scholarly journals 132 Brushstrokes after stroke – art and neuroplasticity

2019 ◽  
Vol 90 (e7) ◽  
pp. A43.1-A43
Author(s):  
Manisha Narasimhan ◽  
Lucy Ramon
Keyword(s):  
Acute Stroke ◽  
Motor Skills ◽  
Neurological Deficits ◽  
Independent Mobility ◽  
Art Gallery ◽  
Active Life ◽  
Need Support ◽  
Significant Disability ◽  
The Right

IntroductionDespite current developments in acute stroke therapies, 65% of stroke patients have varying degrees of disability. Whilst focus on acute stroke reperfusion strategies is vital, stroke survivors still need support and appropriate opportunities for rehabilitation.Methods and resultsThis is an inspiring story of an 86-year old patient with locked in syndrome who rediscovered her artistic talent after a disabling stroke. She presented with right hemiparesis, bilateral ptosis, ophthalmoplegia and aphasia. Her MRI showed multiple infarcts affecting the midbrain, thalamic, cerebellar and occipital regions. There was stenosis of the right vertebral artery- the left was hypoplastic, and new atrial fibrillation was detected.There was no response to early rehabilitation strategies and her husband decided to care for her at home. He used creative strategies to encourage motor skills and participation in daily activities, and despite never regaining speech or independent mobility, she was able to interact meaningfully with him and her environment. They enjoyed a full and active life until her demise last year.The patient was an accomplished artist and, with the help of her husband, reengaged in painting. This resulted in an original collection of paintings that formed an exhibition in Wollongong Art Gallery.ConclusionThis is a life affirming story of love, enablement and ingenuity after disabling strokes, and a reminder that neuroplasticity can occur at any age. Art can provide a way to harness neuroplasticity to improve neurological deficits and quality of life, even despite significant disability. ‘A man paints with his brains and not with his hands. ‘(Michaelangelo).

scholarly journals 101 Case report: to stent, or not to stent? The pale cast of evidence-based practice in acute stroke

2019 ◽  
Vol 90 (e7) ◽  
pp. A33.1-A33
Author(s):  
Chris Blair ◽  
Kartik Bhatia ◽  
David Brunacci ◽  
John Worthington ◽  
Rebekah Ahmed
Keyword(s):  
Blood Pressure ◽  
Acute Stroke ◽  
Evidence Based Practice ◽  
Blood Pressure Monitoring ◽  
Neurological Deficits ◽  
Evidence Based ◽  
Limb Weakness ◽  
Vasopressor Support ◽  
Course Of Action ◽  
The Right

IntroductionWith approximately 200 procedures performed in the last year at our centre, worthwhile clinical lessons continue to emerge in the practice of endovascular clot retrieval (ECR) for acute stroke. This case demonstrates the value of considered clinical appraisal in a dynamic, information-rich setting. A 68 year-old man with established vertebrobasilar atherosclerotic disease developed capricious, blood pressure-sensitive neurological deficits after successful ECR for a basilar artery stroke, inviting the possibility of further intervention in the form of intracranial stenting. We avoided pursuing this course of action in favour of a more measured approach, entailing the provision of vasopressor support over the following week.MethodFollowing ECR, our patient was admitted to the intensive care unit for continuous blood pressure monitoring and close observation of his neurological deficits with serial NIHSS (National Institutes of Health Stroke Scale) scoring. Systolic blood pressures were maintained between 140–160 mmHg using vasopressor support, with the aim of allowing time for recovery of vascular autoregulation and collateralization.ResultsOver six days, the patient developed moderate left upper and lower limb weakness. An MRI performed on Day 5 revealed limited interval infarction of the right hemipons and cerebellum, with complete re-occlusion of the mid-basilar arterial segment. He left the ICU with a NIHSS score of 7, and was living independently at 90-day follow-up (Modified Rankin Score 1).ConclusionThe ultimately favourable net outcome for our patient clearly illustrates the imperative to remain within the boundaries of evidence-based practice in this bold and rapidly evolving discipline.

scholarly journals Disorders of fine motor skills after a stroke: the processes of neuroplasticity and sensorimotor integration

2019 ◽  
Vol 10 (1) ◽  
pp. 16-22
Author(s):  
Eugeniia V. Ekusheva ◽  
A. A. Komazov
Keyword(s):  
Ischemic Stroke ◽  
Motor Skills ◽  
Motor Impairment ◽  
Fine Motor ◽  
Voluntary Movements ◽  
Moderate Degree ◽  
Fine Motor Skills ◽  
Social Maladjustment ◽  
The Right

