologic patients, with the intention of building up a complete neurological iconographic collection. This collection has survived and has been restored in the laboratory of the Royal Belgian Film Archive where the films are now safely stored in their vaults.

Neurological development of children born to mothers after kidney transplantation.

Science.gov (United States)

Schreiber-Zamora, Joanna; Szpotanska-Sikorska, Monika; Drozdowska-Szymczak, Agnieszka; Czaplinska, Natalia; Pietrzak, Bronisława; Wielgos, Miroslaw; Kociszewska-Najman, Bozena

2017-12-03

Pregnancies after kidney transplantation are at high risk of complications such as preterm birth and foetal growth restriction. Until now, the impact of these factors on neurological development of children born to transplant mothers has not been established. A comparison of neurological examinations performed in 36 children of kidney transplant women (study group) and 36 children born to healthy mothers (control group). The children from both groups were born at a similar gestational age and in the similar time period from 12/1996 to 09/2012. Neurological examinations were performed from 07/2010 to 11/2013. Each examination was adjusted to the patient's age and performed after the neonatal period. Three years later children were re-consulted, if they presented neurological deviations or were less than 12 months old at the time of the first examination. Normal neurological development was found in 86% of children in both groups (p = .999). Mild neurological deviations were observed in four (11%) children born to kidney transplant mothers and in five (14%) children born to healthy mothers (p = .999). Moderate deviations were diagnosed in one premature child born to transplant mother, whose pregnancy was complicated with a severe preeclampsia and foetal growth restriction. In the study population, no severe neurological disorders were found. Almost all (8/10) children with neurological deviations were born prematurely in good general conditions. The neurological deviations observed in the first year of life were mild and transient. In children over 1 year of age, deviations were more pronounced and continued to maintain. The neurological development of children of kidney transplant women is similar to that of the general population and possible deviations seem to be the result of intrauterine hypotrophy and prematurity. Therefore, in clinical practice, it is necessary to plan post-transplant pregnancies especially in women at high risk of these complications.

[Charles Miller Fisher: the grandmaster of neurological observation].

Science.gov (United States)

Fukutake, Toshio

2014-11-01

Charles Miller Fisher is widely regarded as the father of modern stroke neurology. He discovered almost all pathomechanisms of cerebral infarction, including embolism from atrial fibrillation, carotid artery disease, and lacunar infarcts and their syndromes, by the most meticulous clinico-pathological observations. Moreover, his work provided the basis for treatments such as anticoagulation, antiplatelet therapy, and carotid endarterectomy. He also contributed greatly to several topics of General Neurology; for example, migraine, normal pressure hydrocephalus, and Miller Fisher syndrome. In his late years, he tried to expand the neurological field to the more complex disorders of human behavior, including hysteria, dementia, and ill-defined pain syndromes. He thus became known as the grandmaster of refined neurological observation. His lifelong detailed studies were crucially important in helping neurologists all over the world recognize disorders and syndromes that had not previously been understood.

Feasibility of ballistic strengthening exercises in neurologic rehabilitation.

Science.gov (United States)

Williams, Gavin; Clark, Ross A; Hansson, Jessica; Paterson, Kade

2014-09-01

Conventional methods for strength training in neurologic rehabilitation are not task specific for walking. Ballistic strength training was developed to improve the functional transfer of strength training; however, no research has investigated this in neurologic populations. The aim of this pilot study was to evaluate the feasibility of applying ballistic principles to conventional leg strengthening exercises in individuals with mobility limitations as a result of neurologic injuries. Eleven individuals with neurologic injuries completed seated and reclined leg press using conventional and ballistic techniques. A 2 × 2 repeated-measures analysis of variance was used to compare power measures (peak movement height and peak velocity) between exercises and conditions. Peak jump velocity and peak jump height were greater when using the ballistic jump technique rather than the conventional concentric technique (P ballistic principles was associated with increased peak height and peak velocities.

