New York City plays host to a Medicaid shuttle program for people with traumatic brain injuries to get around town for errands and short trips around the city. Recently, the program has been under fire after an unknown whistleblower revealed that some clients have been using the shuttle service to purchase cigarettes. Apparently, it wasn’t just a trip to the grocery store either. The person in question allegedly made 20 trips over 3 months to Seneca Nation Reservation to buy cheaper cigarettes, according to a Behavioral Health Central article.
Social Services Commissioner Carol Dankert said, “It seems counter-intuitive to me to use Medicaid dollars to make unhealthy choices,” the article reported. She then made a formal letter to the New York State Health Commissioner Richard F. Daines asking why clients were able to make cigarette runs using Medicaid dollars.
The shuttle services are available for traumatic brain injury victims who need nursing home care but who choose to live independently of a nursing home. The program – Medicaid Waiver for Individuals with Traumatic Brain Injury – is run by the state of New York, but county employees keep track of the mileage and trip destinations.
Todd Vaarwerk of the Western New York Independent Living Project said that although buying cigarettes might be a bad choice, “the county doesn’t have the right to deny something that a person without a disability would otherwise be entitled to. That would be paternalism,” the article said. He advocated for the County to keep playing its part in the shuttle program instead of handing responsibility over to the state. “The county has a role in making sure the money is spent to meet the broader needs of the community,” he told The Buffalo News.
Since the Medicaid program was intended to assist brain injured clients live a more normal life, it makes sense that certain individuals’ normal lives include buying packs of cigarettes and going out to eat at their favorite restaurants. The shuttle program exists to assist them in living their lives, not to dictate how those lives are lived, some supporters of the shuttle have suggested.
TORRINGTON—The Charlotte Hungerford Hospital announced it is collaborating with Hartford Hospital to present a free heart health education program Thursday, May 20 at The Charlotte Hungerford Hospital Cafeteria, 540 Litchfield Street, Torrington. “Heart & Brain Attacks: Risk Factors, Symptoms, Prevention” will provide information on what patients need to know about prevention, diagnosis and treatment for heart disease and strokes.
The evening will include talks will be presented by Charlotte Hungerford cardiologist Michael Fowler, M.D., of Torrington’s Associates in Cardiovascular Medicine, and Eric M. Crespo, M.D., M.P.H., an electrophysiologist from Hartford Hospital’s Cardiology Department.
The event begins at 6 p.m. with heart -elated information, light refreshments and free blood pressure screenings. The physician presentations will begin at 6 p.m., and members of the audience will have an opportunity to ask questions. Seating for this seminar is limited. Please pre-register at 860-496-9512 by May 15.
NEW DELHI - In a blow to investigating agencies, the Supreme Court on May 5 declared as “illegal” compulsory use of narco-analysis, brain-mapping and polygraph tests on suspects.
It, however, held that if anything is obtained by the investigators from such techniques in which a person had volunteered, the agencies can use that for further probe.
“We are of the considered opinion that no individual can be forced and subjected to such techniques involuntarily, and by doing so it amounts to unwarranted intrusion of personal liberty,” a Bench headed by Chief Justice K G Balakrishnan said.
The apex court said that involuntarily subjecting an accused, a suspect or a witness to such techniques violates the Constitution, which prohibits self-incrimination.
The judgement assumes significance as probe agencies have used narco-analysis, brain-mapping and polygraph tests in a number of high-profile cases involving fake stamp paper kingpin Abdul Karim Telgi, Nithari killings accused and Aarushi murder case suspects as well as parents of the teenager.
The Bench observed that forcing an individual to such methods of investigation violates the scheme of legal process.
Even if a person is subjected to such a mode of investigation on consent, the result of the test cannot be an admissible piece of evidence, it said.
The Slavica BioChem division of Hard to Treat Diseases, Inc. (HTDS) recently presented results from their hyperbaric oxygen (HBO) chamber study for treatment of traumatic brain injury. The positive results were presented to the 8th World Congress on the Brain Injury in Washington, DC in March, put on by the International Brain Injury Association. The gathering is the largest of its kind in the world. This year’s meeting was the most heavily attended ever, featuring therapists, social workers, medical professionals, psychologists, and researchers from all over the world, a PR Newswire article reported.
