Science.gov

Sample records for patient advocacy movement

  1. Small wins matter in advocacy movements: giving voice to patients.

    PubMed

    Jason, Leonard A

    2012-06-01

    In this article, the various players are delineated in a story of a contested illness and patient advocacy, played out within the corridors of federal power. It is suggested that the mistreatment and negative attitudes that health care providers and others have towards those with chronic fatigue syndrome (CFS) is possibly due to the social construction of this illness as being a "Yuppie flu" disease. Institutional factors are identified that created these norms and attributions, as well as the multiple stakeholders and constituent groups invested in exerting pressure on policy makers to effect systemic change. This article also provides examples of how the field of Community Psychology, which is fundamentally committed to/based on listening to and giving voice to patients, is broadly relevant to patient activism communities. This approach focused, over time, on epidemiological studies, the name, the case definition, and ultimately the change in CFS leadership at the Centers for Disease Control and Prevention. Keys to this "small wins" approach were coalition building, use of "oppositional experts" (professionals in the scientific community who support patient advocacy goals) to challenge federal research, and taking advantage of developing events/shifts in power. Ultimately, this approach can result in significant scientific and policy gains, and changes in medical and public perception of an illness.

  2. Patient advocacy: the role of the nurse.

    PubMed

    Choi, Pin Pin

    2015-06-10

    The role of nurses as patient advocates is well recognised by healthcare professionals, yet the processes and practices involved in patient advocacy are not clearly understood. A suboptimal level of advocacy is often apparent in the literature, encompassing paternalistic concepts of protecting patients from harm. This article examines the concept of patient advocacy and its relevance to nursing, associated goals and outcomes of advocacy and the processes and practices involved. It provides insights into how nurses practise patient advocacy in healthcare settings and how they may develop this role further, through formal education, workplace learning, role modelling by expert nurses and promoting an organisational culture conducive to patient advocacy.

  3. Patient advocacy: the role of the nurse.

    PubMed

    Choi, Pin Pin

    2015-06-10

    The role of nurses as patient advocates is well recognised by healthcare professionals, yet the processes and practices involved in patient advocacy are not clearly understood. A suboptimal level of advocacy is often apparent in the literature, encompassing paternalistic concepts of protecting patients from harm. This article examines the concept of patient advocacy and its relevance to nursing, associated goals and outcomes of advocacy and the processes and practices involved. It provides insights into how nurses practise patient advocacy in healthcare settings and how they may develop this role further, through formal education, workplace learning, role modelling by expert nurses and promoting an organisational culture conducive to patient advocacy. PMID:26058653

  4. Disability Identity of Leaders in the Self-Advocacy Movement

    ERIC Educational Resources Information Center

    Caldwell, Joe

    2011-01-01

    Life stories and perspectives of leaders in the self-advocacy movement were explored to enhance knowledge about disability identity formation. In-depth qualitative interviews were conducted with 13 leaders in the self-advocacy movement. Five major themes emerged: (a) resistance-claiming personhood and voice; (b) connection with disability…

  5. Patient Advocacy in an Obstetric Setting.

    PubMed

    Heelan-Fancher, Lisa M

    2016-10-01

    A correlation study design was used to examine the interrelatedness of power, attitudes regarding intermittent fetal monitoring, and perceived barriers to research utilization with a labor and delivery nurse's attitude toward patient advocacy using the conceptual framework of the science of unitary human beings. The linear combination of the three independent variables was significantly correlated to attitude toward patient advocacy and power as knowing participation in change had the greatest impact on patient advocacy.

  6. Patient Advocacy in an Obstetric Setting.

    PubMed

    Heelan-Fancher, Lisa M

    2016-10-01

    A correlation study design was used to examine the interrelatedness of power, attitudes regarding intermittent fetal monitoring, and perceived barriers to research utilization with a labor and delivery nurse's attitude toward patient advocacy using the conceptual framework of the science of unitary human beings. The linear combination of the three independent variables was significantly correlated to attitude toward patient advocacy and power as knowing participation in change had the greatest impact on patient advocacy. PMID:27641281

  7. Patient advocacy and arthritis: moving forward.

    PubMed Central

    Leong, Amye L.; Euller-Ziegler, Liana

    2004-01-01

    Patient advocacy is based on the premise that people have the right to make their own choices about their health care. Personal advocacy is centred on the experiential expertise of the individual affected by the condition, whereas group advocacy is grounded on patient-centred strategies and actions. The first patient advocacy groups for arthritis were set up over 20 years ago in the USA and have subsequently spread to many other countries. This paper discusses the growth and impact of personal advocacy as well as recent developments in group advocacy in the Asia-Pacific region, Europe, and North America, in terms of arthritis awareness, research, corporate partnerships, and the Bone and Joint Decade global initiative. PMID:15042233

  8. Patient advocacy in the USA: key communication role functions.

    PubMed

    Martin, Donald R; Tipton, Bryan K

    2007-09-01

    Researchers have long documented the importance of patient advocacy programs as a means of providing customer service in health-care organizations. Yet, while effective communication is often acknowledged as key to effective patient advocacy, knowledge of the specific communication role functions enacted by patient advocates remains limited, as does our understanding of the function of patient advocacy at the organizational level. This qualitative investigation not only provides a typology of communication roles enacted by patient advocates while solving problems on behalf of patients and their family members, but also integrates scholarly research on "boundary-spanning" as a means of theoretically contextualizing the advocacy role at the organizational level. PMID:17688476

  9. Patient advocacy and DSM-5.

    PubMed

    Stein, Dan J; Phillips, Katharine A

    2013-05-17

    The revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) provides a useful opportunity to revisit debates about the nature of psychiatric classification. An important debate concerns the involvement of mental health consumers in revisions of the classification. One perspective argues that psychiatric classification is a scientific process undertaken by scientific experts and that including consumers in the revision process is merely pandering to political correctness. A contrasting perspective is that psychiatric classification is a process driven by a range of different values and that the involvement of patients and patient advocates would enhance this process. Here we draw on our experiences with input from the public during the deliberations of the Obsessive Compulsive-Spectrum Disorders subworkgroup of DSM-5, to help make the argument that psychiatric classification does require reasoned debate on a range of different facts and values, and that it is appropriate for scientist experts to review their nosological recommendations in the light of rigorous consideration of patient experience and feedback.

  10. Patient advocacy and DSM-5

    PubMed Central

    2013-01-01

    The revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) provides a useful opportunity to revisit debates about the nature of psychiatric classification. An important debate concerns the involvement of mental health consumers in revisions of the classification. One perspective argues that psychiatric classification is a scientific process undertaken by scientific experts and that including consumers in the revision process is merely pandering to political correctness. A contrasting perspective is that psychiatric classification is a process driven by a range of different values and that the involvement of patients and patient advocates would enhance this process. Here we draw on our experiences with input from the public during the deliberations of the Obsessive Compulsive-Spectrum Disorders subworkgroup of DSM-5, to help make the argument that psychiatric classification does require reasoned debate on a range of different facts and values, and that it is appropriate for scientist experts to review their nosological recommendations in the light of rigorous consideration of patient experience and feedback. PMID:23683696

  11. Advocacy.

    ERIC Educational Resources Information Center

    Scarr, Margaret, Ed.; Varro, Tim, Ed.

    1993-01-01

    This theme issue presents art advocacy as a necessary means of bringing art and art education to an elevated status in the elementary secondary curriculum and educational system. Articles include: (1) "Editor's View" (Margaret Scarr); (2) "Art Education: Why Is It Important" (Arts Education Partnership Working Group); (3) "Why Art in Education and…

  12. Bladder Cancer Patient Advocacy: A Global Perspective

    PubMed Central

    Quale, Diane Zipursky; Bangs, Rick; Smith, Monica; Guttman, David; Northam, Tammy; Winterbottom, Andrew; Necchi, Andrea; Fiorini, Edoardo; Demkiw, Stephanie

    2015-01-01

    Abstract Over the past 20 years, cancer patient advocacy groups have demonstrated that patient engagement in cancer care is essential to improving patient quality of life and outcomes. Bladder cancer patient advocacy only began 10 years ago in the United States, but is now expanding around the globe with non-profit organizations established in Canada, the United Kingdom and Italy, and efforts underway in Australia. These organizations, at different levels of maturity, are raising awareness of bladder cancer and providing essential information and resources to bladder cancer patients and their families. The patient advocacy organizations are also helping to advance research efforts by funding research proposals and facilitating research collaborations. Strong partnerships between these patient advocates and the bladder cancer medical community are essential to ensuringsustainability for these advocacy organizations, increasing funding to support advances in bladder cancer treatment, and improving patient outcomes. PMID:27398397

  13. Patient advocacy from the clinical nurses' viewpoint: a qualitative study.

    PubMed

    Davoodvand, Shirmohammad; Abbaszadeh, Abbas; Ahmadi, Fazlollah

    2016-01-01

    One of the advanced nursing care procedures emphasized by nursing organizations around the world is patient or nursing advocacy. In addition to illustrating the professional power of nursing, it helps to provide effective nursing care. The aim of the present study was to explain the concept of patient advocacy from the perspective of Iranian clinical nurses. This was a qualitative study that examined the viewpoint and experiences of 15 clinical nurses regarding patient advocacy in nursing. The nurses worked in intensive care units (ICUs), coronary care units (CCUs), and emergency units. The study participants were selected via purposeful sampling. The data was collected through semi-structured interviews and analyzed using content analysis. Data analysis showed that patient advocacy consisted of the two themes of empathy with the patient (including understanding, being sympathetic with, and feeling close to the patient) and protecting the patients (including patient care, prioritization of patients' health, commitment to the completion of the care process, and protection of patients' rights). The results of this study suggest that nurses must be empathetic toward and protective of their patients. The results of the present study can be used in health care delivery, nursing education, and nursing management and planning systems to help nurses accomplish their important role as patient advocates. It is necessary to further study the connections between patient advocacy and empathy.

  14. Patient advocacy from the clinical nurses' viewpoint: a qualitative study.

    PubMed

    Davoodvand, Shirmohammad; Abbaszadeh, Abbas; Ahmadi, Fazlollah

    2016-01-01

    One of the advanced nursing care procedures emphasized by nursing organizations around the world is patient or nursing advocacy. In addition to illustrating the professional power of nursing, it helps to provide effective nursing care. The aim of the present study was to explain the concept of patient advocacy from the perspective of Iranian clinical nurses. This was a qualitative study that examined the viewpoint and experiences of 15 clinical nurses regarding patient advocacy in nursing. The nurses worked in intensive care units (ICUs), coronary care units (CCUs), and emergency units. The study participants were selected via purposeful sampling. The data was collected through semi-structured interviews and analyzed using content analysis. Data analysis showed that patient advocacy consisted of the two themes of empathy with the patient (including understanding, being sympathetic with, and feeling close to the patient) and protecting the patients (including patient care, prioritization of patients' health, commitment to the completion of the care process, and protection of patients' rights). The results of this study suggest that nurses must be empathetic toward and protective of their patients. The results of the present study can be used in health care delivery, nursing education, and nursing management and planning systems to help nurses accomplish their important role as patient advocates. It is necessary to further study the connections between patient advocacy and empathy. PMID:27471588

  15. Patient advocacy from the clinical nurses' viewpoint: a qualitative study

    PubMed Central

    Davoodvand, Shirmohammad; Abbaszadeh, Abbas; Ahmadi, Fazlollah

    2016-01-01

    One of the advanced nursing care procedures emphasized by nursing organizations around the world is patient or nursing advocacy. In addition to illustrating the professional power of nursing, it helps to provide effective nursing care. The aim of the present study was to explain the concept of patient advocacy from the perspective of Iranian clinical nurses. This was a qualitative study that examined the viewpoint and experiences of 15 clinical nurses regarding patient advocacy in nursing. The nurses worked in intensive care units (ICUs), coronary care units (CCUs), and emergency units. The study participants were selected via purposeful sampling. The data was collected through semi-structured interviews and analyzed using content analysis. Data analysis showed that patient advocacy consisted of the two themes of empathy with the patient (including understanding, being sympathetic with, and feeling close to the patient) and protecting the patients (including patient care, prioritization of patients’ health, commitment to the completion of the care process, and protection of patients' rights). The results of this study suggest that nurses must be empathetic toward and protective of their patients. The results of the present study can be used in health care delivery, nursing education, and nursing management and planning systems to help nurses accomplish their important role as patient advocates. It is necessary to further study the connections between patient advocacy and empathy. PMID:27471588

  16. Patient activation and advocacy: which literacy skills matter most?

    PubMed

    Martin, Laurie T; Schonlau, Matthias; Haas, Ann; Derose, Kathryn Pitkin; Rosenfeld, Lindsay; Buka, Stephen L; Rudd, Rima

    2011-01-01

    Attention to the effect of a patient's literacy skills on health care interactions is relatively new. So, too, are studies of either structural or personal factors that inhibit or support a patient's ability to navigate health services and systems and to advocate for their own needs within a service delivery system. Contributions of the structural environment, of interpersonal dynamics, and of a variety of psychological and sociological factors in the relationship between patients and providers have long been under study. Less frequently examined is the advocacy role expected of patients. However, the complex nature of health care in the United States increasingly requires a proactive stance. This study examined whether four literacy skills (reading, numeracy, speaking, and listening) were associated with patient self-advocacy--a component of health literacy itself--when faced with a hypothetical barrier to scheduling a medical appointment. Although all literacy skills were significantly associated with advocacy when examined in isolation, greater speaking and listening skills remained significantly associated with better patient advocacy when all four skills were examined simultaneously. These findings suggest that speaking and listening skills and support for such skills may be important factors to consider when developing patient activation and advocacy skills.

  17. Validation of the patient advocacy engagement scale for health professionals.

    PubMed

    Jansson, Bruce S; Nyamathi, Adeleine; Duan, Lei; Kaplan, Charles; Heidemann, Gretchen; Ananias, Debbie

    2015-04-01

    Codes of ethics of nursing, social work, and medicine, as well as Joint Commission Accreditation Standards, require members of these professions to engage in advocacy on behalf of patients. With use of expert panels, seven categories of patient problems in the healthcare milieu were identified: ethical rights, quality care, preventive care, culturally competent care, affordable/accessible care, mental health care, and care linked to patients' homes and communities. To measure the frequency with which healthcare professionals engage in patient advocacy related to these specific problems, the Patient Advocacy Engagement Scale (Patient-AES) scale was developed and validated through analysis of responses of 297 professionals (94 social workers, 97 nurses, and 104 medical residents) recruited from the personnel rosters of eight acute-care hospitals in Los Angeles County. Hospitals included public, not-for-profit, HMO, and church-affiliated hospitals that served general hospital populations, veterans, cancer patients, and children. Results supported the validity of both the concept and the instrument. Construct validity was supported by testing the hypothesized seven-factor solution through confirmatory factor analysis; 26 items loaded onto seven components. Pearson correlations for the overall scale and seven subscales in two administrations supported their test-retest stability. Cronbach α ranged from .55 to .94 for the seven subscales and .95 for the overall Patient-AES. The Patient-AES is, to our knowledge, the first scale that measures patient advocacy engagement by healthcare professionals in acute-care settings related to a broad range of specific patient problems. © 2014 Wiley Periodicals, Inc.

  18. Enhancing patient well-being: advocacy or negotiation?

    PubMed Central

    Bird, A W

    1994-01-01

    The United Kingdom Central Council for Nursing, Midwifery and Health Visitors (UKCC) document, Exercising Accountability, states that the role of patient's advocate is an essential aspect of good professional nursing practice (1). The author examines the case for and against the nurse being the best person to act as advocate, and critically evaluates the criteria of advocacy. The problematic moral issues arising are discussed, and a case made for negotiation between the members of the multidisciplinary team and the patient/client (or a significant person to the patient) in order to promote the well-being of the patient and to minimise suffering. She concludes that the health care professional's (including the nurse's) role is to help people to assert control over the factors which affect their lives, that is empowerment, rather than advocacy. PMID:7996560

  19. The internal dynamics of environmental organizations: Movement interest groups, communal advocacy groups, and the policy process

    SciTech Connect

    Shaffer, M.B.

    1995-12-31

    How do the diverse qualities that movement organizations bring to the policy process affect the representation of particular interests? This question is explored by analyzing environmental organizations across the national, state, and local levels of the American political system. This article suggests that two types of social movement organizations exist: movement interest groups and communal advocacy groups. While this article does not provide direct evidence of the different policy capabilities of the two types of movement organizations, existing research is drawn upon to consider how each type might fare in the policy process. One approach suggests that centralized organizations with incremental goals are better equipped to attain policy success, while the other stresses the need for active member involvement to engage in disruptive politics. To fully assess these divergent views, this article presents a broad review and analysis of the literature.