Real-time monitoring of capacity loss for vanadium redox flow battery

Science.gov (United States)

Wei, Zhongbao; Bhattarai, Arjun; Zou, Changfu; Meng, Shujuan; Lim, Tuti Mariana; Skyllas-Kazacos, Maria

2018-06-01

The long-term operation of the vanadium redox flow battery is accompanied by ion diffusion across the separator and side reactions, which can lead to electrolyte imbalance and capacity loss. The accurate online monitoring of capacity loss is therefore valuable for the reliable and efficient operation of vanadium redox flow battery system. In this paper, a model-based online monitoring method is proposed to detect capacity loss in the vanadium redox flow battery in real time. A first-order equivalent circuit model is built to capture the dynamics of the vanadium redox flow battery. The model parameters are online identified from the onboard measureable signals with the recursive least squares, in seeking to keep a high modeling accuracy and robustness under a wide range of working scenarios. Based on the online adapted model, an observer is designed with the extended Kalman Filter to keep tracking both the capacity and state of charge of the battery in real time. Experiments are conducted on a lab-scale battery system. Results suggest that the online adapted model is able to simulate the battery behavior with high accuracy. The capacity loss as well as the state of charge can be estimated accurately in a real-time manner.

Neurology check list. 5. rev. and enl. ed.; Checkliste Neurologie

Energy Technology Data Exchange (ETDEWEB)

Grehl, Holger [Evangelisches und Johanniter Klinikum, Duisburg (Germany). Neurologische Klinik; Reinhardt, Frank

2013-02-01

The neurology check list covers the following issues, organized in four parts: Grey part - diagnostic fundamentals, therapeutic principles: clinical neurological examination, liquor puncture, specific laboratory diagnostics, neurophysical diagnostics, imaging techniques, therapeutic principles, legal aspects, neurological assessment. Green Part - leading syndromes and leading symptoms. Blue part - neurological disease appearance: pains in head and face, pain syndrome, congenital and development disturbances, liquor circulation disturbances, ZNS hemorrhages, tumors and neoplasm, paraneoplastic syndromes, inflammatory diseases of the nervous system, dementia diseases, metabolic and other encephalopathy, cerebellum diseases and system surmounting processes, movement degeneration, basal ganglion diseases, epilepsy, non-epileptic attacks, medulla diseases, brain nerve diseases, plexus lesions, radicular lesions, peripheric neuropathy, neuromuscular transfer disturbances, muscular diseases. Red part: neurological intensive medicine.

Contemporary Teaching of Neurology. Teaching Neurological Behavior to General Practitioners: A Fresh Approach

Science.gov (United States)

Derouesne, C.; Salamon, R.

1977-01-01

Ways in which teaching neurology can be simplified for the nonspecialist practitioner are addressed in this assessment of the state-of-the-art in France. The hypothesis implies simplifying both the diagnoses and symptomatology. (LBH)

Disrupted avoidance learning in functional neurological disorder: Implications for harm avoidance theories

Directory of Open Access Journals (Sweden)

Laurel S. Morris

. We highlight a potential mechanism by which negative contexts interfere with adaptive behaviours in this under-explored disorder. Keywords: Functional neurological disorder, Avoidance learning, Conversion disorder, Amygdala

Neurology in Federico Fellini?s work and life.

Science.gov (United States)

Teive, Hélio Afonso Ghizoni; Caramelli, Paulo; Cardoso, Francisco Eduardo Costa

2014-09-01

The authors present a historical review of the neurological diseases related to the famous moviemaker Federico Fellini. There is an account of diseases depicted on his movies as well as his ischemic stroke and consequent neurological deficit - left spatial neglect.

Functional MRT in psychiatry and neurology

International Nuclear Information System (INIS)

Schneider, F.; Fink, G.R.

2007-01-01

Almost no other method has reach such an interest as the functional imaging in psychiatric and neurological science; it is fascinating to observe the brain at work. The fundamentals of functional magnetic resonance tomography (fMRT) and the interpretation of MRT images are explained; the state-of-the-art is discussed. The book is focussed on the functional imaging within psychiatry and neurology. The book contains 45 contributions within the following chapters: fundamentals, higher brain accomplishments, disease pattern, examinatory examples, perspectives

Networked Airborne Communications Using Adaptive Multi Beam Directional Links

Science.gov (United States)

2016-03-05

Networked Airborne Communications Using Adaptive Multi-Beam Directional Links R. Bruce MacLeod Member, IEEE, and Adam Margetts Member, IEEE MIT...provide new techniques for increasing throughput in airborne adaptive directional net- works. By adaptive directional linking, we mean systems that can...techniques can dramatically increase the capacity in airborne networks. Advances in digital array technology are beginning to put these gains within reach