The head scientist of HTDS, Dr. Sanja Pekovic, said in the article, “This Congress was an excellent opportunity to get insight into the state-of-the-art research, covering all from the basic science to the clinical aspects of brain injury, as well as for establishing important contacts with international professionals involved in the brain injury research and the care of people with acquired brain injury.” He added that the conference was a perfect venue to present the results of the Serbian team’s hyperbaric oxygen chamber animal trials for brain injury treatment.
While rats were used in the study, the same hyperbaric oxygen chambers used for humans were used in the experiment. Slavica Biochem conducted the study in conjunction with researchers from the Hyperbaric Medical Center at the School of Medicine at University of Belgrade in Serbia. The results of the study were promising and added new data upon their previous positive achievements.
Dr. Pekovic continued, “Our previous experiments showed that repetitive HBO treatments significantly reduced neuronal loss and degeneration, suggesting that HBO was able to attenuate the effects of brain damage by reducing the progression of neuronal injury,” the article reported. He added that his team’s most recent study “revealed new beneficial effects of HBO treatment on glial scarring and inflammatory processes after traumatic brain injury.” The positive results did not end there.
Pekovic asserted that HBO treatments reduced inflammation in the brains of the rats in the study and suggested that HBO be used for brain injury recovery as soon as it becomes available for such use. Pekovic ended by calling HBO chambers an “attractive therapeutic tool for improving recovery from head injury.” With any luck, the treatments will become widely available sooner than later.
A new guidance system has been developed which gives surgeons a precise route map deep inside the brain.
A sat nav-style guidance system has given surgeons a precise route map deep inside the brain.
The technique, unveiled by Alder Hey children's hospital in the UK, allows doctors to remove tumours and other abnormal tissue more safely.
And for the first time in Europe, surgeons can also wheel their patient straight into an MRI scanner to double-check all diseased areas have been removed.
Patients remain anaesthetised and only have their wound closed up once the scan gives the all-clear.
Paediatric surgeon Sasha Burn said a brain tumour can re-grow if any cells are left behind in an operation.
The new set-up gives peace of mind, she said.
'With children's tumours it's very important that we take away all the tumour at the first operation. It increases the survival after the operation enormously,' she said.
The navigation system - called BrainLAB - synchronises pre-operative brain scans with the child's position on the operating table.
It shows surgeons the best route to the target area in the brain.
The scans can be updated during the operation, allowing the route map to be refreshed.
Millimetres matter because diseased tissue can be next to crucial parts of the brain, including those controlling speech and vision.
One of the first patients to benefit from the system is 12-year-old Bradley Martin.
He has epilepsy caused by a pea-sized cyst on his brain - and surgeons were able to remove it in a five-hour operation, which could prevent future seizures.
Before the surgery, his dad, Brett, said: 'He loves mountain biking, but it's a terrible worry for us that he might have an episode when he is cycling quickly.
'To have him fit-free would be a wonderful thing.'
Afterwards Miss Burn said he had 'an extremely good chance of being completely seizure free'.
The operating theatre was made possible with a 3m donation from the Barclay Foundation.
Washington, May 13 (ANI): A new research has helped researchers identify potential target for drugs to combat alcohol addiction.
A team at The Scripps Research Institute has found decisive evidence that a specific neurotransmitter system-the endocannabinoid system-is active in a brain region known to play a key role in the processing of memory, emotional reactions, and addiction formation.
Their study also shows that this system can dampen the effects of alcohol, suggesting an avenue for the development of drugs to combat alcohol addiction.
"This study will change a lot in the field. I'm confident it will have a big impact," said Scripps Research Associate Professor Marisa Roberto, who was first author of the paper.
Paul Schweitzer, associate professor of the neurobiology of addiction at Scripps Research and corresponding author of the paper, said: "This is very new. It is the first time a study has shown a direct cellular interaction between endocannabinoids and alcohol in the brain."
The new research overturns the conclusions of a paper published by a European group in the Journal of Neuroscience in 2001. This paper claimed that endocannabinoid receptors, in particular the most common type called CB1, did not exist in the brain region called the central amygdala.
Schweitzer said: "Yet CB1 receptors are very abundant. They are almost everywhere in the brain and there are lots of them. The endocannabinoid system acts on appetite, mood, memory-and addiction. Addiction is why we started to study it in the central amygdala."
The research was published in the journal Neuropsychopharmacology on May 12.