  20. Advocacy and hope for the patient with pityriasis rubra pilaris.

    PubMed

    Nunemacher, Kathy J

    2008-10-01

    Pityriasis rubra pilaris (PRP) is a rare skin disease that can cause severe physical and psychological manifestations. A short case study of an adult with PRP who was denied access to medications and his journey towards improved health is discussed. Through advocacy and support, health care providers can make a difference in the care of patients with PRP and improve their quality of life. PMID:19051784

  1. Patient Education vs. Patient Experiences of Self-advocacy: Changing the Discourse to Support Cancer Survivors.

    PubMed

    Hagan, Teresa L; Medberry, Elizabeth

    2016-06-01

    A growing emphasis on patient self-advocacy has emerged in the public discourse on cancer survivorship. This discourse shapes patients' conceptualizations about self-advocacy and in turn influences their health care attitudes and behaviors. The purpose of this discourse analysis is to explore the language of self-advocacy by comparing a published self-advocacy guide with the lived experiences of women with ovarian cancer. Data sources include (1) a self-advocacy patient education guide published by the National Coalition for Cancer Survivorship and (2) transcripts of focus groups conducted with ovarian cancer survivors. Discourse analysis techniques were used to take a close look at the language used by both to uncover the meaning each group ascribed to self-advocacy. Challenges and inconsistencies were noted between the patient education guide and transcripts including viewing self-advocacy as a skill set to assert one's needs as opposed to a means by which to preserve a positive attitude and maintain a trusting relationship with health care providers, respectively. Some women saw themselves as self-advocates yet struggled to locate relevant health information and hesitated to upset their relationship with their health care providers. This analysis highlights tensions between the discourses and points to ways in which patient education materials can be adjusted to support cancer survivors in advocating for their needs according to their unique situations and preferences.

  2. Engaging patients in public policy advocacy.

    PubMed

    Collins, Charlotte W; Moore, Nuala S

    2014-02-01

    Health professionals can and should be game-changing influencers of U.S. health policies. The American Thoracic Society (ATS) is enabling its members to advocate on important issues through such initiatives as the Breathing Better Alliance network and the annual ATS Hill Day. Patients are also organizing to make their voices heard by participating in the member organizations of the ATS Public Advisory Roundtable and by accompanying ATS members and staff on visits to legislators and government regulators. If we join together, we can amplify our messages and promote better health policies. Doing so will require us to embrace a partnership steeped in trust and hope. PMID:24575996

  3. 76 FR 78931 - Food and Drug Administration Rare Disease Patient Advocacy Day; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-20

    ... HUMAN SERVICES Food and Drug Administration Food and Drug Administration Rare Disease Patient Advocacy Day; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. The Food and Drug... Disease Patient Advocacy Day. This meeting is intended to enhance the awareness of the rare...

  4. Predicting Patient Advocacy Engagement: A Multiple Regression Analysis Using Data From Health Professionals in Acute-Care Hospitals.

    PubMed

    Jansson, Bruce S; Nyamathi, Adeline; Heidemann, Gretchen; Duan, Lei; Kaplan, Charles

    2015-01-01

    Although literature documents the need for hospital social workers, nurses, and medical residents to engage in patient advocacy, little information exists about what predicts the extent they do so. This study aims to identify predictors of health professionals' patient advocacy engagement with respect to a broad range of patients' problems. A cross-sectional research design was employed with a sample of 94 social workers, 97 nurses, and 104 medical residents recruited from eight hospitals in Los Angeles. Bivariate correlations explored whether seven scales (Patient Advocacy Eagerness, Ethical Commitment, Skills, Tangible Support, Organizational Receptivity, Belief Other Professionals Engage, and Belief the Hospital Empowers Patients) were associated with patient advocacy engagement, measured by the validated Patient Advocacy Engagement Scale. Regression analysis examined whether these scales, when controlling for sociodemographic and setting variables, predicted patient advocacy engagement. While all seven predictor scales were significantly associated with patient advocacy engagement in correlational analyses, only Eagerness, Skills, and Belief the Hospital Empowers Patients predicted patient advocacy engagement in regression analyses. Additionally, younger professionals engaged in higher levels of patient advocacy than older professionals, and social workers engaged in greater patient advocacy than nurses. Limitations and the utility of these findings for acute-care hospitals are discussed. PMID:26317762

  5. Predicting Patient Advocacy Engagement: A Multiple Regression Analysis Using Data From Health Professionals in Acute-Care Hospitals.

    PubMed

    Jansson, Bruce S; Nyamathi, Adeline; Heidemann, Gretchen; Duan, Lei; Kaplan, Charles

    2015-01-01

    Although literature documents the need for hospital social workers, nurses, and medical residents to engage in patient advocacy, little information exists about what predicts the extent they do so. This study aims to identify predictors of health professionals' patient advocacy engagement with respect to a broad range of patients' problems. A cross-sectional research design was employed with a sample of 94 social workers, 97 nurses, and 104 medical residents recruited from eight hospitals in Los Angeles. Bivariate correlations explored whether seven scales (Patient Advocacy Eagerness, Ethical Commitment, Skills, Tangible Support, Organizational Receptivity, Belief Other Professionals Engage, and Belief the Hospital Empowers Patients) were associated with patient advocacy engagement, measured by the validated Patient Advocacy Engagement Scale. Regression analysis examined whether these scales, when controlling for sociodemographic and setting variables, predicted patient advocacy engagement. While all seven predictor scales were significantly associated with patient advocacy engagement in correlational analyses, only Eagerness, Skills, and Belief the Hospital Empowers Patients predicted patient advocacy engagement in regression analyses. Additionally, younger professionals engaged in higher levels of patient advocacy than older professionals, and social workers engaged in greater patient advocacy than nurses. Limitations and the utility of these findings for acute-care hospitals are discussed.

  6. Social justice advocacy in nursing: what is it? How do we get there?

    PubMed

    Paquin, Siobhan O'Mahony

    2011-01-01

    Social justice advocacy is an expectation of all nurses as expressed in the professional codes that guide nursing practice. Nursing literature reflects this shift in the focus of nursing advocacy, providing insight into the potentials and challenges associated with nursing's evolution toward a broader social justice advocacy model. This article describes the concept of social justice advocacy as currently reflected in professional codes and nursing literature and contrasts this with the individual patient-nurse advocacy model, which continues to dominate in nursing practice today. Challenges associated with movement toward a social justice advocacy model and options for addressing these hurdles are also discussed.

  7. \\Defining Patient Advocacy for the Context of Clinical Ethics Consultation: A Review of the Literature and Recommendations for Consultants.

    PubMed

    Brazg, Tracy; Lindhorst, Taryn; Dudzinski, Denise; Wilfond, Benjamin

    2016-01-01

    The idea of patient advocacy as a function of clinical ethics consultation (CEC) has been debated in the bioethics literature. In particular, opinion is divided as to whether patient advocacy inherently is in conflict with the other duties of the ethics consultant, especially that of impartial mediator. The debate is complicated, however, because patient advocacy is not uniformly conceptualized. This article examines two literatures that are crucial to understanding patient advocacy in the context of bioethical deliberations: the CEC literature and the literature on advocacy in the social work profession. A review of this literature identifies four distinct approaches to patient advocacy that are relevant to CEC: (1) the best interest approach, (2) the patient rights approach, (3) the representational approach, and (4) the empowerment approach. After providing a clearer understanding of the varied meanings of patient advocacy in the context of CEC, we assert that patient advocacy is not inherently inconsistent with the function of the ethics consultant and the CEC process. Finally, we provide a framework to help consultants determine if they should adopt an advocacy role.

  8. Financial stability in biobanking: unique challenges for disease-focused foundations and patient advocacy organizations.

    PubMed

    Bromley, Russell L

    2014-10-01

    In the last decade, many disease-focused foundations and patient advocacy organizations that support biomedical research have created patient registries and biobanks. This article reviews the motivations behind the creation of those biobanks and how they are different from biobanks sponsored by government or industry. It also discusses some of the different funding models being employed by these organizations. Finally, it highlights some of the unique challenges faced by disease-focused foundations and advocacy organizations that sponsor biobanks, and how they are overcoming those challenges to achieve both financial and operational sustainability.

  9. Generating sociability to drive science: patient advocacy organizations and genetics research.

    PubMed

    Panofsky, Aaron

    2011-02-01

    This paper examines how patient advocacy organizations (PAOs) representing those with rare genetic disorders drive research to their concerns. The rarity of the diseases produces a basic condition of marginalization: small numbers of widely distributed disease sufferers. The lack of promise of an eventual market makes it difficult to attract the economic and biological resources necessary for sustained research. My analysis relies mainly on 21 interviews with leaders from nine PAOs and scientists involved with them, and seeks to understand how PAOs try to attract and influence scientific research. Using a comparative framework, I find that the five main mechanisms emphasized in the literature--economic resources, social movement-style mobilization, moving early, lay expertise, and organizational controls--cannot fully explain the differences in strategies and relationships among members of my PAO sample. I propose instead to show how 'sociability'--forging close relationships with scientists and orchestrating relationships among them--enables PAOs to drive research to their concerns. I show how the strategic manipulation of sociability can give PAOs substantial influence over the research process. However, the forms of sociability that yield the greatest effects are difficult to achieve, and most forms of relationship-building offer PAOs much less influence on research.

  10. An exploration of the relationship between patient autonomy and patient advocacy: implications for nursing practice.

    PubMed

    Hyland, Deirdre

    2002-09-01

    The purpose of this article is to examine whether patient/client autonomy is always compatible with the nurse's role of advocacy. The author looks separately at the concepts of autonomy and advocacy, and considers them in relation to the reality of clinical practice from professional, ethical and legal perspectives. Considerable ambiguity is found regarding the legitimacy of claims of a unique function for nurses to act as patient advocates. To act as an advocate may put nurses at personal and professional risk. It may also be deemed arrogant and insulting to other health care professionals. Patient autonomy can be seen as a subcategory of the right of every individual to self-determination, and as such is protected by law. However, it is questionable whether the traditionally paternalistic approach to health care provision truly respects the autonomous rights of each patient. The author considers examples and cases from the literature that resulted in professional and/or personal difficulties for the nurses involved, and also reflects on an incident from her own practice where a positive outcome was achieved that demonstrated compatibility between the concepts under consideration.

  11. The mental patients' rights movement and mental health institutional change.

    PubMed

    Brown, P

    1981-01-01

    The mental patients' rights movement has added to the widespread critique of institutional psychiatry and provided leadership in opposing treatment methods such as electroshock, psychosurgery, and overdrugging, which are dangerous and regressive not only to patients, but to the expanded population of non-institutionalized persons as well. The movement has had some success in court cases for democratic rights, such as the right to treatment, the right to refuse treatment, patient labor, and commitment law. At the same time patients' rights demands have been partly coopted by mental health administrators. In a number to cases, mental health officials supported patients' rights litigation because it enabled them to speed up their deinstitutionalization programs. Overall, the conjuncture of the movement with economic impetus toward deinstitutionalization has allowed mental health planners to use the patients' rights issues to justify their essentially fiscal policy. Providers and administrators have set up advocacy offices, posted patients' bills of rights, and incorporated ex-patient representatives on advisory boards. Yet mental health administrators are generally opposed to a broad application of patients' rights. PMID:7333723

  12. Advocacy at the end of life: meeting the needs of vulnerable Latino patients.

    PubMed

    Nedjat-Haiem, Frances R; Carrion, Iraida V; Cribbs, Kristen; Lorenz, Karl

    2013-01-01

    This research explores health care professionals' understanding of the problems that arise in managing a terminal condition impacting the Latino population and conceptualizes the components of patient advocacy that address gaps in end-of-life care for patients and their family members. Limited research exists regarding patient advocacy from the perspectives of health care providers working with vulnerable Latino populations utilizing a public sector health care system. Forty-six semi-structured interviews were conducted with providers from different disciplines including medicine, nursing, social work, and chaplaincy. Although roles and responsibilities vary among health providers, it is imperative that all providers become aware of the need for patient advocacy. Doing so is not only in the best interest of vulnerable Latino populations but also has overarching financial benefits and positive outcomes for patients, administrators, and public health care systems. Social workers are the ideal professionals to assume leadership roles and share their knowledge of how to advocate effectively for the most vulnerable populations. PMID:23865972

  13. Professionalization as an Advocacy Strategy: A Content Analysis of Canadian Child Care Social Movement Organizations' 2008 Discursive Resources

    ERIC Educational Resources Information Center

    Langford, Rachel; Prentice, Susan; Albanese, Patrizia; Summers, Bernadette; Messina-Goertzen, Brianne; Richardson, Brooke

    2013-01-01

    Do early childhood education and care (ECEC) professionals make good advocates? Canadian advocates have fought for better child care policies since the mid-1940s. What has happened to this advocacy with the recent increased professionalization of the ECEC sector? How does increased professionalization limit, innovate or expand advocacy strategies?…

  14. The myth of advocacy.

    PubMed

    Stone, A A

    1979-12-01

    In an era in which advocacy has become a buzzword, both psychiatry and the legal profession have climbed aboard the advocacy bandwagon. Yet the American Psychiatric Association's notion of advocacy--championing the medical needs of patients--is often in direct conflict with the lawyers' notion of advocacy--championing the legal rights of their clients. The author observes that psychiatry has proved to be a weak adversary for patients' legal advocates; the result has been a one-sided advocacy system that has advanced patients' rights at the expense of their needs. He believes that if the APA is to become an effective advocate for patients, it must hire lawyers and work with them to reverse the trend of turning rights into needs.

  15. Integrating medical ethics with normative theory: patient advocacy and social responsibility.

    PubMed

    Jecker, N S

    1990-06-01

    It is often assumed that the chief responsibility medical professionals bear is patient care and advocacy. The meeting of other duties, such as ensuring a more just distribution of medical resources and promoting the public good, is not considered a legitimate basis for curtailing or slackening beneficial patient services. It is argued that this assumption is often made without sufficient attention to foundational principles of professional ethics; that once core principles are laid bare this assumption is revealed as largely unwarranted; and, finally, that these observations at the level of moral theory should be reflected, in various ways, in medical practice. Specifically, this essay clarifies a tension that exists between different kinds of moral principles and explores the possibility of dissipating that tension by shoring up foundational principles. The paper begins by setting out three alternative models of how best to balance patient advocacy responsibilities with broader social responsibilities. It then turns to critically assess these models and argue that one has several advantages over the others. PMID:2203177

  16. Integrating medical ethics with normative theory: patient advocacy and social responsibility.

    PubMed

    Jecker, N S

    1990-06-01

    It is often assumed that the chief responsibility medical professionals bear is patient care and advocacy. The meeting of other duties, such as ensuring a more just distribution of medical resources and promoting the public good, is not considered a legitimate basis for curtailing or slackening beneficial patient services. It is argued that this assumption is often made without sufficient attention to foundational principles of professional ethics; that once core principles are laid bare this assumption is revealed as largely unwarranted; and, finally, that these observations at the level of moral theory should be reflected, in various ways, in medical practice. Specifically, this essay clarifies a tension that exists between different kinds of moral principles and explores the possibility of dissipating that tension by shoring up foundational principles. The paper begins by setting out three alternative models of how best to balance patient advocacy responsibilities with broader social responsibilities. It then turns to critically assess these models and argue that one has several advantages over the others.

  17. Movement disorders in patients with diabetes mellitus.

    PubMed

    Jagota, Priya; Bhidayasiri, Roongroj; Lang, Anthony E

    2012-03-15

    Movement disorders are not infrequent in patients with diabetes mellitus. These may occur on the basis of both central and peripheral nervous system dysfunction and can be secondary to severe hyperglycemia, complications of diabetes or its treatment and less often to diseases in which both diabetes and a movement disorder are primary manifestations of the same underlying disease. We present a typical case of a severe movement disorder complicating diabetes as a springboard to review the spectrum of disorders associated with this condition.