The Neurology of Proverbs

Directory of Open Access Journals (Sweden)

Diana Van Lancker

1990-01-01

Full Text Available Although proverb tests are commonly used in the mental status examination surprisingly little is known about either normal comprehension or the interpretation of proverbial expressions. Current proverbs tests have conceptual and linguistic shortcomings, and few studies have been done to investigate the specific effects of neurological and psychiatric disorders on the interpretation of proverbs. Although frontal lobes have traditionally been impugned in patients who are “concrete”, recent studies targeting deficient comprehension of non literal language (e.g. proverbs, idioms, speech formulas, and indirect requests point to an important role of the right hemisphere (RH. Research describing responses of psychiatrically and neurologically classified groups to tests of proverb and idiom usage is needed to clarify details of aberrant processing of nonliteral meanings. Meanwhile, the proverb test, drawing on diverse cognitive skills, is a nonspecific but sensitive probe of mental status.

Antroduodenal motility in neurologically handicapped children with feeding intolerance

Directory of Open Access Journals (Sweden)

Werlin Steven L

2004-09-01

Full Text Available Abstract Background Dysphagia and feeding intolerance are common in neurologically handicapped children. The aim is to determine the etiologies of feeding intolerance in neurologically handicapped children who are intolerant of tube feedings. Methods Eighteen neurologically handicapped children, followed in the Tube Feeding Clinic at the Children's Hospital of Wisconsin who were intolerant of gastrostomy feedings. The charts of these 18 patients were reviewed. Past medical history, diagnoses, history of fundoplication and results of various tests of gastrointestinal function including barium contrast radiography, endoscopy and antroduodenal manometry were documented. Results Five of 11 children had abnormal barium upper gastrointestinal series. Seven of 14 had abnormal liquid phase gastric emptying tests. Two of 16 had esophagitis on endoscopy. All 18 children had abnormal antroduodenal motility. Conclusions In neurologically handicapped children foregut dysmotility may be more common than is generally recognized and can explain many of the upper gastrointestinal symptoms in neurologically handicapped children.

Diagnostic Exercise: Neurologic Disorder in a Cat

Science.gov (United States)

1989-12-21

IWORK UNIT ELEMENT NO. NO. NO. ACCESSION NO. 11. TITLE (Include Security Classification) Diagnostic Exercise - Neurologic Disorder in a Cat 12...and identify by block number) This report documents the fifth reported occurrance of cerebral phaeophyphomycosis in cats . Because mycotic...Exercise: Neurologic Disorder in a Cat Ronald C. Bell United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick

CSF HYPOCRETIN CONCENTRATION IN VARIOUS NEUROLOGICAL AND SLEEP DISORDERS

OpenAIRE

Tsutsui, Kou; Kanbayashi, Takashi; Sawaishi, Yukio; Tokunaga, Jun; Sato, Masahiro; Shimizu, Tetsuo

2011-01-01

Recent CSF and postmortem brain hypocretin measurements in human narcolepsy suggest that hypocretin deficiency is involved in the pathophysiology of the disease. Thus, it is important to study whether neurological disorders also have abnormal CSF hypocretin levels. We therefore measured hypocretins in the CSF of various neurological disorders and obstructive sleep apnea syndrome (OSAS) to identify altered hypocretin levels. CSF hypocretin levels in patients with OSAS and neurological diseases...

Neurologic Manifestations of Vitamin B Deficiency after Bariatric Surgery.

Science.gov (United States)

Punchai, Suriya; Hanipah, Zubaidah Nor; Meister, Katherine M; Schauer, Philip R; Brethauer, Stacy A; Aminian, Ali