Background. Impairment of fine motor skills in the hand is one of the most frequent causes of the persistent loss of professional skills, social maladjustment, and the impossibility of self-care in patients after a stroke, which ultimately leads to a significant reduction in the quality of their life. The article discusses the features of the fine motor skills’ impairment in the hand in patients after a stroke, in the context of a lateralized hemispheric lesion. Methods. We have studied 26 patients after a primary ischemic stroke in the pool of middle cerebral artery of the right (n=12) or left (n=14) brain hemisphere. The average age of patients was 55.7±7.3 years. Patients with a right-sided ischemic stroke were comparable to those with a left-sided stroke in their age, disease duration, size of the lesion and the gender ratio. Results. All the patients after an ischemic stroke had motor impairment in the form of a hemiparesis of a mild or moderate degree. Discussion. We suggest the existence of differentiated mechanisms for the development of fine and highly coordinated voluntary movements in the hand of patients after an ischemic stroke, depending on the lateralization of the supratentorial lesion: diffuse deficit of the afferent support in a right-sided ischemic stroke vs. bilateral efferent deficit for a left hemisphere lesion. Conclusion. The obtained data on the differentiated mechanisms for the development of fine and highly coordinated voluntary movements in the hand of patients after an ischemic stroke warrant the necessity of a further, more targeted research on those disorders in the post-stroke period, on order to optimize the existing rehabilitation approaches and improve the functional potential and quality of life of such patients.

scholarly journals Induced Contention Therapy and functional bandage in children with cerebral palsy: Case report

2020 ◽  
Vol 18 ◽  
pp. 1-9
Author(s):  
Priscila Oliveira Bortoli ◽  
Letícia Ramos Dutra ◽  
Rodrigo José Knabben ◽  
Claudia Mirian de Godoy Marques ◽  
Micheli Martinello
Keyword(s):  
Cerebral Palsy ◽  
Motor Skills ◽  
Upper Limb ◽  
Handgrip Strength ◽  
Hemiplegic Cerebral Palsy ◽  
Motor Activities ◽  
The Right ◽  
Positive Effect ◽  
Manual Activity

Background: The decrease in the manual activity of hemiparetic children, affects their functionality and independence. Among the therapies used to improve manual function, there is Induced Contention Therapy (ICT) and functional bandaging (FB). Such approaches aim to improve the use and decrease the disuse learned from the upper limb in subjects with hemiparesis. Objective: Identify the effect of ICT, associated with the application of functional bandaging on the affected upper limb, in the function of the upper limb and on the handgrip of a child with spastic hemiplegic cerebral palsy. Methods: A 5-year-old child received ICT for three hours daily for three consecutive weeks associated with FB in the right upper limb. The use of the upper limb was evaluated using the Pediatric Upper Extremity Motor Activity Log (PMAL) scale, the acquisition of new motor standards using the Inventory of New Motor Activities and Program (INMAP) scale, the motor skill by the Pediatric Arm Functional Test (PAFT) and the handgrip strength by the dynamometer. Results: There was an improvement in the quantity and quality of use of the paretic upper limb after the application of ICT, which remained after one month of therapy. In addition, it was observed the acquisition of new motor skills and improvement in handgrip strength. Conclusion: This study had a potential positive effect on handgrip strength, functionality and quality of use of the paretic upper limb of a child with spastic CP after the application of ICT associated with functional bandaging.

Mood Changes After Right-Hemisphere Lesions

1989 ◽  
Vol 155 (1) ◽  
pp. 79-85 ◽  
Author(s):  
Sergio E. Starkstein ◽  
Robert G. Robinson ◽  
Marc A. Honig ◽  
Rajesh M. Parikh ◽  
John Joselyn ◽  
...  
Keyword(s):  
Major Depression ◽  
Daily Living ◽  
Right Hemisphere ◽  
Demographic Variables ◽  
Neurological Deficits ◽  
Mood Changes ◽  
Frontal Operculum ◽  
History Of ◽  
The Right

Ninety-three patients with acute stroke lesions restricted to the right hemisphere were examined for the presence of mood changes. While 46 patients showed no mood changes, 19 were unduly cheerful, 17 had developed major depression, and 11 had developed minor depression. Although there were no significant between-groups differences in other demographic variables, neurological deficits, activities of daily living, cognitive impairment, or quality of social support, patients with major depression had a significantly higher frequency of familial history of psychiatric disorder and lesions of the parietal cortex than patients with either no mood change or major depression following left-hemisphere lesions. On the other hand, undue cheerfulness was significantly associated with lesions of the right frontal operculum. These findings suggest that major depression following right-hemisphere lesions may have a different aetiology and mechanism than major depression following left frontal or basal ganglia lesions.