  18. Vergence Eye Movements in Patients with Schizophrenia

    PubMed Central

    Bolding, MS; Lahti, AC; White, D; Moore, C; Gurler, D; Gawne, TJ; Gamlin, PD

    2014-01-01

    Previous studies have shown that smooth pursuit eye movements are impaired in patients with schizophrenia. However, under normal viewing conditions, targets move not only in the frontoparallel plane but also in depth, and tracking them requires both smooth pursuit and vergence eye movements. Although previous studies in humans and non-human primates suggest that these two eye movement subsystems are relatively independent of one another, to our knowledge, there have been no prior studies of vergence tracking behavior in patients with schizophrenia. Therefore, we have investigated these eye movements in patients with schizophrenia and in healthy controls. We found that patients with schizophrenia exhibited substantially lower gains compared to healthy controls during vergence tracking at all tested speeds (e.g. 0.25 Hz vergence tracking mean gain of 0.59 vs. 0.86). Further, consistent with previous reports, patients with schizophrenia exhibited significantly lower gains than healthy controls during smooth pursuit at higher target speeds (e.g. 0.5 Hz smooth pursuit mean gain of 0.64 vs. 0.73). In addition, there was a modest (r≈0.5), but significant, correlation between smooth pursuit and vergence tracking performance in patients with schizophrenia. Our observations clearly demonstrate substantial vergence tracking deficits in patients with schizophrenia. In these patients, deficits for smooth pursuit and vergence tracking are partially correlated suggesting overlap in the central control of smooth pursuit and vergence eye movements. PMID:25088242

  19. Bladder Cancer Advocacy Network

    MedlinePlus

    ... future bladder cancer research through the Patient Survey Network. Read More... The JPB Foundation 2016 Bladder Cancer ... 2016 Young Investigator Awardees The Bladder Cancer Advocacy Network (BCAN) has announced the recipients of the 2016 ...

  20. A pilot study of selected Japanese nurses' ideas on patient advocacy.

    PubMed

    Davis, Anne J; Konishi, Emiko; Tashiro, Marie

    2003-07-01

    This pilot study had two purposes: (1) to review recent Japanese nursing literature nursing advocacy; and (2) to obtain data from nurses on advocacy. For the second purpose, 24 nurses at a nursing college in Japan responded to a questionnaire. The concept of advocacy, taken from the West, has become an ethical ideal for Japanese nurses but one that they do not always understand, or, if they do, they find it difficult to fulfil. They cite nursing leadership support as necessary to enacting this role. Discussion on meaning of and the rationale for advocacy in a society where goodness or badness is relative to social situations and its impact may reveal two parallel but overlapping views of morality. Such a situation would not only influence notions of advocacy but also possibly render them more complex.

  1. Resident guide to advocacy in dermatology.

    PubMed

    Park, Kelly K

    2015-12-01

    Many opportunities exist for residents to get involved in advocacy in dermatology, from national to grassroots levels. Residents also should be aware of opportunities to get involved in patient advocacy and become familiar with the myriad of patient advocacy groups that exist. These groups offer support and education for patients and initiate research efforts for specific dermatologic conditions that provide support for patients beyond what can be offered during a standard office visit. The value of resident involvement in advocacy also is discussed.

  2. Library Advocacy

    ERIC Educational Resources Information Center

    Plunkett, Kate

    2010-01-01

    This paper is about the issue of advocacy. Standing at the vanguard of literacy, library media specialists have a unique role. However, it is time for media specialists to advocate their services in a proactive way. If library media specialists cannot, both individually and collectively, put advocacy at the forefront, then students will suffer the…

  3. Advocacy Simplified

    ERIC Educational Resources Information Center

    Dowd, Karen J.; Curva, Fely

    2008-01-01

    Most state professional associations promote and fund at some level, an advocacy program. These advocacy programs usually aim to support or plead for a program, policy, or proposal. They can range from simple communication to complex strategies, from daily interactions to annual productions, and from position papers to onsite, legislative visits.…

  4. Advocacy ABC's

    ERIC Educational Resources Information Center

    Sims, Sandra

    2008-01-01

    Advocacy is a continuous process that involves more than simply passing legislation. It is a year-round commitment that involves educating policymakers about the importance of achieving health and wellness in any state. As such, it is important for the advocacy group to have a plan, be organized, and work together toward a unified goal. Success is…

  5. Inadvertent advocacy.

    PubMed

    Wilhere, George F

    2012-02-01

    Policy advocacy is an issue regularly debated among conservation scientists. These debates have focused on intentional policy advocacy by scientists, but advocacy can also be unintentional. I define inadvertent policy advocacy as the act of unintentionally expressing personal policy preferences or ethical judgments in a way that is nearly indistinguishable from scientific judgments. A scientist may be well intentioned and intellectually honest but still inadvertently engage in policy advocacy. There are two ways to inadvertently engage in policy advocacy. First, a scientist expresses an opinion that she or he believes is a scientific judgment but it is actually an ethical judgment or personal policy preference. Second, a scientist expresses an opinion that he or she knows is an ethical judgment or personal policy preference but inadvertently fails to effectively communicate the nature of the opinion to policy makers or the public. I illustrate inadvertent advocacy with three examples: recovery criteria in recovery plans for species listed under the U.S. Endangered Species Act, a scientific peer review of a recovery plan for the Northern Spotted Owl (Strix occidentalis caurina), and the International Union for Conservation of Nature's definition of threatened. In each example, scientists expressed ethical judgments or policy preferences, but their value judgments were not identified as such, and, hence, their value judgments were opaque to policy makers and the public. Circumstances suggest their advocacy was inadvertent. I believe conservation scientists must become acutely aware of the line between science and policy and avoid inadvertent policy advocacy because it is professional negligence, erodes trust in scientists and science, and perpetuates an ethical vacuum that undermines the rational political discourse necessary for the evolution of society's values. The principal remedy for inadvertent advocacy is education of conservation scientists in an effort to

  6. Rethinking the therapeutic misconception: social justice, patient advocacy, and cancer clinical trial recruitment in the US safety net

    PubMed Central

    2014-01-01

    Background Approximately 20% of adult cancer patients are eligible to participate in a clinical trial, but only 2.5-9% do so. Accrual is even less for minority and medically underserved populations. As a result, critical life-saving treatments and quality of life services developed from research studies may not address their needs. This study questions the utility of the bioethical concern with therapeutic misconception (TM), a misconception that occurs when research subjects fail to distinguish between clinical research and ordinary treatment, and therefore attribute therapeutic intent to research procedures in the safety net setting. This paper provides ethnographic insight into the ways in which research is discussed and related to standard treatment. Methods In the course of two years of ethnographic fieldwork in a safety net hospital, I conducted clinic observations (n = 150 clinic days) and in-depth in-person qualitative interviews with patients (n = 37) and providers (n = 15). I used standard qualitative methods to organize and code resulting fieldnote and interview data. Results Findings suggest that TM is limited in relevance for the interdisciplinary context of cancer clinical trial recruitment in the safety net setting. Ethnographic data show the value of the discussions that happen prior to the informed consent, those that introduce the idea of participation in research. These preliminary discussions are elemental especially when recruiting underserved and vulnerable patients for clinical trial participation who are often unfamiliar with medical research and how it relates to medical care. Data also highlight the multiple actors involved in research discussions and the ethics of social justice and patient advocacy they mobilize, suggesting that class, inequality, and dependency influence the forms of ethical engagements in public hospital settings. Conclusion On the ground ethics of social justice and patient advocacy are more relevant than

  7. Effective advocacy for patients with inflammatory bowel disease: communication with insurance companies, school administrators, employers, and other health care overseers.

    PubMed

    Jaff, Jennifer C; Arnold, Janis; Bousvaros, Athos

    2006-08-01

    In addition to their physical challenges, children and adolescents with inflammatory bowel disease (IBD) living in the United States face a number of administrative and regulatory hurdles that affect their quality of life. This article, written by a physician, attorney/patient advocate, and social worker, discusses a number of these challenges and describes how the provider can help his or her patient overcome them. Specifically, the article discusses 4 areas in detail: appeals of denials of coverage from insurance companies and third party payors; assisting children with IBD with classroom and school accommodations; assisting uninsured children in obtaining Social Security benefits; and aiding a parent to care for their child using the Family and Medical Leave Act. Although this article has a pediatric focus, adults have similar advocacy needs. Case examples and sample letters to third-party payors, schools, and employers are included in this article.

  8. Advocacy for eye care

    PubMed Central

    Ravilla, Thulasiraj D; Ramasamy, Dhivya

    2012-01-01

    The effectiveness of eye care service delivery is often dependant on how the different stakeholders are aligned. These stakeholders range from the ministries of health who have the capacity to grant government subsidies for eye care, down to the primary healthcare workers who can be enrolled to screen for basic eye diseases. Advocacy is a tool that can help service providers draw the attention of key stakeholders to a particular area of concern. By enlisting the support, endorsement and participation of a wider circle of players, advocacy can help to improve the penetration and effectiveness of the services provided. There are several factors in the external environmental that influence the eye care services – such as the availability of trained manpower, supply of eye care consumables, government rules and regulations. There are several instances where successful advocacy has helped to create an enabling environment for eye care service delivery. Providing eye care services in developing countries requires the support – either for direct patient care or for support services such as producing trained manpower or for research and dissemination. Such support, in the form of financial or other resources, can be garnered through advocacy. PMID:22944745

  9. Advocacy for Art Education: Beyond Tee-Shirts and Bumper Stickers

    ERIC Educational Resources Information Center

    Bobick, Bryna; DiCindio, Carissa

    2012-01-01

    Advocacy is not new to art education. Over the years, Goldfarb (1979), Hodsoll (1985), and Erickson and Young (1996) have written about the importance of arts advocacy, but the concept of advocacy has evolved with the times. For example, in the 1970s, arts advocacy was described as a "movement" and brought together art educators, administrators,…

  10. Post-stroke movement disorders: report of 56 patients

    PubMed Central

    Alarcon, F; Zijlmans, J; Duenas, G; Cevallos, N

    2004-01-01

    Background: Although movement disorders that occur following a stroke have long been recognised in short series of patients, their frequency and clinical and imaging features have not been reported in large series of patients with stroke. Methods: We reviewed consecutive patients with involuntary abnormal movements (IAMs) following a stroke who were included in the Eugenio Espejo Hospital Stroke Registry and they were followed up for at least one year after the onset of the IAM. We determined the clinical features, topographical correlations, and pathophysiological implications of the IAMs. Results: Of 1500 patients with stroke 56 developed movement disorders up to one year after the stroke. Patients with chorea were older and the patients with dystonia were younger than the patients with other IAMs. In patients with isolated vascular lesions without IAMs, surface lesions prevailed but patients with deep vascular lesions showed a higher probability of developing abnormal movements. One year after onset of the IAMs, 12 patients (21.4%) completely improved their abnormal movements, 38 patients (67.8%) partially improved, four did not improve (7.1%), and two patients with chorea died. In the nested case–control analysis, the patients with IAMs displayed a higher frequency of deep lesions (63% v 33%; OR 3.38, 95% CI 1.64 to 6.99, p<0.001). Patients with deep haemorrhagic lesions showed a higher probability of developing IAMs (OR 4.8, 95% CI 0.8 to 36.6). Conclusions: Chorea is the commonest movement disorder following stroke and appears in older patients. Involuntary movements tend to persist despite the functional recovery of motor deficit. Deep vascular lesions are more frequent in patients with movement disorders. PMID:15489389

  11. Evaluation of Advocacy Models.

    ERIC Educational Resources Information Center

    Bradley, Valerie J.

    The paper describes approaches and findings of an evaluation of 10 advocacy projects providing services to developmentally disabled and mentally ill persons across the country. The projects included internal rights protection organizations, independent legal advocacy mechanisms, self-advocacy training centers, and legal advocacy providers in…

  12. (R)evolution: toward a new paradigm of policy and patient advocacy for expanded access to experimental treatments.

    PubMed

    Hogan, Melissa

    2016-01-01

    In life-threatening conditions such as cancer and rare diseases, where there is no cure and no U.S. Food and Drug Administration (FDA)-approved therapy, patients sometimes seek access to an unapproved, experimental therapy through expanded access programs as their last, best hope for treatment to save their lives. Since the 1980s, the policies and the practice of expanded access have evolved, but a common challenge remains that there is no obligation, and often little incentive, for manufacturers to offer expanded access programs, especially for individual patients. In recent years, online campaigns seeking access to an experimental therapy have become more common, paralleling growth in and representing an intersection of social media, digital health, and patient advocacy.Mackey and Schoenfeld have examined the evolution of expanded access policy, practice, and trends, as well as case studies of online campaigns to access experimental therapies, to arrive at several recommendations for the future of expanded access. This commentary puts their paper in context, examines their recommendations, and suggests further reforms.Please see related article: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-016-0568-8. PMID:26926908

  13. Pharmaceuticals and the consumer movement: the ambivalences of 'patient power'.

    PubMed

    Lofgren, Hans

    2004-11-01

    Consumer and patient advocacy groups (PAGs) are important participants in the politics of pharmaceuticals. Yet very little is known about the precise nature and extent of their influence. It is argued in this article that PAGs fulfil a mixed role within the health system at national and transnational levels, and that they are at times fully incorporated into economic and political power structures. Their frequent dependence on pharma industry funding is of particular concern. PAGs provide a means of direct industry interaction with the final customer, thereby partially bypassing and putting additional pressure on doctors and regulators. The article presents the case for research to establish a better empirical base for discussions about the role of PAGs within contemporary neo-liberal governance structures. PMID:15527403

  14. Extra patient movement during mammographic imaging: an experimental study

    PubMed Central

    Brettle, D; Howard, D; Kelly, J; Millington, S; Hogg, P

    2014-01-01

    Objective: To determine if movement external to the patient occurring during mammography may be a source of image blur. Methods: Four mammography machines with eight flexible and eight fixed paddles were evaluated. In the first stage, movement at the paddle was measured mechanically using two calibrated linear potentiometers. A deformable breast phantom was used to mimic a female breast. For each paddle, the movement in millimetres and change in compression force in Newton was recorded at 0.5- and 1-s intervals, respectively, for 40 s with the phantom in an initially compressed state under a load of 80 N. In the second stage, clinical audit on 28 females was conducted on one mammography machine with the 18 × 24- and 24 × 29-cm flexible paddles. Results: Movement at the paddle followed an exponential decay with a settling period of approximately 40 s. The compression force readings for both fixed and flexible paddles decreased exponentially with time, while fixed paddles had a larger drop in compression force than did flexible paddles. There is a linear relationship between movement at the paddle and change in compression force. Conclusion: Movement measured at the paddle during an exposure can be represented by a second order system. The amount of extra patient movement during the actual exposure can be estimated using the linear relationship between movement at the paddle and the change in compression force. Advances in knowledge: This research provides a possible explanation to mammography image blurring caused by extra patient movement and proposes a theoretical model to analyse the movement. PMID:25348098

  15. Clinical ethics and patient advocacy: the power of communication in health care.

    PubMed

    Emrich, Inken Annegret; Fröhlich-Güzelsoy, Leyla; Bruns, Florian; Friedrich, Bernd; Frewer, Andreas

    2014-06-01

    In recent years, the rights of patients have assumed a more pivotal role in international discussion. Stricter laws on the protection of patients place greater priority on the perspective and the status of patients. The purpose of this study is to emphasize ethical aspects in communication, the role of patient advocates as contacts for the concerns and suggestions of patients, and how many problems of ethics disappear when communication is highlighted. We reviewed 680 documented cases of consultation in a 10-year period of patient advocates' activity at a big German university hospital with 1,300 beds. On the basis of this extensive material, the article will focus on the intersection of the advocate's work with the problems of patients in hospitals. Deficits in the level of communication between health care professionals and patients were frequently uncovered. Patients primarily complain about the lack of dialogue and empathy. Middle-aged patients consulted the patients' advocate disproportionately more often. Measured against this baseline, the group of 65 and older complained less frequently. Besides complaints the advocate was asked in more than one-third of all cases for information about medical matters, hospital regulations or administrative problems. Patients obviously see the advocate as a well-connected and ideally unbiased contact person for uncertainties concerning their malady or a potential stay in hospital. Those seeking help often set hope in the information given by the voluntary patient representative. It should be highly recommended for every German hospital to establish the position of a patient advocate. Furthermore, patients can profit from regular exchange between the advocate and the Ethics Committee, also, to help ensure that their rights are taken into account and implemented in an ethically desirable context.

  16. Analysis of patient movement during 3D USCT data acquisition

    NASA Astrophysics Data System (ADS)

    Ruiter, N. V.; Hopp, T.; Zapf, M.; Kretzek, E.; Gemmeke, H.