2017-08-01

The aim of this study was to assess the incidence, clinical presentation, and outcomes of neurologic disorders secondary to vitamin B deficiencies following bariatric surgery. Patients at a single academic institution who underwent bariatric surgery and developed neurologic complications secondary to low levels of vitamins B1, B2, B6, and B12 between the years 2004 and 2015 were studied. In total, 47 (0.7%) bariatric surgical patients (Roux-en-Y gastric bypass n = 36, sleeve gastrectomy n = 9, and duodenal switch n = 2) developed neurologic manifestations secondary to vitamin B deficiencies. Eleven (23%) patients developed postoperative anatomical complications contributed to poor oral intake. Median duration to onset of neurologic manifestation following surgery was 12 months (IQR, 5-32). Vitamin deficiencies reported in the cohort included B1 (n = 30), B2 (n = 1), B6 (n = 12), and B12 (n = 12) deficiency. The most common manifestations were paresthesia (n = 31), muscle weakness (n = 15), abnormal gait (n = 11), and polyneuropathy (n = 7). Four patients were diagnosed with Wernicke-Korsakoff syndrome (WKS) which was developed after gastric bypass (n = 3) and sleeve gastrectomy (n = 1). Seven patients required readmission for management of severe vitamin B deficiencies. Overall, resolution of neurologic symptoms with nutritional interventions and pharmacotherapy was noted in 40 patients (85%). The WKS was not reversible, and all four patients had residual mild ataxia and nystagmus at the last follow-up time. Nutritional neurologic disorders secondary to vitamin B deficiency are relatively uncommon after bariatric surgery. While neurologic disorders are reversible in most patients (85%) with vitamin replacements, persistent residual neurologic symptoms are common in patients with WKS.

Clinical profile of neurological complications in HIV- reactive ...

African Journals Online (AJOL)

McRoy

2014-07-26

Jul 26, 2014 ... reproduction in any medium, provided the original work is properly cited. Clinical profile of ... cytology, staining including grams staining, acid-fast ... manifestation of neurological involvement. Exclusion criteria. HIV-positive patients not showing any manifestation of neurological involvement. Ethical issues.

Neurology in Federico Fellini?s work and life

Directory of Open Access Journals (Sweden)

Hélio Afonso Ghizoni Teive

Full Text Available The authors present a historical review of the neurological diseases related to the famous moviemaker Federico Fellini. There is an account of diseases depicted on his movies as well as his ischemic stroke and consequent neurological deficit - left spatial neglect.

Extrarenal potassium adaptation: role of skeletal muscle

International Nuclear Information System (INIS)

Blachley, J.D.; Crider, B.P.; Johnson, J.H.

1986-01-01

Following the ingestion of a high-potassium-content diet for only a few days, the plasma potassium of rats rises only modestly in response to a previously lethal dose of potassium salts. This acquired tolerance, termed potassium adaptation, is principally the result of increased capacity to excrete potassium into the urine. However, a substantial portion of the acute potassium dose is not immediately excreted and is apparently translocated into cells. Previous studies have failed to show an increase in the content of potassium of a variety of tissues from such animals. Using 86 Rb as a potassium analogue, we have shown that the skeletal muscle of potassium-adapted rats takes up significantly greater amounts of potassium in vivo in response to an acute challenge than does that of control animals. Furthermore, the same animals exhibit greater efflux of 86 Rb following the termination of the acute infusion. We have also shown that the Na+-K+-ATPase activity and ouabain-binding capacity of skeletal muscle microsomes are increased by the process of potassium adaptation. We conclude that skeletal muscle is an important participant in potassium adaptation and acts to temporarily buffer acute increases in the extracellular concentration of potassium

Determination of the Innovative Capacity of Ecuadorian Universities

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María Isabel Loaiza

2017-01-01

Full Text Available Today the Higher Education Institutions are immersed in a world of constant change, and it is necessary to adapt to this environment with skill and speed. This has forced universities to adopt practices that create or strengthen their capacity to innovate, based on the determination of factors that influence it positively. This study is centered on the implementation of the Innovation Model of Higher Education (MIES prepared by Villa, Escotet and Goni (2007, adapted to the university context. This model allows Higher Education Institutions to diagnose their innovative capacity. This model is developed in the field of academic innovation, which is defined as the organizational competence of institutions to respond to the environment quickly enough, to cover existing needs and to anticipate future ones. As a case study, MIES was applied to Ecuadorian universities where the perception of different university actors was obtained and the factors driving innovation in this context were determined as a reference for the application of strategies promoting innovation.

Neurologic complications of cerebral angiography in childhood moyamoya syndrome

International Nuclear Information System (INIS)

Robertson, R.L.; Chavali, R.V.; Robson, C.D.; Barnes, P.D.; Burrows, P.E.; Eldredge, E.A.; Scott, R.M.

