Cognitive Impact of Cerebellar Damage: Is There a Future for Cognitive Rehabilitation?

2018 ◽  
Vol 17 (3) ◽  
pp. 199-206 ◽  
Author(s):  
Kim van Dun ◽  
Frank V. Overwalle ◽  
Mario Manto ◽  
Peter Marien

Background & Objective: During the past 3 decades, numerous neurophysiological, neuroimaging, experimental and clinical studies have evidenced a crucial role for the cerebellum in cognitive, affective and behavioral functions. As a result of the acknowledged modulatory role of the cerebellum upon remote structures such as the cerebral cortex, cerebellar injury may give rise to a constellation of behavioral, affective and cognitive symptoms (Schmahmann's Syndrome). In sharp contrast to the wide range of therapeutic interventions to treat cognitive and affective disorders following cerebral cortical lesions and despite the consequences of Schmahmann’s syndrome upon daily life activities, the literature is surprisingly only scantly documented with studies investigating the impact of cognitive therapies on cerebellar induced cognitive and affective disorders. This survey aims to present an overview of the therapeutic interventions available in the literature as a possible treatment for Schmahmann’s Syndrome after cerebellar injury, after posterior fossa surgery in children, and in children with neurodevelopmental disorders. Although systematical studies are clearly warranted, available evidence suggests that cerebellar-induced cognitive and affective disorders should be treated in a specific way. Approaches where the patients are explicitly made aware of their deficits and are considered to act as an “external cerebellum” are the most promising. Conclusion: The study of the anatomical connectivity of the cerebellar microcomplexes involved in cognitive/affective deficits is likely to play a major-role in the future.

This book provides an academically oriented and scientifically based description of how technological advances may have contributed to a wide range of mental health outcomes, covering the spectrum from problems and maladies to improved and expanded healthcare services. Digital technologies covered include internet use (including social networking, shopping, gambling, viewing of pornography, etc.), digital gaming, smartphones, mobile applications, virtual reality, and computer-based therapeutic interventions. Both the positive and negative aspects of these various types of digital technologies are discussed. Further, some chapters include a discussion of future developments in the field. The book has been written by international experts in the applications of digital technology across many countries and quality universities. This book consists of eight sections. The first focuses on digital technology in the general population. The second covers problematic conceptual issues in the impact of technology use. The third discusses potential positive impacts of digital technology. The fourth covers potential negative impacts of digital technologies. The fifth evaluates utilizing digital technologies for assessment and legal considerations. The sixth explores using digital technologies to improve overall well-being. The seventh discusses the use of digital technologies to treat specific disorders, and the eighth presents a discussion on treatments of problematic technology use. The book concludes with a brief summary as well as a discussion of future directions for digital technologies.


2020 ◽  
Author(s):  
Eduardo Cisneros ◽  
Véronique Beauséjour ◽  
Elaine de Guise ◽  
Sylvie Belleville ◽  
Michelle McKerral

AbstractObjectivesThis study evaluated the impact of a multimodal cognitive rehabilitation intervention, the Cognitive Enrichment Program (CEP), on executive functioning (EF) and resumption of daily activities following traumatic brain injury (TBI) in older individuals, in comparison to an active control group having received holistic rehabilitation as usual care.MethodsThe CEP’sexecutive function module included planning, problem solving, and goal management training, as well as strategies focusing on self-awareness. Effectiveness was evaluated by psychometric tests (Modified Six Elements Task-adapted – MSET-A, D-KEFS Sorting test and Stroop four-color version), while generalization was measured through self-reported questionnaires about daily functioning (Dysexecutive Functioning Questionnaire – DEX, Forsaken daily life activities). Measures were obtained before and after intervention, and six months later.ResultsANCOVA results showed significant group-by-time interactions on Tackling the 6 subtasks and Avoiding rule-breaking measures of the MSET-A, with moderate effect sizes. Despite improvements in Sorting and Stroop scores, there were no group-by-time interaction on these measures. DEX generalization measure showed a significant reduction in patient/significant other difference on the Executive Cognition subscale. There was a reduction in the number of Forsaken daily life activities in the experimental group compared to controls which was not significant immediately after CEP, but that was significant six months later.ConclusionsOur study shows that older adults with TBI can improve their executive functioning with a positive impact on everyday activities after receiving multimodal cognitive training compared to an active control group.