    2016-04-01

    In our first clinical study with a full 3D Ultrasound Computer Tomography (USCT) system patient data was acquired in eight minutes for one breast. In this paper the patient movement during the acquisition was analyzed quantitatively and as far as possible corrected in the resulting images. The movement was tracked in ten successive reflectivity reconstructions of full breast volumes acquired during 10 s intervals at different aperture positions, which were separated by 41 s intervals. The mean distance between initial and final position was 2.2 mm (standard deviation (STD) +/- 0.9 mm, max. 4.1 mm, min. 0.8 mm) and the average sum of all moved distances was 4.9 mm (STD +/- 1.9 mm, max. 8.8 mm, min. 2.7 mm). The tracked movement was corrected by summing successive images, which were transformed according to the detected movement. The contrast of these images increased and additional image content became visible.

  17. Decreased Nocturnal Movements in Patients with Facioscapulohumeral Muscular Dystrophy

    PubMed Central

    Marca, Giacomo Della; Frusciante, Roberto; Dittoni, Serena; Vollono, Catello; Losurdo, Anna; Testani, Elisa; Scarano, Emanuele; Colicchio, Salvatore; Iannaccone, Elisabetta; Tonali, Pietro A.; Ricci, Enzo

    2010-01-01

    Study Objectives: Reduced mobility during sleep characterizes a variety of movement disorders and neuromuscular diseases. Facioscapulohumeral muscular dystrophy (FSHD) is the third most common form of muscular dystrophy in the general population, and people with FSHD have poor sleep quality. The aims of the present study were to evaluate nocturnal motor activity in patients with FSHD by means of videopolysomnography and to verify whether activity was associated with modifications in sleep structure. Methods: We enrolled 32 adult patients affected by genetically confirmed FSHD (18 women and 14 men, mean age 45.1 ± 13.4 years) and 32 matched control subjects, (18 women and 14 men, mean age 45.5 ± 11.4 years). Major body movements (MBM) were scored in videopolygraphic recordings in accordance with established criteria. An MBM index was calculated (number of MBM per hour of sleep). Results: The FSHD group showed a decrease in the MBM index (FSHD: 1.2 ± 1.1; control subjects: 2.3 ± 1.2, analysis of variance F = 13.672; p = 0.008). The sleep pattern of patients with FSHD, as compared with that of controls, was characterized by longer sleep latencies, shorter sleep durations, an increased percentage of wake during sleep, and a decreased percentage of rapid eye movement sleep. In the patient group, the MBM index was inversely correlated with severity of disease (Spearman test: r30 = −0.387; p < 0.05). Conclusions: The present findings suggest that patients with FSHD have a reduced number of nocturnal movements, which is related to disease severity. Reduced movement in bed may contribute to the sleep modifications observed in these patients. Citation: Marca GD; Frusciante R; Dittoni S; Vollono C; Losurdo A; Testani E; Scarano E; Colicchio S; Iannaccone E; Tonali PA; Ricci E. Decreased nocturnal movements in patients with facioscapulohumeral muscular dystrophy. J Clin Sleep Med 2010;6(3):276-280. PMID:20572422

  18. Patient perception of tics and other movement disorders.

    PubMed

    Lang, A

    1991-02-01

    To determine the subjective perception patients have of abnormal movements, 170 patients with various hyperkinesias were interviewed with questions directed at the "voluntary" or intentional versus "involuntary" aspects of their symptoms. One hundred and two of 110 patients with non-tic disorders thought that the abnormal movements were entirely involuntary. Forty-one of 60 tic disorder patients stated that all their motor and phonic tics were intentionally produced. Fifteen others had both voluntary and involuntary components, usually with the former predominating. A "voluntary" response could be used to predict the correct diagnostic category (tic versus non-tic) in 8 of 9 patients for whom the referral category was incorrect. These results suggest that a large proportion of the motor and phonic symptoms experienced by tic patients are irresistibly but purposefully executed, more akin to compulsions than to the other "involuntary" hyperkinesias with which they are commonly discussed.

  19. [Self-Advocacy.

    ERIC Educational Resources Information Center

    Carr, Theresa, Ed.

    1994-01-01

    This theme issue presents personal perspectives and approaches to self-advocacy from individuals who are deaf-blind. Individual articles are: (1) "Self-Advocacy: Attaining Personal Stature" by Michelle J. Smithdas; (2) "The American Association of the Deaf-Blind: A National Consumer Advocacy Organization" by Jeffrey S. Bohrman; (3) a description…

  20. Hemiballistic movements in a newly HIV patient.

    PubMed

    Magano, Rita; Jorge, Rita; Prata, Margarida; Ventura, Maria Conceição; Saraiva da Cunha, José Gabriel

    2016-01-01

    Infections of central nervous system (CNS) include a broad group of conditions and pose a particular challenge to physicians, especially in immunocompromised individuals. This case refers to a 26-year-old male patient with a history of smoked hashish and drug abuse admitted to the infectious disease department with hemiballismus of left hemibody and a positive HIV serologic test. A magnetic resonance imaging (MRI) study showed lesions at lower left and right cerebellar hemisphere, one of them thalamus - mesencephalic suggesting an opportunistic infection or an HIV associated encephalopathy. Lumbar puncture, brain biopsy and successive neuroimaging were not conclusive for one disease and despite the use of directed therapy for cerebral toxoplasmosis, meningeal tuberculosis, anti-retrovirals and sedative medication, after over 6 weeks of hospitalization pallidotomy was performed. After 5 months of oral and surgical treatment the patient showed clinical, immunological and radiological recovery. PMID:27583209

  1. Electrophysiology of the corticomotoneurone pathways in patients with movement disorders.

    PubMed

    Thompson, P D; Dick, J P; Day, B L; Rothwell, J C; Berardelli, A; Kachi, T; Marsden, C D

    1986-01-01

    The corticomotoneurone pathways were examined in 21 patients with movement disorders, using the technique of percutaneous electrical stimulation of the motor cortex. Conduction in these pathways was assessed by measuring the latency to onset of electromyographic activity in the muscles of the upper limb after cortical stimulation. In all patients [five with primary (idiopathic) torsion dystonia and two with secondary (symptomatic) hemidystonia, seven with Huntington's disease, four with essential tremor, and three with Parkinson's disease] central motor conduction was normal. This and other evidence suggests that the origin of the disorder of movement in these conditions lies in the delivery of abnormal motor commands to a normal corticomotoneuronal system. PMID:3504237

  2. Advocacy: exploring the concept.

    PubMed

    Mardell, A

    1996-10-01

    The concept of the nurse as the patient's advocate is one that has become popular in the last fifteen years or so in both North America and the United Kingdom, having its basis in nursing theory. The UKCC first embraced the concept, stating in the Code of Professional Conduct that nurses must; 'act always in such a manner so as to promote and safeguard the interests and well being of patients and clients'. This is a laudable principle and one that nurses cannot dispute as there are many members of our society who are weak and vulnerable and may be unable to speak up for themselves. But are nurses always in a position to be an advocate for their patients? As the nature of nursing is so diverse then the nature of advocacy will be different in the multifarious settings in which nurses practise. Can theatre nurses ever be in a position to act as an advocate for a patient who is often anaesthetised? What precisely is advocacy and is the Concise Oxford Dictionary definition of 'one who pleads for another' appropriate in the nursing context? Then there is the position of nurses in the healthcare organisation in which they practise. In advocating for their patients, nurses may find they are pleading a case for a patient, or a group of patients, that could bring the nurse into conflict with their medical colleagues or with the management of the organisation by whom they are employed. Additionally, they may not posses the skills and knowledge to advocate effectively under such circumstances. Nursing is littered with the casualties of such conflicts over the years, the most publicised of whom, in the UK, was probably Graham Pink who lost his job as a charge nurse after drawing public attention to what he considered to be an unacceptable standard of care in the hospital in which he worked. PMID:8974516

  3. Advocacy: exploring the concept.

    PubMed

    Mardell, A

    1996-10-01

    The concept of the nurse as the patient's advocate is one that has become popular in the last fifteen years or so in both North America and the United Kingdom, having its basis in nursing theory. The UKCC first embraced the concept, stating in the Code of Professional Conduct that nurses must; 'act always in such a manner so as to promote and safeguard the interests and well being of patients and clients'. This is a laudable principle and one that nurses cannot dispute as there are many members of our society who are weak and vulnerable and may be unable to speak up for themselves. But are nurses always in a position to be an advocate for their patients? As the nature of nursing is so diverse then the nature of advocacy will be different in the multifarious settings in which nurses practise. Can theatre nurses ever be in a position to act as an advocate for a patient who is often anaesthetised? What precisely is advocacy and is the Concise Oxford Dictionary definition of 'one who pleads for another' appropriate in the nursing context? Then there is the position of nurses in the healthcare organisation in which they practise. In advocating for their patients, nurses may find they are pleading a case for a patient, or a group of patients, that could bring the nurse into conflict with their medical colleagues or with the management of the organisation by whom they are employed. Additionally, they may not posses the skills and knowledge to advocate effectively under such circumstances. Nursing is littered with the casualties of such conflicts over the years, the most publicised of whom, in the UK, was probably Graham Pink who lost his job as a charge nurse after drawing public attention to what he considered to be an unacceptable standard of care in the hospital in which he worked.

  4. Building Trust: The History and Ongoing Relationships Amongst DSD Clinicians, Researchers, and Patient Advocacy Groups.

    PubMed

    Lossie, A C; Green, J

    2015-05-01

    Individuals born with differences or disorders of sex development (DSD) have been marginalized by society and the health care system. Standards of care in the mid-20(th) century were based on fixing the child with a DSD, using hormonal and surgical interventions; these treatments and the diagnoses were almost never disclosed to the child, and sometimes they were not disclosed to the parents. This led to secrecy, shame, and stigma. When these children became adults and demanded access to their medical records, the realization of the depth of secrecy led to the formation of activism groups that shook the medical community. Despite precarious beginnings, advocates, health care professionals, and researchers were able to elicit changes in the standard of care. The 2006 Consensus Statement on Management of Intersex Disorders called for a multidisciplinary approach to care and questioned the evidence for many of the standard procedures. Standard of care moved from a concealment model to a patient-centered paradigm, and funding agencies put resources into determining the future paths of research on DSD. Recognition of the need to address patient priorities led to changing international standards for including patients in research design. Some challenges that remain include: the findings from the Institute of Medicine that sexual and gender minorities experience poor health outcomes; establishing trust across all parties; developing a common language and creating venues where individuals can participate in dialogue that addresses personal experiences, research design, clinical practices and intervention strategies. PMID:25868122

  5. What Is Self-Advocacy? NRC Fact Sheet

    ERIC Educational Resources Information Center

    Hall, Mair

    2010-01-01

    Self-advocacy is about independent groups of people with disabilities working together for justice by helping each other take charge of their lives and fight discrimination. The seeds of the self-advocacy movement go back to 1968 when a Swedish parent's organization held a meeting for people with developmental disabilities. Today, the…

  6. The Big Picture of Advocacy: Counselor, Heal Society and Thyself

    ERIC Educational Resources Information Center

    Roysircar, Gargi

    2009-01-01

    This article, motivational in purpose, encourages counselors to be engaged in the growing movement for social justice advocacy in counseling. Analyses of a macrolevel framework of advocacy extend to microlevel operations of recruitment, sociopolitical education, diversity management, and self-care of counselor-advocates. Case studies and exemplars…

  7. Evaluation of Ocular Movements in Patients with Dyslexia

    ERIC Educational Resources Information Center

    Vagge, Aldo; Cavanna, Margherita; Traverso, Carlo Enrico; Iester, Michele

    2015-01-01

    The aims of this study were to analyze the relationship between dyslexia and eye movements and to assess whether this method can be added to the workup of dyslexic patients. The sample was comprised of 11 children with a diagnosis of dyslexia and 11 normal between 8 and 13 years of age. All subjects underwent orthoptic evaluation, ophthalmological…

  8. Movement disorders in ischemic stroke: clinical study of 22 patients.

    PubMed

    D'Olhaberriague, L; Arboix, A; Martí-Vilalta, J L; Moral, A; Massons, J

    1995-12-01

    Movement disorders (bemichorea-hemiballismus, hemidystonia and isolated tremor) are an uncommon clinical manifestation in ischemic stroke (IS), and their anatomical basis is poorly understood. We analyzed the clinical and neuroimaging characteristics of 22 consecutive patients who bad movement disorders associated with cerebral infarction (MDCI), studied at four institutions over 8 years. In one institution (from the La Alianza-Central Hospital of Barcelona Stroke Registry) nine patients with MDCI were identified among 1099 consecutive first ever stroke patients (0.8%) (908 with IS, 1%). Fifteen out of 22 patients (68%) had hemichorea-hemiballismus, five (23%) hemidystonia and two (9%) isolated tremor. MDCI were more often left sided (n = 15, 68%), being bilateral in one patient (4.5%). A lesion was found on neuroimaging (CT and/or MRI) in 15 patients (68%), in the territory of the posterior cerebral artery (n = 8) and middle cerebral artery (six deep and one superficial). The most commonly involved structure was the thalamus (n = 8, 36.5%). IS subtypes were; presumed lacunar infarcts in 14 patients (64%), atherothrombotic infarcts in two patients (9%), cardioembolic infarcts in two patients (9%) and infarcts of unknown etiology in four patients (18%). Hemichorea-hemiballismus was the most common type of MDCI in our study, usually being the result of a thalamic infarction. The thalamus was the most frequently damaged structure underlying all types of MDCI. There was a striking propensity of MDCI which resulted from nondominant deep hemispheric small vessel infarctions.

  9. Effects of object size on unimanual and bimanual movements in patients with schizophrenia.

    PubMed

    Wang, Shu-Mei; Kuo, Li-Chieh; Ouyang, Wen-Chen; Hsu, Hsiao-Man; Lin, Keh-Chung; Ma, Hui-Ing

    2014-01-01

    Schizophrenia affects not only mental function but also movement. We compared the movement of patients with mild schizophrenia and healthy control participants during a bimanual assembly task and examined whether changes in object size affected unimanual and bimanual movements. Fifteen patients with schizophrenia and 15 age- and gender-matched control participants were instructed to bimanually reach for and assemble objects. We manipulated the object size for the left hand (large vs. small) and measured movement time, peak velocity, and bimanual synchronization to represent movement speed, forcefulness, and bimanual coordination. Patients with schizophrenia showed slower and less forceful unimanual movements and less coordinated bimanual movements than control participants. Increasing the object size elicited faster and more forceful unimanual movements and more coordinated bimanual movements in patients. The results suggest the need for movement rehabilitation in patients with schizophrenia and the possibility of manipulating object size to optimize patients' movements. These results benefit the practice of evidence-based therapy.

  10. Diagnostic Agreement in Patients with Psychogenic Movement Disorders

    PubMed Central

    Morgante, Francesca; Edwards, Mark J.; Espay, Alberto J.; Fasano, Alfonso; Mir, Pablo; Martino, Davide

    2013-01-01

    Background The reliability and applicability of published diagnostic criteria for psychogenic movement disorders (PMDs) have never been examined. Methods Eight movement disorder and six general neurologists rated 14 patients diagnosed with PMD and 14 patients diagnosed with organic movement disorders. Raters provided a dichotomous judgment (i.e., psychogenic or organic) upon review of video-based movement phenomenology and a category of diagnostic certainty based on the Fahn-Williams and Shill-Gerber criteria after accessing standardized clinical information. We measured interobserver agreement on the diagnosis and clinical certainty judgment of PMD. Results In both groups of raters, agreements were “fair” on the video-based dichotomous judgment, but improved to “substantial” after access to standardized clinical information. “Slight” to “poor” agreement was reached for the “probable” and “possible” categories of diagnostic certainty corresponding to both diagnostic criteria. Conclusions Diagnosis according to clinical available criteria for PMD yields poor diagnostic agreement. PMID:22488862

  11. Eye movements of patients with schizophrenia in a natural environment.

    PubMed

    Dowiasch, Stefan; Backasch, Bianca; Einhäuser, Wolfgang; Leube, Dirk; Kircher, Tilo; Bremmer, Frank

    2016-02-01

    Alterations of eye movements in schizophrenia patients have been widely described for laboratory settings. For example, gain during smooth tracking is reduced, and fixation patterns differ between patients and healthy controls. The question remains, whether such results are related to the specifics of the experimental environment, or whether they transfer to natural settings. Twenty ICD-10 diagnosed schizophrenia patients and 20 healthy age-matched controls participated in the study, each performing four different oculomotor tasks corresponding to natural everyday behavior in an indoor environment: (I) fixating stationary targets, (II) sitting in a hallway with free gaze, (III) walking down the hallway, and (IV) visually tracking a target on the floor while walking straight-ahead. In all conditions, eye movements were continuously recorded binocularly by a mobile lightweight eye tracker (EyeSeeCam). When patients looked at predefined targets, they showed more fixations with reduced durations than controls. The opposite was true when participants were sitting in a hallway with free gaze. During visual tracking, patients showed a significantly greater root-mean-square error (representing the mean deviation from optimal) of retinal target velocity. Different from previous results on smooth-pursuit eye movements obtained in laboratory settings, no such difference was found for velocity gain. Taken together, we have identified significant differences in fundamental oculomotor parameters between schizophrenia patients and healthy controls during natural behavior in a real environment. Moreover, our data provide evidence that in natural settings, patients overcome some impairments, which might be present only in laboratory studies, by as of now unknown compensatory mechanisms or strategies.