1998-01-01

Purpose. To determine the incidence of neurologic complications of cerebral angiography in children with moyamoya syndrome (MMS) as compared to children without MMS. Materials and methods. One-hundred-ninety consecutive cerebral angiograms obtained in 152 children were evaluated. Sixty of these angiograms were obtained in 40 children with MMS. Patients underwent neurologic evaluation prior to and after the procedure. For this study, a neurologic complication was defined as any new focal neurologic deficit or alteration in mental status occurring during the procedure or within the ensuing 24 hours. Results. There were 2 neurologic complications within 24 hours of angiography, one in the MMS group and one in the non-MMS group. One patient with MMS became mute following angiography. The symptom resolved within 12 hours. One patient without MMS being examined postoperatively for residual arteriovenous malformation developed intracranial hemorrhage requiring reexploration 12 hours after the angiogram. Using a two-tail Fisher's exact test, there was no significant statistical difference in the ischemic (P = 0.3) or hemorrhagic (P = 1.0) complication rates between the group of patients with MMS and the non-MMS groups. Conclusion. The risk of a neurologic complication from cerebral angiography in children with MMS is low and not statistically different from the risk in children with other cerebrovascular disorders. (orig.)

Models Provide Specificity: Testing a Proposed Mechanism of Visual Working Memory Capacity Development

Science.gov (United States)

Simmering, Vanessa R.; Patterson, Rebecca

2012-01-01

Numerous studies have established that visual working memory has a limited capacity that increases during childhood. However, debate continues over the source of capacity limits and its developmental increase. Simmering (2008) adapted a computational model of spatial cognitive development, the Dynamic Field Theory, to explain not only the source…

Circular RNA: a new star in neurological diseases.

Science.gov (United States)

Li, Tao-Ran; Jia, Yan-Jie; Wang, Qun; Shao, Xiao-Qiu; Lv, Rui-Juan

2017-08-01

Circular RNAs (circRNAs) are novel endogenous non-coding RNAs characterized by the presence of a covalent bond linking the 3' and 5' ends generated by backsplicing. In this review, we summarize a number of the latest theories regarding the biogenesis, properties and functions of circRNAs. Specifically, we focus on the advancing characteristics and functions of circRNAs in the brain and neurological diseases. CircRNAs exhibit the characteristics of species conservation, abundance and tissue/developmental-stage-specific expression in the brain. We also describe the relationship between circRNAs and several neurological diseases and highlight their functions in neurological diseases.

Neurological Disorders in Primary Sjögren's Syndrome

Directory of Open Access Journals (Sweden)

Gabriel J. Tobón

2012-01-01

Full Text Available Sjögren's syndrome is an autoimmune disease characterized by an autoimmune exocrinopathy involving mainly salivary and lacrimal glands. The histopathological hallmark is periductal lymphocytic infiltration of the exocrine glands, resulting in loss of their secretory function. Several systemic manifestations may be found in patients with Sjögren's syndrome including neurological disorders. Neurological involvement ranges from 0 to 70% among various series and may present with central nervous system and/or peripheral nervous system involvement. This paper endeavors to review the main clinical neurological manifestations in Sjögren syndrome, the physiopathology, and their therapeutic response.

Growing organizational capacity through a systems approach: one health network's experience.

Science.gov (United States)

MacKenzie, Richard; Capuano, Terry; Durishin, Linda Drexinger; Stern, Glen; Burke, James B

2008-02-01

Hospitals are reporting unexpected surges in demand for services. Lehigh Valley Hospital challenged its clinical and administrative staff to increase capacity by at least 4% per year using an interdepartmental, systemwide initiative, Growing Organizational Capacity (GOC). Following a systemwide leadership retreat that yielded more than 1,000 ideas, the initiative's principal sponsor convened a cross-functional improvement team. During a two-year period, 17 projects were implemented. Using a complex systems approach, improvement ideas "emerged" from microsystems at the points of care. Through rigorous reporting and testing of process adaptations, need, data, and people drove innovation. Hundreds of multilevel clinical and administrative staff redesigned processes and roles to increase organizational capacity. Admissions rose by 6.1%, 5.5 %, 8.7%, 5.0%, and 3.8% in fiscal years 2003 through 2007, respectively. Process enhancements cost approximately $1 million, while increased revenues attributable to increased capacity totaled $2.5 million. Multiple, coordinated, and concurrent projects created a greater impact than that possible with a single project. GOC and its success, best explained in the context of complex adaptive systems and microsystem theories, are transferrable to throughput issues that challenge efficiency and effectiveness in other health care systems.