2009 ◽  
Vol 8 (1) ◽  
Author(s):  
Chalimah .

eamwork is becoming increasingly important to wide range of operations. It applies to all levels of the company. It is just as important for top executives as it is to middle management, supervisors and shop floor workers. Poor teamwork at any level or between levels can seriously damage organizational effectiveness. The focus of this paper was therefore to examine whether leadership practices consist of team leader behavior, conflict resolution style and openness in communication significantly influenced the team member’s satisfaction in hotel industry. Result indicates that team leader behavior and the conflict resolution style significantly influenced team member satisfaction. It was surprising that openness in communication did not affect significantly to the team members’ satisfaction.


2021 ◽  
Author(s):  
Ekaterina Mosolova ◽  
Dmitry Sosin ◽  
Sergey Mosolov

During the COVID-19 pandemic, healthcare workers (HCWs) have been subject to increased workload while also exposed to many psychosocial stressors. In a systematic review we analyze the impact that the pandemic has had on HCWs mental state and associated risk factors. Most studies reported high levels of depression and anxiety among HCWs worldwide, however, due to a wide range of assessment tools, cut-off scores, and number of frontline participants in the studies, results were difficult to compare. Our study is based on two online surveys of 2195 HCWs from different regions of Russia during spring and autumn epidemic outbreaks revealed the rates of anxiety, stress, depression, emotional exhaustion and depersonalization and perceived stress as 32.3%, 31.1%, 45.5%, 74.2%, 37.7% ,67.8%, respectively. Moreover, 2.4% of HCWs reported suicidal thoughts. The most common risk factors include: female gender, nurse as an occupation, younger age, working for over 6 months, chronic diseases, smoking, high working demands, lack of personal protective equipment, low salary, lack of social support, isolation from families, the fear of relatives getting infected. These results demonstrate the need for urgent supportive programs for HCWs fighting COVID-19 that fall into higher risk factors groups.


Author(s):  
Sergei Soldatenko ◽  
Sergei Soldatenko ◽  
Genrikh Alekseev ◽  
Genrikh Alekseev ◽  
Alexander Danilov ◽  
...  

Every aspect of human operations faces a wide range of risks, some of which can cause serious consequences. By the start of 21st century, mankind has recognized a new class of risks posed by climate change. It is obvious, that the global climate is changing, and will continue to change, in ways that affect the planning and day to day operations of businesses, government agencies and other organizations and institutions. The manifestations of climate change include but not limited to rising sea levels, increasing temperature, flooding, melting polar sea ice, adverse weather events (e.g. heatwaves, drought, and storms) and a rise in related problems (e.g. health and environmental). Assessing and managing climate risks represent one of the most challenging issues of today and for the future. The purpose of the risk modeling system discussed in this paper is to provide a framework and methodology to quantify risks caused by climate change, to facilitate estimates of the impact of climate change on various spheres of human activities and to compare eventual adaptation and risk mitigation strategies. The system integrates both physical climate system and economic models together with knowledge-based subsystem, which can help support proactive risk management. System structure and its main components are considered. Special attention is paid to climate risk assessment, management and hedging in the Arctic coastal areas.


2019 ◽  
Vol 24 (6) ◽  
pp. 722-727
Author(s):  
Aladine A. Elsamadicy ◽  
Andrew B. Koo ◽  
Megan Lee ◽  
Adam J. Kundishora ◽  
Christopher S. Hong ◽  
...  