  12. A holistic model of advocacy: factors that influence its use.

    PubMed

    Kubsch, Sylvia M; Sternard, Marsha J; Hovarter, Rebecca; Matzke, Vicki

    2004-02-01

    Although advocacy is embraced by nursing as an essential component of holistic philosophy, its scope is often limited in practice. In this article, a research study that examined the use of an expanded definition of advocacy is described. A link to the role of advocacy as a complementary therapy and in relation to facilitating the use of complementary therapies by patients is provided. Fifty-two registered nurses completed a researcher developed advocacy research instrument that assessed the use of moral-ethical, legal, political, spiritual, and substitutive advocacy along with various factors thought to influence the use of advocacy including moral development, perceived assertiveness, and perceived job security. An additional 40 RN-BSN students generated case studies of advocacy enacted in practice that were used as examples of the five categories of advocacy and to support the findings of the survey. Results indicated that moral-ethical advocacy was used more often than the other four categories. Moral stage development had a significant effect on substitutive advocacy but assertiveness and job security were not significant factors influencing any category of advocacy. PMID:14744505

  13. A holistic model of advocacy: factors that influence its use.

    PubMed

    Kubsch, Sylvia M; Sternard, Marsha J; Hovarter, Rebecca; Matzke, Vicki

    2004-02-01

    Although advocacy is embraced by nursing as an essential component of holistic philosophy, its scope is often limited in practice. In this article, a research study that examined the use of an expanded definition of advocacy is described. A link to the role of advocacy as a complementary therapy and in relation to facilitating the use of complementary therapies by patients is provided. Fifty-two registered nurses completed a researcher developed advocacy research instrument that assessed the use of moral-ethical, legal, political, spiritual, and substitutive advocacy along with various factors thought to influence the use of advocacy including moral development, perceived assertiveness, and perceived job security. An additional 40 RN-BSN students generated case studies of advocacy enacted in practice that were used as examples of the five categories of advocacy and to support the findings of the survey. Results indicated that moral-ethical advocacy was used more often than the other four categories. Moral stage development had a significant effect on substitutive advocacy but assertiveness and job security were not significant factors influencing any category of advocacy.

  14. A History of Music Education Advocacy.

    ERIC Educational Resources Information Center

    Mark, Michael L.

    2002-01-01

    Provides a history of advocacy in music education discussing when formal advocacy started as well as advocacy with government agencies, the state level, and other types of advocacy. Includes a bibliography of resources related to music advocacy. (CMK)

  15. Will my job be safe if I defend my patients? When patient advocacy collides with employment law.

    PubMed

    Manthous, Constantine A; Moncrieff, Abigail R

    2013-10-01

    Physicians are moving increasingly from self-employed, private practices to at-will employment relationships. This historic change in the organizational administration of medical services is likely to accelerate as the Affordable Care Act is implemented and as accountable care organizations permeate the medical marketplace. Physicians vow an ascendant oath to safeguard patients' welfare, but as they become employees, they may sign legal contracts that also oblige obedience to the institutions that hire them. What happens when an employer makes a decision that is not in the best interests of patients and the physicians fulfill their Hippocratic obligation to voice dissent on their patients' behalf rather than abiding by their contractual obligation to obey their employer? This article explores the philosophical and legal ramifications of this potential collision of obligations to patients and to employers. PMID:24081344

  16. Community health advocacy

    PubMed Central

    Loue, Sana

    2006-01-01

    Competing health needs of diverse populations and ever shrinking resources available to support these needs often serve as the impetus for the initiation of advocacy efforts to improve community health. However, perceptions of what constitutes a community differ, as do approaches to advocacy itself. This glossary addresses five key questions: (1) What is advocacy?; (2) What is meant by community?; (3) What are the different approaches to community health advocacy?; (4) How are priorities established in the face of competing health advocacy goals?; (5) How can community health advocacy efforts be evaluated?; and (6) What challenges may be encountered in advocating for community health? Each of these issues could serve as the basis for a text on that subject alone. Accordingly, this article is not meant to be comprehensive text on these issues but is, instead, intended to highlight key foundational issues. And, although advocacy efforts can be conducted by individuals, this article focuses specifically on advocacy efforts of communities, however they may be defined and characterised. PMID:16698972

  17. Philosophy + Advocacy = Success

    ERIC Educational Resources Information Center

    Tutt, Kevin; Townley, Marc

    2011-01-01

    Knowledge about music advocacy strategies has long been promoted as important for music educators, not only for the benefit of their individual programs but also for the specific benefit of music students and the general public. This article suggests an approach to advocacy grounded in the teacher's professional beliefs, phrased in terms…

  18. Advocacy and Institutional Racism.

    ERIC Educational Resources Information Center

    Brophy, Michael C.; And Others

    The purpose of this paper is to provide a perspective on advocacy and advocate counseling for participants in the University of Maryland Sixth Annual Community-Clinical Workshop, 1976. It attempts to define relevant terms and outline a method of self-advocacy which can, if utilized properly, lessen the impact of institutional racism. The terms,…

  19. Arts Advocacy Roundtable.

    ERIC Educational Resources Information Center

    Costa, Ann Marie; Green, Sharon; Haedicke, Susan; Mardirosian, Gail Humphries; Martin, Deborah; Schildcrout, Jordan; Spencer, Jenny; Weinberg, Mark

    2001-01-01

    Records discussion of an arts advocacy roundtable began at the August 2000 meeting of the Association for Theatre in Higher Education and continued online. Explains how theatre departments have found themselves defending their very existence in the past decade. Includes discussions of the meaning of arts advocacy; how to incorporate arts advocacy…

  20. Advocacy & Lobbying: Influencing Policy.

    ERIC Educational Resources Information Center

    ASPBAE Courier, 1994

    1994-01-01

    This issue contains nine papers dealing with influencing public policy through advocacy and lobbying. "Influencing Public Policy" (Rajesh Tandon) looks at opportunities nongovernmental organizations (NGOs) have for influencing public policy and constraints to advocacy. "Recent Changes in the Global Aid Environment" (Sunimal Fernando) considers…

  1. Handbook for Rehabilitation Advocacy.

    ERIC Educational Resources Information Center

    National Rehabilitation Association, Alexandria, VA.

    This handbook is intended to help advocates for persons with disabilities organize for advocacy, build effective coalitions, frame key issues, package critical information, and use the media to advance the cause. Individual sections address the following topics: how to change public policy; myths about advocacy; what makes politicians tick;…

  2. Abnormal head movement in a patient with tuberculous meningitis.

    PubMed

    Garg, Ravindra Kumar; Singh, Sunil Kumar; Malhotra, Hardeep Singh; Singh, Maneesh Kumar

    2012-01-01

    The bobble-head doll syndrome is characterised by abnormal head movements. These head movements are usually 'yes-yes' (up and down) type; rarely, head movements are 'no-no' (side-to-side) type. Commonly described causes of the bobble-head doll syndrome include third ventricular tumours, suprasellar arachnoid cysts, aqueductal stenosis and other lesions in the region of the third ventricle of the brain. We report a case of tuberculous meningitis with hydrocephalus; in this patient bobble-head doll syndrome developed following external ventricular drainage. In our patient, placement of intraventricular drain led to massive dilatation of the frontal horn of the left lateral ventricle because of blocked foramina of Monro on the left side. The bobble-head doll syndrome, presumably, developed because of the pressure effect of the dilated third ventricle on the dorsomedial nucleus of the thalamus, red nucleus and dentatorubrothalamic pathways. We think that distortion of the third ventricle was responsible for the impairment of the functions of all these structures. PMID:23035162

  3. Is the movement-evoked potential mandatory for movement execution? A high-resolution EEG study in a deafferented patient.

    PubMed

    Kristeva, Rumyana; Chakarov, Vihren; Wagner, Michael; Schulte-Mönting, Jürgen; Hepp-Reymond, M-C

    2006-06-01

    During simple self-paced index finger flexion with and without visual feedback of the finger, we compared the movement-evoked potentials of the completely deafferented patient GL with those of 7 age-matched healthy subjects. EEG was recorded from 58 scalp positions, together with the electromyogram (EMG) from the first dorsal interosseous muscle and the movement trace. We analyzed the movement parameters and the contralateral movement-evoked potential and its source. The patient performed the voluntary movements almost as well as the controls in spite of her lack of sensory information from the periphery. In contrast, the movement-evoked potential was observed only in the controls and not in the patient. These findings clearly demonstrate that the movement-evoked potential reflects cutaneous and proprioceptive feedback from the moving part of the body. They also indicate that in absence of sensory peripheral input the motor control switches from an internal "sensory feedback-driven" to a "feedforward" mode. The role of the sensory feedback in updating the internal models and of the movement-evoked potential as a possible cortical correlate of motor awareness is discussed.

  4. Eye Movements of Patients with Tunnel Vision while Walking

    PubMed Central

    Vargas-Martín, Fernando; Peli, Eli

    2006-01-01

    Purpose To determine how severe peripheral field loss (PFL) affects the dispersion of eye movements relative to the head, while walking in real environments. This information should help to better define the visual field and clearance requirements for head-mounted mobility visual aids. Methods Eye positions relative to the head were recorded in five retinitis pigmentosa patients with less than 15° of visual field and three normally-sighted people, each walking in varied environments for more than 30 minutes. The eye position recorder was made portable by modifying a head-mounted ISCAN system. Custom data processing was implemented to reject unreliable data. Sample standard deviations of eye position (dispersion) were compared across subject groups and environments. Results PFL patients exhibited narrower horizontal eye position dispersions than normally-sighted subjects (9.4° vs. 14.2°, p < 0.0001) and PFL patients’ vertical dispersions were smaller when walking indoors than outdoors (8.2° vs. 10.3°, p = 0.048). Conclusions When walking, the PFL patients did not increase their scanning eye movements to compensate for missing peripheral vision information. Their horizontal scanning was actually reduced, possibly because saccadic amplitude is limited by a lack of peripheral stimulation. The results suggest that a field-of-view as wide as 40° may be needed for closed (immersive) head-mounted mobility aids, while a much narrower display, perhaps as narrow as 20°, might be sufficient with an open design. PMID:17122116

  5. Evaluation of ocular movements in patients with dyslexia.

    PubMed

    Vagge, Aldo; Cavanna, Margherita; Traverso, Carlo Enrico; Iester, Michele

    2015-04-01

    The aims of this study were to analyze the relationship between dyslexia and eye movements and to assess whether this method can be added to the workup of dyslexic patients. The sample was comprised of 11 children with a diagnosis of dyslexia and 11 normal between 8 and 13 years of age. All subjects underwent orthoptic evaluation, ophthalmological examinations, and eye movement analysis, specifically, stability analysis on fixating a still target, tracking saccades, analysis of fixation pauses, speed reading, saccades, and regressions through the reading of a text. Stability analysis on fixating a still target showed a significant (p < 0.001) difference between the two groups showing an increased amount of loss of fixation among dyslexic subjects (5.36 ± 2.5 s and 0.82 ± 2.1, respectively). Tracking saccades (left and right horizontal axis) did not show a significant difference. When reading parameters were looked into (number of saccades, number of regressions, reading time through the reading of a text), a significant (p < 0.001) difference was found between the groups. This study supports the belief that the alteration of eye movement does not depend on oculo-motor dysfunction but is secondary to a defect in the visual processing of linguistic material. Inclusion of assessment of this defect might prove beneficial in determining the presence of dyslexia in young children at a younger age, and an earlier intervention could be initiated.

  6. Evaluation of ocular movements in patients with dyslexia.

    PubMed

    Vagge, Aldo; Cavanna, Margherita; Traverso, Carlo Enrico; Iester, Michele

    2015-04-01

    The aims of this study were to analyze the relationship between dyslexia and eye movements and to assess whether this method can be added to the workup of dyslexic patients. The sample was comprised of 11 children with a diagnosis of dyslexia and 11 normal between 8 and 13 years of age. All subjects underwent orthoptic evaluation, ophthalmological examinations, and eye movement analysis, specifically, stability analysis on fixating a still target, tracking saccades, analysis of fixation pauses, speed reading, saccades, and regressions through the reading of a text. Stability analysis on fixating a still target showed a significant (p < 0.001) difference between the two groups showing an increased amount of loss of fixation among dyslexic subjects (5.36 ± 2.5 s and 0.82 ± 2.1, respectively). Tracking saccades (left and right horizontal axis) did not show a significant difference. When reading parameters were looked into (number of saccades, number of regressions, reading time through the reading of a text), a significant (p < 0.001) difference was found between the groups. This study supports the belief that the alteration of eye movement does not depend on oculo-motor dysfunction but is secondary to a defect in the visual processing of linguistic material. Inclusion of assessment of this defect might prove beneficial in determining the presence of dyslexia in young children at a younger age, and an earlier intervention could be initiated. PMID:25804764

  7. Nursing education: a catalyst for the patient safety movement.

    PubMed

    Neudorf, Kim; Dyck, Netha; Scott, Darlene; Davidson Dick, Diana

    2008-01-01

    Creating a culture of safety in healthcare systems is a goal of leaders in the patient safety movement. Commitment of leadership to safety in the Saskatchewan Institute of Applied Science and Technology (SIAST) Nursing Division has resulted in the development of the Patient Safety Project Team (PSPT) and a steady shift in the culture of the organization toward a systems approach to patient safety. Graduates prepared with the competencies necessary to be diligent about their practice and skilled in determining the root causes of system error in healthcare will become leaders in shifting the healthcare culture to strengthen patient safety. The PSPT believes this cultural shift begins with the education system. It involves modifications to curricula content, facilitation of multidisciplinary processes, and inclusion of theory and practice that reflect critical inquiry into healthcare and nursing education systems to ensure patient safety. In this paper the practical approaches and initiatives of the PSPT are reviewed. The integration of Patient Safety Core Curriculum modules for competency development is described. The policy for reporting adverse events and near misses is outlined. In addition, the student-focused reporting tool, the results and the implications for teaching in the clinical setting are discussed. Processes used to engage faculty are also addressed.

  8. Going "social" to access experimental and potentially life-saving treatment: an assessment of the policy and online patient advocacy environment for expanded access.

    PubMed

    Mackey, Tim K; Schoenfeld, Virginia J

    2016-02-02

    Social media is fundamentally altering how we access health information and make decisions about medical treatment, including for terminally ill patients. This specifically includes the growing phenomenon of patients who use online petitions and social media campaigns in an attempt to gain access to experimental drugs through expanded access pathways. Importantly, controversy surrounding expanded access and "compassionate use" involves several disparate stakeholders, including patients, manufacturers, policymakers, and regulatory agencies-all with competing interests and priorities, leading to confusion, frustration, and ultimately advocacy. In order to explore this issue in detail, this correspondence article first conducts a literature review to describe how the expanded access policy and regulatory environment in the United States has evolved over time and how it currently impacts access to experimental drugs. We then conducted structured web searches to identify patient use of online petitions and social media campaigns aimed at compelling access to experimental drugs. This was carried out in order to characterize the types of communication strategies utilized, the diseases and drugs subject to expanded access petitions, and the prevalent themes associated with this form of "digital" patient advocacy. We find that patients and their families experience mixed results, but still gravitate towards the use of online campaigns out of desperation, lack of reliable information about treatment access options, and in direct response to limitations of the current fragmented structure of expanded access regulation and policy currently in place. In response, we discuss potential policy reforms to improve expanded access processes, including advocating greater transparency for expanded access programs, exploring use of targeted economic incentives for manufacturers, and developing systems to facilitate patient information about existing treatment options. This includes

  9. Going "social" to access experimental and potentially life-saving treatment: an assessment of the policy and online patient advocacy environment for expanded access.