African Development of AIDS Prevention Trials (ADAPT2) | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

The African Development of AIDS Prevention Trials (ADAPT2) capacity building initiative is an African-Canadian partnership that aims to increase the number and quality of HIV prevention trials led by African researchers. Building on experience gained during ADAPT1 - funded by the Global Health Research Initiative ...

African Development of AIDS Prevention Trials (ADAPT2) | CRDI ...

International Development Research Centre (IDRC) Digital Library (Canada)

The African Development of AIDS Prevention Trials (ADAPT2) capacity building initiative is an African-Canadian partnership that aims to increase the number and quality of HIV prevention trials led by African researchers. Building on experience gained during ADAPT1 - funded by the Global Health Research Initiative ...

Results of the American Academy of Neurology resident survey.

Science.gov (United States)

Freeman, W D; Nolte, C M; Matthews, B R; Coleman, M; Corboy, J R

2011-03-29

To assess the effect of neurology residency education as trainees advance into independent practice, the American Academy of Neurology (AAN) elected to survey all graduating neurology residents at time of graduation and in 3-year cycles thereafter. A 22-question survey was sent to all neurology residents completing residency training in the United States in 2007. Of 523 eligible residents, 285 (54.5%) responded. Of these, 92% reported good to excellent quality teaching of basic neurology from their faculty; however, 47% noted less than ideal training in basic neuroscience. Two-thirds indicated that the Residency In-service Training Examination was used only as a self-assessment tool, but reports of misuse were made by some residents. After residency, 78% entered fellowships (with 61% choosing a fellowship based on interactions with a mentor at their institution), whereas 20% entered practice directly. After adjustment for the proportion of residents who worked before the duty hour rules were implemented and after their implementation, more than half reported improvement in quality of life (87%), education (60%), and patient care (62%). The majority of international medical graduates reported wanting to stay in the United States to practice rather than return to their country of residence. Neurology residents are generally satisfied with training, and most entered a fellowship. Duty hour implementation may have improved resident quality of life, but reciprocal concerns were raised about impact on patient care and education. Despite the majority of international trainees wishing to stay in the United States, stricter immigration laws may limit their entry into the future neurology workforce.

The use of and obstacles to social learning in climate change adaptation initiatives in South Africa

OpenAIRE

Mudombi, Shakespear; Fabricius, Christo; Van Zyl-Bulitta, Verena; Patt, Anthony

2017-01-01

Global environmental change will have major impacts on ecosystems and human livelihoods while challenging the adaptive capacity of individuals and communities. Social learning, an ongoing adaptive process of knowledge generation, reflection and synthesis, may enhance people’s awareness about climate change and its impacts, with positive outcomes for their adaptive capacity. The objectives of this study were to assess the prevalence of factors promoting social learning in climate change adapta...

Cerebral metastases from lung carcinoma: neurological and CT correlation: work in progress

International Nuclear Information System (INIS)

Tarver, R.D.; Richmond, B.D.; Klatte, E.C.

1984-01-01

To determine the role of brain CT in neurologically asymptomatic lung cancer patients a review was made of the CT and clinical findings in 279 patients. Brain metastases were found in 94.5% of patients with specific abnormal neurological findings, 26.6% of patients with vague neurological signs and symptoms, 11% of patients with oat cell carcinoma and a normal neurological examination, and 40% of patients with adenocarcinoma and a normal neurological examination. Brain metastasis was not seen on CT in the 29 patients with squamous cell carcinoma and a normal neurological examination. It is concluded that brain CT is useful for the detection of occult brain metastases, particularly oat cell carcinoma and adenocarcinoma, in neurologically asymptomatic lung cancer patients

VEGF Signaling in Neurological Disorders

Directory of Open Access Journals (Sweden)