OBJECTIVEIn the past decade, a gradual transition of health policy to value-based healthcare has brought increased attention to measuring the quality of care delivered. In spine surgery, adolescents with scoliosis are a population particularly at risk for depression, anxious feelings, and impaired quality of life related to back pain and cosmetic appearance of the deformity. With the rising prevalence of mental health ailments, it is necessary to evaluate the impact of concurrent affective disorders on patient care after spinal surgery in adolescents. The aim of this study was to investigate the impact that affective disorders have on perioperative complication rates, length of stay (LOS), and total costs in adolescents undergoing elective posterior spinal fusion (PSF) (≥ 4 levels) for idiopathic scoliosis.METHODSA retrospective study of the Kids’ Inpatient Database for the year 2012 was performed. Adolescent patients (age range 10–17 years old) with AIS undergoing elective PSF (≥ 4 levels) were selected using the International Classification of Diseases, Ninth Revision, Clinical Modification coding system. Patients were categorized into 2 groups at discharge: affective disorder or no affective disorder. Patient demographics, comorbidities, complications, LOS, discharge disposition, and total cost were assessed. The primary outcomes were perioperative complication rates, LOS, total cost, and discharge dispositions.RESULTSThere were 3759 adolescents included in this study, of whom 164 (4.4%) were identified with an affective disorder (no affective disorder: n = 3595). Adolescents with affective disorders were significantly older than adolescents with no affective disorders (affective disorder: 14.4 ± 1.9 years vs no affective disorder: 13.9 ± 1.8 years, p = 0.001), and had significantly different proportions of race (p = 0.005). Aside from hospital region (p = 0.016), no other patient- or hospital-level factors differed between the cohorts. Patient comorbidities did not differ significantly between cohorts. The number of vertebral levels involved was similar between the cohorts, with the majority of patients having 9 or more levels involved (affective disorder: 76.8% vs no affective disorder: 79.5%, p = 0.403). Postoperative complications were similar between the cohorts, with no significant difference in the proportion of patients experiencing a postoperative complication (p = 0.079) or number of complications (p = 0.124). The mean length of stay and mean total cost were similar between the cohorts. Moreover, the routine and nonroutine discharge dispositions were also similar between the cohorts, with the majority of patients having routine discharges (affective disorder: 93.9% vs no affective disorder: 94.9%, p = 0.591).CONCLUSIONSThis study suggests that affective disorders may not have a significant impact on surgical outcomes in adolescent patients undergoing surgery for scoliosis in comparison with adults. Further studies are necessary to elucidate how affective disorders affect adolescent patients with idiopathic scoliosis, which may improve provider approach in managing these patients perioperatively and at follow-up in hopes to better the overall patient satisfaction and quality of care delivered.


2019 ◽  
Vol 70 (10) ◽  
pp. 3738-3740

The Tonsillectomy in children or adults is an intervention commonly encountered in the ENT (Ear Nose and Throat) and Head and Neck surgeon practice. The current tendency is to perform this type of surgery in major ambulatory surgery centers. Two objectives are thus pursued: first of all, the increase of the patient quality of life through the reintegration into the family as quickly as possible and secondly, the expenses associated with continuous hospitalization are reduced. Any tertiary (multidisciplinary) sleep center must ensure the complete diagnosis and treatment (including surgery) of sleep respiratory disorders. Under these conditions the selection of patients and especially the implementation of the specific protocols in order to control the postoperative complications it becomes essential. The present paper describes our experience of tonsillectomy as treatment for selected patients with chronic rhonchopathy (snoring) and mild to moderate obstructive sleep apnoea. It was presented the impact of antibiotics protocols in reducing the main morbid outcomes following tonsillectomy, in our day surgery center. The obtained results can also be a prerequisite for the integrative approach of the patients with sleep apnoea who were recommended surgical treatment. Considering the wide range of therapeutic modalities used in sleep apnoea, each with its specific advantages and disadvantages, more extensive and multicenter studies are needed. Keywords: post-tonsillectomy morbidity, day surgery center, sleep disorders