Washington, DC: In a new study, boffins at MIT's Picower Institute for Learning and Memory have analysed the interaction of two proteins key to brain development.
The work may one day correct or prevent genetic conditions tied to smaller-than-normal brains and shed light on the evolution of human head size.
Neurogenesis is the process through which neurons are created during prenatal development to populate the growing brain.
Li-Huei Tsai, director of the Picower Institute and Picower Professor of Neuroscience, found that two proteins--Cdk5rap2 and pericentrin-work together to regulate neural growth in the developing brain. Loss of function of these proteins results in human disorders such as primary autosomal recessive microcephaly (MCPH) and Majewski osteodysplastic primordial dwarfism, type II (MOPDII), genetic conditions characterized in part by abnormally small head circumference.
An understanding of these rare genetic disorders may offer insight into one of the most striking differences between us and our closest living relatives: brain size and cognitive ability.
The researchers show that Cdk5rap2 and pericentrin interact with one another to regulate proliferation of neural progenitor cells that give rise to the brain layer called the neocortex. Pericentrin recruits Cdk5rap2 to structures within the neural progenitor cells, and loss of Cdk5rap2 results in decreased cell proliferation.
"Given the link between head circumference, intelligence deficits and psychiatric disorders, these findings have implications for our understanding of how abnormalities in brain development can play a role in a number of diseases," said Tsai, a Howard Hughes Medical Institute investigator and the director of the neurobiology programme at the Broad Institute's Stanley Center for Psychiatric Research. In addition to leading to potential treatments for MCPH and MOPDII, the work may also shed light on the increase in brain size during human evolution.
Sickle cell disease is a genetic life-long blood disorder, identified by red blood cells in the blood. According to a study conducted within the NHLBI-supported Comprehensive Sickle Cell Center, sickle cell disease may affect brain function in adults facing few or mild complexities, of the congenital blood disease. The investigators compared the brain function scores and imaging tests in adult patients, with few sickle cell complications. The results were astonishing, as they were similar to adults who did not have the blood disease.
The authors announced that, the brain function scores in sickle cell patients were, on average, in the normal range. But, approximately 33 percent healthy patients, scored below normal levels. The participants who were more likely to score lower were older. They had the lowest levels of hemoglobin in red blood cells, when compared to sickle cell participants who scored higher. Hemoglobin is the protein in red blood cells and is responsible for carrying oxygen in the blood. However, the brain magnetic resonance imaging scans, were unable to give a reason for the differences in scores. NHLBI Acting Director Susan B. Shurin, M.D, shared, “This study suggests that some adult patients who have sickle cell disease may develop cognitive problems, such as having difficulty organizing their thoughts, making decisions, or learning, even if they do not have severe complications such as stroke related to sickle cell disease. Such challenges can tremendously affect a patient’s quality of life, and we need to address these concerns as part of an overall approach to effectively managing sickle cell disease.”
The study authors at 12 sites conducted the study on 149 adult patients, suffering from sickle cell disease. All the participants were between the age group of 19 and 55 years. The authors examined the cognitive functioning of each of these participants. Their results were then compared to 47 healthy study participants. All the participants shared similar age and education levels and came from the same communities. All the participants were African-American.
Almost, all the sickle cell disease patients scored lower, on measures such as intellectual ability, short-term memory, processing speed, and attention, than participants in the healthy group. None of these patients had ever undergone an end-organ failure, stroke, high blood pressure, or other conditions that might otherwise affect brain function. Elliott P. Vichinsky, M.D., of the Children’s Hospital & Research Center Oakland, principal investigator of the study and the lead author of the paper remarked, “We need to study whether existing therapies, such as blood transfusions, can help maintain brain function, or perhaps even reverse any loss of function. These effects were found in patients who have clinically mild sickle cell disease, which raises the question of whether therapies should be given to all patients to help prevent these problems from developing.”
The study authors further employed patients, with sickle cell disease in the study, to conclude whether or not blood transfusions may help preserve cognitive function. In case it is possible, then these patients may receive transfusions every three or four weeks for six months as part of the clinical study.
Approximately, 70,000 Americans, seem to face this aliment. Many children in the past have died from this disease. But today, there are various new and advanced therapies that help sickle cell disease patients to live well into middle age or beyond. Since, many people are surviving into adulthood, more thorough studies are being conducted, to uncover various complications of this disease.