Joon W. Shim

2018-01-01

Full Text Available Vascular endothelial growth factor (VEGF is a potent growth factor playing diverse roles in vasculogenesis and angiogenesis. In the brain, VEGF mediates angiogenesis, neural migration and neuroprotection. As a permeability factor, excessive VEGF disrupts intracellular barriers, increases leakage of the choroid plexus endothelia, evokes edema, and activates the inflammatory pathway. Recently, we discovered that a heparin binding epidermal growth factor like growth factor (HB-EGF—a class of EGF receptor (EGFR family ligands—contributes to the development of hydrocephalus with subarachnoid hemorrhage through activation of VEGF signaling. The objective of this review is to entail a recent update on causes of death due to neurological disorders involving cerebrovascular and age-related neurological conditions and to understand the mechanism by which angiogenesis-dependent pathological events can be treated with VEGF antagonisms. The Global Burden of Disease study indicates that cancer and cardiovascular disease including ischemic and hemorrhagic stroke are two leading causes of death worldwide. The literature suggests that VEGF signaling in ischemic brains highlights the importance of concentration, timing, and alternate route of modulating VEGF signaling pathway. Molecular targets distinguishing two distinct pathways of VEGF signaling may provide novel therapies for the treatment of neurological disorders and for maintaining lower mortality due to these conditions.

Modern network science of neurological disorders.

Science.gov (United States)

Stam, Cornelis J

2014-10-01

Modern network science has revealed fundamental aspects of normal brain-network organization, such as small-world and scale-free patterns, hierarchical modularity, hubs and rich clubs. The next challenge is to use this knowledge to gain a better understanding of brain disease. Recent developments in the application of network science to conditions such as Alzheimer's disease, multiple sclerosis, traumatic brain injury and epilepsy have challenged the classical concept of neurological disorders being either 'local' or 'global', and have pointed to the overload and failure of hubs as a possible final common pathway in neurological disorders.

Laryngotracheal Stenosis in Children and Infants With Neurological Disorders: Management and Outcome.

Science.gov (United States)

Nicollas, Richard; Moreddu, Eric; Le Treut-Gay, Claire; Roman, Stéphane; Mancini, Julien; Triglia, Jean-Michel

2016-12-01

The goal of this retrospective study is to compare the management and outcome of surgical treatment of laryngotracheal stenosis in children and infants with and without an associated neurological disorder. In a series of children operated on for subglottic stenosis (SGS), patients with an associated neurological disorder were identified. The following criteria were compared in children with and without neurological disease: grade of stenosis, age, technique (Crico-Tracheal Resection (CTR), Laryngo-Tracheo-Plasty (LTP) in single and 2 stage, laser), analyzing duration, preoperative tracheostomy, decannulation rate, preoperative gastrostomy, and number of days in intensive care unit and in hospital. Two hundred twenty-three children were operated on for subglottic stenosis, of whom 68 (30.5%) had an associated neurological disorder. Some criteria were found to be statistically different between the 2 populations: mean age of 43 months in neurological population versus 13 months (P neurological disorder-66.6% versus 36.5% (P = .013); the median duration of stenting was 20 days in those with neurological disease versus 12 (P = .021). Preoperative tracheotomy was noted in 75% of neurological patients versus 47.7% of the others (P neurological disorder, as against 86.5% of neurologically unimpaired subjects. The difference in outcome of surgery was not statistically different (P = .392) between the 2 groups. It appears that subglottic stenosis in children with associated neurological disorder is not more severe than in neurologically normal patients. In three-quarters of the neurologically impaired cases, a preoperative tracheostomy was needed, but the rates of failure of postoperative decannulation are not statistically significant between the 2 groups. In our experience, 2-stage techniques are more often performed than single stage in this population in order to allow airway safety, for example after feeding. If properly managed, the final results are similar in the 2

Tracheostomy in neurologically compromised paediatric patients: role of starplasty.

Science.gov (United States)

Gupta, A; Stokken, J; Krakovitz, P; Malhotra, P; Anne, S

2015-10-01

Starplasty tracheostomy is an alternative to traditional tracheostomy. This paper reviews neurologically compromised paediatric patients with tracheostomies and discusses the role of starplasty tracheostomy. A retrospective review was conducted of paediatric patients with a neurological disorder who underwent tracheostomy between 1997 and 2011. Forty-eight patients, with an average age of 7.3 years, were identified. The most common indications for tracheostomy were: ventilator dependence (39.6 per cent), an inability to tolerate secretions or recurrent aspiration pneumonia (33.3 per cent), and upper respiratory obstruction or hypotonia (12.5 per cent). The most common underlying neurological diagnosis was cerebral palsy. There were no early complications. Eighteen (43 per cent) of 42 patients with follow up experienced at least 1 delayed complication. Only 12 patients (28.6 per cent) were decannulated. Patients with primary neurological diagnoses have low rates of decannulation; starplasty tracheostomy should be considered for these patients. Patients with seizure disorder or acute neurological injury tended to have a higher short-term decannulation rate; traditional tracheostomy is recommended in these patients.