    PubMed

    Mackey, Tim K; Schoenfeld, Virginia J

    2016-01-01

    Social media is fundamentally altering how we access health information and make decisions about medical treatment, including for terminally ill patients. This specifically includes the growing phenomenon of patients who use online petitions and social media campaigns in an attempt to gain access to experimental drugs through expanded access pathways. Importantly, controversy surrounding expanded access and "compassionate use" involves several disparate stakeholders, including patients, manufacturers, policymakers, and regulatory agencies-all with competing interests and priorities, leading to confusion, frustration, and ultimately advocacy. In order to explore this issue in detail, this correspondence article first conducts a literature review to describe how the expanded access policy and regulatory environment in the United States has evolved over time and how it currently impacts access to experimental drugs. We then conducted structured web searches to identify patient use of online petitions and social media campaigns aimed at compelling access to experimental drugs. This was carried out in order to characterize the types of communication strategies utilized, the diseases and drugs subject to expanded access petitions, and the prevalent themes associated with this form of "digital" patient advocacy. We find that patients and their families experience mixed results, but still gravitate towards the use of online campaigns out of desperation, lack of reliable information about treatment access options, and in direct response to limitations of the current fragmented structure of expanded access regulation and policy currently in place. In response, we discuss potential policy reforms to improve expanded access processes, including advocating greater transparency for expanded access programs, exploring use of targeted economic incentives for manufacturers, and developing systems to facilitate patient information about existing treatment options. This includes

  10. Advocacy and technology assessment

    NASA Technical Reports Server (NTRS)

    Jones, E. M.

    1975-01-01

    A highly structured treatment is presented of adversarial systems as they apply to technology assessment. One approach to the problem of adequate criteria of assessment focuses upon the internal operations of assessment entities; operations include problem perception, problem formulation, selection, utilization, determination, and evaluation. Potential contributions of advocacy as a mode of inquiry in technology are discussed; advocacy is evaluated by representative sets of criteria of adequate assessment which include participant criteria, perspectives criteria, situations criteria, base values criteria, and strategies criteria.

  11. Political advocacy in pharmacy: challenges and opportunities

    PubMed Central

    Apollonio, Dorie E

    2015-01-01

    Many pharmacists have expressed a desire to become more involved in patient care, in part by being compensated for patient counseling, as well as by providing services traditionally offered by physicians and nurse practitioners. Recent efforts to develop collaborative care models, as well as major restructurings of US health insurance coverage, provide a unique opportunity for pharmacists to become recognized as independent health care providers and be reimbursed as primary care providers. Achieving that goal would require addressing advocacy challenges familiar to other health care professionals who have achieved provider status under existing reimbursement rules. Historically, political advocacy has not been a major part of pharmacy practice, or even viewed as necessary. However, pharmacists would be more politically effective with a single organization to speak for them as a profession, and with further education in advocacy. PMID:26301185

  12. Social Justice Advocacy: Community Collaboration and Systems Advocacy

    ERIC Educational Resources Information Center

    Lopez-Baez, Sandra I.; Paylo, Matthew J.

    2009-01-01

    This article discusses the community collaboration and systems advocacy domains of the ACA (American Counseling Association) Advocacy Competencies (J. A. Lewis, M. S. Arnold, R. House, & R. L. Toporek, 2002). A case illustration is presented, and the 8 Advocacy Competencies within each domain are applied to the case study.

  13. Impact of the increased adoption of prenatal cfDNA screening on non-profit patient advocacy organizations in the United States.

    PubMed

    Meredith, Stephanie; Kaposy, Christopher; Miller, Victoria J; Allyse, Megan; Chandrasekharan, Subhashini; Michie, Marsha

    2016-08-01

    The 'Stakeholder Perspectives on Noninvasive Prenatal Genetic Screening' Symposium was held in conjunction with the 2015 annual meeting of the International Society for Prenatal Diagnosis. During the day-long meeting, a panel of patient advocacy group (PAG) representatives discussed concerns and challenges raised by prenatal cell-free DNA (cfDNA) screening, which has resulted in larger demands upon PAGs from concerned patients receiving prenatal cfDNA screening results. Prominent concerns included confusion about the accuracy of cfDNA screening and a lack of patient education resources about genetic conditions included in cfDNA screens. Some of the challenges faced by PAGs included funding limitations, lack of consistently implemented standards of care and oversight, diverse perspectives among PAGs and questions about neutrality, and lack of access to training and genetic counselors. PAG representatives also put forward suggestions for addressing these challenges, including improving educational and PAG funding and increasing collaboration between PAGs and the medical community. © 2016 John Wiley & Sons, Ltd.

  14. Impact of the increased adoption of prenatal cfDNA screening on non-profit patient advocacy organizations in the United States.

    PubMed

    Meredith, Stephanie; Kaposy, Christopher; Miller, Victoria J; Allyse, Megan; Chandrasekharan, Subhashini; Michie, Marsha

    2016-08-01

    The 'Stakeholder Perspectives on Noninvasive Prenatal Genetic Screening' Symposium was held in conjunction with the 2015 annual meeting of the International Society for Prenatal Diagnosis. During the day-long meeting, a panel of patient advocacy group (PAG) representatives discussed concerns and challenges raised by prenatal cell-free DNA (cfDNA) screening, which has resulted in larger demands upon PAGs from concerned patients receiving prenatal cfDNA screening results. Prominent concerns included confusion about the accuracy of cfDNA screening and a lack of patient education resources about genetic conditions included in cfDNA screens. Some of the challenges faced by PAGs included funding limitations, lack of consistently implemented standards of care and oversight, diverse perspectives among PAGs and questions about neutrality, and lack of access to training and genetic counselors. PAG representatives also put forward suggestions for addressing these challenges, including improving educational and PAG funding and increasing collaboration between PAGs and the medical community. © 2016 John Wiley & Sons, Ltd. PMID:27244688

  15. Event-related beta EEG-changes during passive and attempted foot movements in paraplegic patients.

    PubMed

    Müller-Putz, Gernot R; Zimmermann, Doris; Graimann, Bernhard; Nestinger, Kurt; Korisek, Gerd; Pfurtscheller, Gert

    2007-03-16

    A number of electroencephalographic (EEG) studies report on motor event-related desynchronization and synchronization (ERD/ERS) in the beta band, i.e. a decrease and increase of spectral amplitudes of central beta rhythms in the range from 13 to 35 Hz. Following an ERD that occurs shortly before and during the movement, bursts of beta oscillations (beta ERS) appear within a 1-s interval after movement offset. Such a post-movement beta ERS has been reported after voluntary hand movements, passive movements, movement imagination, and also after movements induced by functional electrical stimulation. The present study compares ERD/ERS patterns in paraplegic patients (suffering from a complete spinal cord injury) and healthy subjects during attempted (active) and passive foot movements. The aim of this work is to address the question, whether patients do have the same focal beta ERD/ERS pattern during attempted foot movement as healthy subjects do. The results showed midcentral-focused beta ERD/ERS patterns during passive, active, and imagined foot movements in healthy subjects. This is in contrast to a diffuse and broad distributed ERD/ERS pattern during attempted foot movements in patients. Only one patient showed a similar ERD/ERS pattern. Furthermore, no significant ERD/ERS patterns during passive foot movement in the group of the paraplegics could be found. PMID:17229403

  16. Ictal SPECT in patients with rapid eye movement sleep behaviour disorder.

    PubMed

    Mayer, Geert; Bitterlich, Marion; Kuwert, Torsten; Ritt, Philipp; Stefan, Hermann

    2015-05-01

    Rapid eye movement sleep behaviour disorder is a rapid eye movement parasomnia clinically characterized by acting out dreams due to disinhibition of muscle tone in rapid eye movement sleep. Up to 80-90% of the patients with rapid eye movement sleep behaviour disorder develop neurodegenerative disorders within 10-15 years after symptom onset. The disorder is reported in 45-60% of all narcoleptic patients. Whether rapid eye movement sleep behaviour disorder is also a predictor for neurodegeneration in narcolepsy is not known. Although the pathophysiology causing the disinhibition of muscle tone in rapid eye movement sleep behaviour disorder has been studied extensively in animals, little is known about the mechanisms in humans. Most of the human data are from imaging or post-mortem studies. Recent studies show altered functional connectivity between substantia nigra and striatum in patients with rapid eye movement sleep behaviour disorder. We were interested to study which regions are activated in rapid eye movement sleep behaviour disorder during actual episodes by performing ictal single photon emission tomography. We studied one patient with idiopathic rapid eye movement sleep behaviour disorder, one with Parkinson's disease and rapid eye movement sleep behaviour disorder, and two patients with narcolepsy and rapid eye movement sleep behaviour disorder. All patients underwent extended video polysomnography. The tracer was injected after at least 10 s of consecutive rapid eye movement sleep and 10 s of disinhibited muscle tone accompanied by movements registered by an experienced sleep technician. Ictal single photon emission tomography displayed the same activation in the bilateral premotor areas, the interhemispheric cleft, the periaqueductal area, the dorsal and ventral pons and the anterior lobe of the cerebellum in all patients. Our study shows that in patients with Parkinson's disease and rapid eye movement sleep behaviour disorder-in contrast to wakefulness

  17. Do we take self-advocacy seriously?

    PubMed

    Dawson, P

    A training pack has been developed to help staff introduce the concept of self-advocacy to patients who are disabled or have learning difficulties so that they may challenge service providers. It should be possible to provide working and living environments in which respect for one another's humanity can be shared.

  18. Advocacy communication, vaccines and the role of scientific societies.

    PubMed

    Signorelli, C; Odone, A

    2015-01-01

    In 1986 the Ottawa Charter underlined the importance of advocacy in health. This article analyzes the role of advocacy in Public Health making the case of immunization, whose coverage rates are decreasing in many countries. An effective advocacy action could counteract the growing phenomenon of the vaccine hesitancy within both the general population and an increasing share of healthcare providers as well as contrast antivax movements' action. We identify who are the advocates focusing on Italy and on the crucial role of scientific societies which share the responsibility of making the latest scientific evidence and most effective infectious diseases' control strategies available to health policy makers. The Italian Society of Hygiene (SItI) has been actively engaged for several years in a number of initiatives of advocacy communication and vaccines including research, training, media exposure and a dedicated website portal (vaccinarSì).

  19. Public health and media advocacy.

    PubMed

    Dorfman, Lori; Krasnow, Ingrid Daffner

    2014-01-01

    Media advocacy blends communications, science, politics, and advocacy to advance public health goals. In this article, we explain how media advocacy supports the social justice grounding of public health while addressing public health's "wicked problems" in the context of American politics. We outline media advocacy's theoretical foundations in agenda setting and framing and describe its practical application, from the layers of strategy to storytelling, which can illuminate public health solutions for journalists, policy makers, and the general public. Finally, we describe the challenges in evaluating media advocacy campaigns.

  20. Constraint-induced movement therapy promotes brain functional reorganization in stroke patients with hemiplegia.

    PubMed

    Wang, Wenqing; Wang, Aihui; Yu, Limin; Han, Xuesong; Jiang, Guiyun; Weng, Changshui; Zhang, Hongwei; Zhou, Zhiqiang

    2012-11-15

    Stroke patients with hemiplegia exhibit flexor spasms in the upper limb and extensor spasms in the lower limb, and their movement patterns vary greatly. Constraint-induced movement therapy is an upper limb rehabilitation technique used in stroke patients with hemiplegia; however, studies of lower extremity rehabilitation are scarce. In this study, stroke patients with lower limb hemiplegia underwent conventional Bobath therapy for 4 weeks as baseline treatment, followed by constraint-induced movement therapy for an additional 4 weeks. The 10-m maximum walking speed and Berg balance scale scores significantly improved following treatment, and lower extremity motor function also improved. The results of functional MRI showed that constraint-induced movement therapy alleviates the reduction in cerebral functional activation in patients, which indicates activation of functional brain regions and a significant increase in cerebral blood perfusion. These results demonstrate that constraint-induced movement therapy promotes brain functional reorganization in stroke patients with lower limb hemiplegia.

  1. Constraint-induced movement therapy promotes brain functional reorganization in stroke patients with hemiplegia

    PubMed Central

    Wang, Wenqing; Wang, Aihui; Yu, Limin; Han, Xuesong; Jiang, Guiyun; Weng, Changshui; Zhang, Hongwei; Zhou, Zhiqiang

    2012-01-01

    Stroke patients with hemiplegia exhibit flexor spasms in the upper limb and extensor spasms in the lower limb, and their movement patterns vary greatly. Constraint-induced movement therapy is an upper limb rehabilitation technique used in stroke patients with hemiplegia; however, studies of lower extremity rehabilitation are scarce. In this study, stroke patients with lower limb hemiplegia underwent conventional Bobath therapy for 4 weeks as baseline treatment, followed by constraint-induced movement therapy for an additional 4 weeks. The 10-m maximum walking speed and Berg balance scale scores significantly improved following treatment, and lower extremity motor function also improved. The results of functional MRI showed that constraint-induced movement therapy alleviates the reduction in cerebral functional activation in patients, which indicates activation of functional brain regions and a significant increase in cerebral blood perfusion. These results demonstrate that constraint-induced movement therapy promotes brain functional reorganization in stroke patients with lower limb hemiplegia. PMID:25337108

  2. Constraint-induced movement therapy promotes brain functional reorganization in stroke patients with hemiplegia.

    PubMed

    Wang, Wenqing; Wang, Aihui; Yu, Limin; Han, Xuesong; Jiang, Guiyun; Weng, Changshui; Zhang, Hongwei; Zhou, Zhiqiang

    2012-11-15

    Stroke patients with hemiplegia exhibit flexor spasms in the upper limb and extensor spasms in the lower limb, and their movement patterns vary greatly. Constraint-induced movement therapy is an upper limb rehabilitation technique used in stroke patients with hemiplegia; however, studies of lower extremity rehabilitation are scarce. In this study, stroke patients with lower limb hemiplegia underwent conventional Bobath therapy for 4 weeks as baseline treatment, followed by constraint-induced movement therapy for an additional 4 weeks. The 10-m maximum walking speed and Berg balance scale scores significantly improved following treatment, and lower extremity motor function also improved. The results of functional MRI showed that constraint-induced movement therapy alleviates the reduction in cerebral functional activation in patients, which indicates activation of functional brain regions and a significant increase in cerebral blood perfusion. These results demonstrate that constraint-induced movement therapy promotes brain functional reorganization in stroke patients with lower limb hemiplegia. PMID:25337108

  3. Head movements during conversational speech in patients with schizophrenia

    PubMed Central

    Park, Bert; Khana, Priya; DiMambro, Ben

    2013-01-01

    Background: Motor abnormalities are frequently described in schizophrenia, and work by Altorfer and colleagues suggests that measuring head movements during conversational speech shows differences at the level of the individual. We wished to see whether their findings, conducted using computer analysis of video obtained in motion capture suites, could be replicated using compact, portable movement sensors, in a case–control study comparing the mean amplitude of head movements during general conversation. Methods: A referred sample of inpatients and outpatients with a diagnosis of paranoid schizophrenia was identified from case note information. Movement sensors, mounted in a baseball cap worn by subjects, transmitted data via Bluetooth to a laptop, which simultaneously captured audio to identify who was speaking. Subjects also completed a series of rating scales. Results: Data from the final 11 cases and 11 controls demonstrated a substantial group difference in mean amplitude of head movement velocity during speech (p < 0.0001), although this was not significant at the level of the individual. Conclusions: Movement sensors proved well suited to capturing head movements, demonstrating a large effect size in subjects with schizophrenia. PMID:23983990

  4. Immediately loaded implants in a patient with involuntary mandibular movements: a clinical report.

    PubMed

    Shek, Justin W; Plesh, Octavia; Curtis, Donald A

    2014-07-01

    Immediately loaded implant prostheses have been used to successfully rehabilitate completely edentulous arches. Risk factors for successful treatment have not included involuntary mandibular movements. The treatment was completed on a patient with a history of neuroleptic medications who had remaining mandibular teeth extracted and then developed involuntary mandibular movements. The patient was dissatisfied with a mandibular removable prosthesis and wanted a fixed prosthesis. The immediate implant loading of a complete arch fixed prosthesis was delivered, and the patient lost 3 of the 6 implants. The patient continued to have problems with her definitive prostheses as the symptoms of her involuntary mandibular movements worsened.