Studies of brain function in children seem to suggest that, some children who have sickle cell disease have experienced silent brain injury, even though they have not suffered a stroke. While others, may experience some level of cognitive dysfunction, which may further worsen with age. A common complication that arises in this disease is stroke, which can probably lead to learning disabilities, lasting brain damage, long-term disability, paralysis, or death.
The investigators illustrated that, this disease includes an altered gene that apparently produces, abnormal hemoglobin. The C-shape of this sickle hemoglobin has very little oxygen and is very stiff and sticky. These crescent-shaped cells can probably, clump to block blood flow causing severe pain. They also have the potential of causing organ damage. It is claimed that in the United States, the disease mainly affects those of African descent. But, it has also been noted in other ethnic groups, including those of Hispanic and Middle Eastern descent.
The study is published in the May 12 issue of the Journal of the American Medical Association.
In 1953, Professor James McConell taught flatworms to run through a maze by administering shocks to them when they took a wrong turn. There was nothing new in this simple demonstration of operant conditioning, but the next phase of the experiment got really interesting. McConell ground up the worms, fed them to another batch, and watched them learn to run through the maze in a much shorter period of time.
During my almost three decades of working with managers in the corporate world, I often wondered if McConell wasn't on to something. Rather than the rewards and threats of punishment employed to improve performance, usually with little effect, it would've been easier and more cost effective to grind up the top performers and feed them to those in need of development.
The problem, of course, is that there is a fundamental difference between worms and human beings. Rather than just react to stimuli, we interpret it and then decide how we will respond. While flat worms may have a rich inner life we're simply not privy to, it doesn't appear to drive their behavior. But our inner life does.
Put a human being in a maze and tell him to negotiate it successfully or you'll administer an electric shock, and the odds are he'll rebel and refuse to participate. He'll be even less willing if he anticipates being ground up and fed to his coworkers, or is served his coworkers for lunch. That's why I never advocated McConell's approach.
Our penchant for thinking, rather than just reacting, is why managers end up with such unreasonable responses to their time-honored practices. They dispense rewards, only to see motivation decrease. The more they punish performance, the worse it gets. The feedback they give produces the opposite of what they intend. It's why Peter Drucker quipped, "Most of what we call management consists of making it difficult for people to do their jobs."
But try telling that to managers hemmed in by a corporate compensation system and mandatory performance appraisals, to say nothing of behavior-oriented training programs. Rather than admitting that the corporate world's vaunted objectivity is an illusion and their managerial practices are self-defeating, it's much easier to conclude that their employees are simply defective.
Corporate clients don't suffer fools gladly, even when they're high priced ones, so management consultants either quickly figure out what works or are masochists. I learned that asking questions to encourage self-feedback, instead of rendering judgments, overcame perceptual conflicts. I saw that better decisions were made when the role of emotion was acknowledged, not denied. And I witnessed higher motivation and better performance when people pursued an inspirational vision rather than just incentive compensation.
But I never had the science, the hard data to explain to my skeptical and hard-nosed clients why these counterintuitive practices worked, until neuroscientists started scanning brains with an fMRI. For the first time in history, we didn't have to philosophize about what's real, construct elaborate models of how we think decisions are made, or speculate about what motivates people. We could watch the brain at work, and theories were replaced with exactly the kind of hard data managers long for and find convincing.
What did the data tell us? We don't record our experience of the world, we construct it with input from the areas of the brain responsible for our memories, beliefs, and desires. Our decisions aren't made with cold objective logic, but with our emotion-generating amygdala. The pleasure inducing neurotransmitter dopamine is released not when we receive a reward, but when we're engaged in the work that leads to a reward.
I wrote Management Rewired: Why Feedback Doesn't Work and Other Surprising Lessons of the Latest Brain Science so that I could understand why what I had learned from experience the hard way worked so well. It was only once the book was finished that I realized it also provided a justification for the kind of management we all want to believe in. For it turns out that acting with integrity and treating people with respect is actually quite profitable.
But perhaps the greatest benefit of the book is that I'm no longer haunted by fantasies of grinding up high performing managers and feeding them to their less adept counterparts. All I do now is hand out copies of the book and let the science do the rest.
Many years ago, scientists observed that when such bats bit other animals, they would cause their victims to bleed to death.