ANALYSIS OF REGULATIONS REGARDING THE SETTLEMENT OF ISSUES ON THE REMOVAL AND RECOVERY OF PLANTATIONS IN THE RIGHT-OF-WAY OF PUBLIC ROADS

2020 ◽  
pp. 55-60
Author(s):  
Nataliia Kharytonova ◽  
Olha Mykolaienko ◽  
Tetyana Lozova
Keyword(s):  
Traffic Safety ◽  
Climatic Factors ◽  
Visual Orientation ◽  
Right Of Way ◽  
Adverse Weather ◽  
Overhead Power Lines ◽  
The Right ◽  
Neck Diameter ◽  
Proper Operation

Greening of roads contributes to the protection of roads and their elements from influence of adverse weather and climatic factors; it includes the measures for improvement and landscaping of roads, ensures the protection of roadside areas from transport pollution, provides visual orientation of drivers. The solution of these issues will ensure creation and maintenance of safe and comfortable conditions for travelers. Green plantings in the right-of-way road area include woody, bushy, flower and grass vegetation of natural and artificial origin. For proper operation of public roads and satisfaction of other needs of the industry, there may be the need in removing the greenery. The reason for the removal of greenery in the right-of-way road area may be due to the following factors: construction of the architectural object, widening of the motor road, repair works in the security zone of overhead power lines, water supply, drainage, heating, telecommunications facilities, cutting of hazardous, dry and fautal trees, as well as self-grown and brushwood trees with a root neck diameter not exceeding 5 cm, elimination of the consequences of natural disasters and emergencies. The removal of plantations in the right-of-way area is executed in order to ensure traffic safety conditions and to improve the quality of plantations composition and their protective properties. Nowadays, in Ukraine there is no clear procedure for issuing permits for removing of such plantations. In order to resolve this issue, there is a need in determining the list of regulations in the area of forest resources of Ukraine and, if needed, the list of regulatory acts that have to be improved; to prepare a draft of the regulatory legal act that would establish the procedure of plantations cutting, the methodology of their condition determination, recovery costs determination, the features of cutting. Keywords: plantations, cutting, right-of-way, woodcutting permit, order.

Modifikasi Model Pembelajaran Problem Based Learning (PBL) dengan Strategi Pembelajaran Tugas dan Paksa

2019 ◽  
Vol 2 ◽  
Author(s):  
Tita Mila Mustofani ◽  
Ita Hartinah
Keyword(s):  
Critical Thinking ◽  
Learning Strategies ◽  
Student Motivation ◽  
Problem Based Learning ◽  
Learning Model ◽  
Learning Material ◽  
Task Strategies ◽  
The Right ◽  
Increasing Student Learning

This writing aims to help teachers to increase motivation, activity, creativity, and critical thinking of students in solving problems in class. The way to increase student motivation in learning in class is to choose the right learning model with ongoing learning material. One learning model that increases students' creativity and critical thinking in problem solving is a Problem Based Learning (PBL) learning model. To improve students' insights in order to easily solve problems there is a need to do tasks, if students do not do the task then they must accept the agreed upon consequences when making learning contracts, thus modifying the Problem Based Learning (PBL) learning model with task strategies and forced. The results of the modification of learning with the Problem Based Learning (PBL) learning model through forced and forced strategies are expected to improve the learning process so that students become more disciplined and do not waste time doing assignments. The advantages of modifying the Problem Based Learning (PBL) learning model with task and forced learning strategies are increasing student learning motivation, improving the quality of learning, training students' understanding by giving assignments continuously, teaching discipline to students in order to be accountable for tasks assigned, and reducing laziness in students.

THE VALUE OF LOVE IN THE SYSTEM OF FORMATION OF THE PROFESSIONAL MATURITY OF THE EDUCATOR

2020 ◽  
Vol 1 (10(79)) ◽  
pp. 12-18
Author(s):  
G. Bubyreva
Keyword(s):  
Russian Federation ◽  
The State ◽  
Educational Process ◽  
Wide Range ◽  
The Family ◽  
The Russian Federation ◽  
The Government ◽  
The Individual ◽  
The Right