  5. Immediately loaded implants in a patient with involuntary mandibular movements: a clinical report.

    PubMed

    Shek, Justin W; Plesh, Octavia; Curtis, Donald A

    2014-07-01

    Immediately loaded implant prostheses have been used to successfully rehabilitate completely edentulous arches. Risk factors for successful treatment have not included involuntary mandibular movements. The treatment was completed on a patient with a history of neuroleptic medications who had remaining mandibular teeth extracted and then developed involuntary mandibular movements. The patient was dissatisfied with a mandibular removable prosthesis and wanted a fixed prosthesis. The immediate implant loading of a complete arch fixed prosthesis was delivered, and the patient lost 3 of the 6 implants. The patient continued to have problems with her definitive prostheses as the symptoms of her involuntary mandibular movements worsened. PMID:24393329

  6. Cerebral Activations Related to Ballistic, Stepwise Interrupted and Gradually Modulated Movements in Parkinson Patients

    PubMed Central

    Toxopeus, Carolien M.; Maurits, Natasha M.; Valsan, Gopal; Conway, Bernard A.; Leenders, Klaus L.; de Jong, Bauke M.

    2012-01-01

    Patients with Parkinson’s disease (PD) experience impaired initiation and inhibition of movements such as difficulty to start/stop walking. At single-joint level this is accompanied by reduced inhibition of antagonist muscle activity. While normal basal ganglia (BG) contributions to motor control include selecting appropriate muscles by inhibiting others, it is unclear how PD-related changes in BG function cause impaired movement initiation and inhibition at single-joint level. To further elucidate these changes we studied 4 right-hand movement tasks with fMRI, by dissociating activations related to abrupt movement initiation, inhibition and gradual movement modulation. Initiation and inhibition were inferred from ballistic and stepwise interrupted movement, respectively, while smooth wrist circumduction enabled the assessment of gradually modulated movement. Task-related activations were compared between PD patients (N = 12) and healthy subjects (N = 18). In healthy subjects, movement initiation was characterized by antero-ventral striatum, substantia nigra (SN) and premotor activations while inhibition was dominated by subthalamic nucleus (STN) and pallidal activations, in line with the known role of these areas in simple movement. Gradual movement mainly involved antero-dorsal putamen and pallidum. Compared to healthy subjects, patients showed reduced striatal/SN and increased pallidal activation for initiation, whereas for inhibition STN activation was reduced and striatal-thalamo-cortical activation increased. For gradual movement patients showed reduced pallidal and increased thalamo-cortical activation. We conclude that PD-related changes during movement initiation fit the (rather static) model of alterations in direct and indirect BG pathways. Reduced STN activation and regional cortical increased activation in PD during inhibition and gradual movement modulation are better explained by a dynamic model that also takes into account enhanced

  7. Cerebral activations related to ballistic, stepwise interrupted and gradually modulated movements in Parkinson patients.

    PubMed

    Toxopeus, Carolien M; Maurits, Natasha M; Valsan, Gopal; Conway, Bernard A; Leenders, Klaus L; de Jong, Bauke M

    2012-01-01

    Patients with Parkinson's disease (PD) experience impaired initiation and inhibition of movements such as difficulty to start/stop walking. At single-joint level this is accompanied by reduced inhibition of antagonist muscle activity. While normal basal ganglia (BG) contributions to motor control include selecting appropriate muscles by inhibiting others, it is unclear how PD-related changes in BG function cause impaired movement initiation and inhibition at single-joint level. To further elucidate these changes we studied 4 right-hand movement tasks with fMRI, by dissociating activations related to abrupt movement initiation, inhibition and gradual movement modulation. Initiation and inhibition were inferred from ballistic and stepwise interrupted movement, respectively, while smooth wrist circumduction enabled the assessment of gradually modulated movement. Task-related activations were compared between PD patients (N = 12) and healthy subjects (N = 18). In healthy subjects, movement initiation was characterized by antero-ventral striatum, substantia nigra (SN) and premotor activations while inhibition was dominated by subthalamic nucleus (STN) and pallidal activations, in line with the known role of these areas in simple movement. Gradual movement mainly involved antero-dorsal putamen and pallidum. Compared to healthy subjects, patients showed reduced striatal/SN and increased pallidal activation for initiation, whereas for inhibition STN activation was reduced and striatal-thalamo-cortical activation increased. For gradual movement patients showed reduced pallidal and increased thalamo-cortical activation. We conclude that PD-related changes during movement initiation fit the (rather static) model of alterations in direct and indirect BG pathways. Reduced STN activation and regional cortical increased activation in PD during inhibition and gradual movement modulation are better explained by a dynamic model that also takes into account enhanced

  8. The role of movement representation in episodic memory for actions: A study of patients with apraxia.

    PubMed

    Masumoto, Kouhei; Shirakawa, Masayuki; Higashiyama, Takeshi; Yokoyama, Kazumasa

    2015-01-01

    In attempting to memorize a sentence about an action, such as "Pick up the glass," performing the action (motor encoding) results in better memory performance than simply memorizing the words (verbal encoding). Such enhancement of memory is known as the enactment effect. Several theories have been proposed to explain this phenomenon using concepts such as physical motor information associated with speed, form, amplitude of movement and/or movement representations involved in movement imaging, knowledge on manipulating tools, and spatial relationships in the enactment effect. However, there have been no cognitive neuropsychological studies investigating whether the enactment effect is crucially influenced by physical motor information or movement representations. To clarify this issue, we compared healthy adult control participants with two different types of apraxia patients. One patient with left hemisphere lesions caused by cerebral infarction had a disability involving multiple movement representations. The other patient showed symptoms of corticobasal syndrome and was not able to benefit from feedback on the accuracy of her motor movements during enactment. Participants memorized action sentences via either verbal or motor encoding and responded to recall and recognition tests. Results indicated that the patient with the movement representation deficits exhibited worse memory performance than the other patient or control participants following both verbal and motor encoding. Although the enactment effect was present during recall in both patients, the effect was not observed for recognition in the patient with severe movement representation deficits. These results suggest that movement representations are involved in encoding episodic memories of action. Moreover, the role of movement representations appears to depend on the form of retrieval that is being used. PMID:25921790

  9. The Role of Social Networks, Medical-Legal Climate, and Patient Advocacy on Surgical Options: A New Era.

    PubMed

    Tracy, Erin E; Bortoletto, Pietro

    2016-04-01

    The dissemination of information online and resultant public discourse through social media and other online channels has influenced the practice of medicine in dramatic ways. Physicians have historically worked to develop new techniques and devices for the benefit of their patients. It is only a more recent phenomenon, however, that these tools are either removed or their use is curtailed largely driven by anecdotal reports; passionate, vocal, often media-savvy advocates; and plaintiff attorneys. The use of power morcellation, hysteroscopic tubal sterilization, and mesh in urogynecologic procedures all have been victims of these societal pressures. It is important for health care professionals to be involved in the debate to ensure that public outcry does not unduly influence what we, as clinicians, are able to safely offer our patients. By being better advocates for our field, our instruments, and our patients, we can ensure medical decision-making is driven by good science and not public fervor. PMID:26959205

  10. The Role of Social Networks, Medical-Legal Climate, and Patient Advocacy on Surgical Options: A New Era.

    PubMed

    Tracy, Erin E; Bortoletto, Pietro

    2016-04-01

    The dissemination of information online and resultant public discourse through social media and other online channels has influenced the practice of medicine in dramatic ways. Physicians have historically worked to develop new techniques and devices for the benefit of their patients. It is only a more recent phenomenon, however, that these tools are either removed or their use is curtailed largely driven by anecdotal reports; passionate, vocal, often media-savvy advocates; and plaintiff attorneys. The use of power morcellation, hysteroscopic tubal sterilization, and mesh in urogynecologic procedures all have been victims of these societal pressures. It is important for health care professionals to be involved in the debate to ensure that public outcry does not unduly influence what we, as clinicians, are able to safely offer our patients. By being better advocates for our field, our instruments, and our patients, we can ensure medical decision-making is driven by good science and not public fervor.

  11. From Individuals to International Policy: Achievements and Ongoing Needs in Diabetes Advocacy.

    PubMed

    Hilliard, Marisa E; Oser, Sean M; Close, Kelly L; Liu, Nancy F; Hood, Korey K; Anderson, Barbara J

    2015-09-01

    Diabetes impacts tens of millions of people in the United States of America and 9 % of the worldwide population. Given the public health implications and economic burden of diabetes, the needs of people with diabetes must be addressed through strategic and effective advocacy efforts. Diabetes advocacy aims to increase public awareness about diabetes, raise funds for research and care, influence policy impacting people with diabetes, and promote optimal individual outcomes. We present a framework for diabetes advocacy activities by individuals and at the community, national, and international levels and identify challenges and gaps in current diabetes advocacy. Various groups have organized successful diabetes advocacy campaigns toward these goals, and lessons for further advancing diabetes advocacy can be learned from other health-related populations. Finally, we discuss the role of healthcare providers and mental/behavioral health professionals in advocacy efforts that can benefit their patients and the broader population of people with diabetes.

  12. From Individuals to International Policy: Achievements and Ongoing Needs in Diabetes Advocacy

    PubMed Central

    Oser, Sean M.; Close, Kelly L.; Liu, Nancy F.; Hood, Korey K.; Anderson, Barbara J.

    2015-01-01

    Diabetes impacts tens of millions of people in the United States of America and 9 % of the worldwide population. Given the public health implications and economic burden of diabetes, the needs of people with diabetes must be addressed through strategic and effective advocacy efforts. Diabetes advocacy aims to increase public awareness about diabetes, raise funds for research and care, influence policy impacting people with diabetes, and promote optimal individual outcomes. We present a framework for diabetes advocacy activities by individuals and at the community, national, and international levels and identify challenges and gaps in current diabetes advocacy. Various groups have organized successful diabetes advocacy campaigns toward these goals, and lessons for further advancing diabetes advocacy can be learned from other health-related populations. Finally, we discuss the role of healthcare providers and mental/behavioral health professionals in advocacy efforts that can benefit their patients and the broader population of people with diabetes. PMID:26194156

  13. Information Politics, Transnational Advocacy, and Education for All

    ERIC Educational Resources Information Center

    Magrath, Bronwen

    2015-01-01

    This article explores transnational activism within Education for All (EFA), looking specifically at the strategic use of information and research by transnational advocacy organizations. Through a comparative case-study examination of two prominent civil society organizations within the EFA movement--the Asia South Pacific Association for Basic…

  14. Minority Women and Advocacy for Women's Health

    PubMed Central

    Kumanyika, Shiriki K.; Morssink, Christiaan B.; Nestle, Marion

    2001-01-01

    US minority health issues involve racial/ethnic disparities that affect both women and men. However, women's health advocacy in the United States does not consistently address problems specific to minority women. The underlying evolution and political strength of the women's health and minority health movements differ profoundly. Women of color comprise only one quarter of women's health movement constituents and are, on average, socioeconomically disadvantaged. Potential alliances may be inhibited by vestiges of historical racial and social divisions that detract from feelings of commonality and mutual support. Nevertheless, insufficient attention to minority women's issues undermines the legitimacy of the women's health movement and may prevent important advances that can be achieved only when diversity is fully considered. PMID:11527764

  15. Minority women and advocacy for women's health.

    PubMed

    Kumanyika, S K; Morssink, C B; Nestle, M

    2001-09-01

    US minority health issues involve racial/ethnic disparities that affect both women and men. However, women's health advocacy in the United States does not consistently address problems specific to minority women. The underlying evolution and political strength of the women's health and minority health movements differ profoundly. Women of color comprise only one quarter of women's health movement constituents and are, on average, socioeconomically disadvantaged. Potential alliances may be inhibited by vestiges of historical racial and social divisions that detract from feelings of commonality and mutual support. Nevertheless, insufficient attention to minority women's issues undermines the legitimacy of the women's health movement and may prevent important advances that can be achieved only when diversity is fully considered.

  16. Effect of Mulligan’s mobilization with movement technique on gait function in stroke patients

    PubMed Central

    Kim, Sang-Lim; Lee, Byoung-Hee

    2016-01-01

    [Purpose] We examined the effectiveness of Mulligan’s mobilization with movement (MWM) technique on spatiotemporal variables of gait in individuals who had a stroke. [Subjects and Methods] Twenty-four subjects were randomly divided into 2 groups: Mulligan’s mobilization with movement group (n=12) and “weight-bearing with placebo” mobilization with movement group (n=12). The subjects in the mobilization with movement group performed 5 sets of 10 glides a day, 5 times a week for 4 weeks. The mobilization with movement technique comprised grade III movements that involved gliding and resting. The control group subjects performed lunges in the same conditions as those of the experimental group. Gait function was measured in terms of spatiotemporal parameters to determine the effect of mobilization with movement. [Results] The mobilization with movement group showed significant improvements in velocity, cadence, stride length, single-support time, and step length of the affected side, and step length and stride length of the non-affected side. Overall, the mobilization with movement group showed significantly greater improvements than the control group in terms of velocity, cadence, and single-support time of the affected side. [Conclusion] Mobilization with movement can be used to improve the gait function of patients recovering from stroke. PMID:27630424

  17. Effect of Mulligan’s mobilization with movement technique on gait function in stroke patients

    PubMed Central

    Kim, Sang-Lim; Lee, Byoung-Hee

    2016-01-01

    [Purpose] We examined the effectiveness of Mulligan’s mobilization with movement (MWM) technique on spatiotemporal variables of gait in individuals who had a stroke. [Subjects and Methods] Twenty-four subjects were randomly divided into 2 groups: Mulligan’s mobilization with movement group (n=12) and “weight-bearing with placebo” mobilization with movement group (n=12). The subjects in the mobilization with movement group performed 5 sets of 10 glides a day, 5 times a week for 4 weeks. The mobilization with movement technique comprised grade III movements that involved gliding and resting. The control group subjects performed lunges in the same conditions as those of the experimental group. Gait function was measured in terms of spatiotemporal parameters to determine the effect of mobilization with movement. [Results] The mobilization with movement group showed significant improvements in velocity, cadence, stride length, single-support time, and step length of the affected side, and step length and stride length of the non-affected side. Overall, the mobilization with movement group showed significantly greater improvements than the control group in terms of velocity, cadence, and single-support time of the affected side. [Conclusion] Mobilization with movement can be used to improve the gait function of patients recovering from stroke.

  18. Further Examination of Modifying Patient-Preferred Movement and Alignment Strategies in Patients with Low Back Pain During Symptomatic Tests

    PubMed Central

    Van Dillen, Linda R.; Maluf, Katrina S.; Sahrmann, Shirley A.

    2009-01-01

    Our purpose was to examine the effect of modifying symptomatic movement and alignment tests in a sample of people with LBP referred to physical therapy. Fifty-one patients (19 males, 32 females; mean age 37±10.59 y) with LBP and a mean Oswestry Disability Index score of 34±18% were examined. The examination included 28 primary tests in which patients used their preferred movement or alignment strategy and reported symptoms. Symptomatic tests were followed by a secondary test in which the patient’s strategy was standardly modified to correct the spinal alignment or movement that occurred with the primary test. Symptoms and directions of movement or alignment modified were recorded. For 82% of the secondary tests, the majority of the patients’ symptoms improved. For 54% of the secondary tests, some patients required modification of more than one direction of movement or alignment to eliminate symptoms. The findings suggest that the modifications described are generalizable across a number of tests with a moderately involved group of patients, and for individual tests there is variability in the numbers and directions of movements or alignments that appear to contribute to symptoms. Information obtained from the modifications is important because it can be used to confirm the patient’s LBP classification and, within the context of the examination, immediately be used to teach the patient strategies to change movements and positions that appear to be contributing to his LBP. PMID:18032090

  19. Nursing advocacy during a military operation.

    PubMed

    Foley, B J; Minick, P; Kee, C

    2000-06-01

    Advocacy is an essential component of the registered nurse's professional role, yet experts provide no consistent definition of advocacy. The purpose of this study was to explore the experiences of military nurses as they engage in advocating practices and to describe their shared practices and common meanings. Heideggerian hermeneutic phenomenology, provided the framework and method for this study. Twenty-four U.S. Army nurses were individually interviewed and the researcher kept interview observational notes. The constant comparative method of analysis was used. The stories of these nurses revealed one constitutive pattern--safeguarding--and four related themes. The themes were advocating as protecting, advocating as attending the whole person, advocating as being the patient's voice, and advocating as preserving personhood. One conclusion was that military nurses must be prepared for the important safe-guarding role. They must be coached in how to deal with other members of the health team on the patient's behalf. PMID:10826256

  20. Effect of visual biofeedback of posterior tongue movement on articulation rehabilitation in dysarthria patients.

    PubMed

    Yano, J; Shirahige, C; Oki, K; Oisaka, N; Kumakura, I; Tsubahara, A; Minagi, S

    2015-08-01

    Articulation is driven by various combinations of movements of the lip, tongue, soft palate, pharynx and larynx, where the tongue plays an especially important role. In patients with cerebrovascular disorder, lingual motor function is often affected, causing dysarthria. We aimed to evaluate the effect of visual biofeedback of posterior tongue movement on articulation rehabilitation in dysarthria patients with cerebrovascular disorder. Fifteen dysarthria patients (10 men and 5 women; mean age, 70.7 ± 10.3 years) agreed to participate in this study. A device for measuring the movement of the posterior part of the tongue was used for the visual biofeedback. Subjects were instructed to produce repetitive articulation of [ka] as fast and steadily as possible between a lungful with/without visual biofeedback. For both the unaffected and affected sides, the range of ascending and descending movement of the posterior tongue with visual biofeedback was significantly larger than that without visual biofeedback. The coefficient of variation for these movements with visual biofeedback was significantly smaller than that without visual biofeedback. With visual biofeedback, the range of ascent exhibited a significant and strong correlation with that of descent for both the unaffected and affected sides. The results of this study revealed that the use of visual biofeedback leads to prompt and preferable change in the movement of the posterior part of the tongue. From the standpoint of pursuing necessary rehabilitation for patients with attention and memory disorders, visualization of tongue movement would be of marked clinical benefit.