VANCOUVER — Hospitals across Canada are helping to test whether a genetically engineered drug made from a protein in vampire bat saliva can treat strokes.
It's part of an international trial taking place in nearly 100 nations.
The drug company-sponsored trial is investigating whether the experimental treatment, Desmoteplase, is safe and effective at breaking up brain clots in patients who arrive at hospital three to nine hours after the onset of symptoms.
Hospitals in Vancouver, Calgary, Edmonton, Toronto, Halifax are taking part in the trial.
The trial is randomized, double-blinded and placebo controlled, which means that patients who enrol have an equal chance of getting the drug or a placebo. Patients consenting to the trial will not know if they received the drug or the placebo.
Dr. Ashfaq Shuaib, the University of Alberta hospital neurologist who is the national co-ordinating investigator of the trial, said this week the intravenous drug originated with vampire bats native to Mexico and South America.
Many years ago, scientists observed that when such bats bit other animals, they would cause their victims to bleed to death.
He said that led to speculation that a drug made from their saliva might be effective at breaking up blood clots causing heart attacks or strokes.
At present, only one clot-busting drug — alteplase, also known as TPA — is approved for acute ischemic stroke patients.
Ischemi stroke is defined as death of brain tissue due to an inadequate supply of blood and oxygen to the brain, which results from blockage of an artery.
TPA can only be administered intravenously if patients get to hospital within 4 1/2 hours of the onset of symptoms.
People living in rural or remote regions often don't have access to such treatment, since it must be given in hospitals with stroke specialists and CT or MRI-imaging equipment to detect blood clots. TPA carries about a five per cent risk of inducing brain bleeding, Shuaib said.
Due to those limitations, only about three per cent of all stroke patients end up being treated with TPA.
At the International Stroke Conference a few months ago in San Antonio, Tex., H. Lundbeck, the Denmark-based drug company involved in the trials, said about 800 patients around the world would be enrolled in two trials.
The National Institutes of Health clinical trials website, an American registry of trials, estimates the trials will be completed by September 2011.
In a 2007 study in the journal Stroke, European researchers called desmoteplase a "promising alternative" to TPA.
The study noted pre-clinical evidence showed the experimental drug may offer benefits over TPA, including a reduced risk of brain hemorrhage, improved safety and a longer treatment window of opportunity.
A sat nav-style guidance system has given surgeons a precise route map deep inside the brain.
The technique, unveiled by Alder Hey children's hospital, allows doctors to remove tumours and other abnormal tissue more safely.
And for the first time in Europe, surgeons can also wheel their patient straight into an MRI scanner to double-check all diseased areas have been removed.
Patients remain anaesthetised and only have their wound closed up once the scan gives the all-clear.
Paediatric surgeon Sasha Burn told Sky News that a brain tumour can re-grow if any cells are left behind in an operation.
The new set-up gives peace of mind, she said.
"With children's tumours it's very important that we take away all the tumour at the first operation. It increases the survival after the operation enormously," she said.
The navigation system - called BrainLAB - synchronises pre-operative brain scans with the child's position on the operating table.
It shows surgeons the best route to the target area in the brain.
Cyst removed: Bradley Martin
The scans can be updated during the operation, allowing the route map to be refreshed.
Millimetres matter because diseased tissue can be next to crucial parts of the brain, including those controlling speech and vision.
One of the first patients to benefit from the system is 12-year-old Bradley Martin.
He has epilepsy caused by a pea-sized cyst on his brain - and surgeons were able to remove it in a five-hour operation, which could prevent future seizures.
Before the surgery, his dad, Brett, said: "He loves mountain biking, but it's a terrible worry for us that he might have an episode when he is cycling quickly.
"To have him fit-free would be a wonderful thing."
Afterwards Miss Burn said he had "an extremely good chance of being completely seizure free".
The operating theatre was made possible with a £3m donation from the Barclay Foundation.
New York City plays host to a Medicaid shuttle program for people with traumatic brain injuries to get around town for errands and short trips around the city. Recently, the program has been under fire after an unknown whistleblower revealed that some clients have been using the shuttle service to purchase cigarettes. Apparently, it wasn’t just a trip to the grocery store either. The person in question allegedly made 20 trips over 3 months to Seneca Nation Reservation to buy cheaper cigarettes, according to a Behavioral Health Central article.