Neurology clerkship goals and their effect on learning and satisfaction.

Science.gov (United States)

Strowd, Roy E; Salas, Rachel Marie E; Cruz, Tiana E; Gamaldo, Charlene E

2016-02-16

To define medical student goals in the neurology clerkship and explore the association between goal setting and student performance, clerkship satisfaction, self-directed learning (SDL), and interest in neurology. A 4-year prospective study of consecutive second- to fourth-year medical students rotating through a required 4-week neurology clerkship was conducted. A goal-generating cohort (first 2 years) was enrolled to describe the breadth of student-derived goals. A goal-evaluating cohort (second 2 years) was used to evaluate the frequency of goal achievement and assess associations with performance (e.g., National Board of Medical Examiners [NBME], examination), satisfaction, and SDL behaviors (both based on 5-point Likert scale). Of 440 evaluable students, 201 were goal-generating and 239 goal-evaluating. The top 3 goals were (1) improvement in neurologic examination, (2) understanding neurologic disease, and (3) deriving a differential diagnosis. More than 90% (n = 216/239) of students reported achieving goals. Achievers reported significantly higher clerkship satisfaction (4.2 ± 0.8 vs. 2.8 ± 1.0, p neurology (71% vs. 35%, p = 0.001), and higher observed tendency toward SDL (4.5 ± 0.5 vs. 4.1 ± 0.8, p neurology clerkship. Goal achievers had better adjusted standardized test scores, higher satisfaction, and greater tendency toward SDL. This student-generated, goal-setting program may be particularly appealing to clinicians, educators, and researchers seeking resource-lean mechanisms to improve student experience and performance in the clinical clerkships. © 2015 American Academy of Neurology.

Neurologic complications of cerebral angiography in childhood moyamoya syndrome

Energy Technology Data Exchange (ETDEWEB)

Robertson, R.L.; Chavali, R.V.; Robson, C.D.; Barnes, P.D.; Burrows, P.E. [Department of Radiology, Children`s Hospital Medical Center, Boston, MA (United States); Eldredge, E.A. [Department of Anesthesia, Children`s Hospital Medical Center and Harvard Medical School, Boston, MA (United States); Scott, R.M. [Department of Neurosurgery, Children`s Hospital Medical Center and Harvard Medical School, Boston, MA (United States)

1998-11-01

Purpose. To determine the incidence of neurologic complications of cerebral angiography in children with moyamoya syndrome (MMS) as compared to children without MMS. Materials and methods. One-hundred-ninety consecutive cerebral angiograms obtained in 152 children were evaluated. Sixty of these angiograms were obtained in 40 children with MMS. Patients underwent neurologic evaluation prior to and after the procedure. For this study, a neurologic complication was defined as any new focal neurologic deficit or alteration in mental status occurring during the procedure or within the ensuing 24 hours. Results. There were 2 neurologic complications within 24 hours of angiography, one in the MMS group and one in the non-MMS group. One patient with MMS became mute following angiography. The symptom resolved within 12 hours. One patient without MMS being examined postoperatively for residual arteriovenous malformation developed intracranial hemorrhage requiring reexploration 12 hours after the angiogram. Using a two-tail Fisher`s exact test, there was no significant statistical difference in the ischemic (P = 0.3) or hemorrhagic (P = 1.0) complication rates between the group of patients with MMS and the non-MMS groups. Conclusion. The risk of a neurologic complication from cerebral angiography in children with MMS is low and not statistically different from the risk in children with other cerebrovascular disorders. (orig.) With 8 tabs., 37 refs.

American Academy of Neurology

Science.gov (United States)

... on draft guideline manuscript on autism and sleep problems. Capitol Hill Report: Opioid Epidemic Declared Public Health Emergency Read the latest news on how the AAN is fighting for neurology in Washington DC. New Study: Virtual Reality Training May Be as Effective as Regular Therapy ...