Author(s):  
Jeff Levin ◽  
Stephen G. Post

In Religion and Medicine, Dr. Jeff Levin, distinguished Baylor University epidemiologist, outlines the longstanding history of multifaceted interconnections between the institutions of religion and medicine. He traces the history of the encounter between these two institutions from antiquity through to the present day, highlighting a myriad of contemporary alliances between the faith-based and medical sectors. Religion and Medicine tells the story of: religious healers and religiously branded hospitals and healthcare institutions; pastoral professionals involved in medical missions, healthcare chaplaincy, and psychological counseling; congregational health promotion and disease prevention programs and global health initiatives; research studies on the impact of religious and spiritual beliefs and practices on physical and mental health, well-being, and healing; programs and centers for medical research and education within major universities and academic institutions; religiously informed bioethics and clinical decision-making; and faith-based health policy initiatives and advocacy for healthcare reform. Religion and Medicine is the first book to cover the full breadth of this subject. It documents religion-medicine alliances across religious traditions, throughout the world, and over the course of history. It summarizes a wide range of material of relevance to historians, medical professionals, pastors and theologians, bioethicists, scientists, public health educators, and policymakers. The product of decades of rigorous and focused research, Dr. Levin has produced the most comprehensive history of these developments and the finest introduction to this emerging field of scholarship.


This collection of twelve original essays by an international team of eminent scholars in the field of book history explores the many ways in which early modern books were subject to reworking, re-presentation, revision and reinterpretation. Their history is often the history of multiple, sometimes competing, agencies as their texts were re-packaged, redirected and transformed in ways that their original authors might hardly recognize. The essays discuss the processes of editing, revision, redaction, selection, abridgement, glossing, disputation, translation and posthumous publication that resulted in a textual elasticity and mobility that could dissolve distinctions between text and paratexts, textuality and intertextuality, manuscript and print, author and reader or editor, such that title and author’s name are no longer sufficient pointers to a book’s identity or contents. The essays are alive to the impact of commercial and technological aspects of book production and distribution (discussing, for example, the career of the pre-eminent bookseller John Nourse, the market appeal of abridgements, and the financial incentives to posthumous publication), but their interest is also in the many additional forms of agency that shaped texts and their meanings as books were repurposed to articulate, and respond to, a variety of cultural and individual needs. They engage with early modern religious, political, philosophical and scholarly trends and debates as they discuss a wide range of genres and kinds of publication (including fictional and non-fictional prose, verse miscellanies, abridgements, sermons, religious controversy) and of authors and booksellers (including Lucy Hutchinson, Richard Baxter, Thomas Burnet, Elizabeth Rowe, John Dryden, and Samuel Taylor Coleridge, Lucy Hutchinson, Henry Maundrell, John Nourse; Jonathan Swift, Samuel Richardson, John Tillotson, Isaac Watts and John Wesley).


Author(s):  
Donald Bloxham

Against majority opinion within his profession, Donald Bloxham argues that it is legitimate, often unavoidable, and frequently important for historians to make value judgements about the past. History and Morality draws on a wide range of historical examples, and its author’s insights as a practising historian. Examining concepts like impartiality, neutrality, contextualization, and the use and abuse of the idea of the past as a foreign country, Bloxham’s book investigates how the discipline has got to the point where what is preached can be so inconsistent with what is practised. It illuminates how far tacit moral judgements infuse works of history, and how strange those histories would look if the judgements were removed. Bloxham argues that rather than trying to eradicate all judgemental elements from their work historians need to think more consistently about how, and with what justification, they make the judgements that they do. The importance of all this lies not just in the responsibilities that historians bear towards the past—responsibilities to take historical actors on those actors’ own terms and to portray the impact of those actors’ deeds—but also in the role of history as a source of identity, pride, and shame in the present. The account of moral thought in History and Morality has ramifications far beyond the activities of vocational historians.


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