The existing legislation determines the education as "an integral and focused process of teaching and upbringing, which represents a socially important value and shall be implemented so as to meet the interests of the individual, the family, the society and the state". However, even in this part, the meaning of the notion ‘socially significant benefit is not specified and allows for a wide range of interpretation [2]. Yet the more inconcrete is the answer to the question – "who and how should determine the interests of the individual, the family and even the state?" The national doctrine of education in the Russian Federation, which determined the goals of teaching and upbringing, the ways to attain them by means of the state policy regulating the field of education, the target achievements of the development of the educational system for the period up to 2025, approved by the Decree of the Government of the Russian Federation of October 4, 2000 #751, was abrogated by the Decree of the Government of the Russian Federation of March 29, 2014 #245 [7]. The new doctrine has not been developed so far. The RAE Academician A.B. Khutorsky believes that the absence of the national doctrine of education presents a threat to national security and a violation of the right of citizens to quality education. Accordingly, the teacher has to solve the problem of achieving the harmony of interests of the individual, the family, the society and the government on their own, which, however, judging by the officially published results, is the task that exceeds the abilities of the participants of the educational process.  The particular concern about the results of the patriotic upbringing served as a basis for the legislative initiative of the RF President V. V. Putin, who introduced the project of an amendment to the Law of RF "About Education of the Russian Federation" to the State Duma in 2020, regarding the quality of patriotic upbringing [3]. Patriotism, considered by the President of RF V. V. Putin as the only possible idea to unite the nation is "THE FEELING OF LOVE OF THE MOTHERLAND" and the readiness for every sacrifice and heroic deed for the sake of the interests of your Motherland. However, the practicing educators experience shortfalls in efficient methodologies of patriotic upbringing, which should let them bring up citizens, loving their Motherland more than themselves. The article is dedicated to solution to this problem based on the Value-sense paradigm of upbringing educational dynasty of the Kurbatovs [15].

Evaluation of staff in Healthcare Companies

2020 ◽  
Author(s):  
Troncone Raffaella ◽  
Coda Marco
Keyword(s):  
Social Context ◽  
Evaluation System ◽  
Daily Life ◽  
Good Health ◽  
Rehabilitation Services ◽  
Individual Contribution ◽  
Personnel Evaluation ◽  
Good Evaluation ◽  
The Right

Evaluation is at the basis of any social context where all individuals are simultaneously "evaluated" and "evaluators" in all areas of daily life. The goal of a good evaluation system is to encourage staff to do "Good Health" through the provision of quality prevention, diagnosis, treatment and rehabilitation services. The main reasons that lead to the evaluation of the personnel lie in the inevitable and primary importance of the human resource in achieving the corporate objectives, and by the pressing need for the quality of the service provided to the citizen, as well as the legitimate need of the employee to differentiate, clarifying its specificities and its own individual contribution to the general objectives of the company. In the working context, the "personnel evaluation" assumes a fundamental importance, if managed with the right criteria, in order to make the employee not a simple pawn to move and manage for use and consumption of the organization, but an integral part of the organization itself.

Current Regulatory Standpoint on Evaluating the Bioequivalence of Different Classes of Generic Drugs - Is the Evaluation in the Right Direction?

2019 ◽  
Vol 20 (10) ◽  
pp. 835-844 ◽  
Author(s):  
Francis Micheal ◽  
Mohanlal Sayana ◽  
Balamurali Musuvathi Motial
Keyword(s):  
Generic Drugs ◽  
Bibliographic Databases ◽  
Eligibility Criteria ◽  
Individual Bioequivalence ◽  
Population Bioequivalence ◽  
Standard Tool ◽  
Review Question ◽  
Guidance Documents ◽  
The Right

Background: The concept of evaluating bioequivalence has changed over a period of time. Currently, the Average Bioequivalence approach (ABE) is the gold standard tool for the evaluation of generics. Of late, many debates had arisen about employing ABE approach for the appraisal of all drug categories. This review aims to examine the limitations of ABE approach and the significances of Population Bioequivalence (PBE) and Individual Bioequivalence (IBE) approach, current regulatory thinking for assessing different categories of the drug, whether they are adequately assessed, and the evaluation is in the right direction. Methods: We carried out an organized search of bibliographic databases for peer-reviewed research literatures, regulatory recommendations, guidance documents using a focused review question and eligibility criteria. The standard tools were used to appraise the quality of retrieved documents and to make sure the authenticity of the data. Results: In total 73 references were used in the review, the majority of the references (guidance documents) were from the different regulatory agencies and product-specific guidance. There were 29 product-specific guidance from USFDA and EMA. The limitations of the ABE approach were discussed in detail along with the significances of Population Bioequivalence (PBE) approach and Individual Bioequivalence (IBE) approaches. Conclusion: It is apparent from the review that IBE approach is a precise method for evaluating the drugs as it answers drug interchangeability (prescribability and switchability). IBE approach is followed by PBE approach and ABE approach for the evaluation of different categories of drugs in terms of precision.

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