  1. Effectiveness of an Inpatient Movement Disorders Program for Patients with Atypical Parkinsonism

    PubMed Central

    Hohler, Anna D.; Tsao, Jyeming M.; Katz, Douglas I.; DiPiero, T. Joy; Hehl, Christina L.; Leonard, Alissa; Allen, Valerie; Gardner, Maura; Phenix, Heidi; Saint-Hilaire, Marie; Ellis, Terry

    2012-01-01

    This paper investigated the effectiveness of an inpatient movement disorders program for patients with atypical parkinsonism, who typically respond poorly to pharmacologic intervention and are challenging to rehabilitate as outpatients. Ninety-one patients with atypical parkinsonism participated in an inpatient movement disorders program. Patients received physical, occupational, and speech therapy for 3 hours/day, 5 to 7 days/week, and pharmacologic adjustments based on daily observation and data. Differences between admission and discharge scores were analyzed for the functional independence measure (FIM), timed up and go test (TUG), two-minute walk test (TMW), Berg balance scale (BBS) and finger tapping test (FT), and all showed significant improvement on discharge (P > .001). Clinically significant improvements in total FIM score were evident in 74% of the patients. Results were similar for ten patients whose medications were not adjusted. Patients with atypical parkinsonism benefit from an inpatient interdisciplinary movement disorders program to improve functional status. PMID:22135763

  2. Effectiveness of an inpatient movement disorders program for patients with atypical parkinsonism.

    PubMed

    Hohler, Anna D; Tsao, Jyeming M; Katz, Douglas I; Dipiero, T Joy; Hehl, Christina L; Leonard, Alissa; Allen, Valerie; Gardner, Maura; Phenix, Heidi; Saint-Hilaire, Marie; Ellis, Terry

    2012-01-01

    This paper investigated the effectiveness of an inpatient movement disorders program for patients with atypical parkinsonism, who typically respond poorly to pharmacologic intervention and are challenging to rehabilitate as outpatients. Ninety-one patients with atypical parkinsonism participated in an inpatient movement disorders program. Patients received physical, occupational, and speech therapy for 3 hours/day, 5 to 7 days/week, and pharmacologic adjustments based on daily observation and data. Differences between admission and discharge scores were analyzed for the functional independence measure (FIM), timed up and go test (TUG), two-minute walk test (TMW), Berg balance scale (BBS) and finger tapping test (FT), and all showed significant improvement on discharge (P > .001). Clinically significant improvements in total FIM score were evident in 74% of the patients. Results were similar for ten patients whose medications were not adjusted. Patients with atypical parkinsonism benefit from an inpatient interdisciplinary movement disorders program to improve functional status. PMID:22135763

  3. Media Advocacy. Technical Assistance Packet.

    ERIC Educational Resources Information Center

    Join Together, Boston, MA.

    Media advocacy is an environmental strategy that can be used to support alcohol and other drug prevention and policy development efforts. It helps shift the focus from understanding public health issues as individual problems to understanding them as social conditions that require collective behavior changes. Successful media advocacy uses the…

  4. Radiographic observers' ability to recognize patient movement during cone beam CT

    PubMed Central

    Matzen, L H; Schropp, L; Liedke, G S; Gotfredsen, E; Wenzel, A

    2014-01-01

    Objectives: To assess radiographic observers' ability to recognize patient movement during cone beam CT and to decide early termination of the examination. Methods: 100 patients were video-recorded during cone beam CT examination. Patients' videos were cropped twice: fitting the active 20-s examination time or the initial non-radiation 3 s of the examination. x- and y-coordinates of pre-defined points marked on the patient's face were used to define the reference standard for movement in the 20-s videos. A sample of 40 non-moving and 20 moving patients was selected. Eight observers scored the videos. The 3-s videos were scored: 0, the patient did not move; 1, the patient moved and the examination should be terminated. The 20-s videos were scored: 0, the patient did not move; 1, the patient moved. Re-assessment of 15% of the videos provided intra-observer reproducibility. The 20-s videos were compared with the reference standard providing sensitivity and specificity values (movement/non-movement recognition). The scores of the 3-s videos were compared with the scores of the 20-s videos. Results: Intra- and interobserver reproducibility ranged from substantial to almost perfect for both videos. The 20-s videos allowed patient movement recognition with a high specificity and a medium to high sensitivity. The 3-s videos allowed early termination of the examination with a small number of incorrect positive scores. The majority of the patients scored as moving in the 20-s videos were detected in the 3-s videos. Conclusions: By observing video recordings, trained observers are able to recognize patient movement during cone beam CT examination with high specificity and to decide an early termination of the examination. PMID:24660954

  5. Exploring Eye Movements in Patients with Glaucoma When Viewing a Driving Scene

    PubMed Central

    Crabb, David P.; Smith, Nicholas D.; Rauscher, Franziska G.; Chisholm, Catharine M.; Barbur, John L.; Edgar, David F.; Garway-Heath, David F.

    2010-01-01

    Background Glaucoma is a progressive eye disease and a leading cause of visual disability. Automated assessment of the visual field determines the different stages in the disease process: it would be desirable to link these measurements taken in the clinic with patient's actual function, or establish if patients compensate for their restricted field of view when performing everyday tasks. Hence, this study investigated eye movements in glaucomatous patients when viewing driving scenes in a hazard perception test (HPT). Methodology/Principal Findings The HPT is a component of the UK driving licence test consisting of a series of short film clips of various traffic scenes viewed from the driver's perspective each containing hazardous situations that require the camera car to change direction or slow down. Data from nine glaucomatous patients with binocular visual field defects and ten age-matched control subjects were considered (all experienced drivers). Each subject viewed 26 different films with eye movements simultaneously monitored by an eye tracker. Computer software was purpose written to pre-process the data, co-register it to the film clips and to quantify eye movements and point-of-regard (using a dynamic bivariate contour ellipse analysis). On average, and across all HPT films, patients exhibited different eye movement characteristics to controls making, for example, significantly more saccades (P<0.001; 95% confidence interval for mean increase: 9.2 to 22.4%). Whilst the average region of ‘point-of-regard’ of the patients did not differ significantly from the controls, there were revealing cases where patients failed to see a hazard in relation to their binocular visual field defect. Conclusions/Significance Characteristics of eye movement patterns in patients with bilateral glaucoma can differ significantly from age-matched controls when viewing a traffic scene. Further studies of eye movements made by glaucomatous patients could provide useful

  6. The effects of eye movement training on gait function in patients with stroke

    PubMed Central

    Kang, Kwon-Young; Yu, Kyung-Hoon

    2016-01-01

    [Purpose] The present study examined the effects of eye movement training on gait function in patients with stroke. [Subjects and Methods] Fourteen patients with stroke were randomly assigned to either an experimental group or a control group. The experimental group underwent eye movement training while the control group underwent general gait training five times per week for six weeks. [Results] Patient walking speed, cadence, and step length were measured by ink-footprint. The experimental group exhibited significant changes in walking speed, cadence, and step length following training, while the control group exhibited no differences. [Conclusion] Findings indicate that eye movement training should be considered as part of a functional gait training program for patients with stroke. PMID:27390423

  7. Detection of mental imagery and attempted movements in patients with disorders of consciousness using EEG

    PubMed Central

    Horki, Petar; Bauernfeind, Günther; Klobassa, Daniela S.; Pokorny, Christoph; Pichler, Gerald; Schippinger, Walter; Müller-Putz, Gernot R.

    2014-01-01

    Further development of an EEG based communication device for patients with disorders of consciousness (DoC) could benefit from addressing the following gaps in knowledge—first, an evaluation of different types of motor imagery; second, an evaluation of passive feet movement as a mean of an initial classifier setup; and third, rapid delivery of biased feedback. To that end we investigated whether complex and/or familiar mental imagery, passive, and attempted feet movement can be reliably detected in patients with DoC using EEG recordings, aiming to provide them with a means of communication. Six patients in a minimally conscious state (MCS) took part in this study. The patients were verbally instructed to perform different mental imagery tasks (sport, navigation), as well as attempted feet movements, to induce distinctive event-related (de)synchronization (ERD/S) patterns in the EEG. Offline classification accuracies above chance level were reached in all three tasks (i.e., attempted feet, sport, and navigation), with motor tasks yielding significant (p < 0.05) results more often than navigation (sport: 10 out of 18 sessions; attempted feet: 7 out of 14 sessions; navigation: 4 out of 12 sessions). The passive feet movements, evaluated in one patient, yielded mixed results: whereas time-frequency analysis revealed task-related EEG changes over neurophysiological plausible cortical areas, the classification results were not significant enough (p < 0.05) to setup an initial classifier for the detection of attempted movements. Concluding, the results presented in this study are consistent with the current state of the art in similar studies, to which we contributed by comparing different types of mental tasks, notably complex motor imagery and attempted feet movements, within patients. Furthermore, we explored new venues, such as an evaluation of passive feet movement as a mean of an initial classifier setup, and rapid delivery of biased feedback. PMID:25566029

  8. A biological measure of stress levels in patients with functional movement disorders

    PubMed Central

    Maurer, Carine W.; LaFaver, Kathrin; Ameli, Rezvan; Toledo, Ryan; Hallett, Mark

    2015-01-01

    Introduction While the presence of co-existing psychological stressors has historically been used as a supportive factor in the diagnosis of functional neurological disorders, many patients with functional neurological disorders deny the presence of these stressors. The stress response circuitry in these patients remains largely unexplored. Methods We performed an observational study examining biological stress levels in patients with functional movement disorders as compared with matched healthy controls. Specifically, we compared levels of circulating cortisol, the end-product of the hypothalamic-pituitary-adrenal axis. Salivary cortisol samples were collected from patients with “clinically definite” functional movement disorders (n=33) and their age- and sex-matched controls (n=33). Collections were performed at five standardized time points, reflecting participants’ diurnal cortisol cycles. To rule out confounders, participants also underwent extensive psychological assessment including Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Hamilton Anxiety Rating Scale, and Hamilton Rating Scale for Depression. Results Patients with functional movement disorders did not differ from matched controls with respect to levels of circulating cortisol. Conclusion We demonstrate that current stress levels are not altered in patients with functional movement disorders. Our results warrant careful review of current management of patients with functional neurological symptoms, and suggest that the insistence on heightened stress levels in these patients is unjustified. PMID:26117436

  9. Harmonization of free mandibular movements by orthodontic-surgical treatment of patients with mandibular retrognathism.

    PubMed

    Schwestka-Polly, R; Kubein-Meesenburg, D; Nägerl, H

    2000-01-01

    The aim of the following study was to investigate whether adult patients with mandibular retrognathism combined with a dental Class II relationship without craniomandibular pain show a characteristic structure of free mandibular movements caused by the neuromuscular system compared to patients with neutral skeletal and dental relationships. The authors also analyzed whether these characteristic structures changed following orthodontic-surgical treatment. To record the spatial movement of the mandible, an ultrasound measurement system was chosen and diagnostic software was developed for computer analysis of the recorded movements based on physical and biomechanical concepts. Clinically complaint-free, adult patients with mandibular retrognathism and distal bite exhibited a structure of mandibular movement that was markedly displaced as compared to patients with neutral skeletal and dental alignment. After completion of orthodontic and surgical treatment, it is apparent that the entire neuromuscular system of movement was transformed from one characterized by massive dysco-ordination to one of harmonized, coordinated motion, as is seen in patients with nonpathologic, neutral relation.

  10. Illusory movements of the contralesional hand in patients with body image disorders

    PubMed Central

    Zampini, M; Moro, V; Aglioti, S

    2004-01-01

    Methods: Ten RBD patients (three with disorders of bodily representations) were asked to report whether movements of their right hand induced any illusory somatic or motor sensations. Inquiries on anomalous sensation of movement of the left hand were carried out while subjects: 1) observed the moving hand in a mirror propped vertically along the parasagittal plane; 2) looked directly at the moving hand; 3) looked at the still hand; 4) kept their eyes closed. Twelve healthy subjects served as controls. Results: Movement of the right hand induced a very clear sensation of movement of the left, contralesional hand in two patients affected by body image disorders. Remarkably, this occurred mainly while subjects were looking in the mirror, that is, when conflicts between visual, somatic, and motor information were maximal. In no condition did control subjects report any consistent anomalous evoked movement or sensation. Conclusions: Illusory movements of the left, plegic hand contingent upon sensorimotor conflicts can be evoked in brain damaged patients with body image disorders. PMID:15489402

  11. Behavioral Characteristics of Bowel Movement and Urination Needs in Patients With Dementia in Taiwan.

    PubMed

    Shih, Yen-Hua; Wang, Chi-Jane; Sue, En-Ping; Wang, Jing-Jy

    2015-06-01

    Patients with dementia, especially those with advanced dementia, may not be able to express their bowel movement and urination needs using lucid language, and instead do so through behaviors. The aim of the current study was to understand and compare the behavioral characteristics of bowel movement and urination needs in patients with dementia. Observations were made by caregivers of 187 patients with dementia based on the Behavior Checklist developed by the research team for bowel movement and urination. Sixteen behavioral characteristics were identified for both bowel movement and urination; among these, anxiety, taking off/putting on clothes inappropriately, restlessness, attempting to go elsewhere, scratching skin, repeated behavior, and making strange sounds were commonly reported. Facial expressions of sorrow, restlessness, and anxiety were the three most common behaviors related to bowel movement needs, whereas anxiety, taking off/putting on clothes inappropriately, and constant moaning were the most common behaviors for urination needs. The findings suggest that the common behavioral characteristics could be seen as indicators of excretion need and the others can be used to distinguish between the need for bowel movement and urination.

  12. Movement and Other Neurodegenerative Syndromes in Patients with Systemic Rheumatic Diseases

    PubMed Central

    Menezes, Rikitha; Pantelyat, Alexander; Izbudak, Izlem; Birnbaum, Julius

    2015-01-01

    Abstract Patients with rheumatic diseases can present with movement and other neurodegenerative disorders. It may be underappreciated that movement and other neurodegenerative disorders can encompass a wide variety of disease entities. Such disorders are strikingly heterogeneous and lead to a wider spectrum of clinical injury than seen in Parkinson's disease. Therefore, we sought to stringently phenotype movement and other neurodegenerative disorders presenting in a case series of rheumatic disease patients. We integrated our findings with a review of the literature to understand mechanisms which may account for such a ubiquitous pattern of clinical injury. Seven rheumatic disease patients (5 Sjögren's syndrome patients, 2 undifferentiated connective tissue disease patients) were referred and could be misdiagnosed as having Parkinson's disease. However, all of these patients were ultimately diagnosed as having other movement or neurodegenerative disorders. Findings inconsistent with and more expansive than Parkinson's disease included cerebellar degeneration, dystonia with an alien-limb phenomenon, and nonfluent aphasias. A notable finding was that individual patients could be affected by cooccurring movement and other neurodegenerative disorders, each of which could be exceptionally rare (ie, prevalence of ∼1:1000), and therefore with the collective probability that such disorders were merely coincidental and causally unrelated being as low as ∼1-per-billion. Whereas our review of the literature revealed that ubiquitous patterns of clinical injury were frequently associated with magnetic resonance imaging (MRI) findings suggestive of a widespread vasculopathy, our patients did not have such neuroimaging findings. Instead, our patients could have syndromes which phenotypically resembled paraneoplastic and other inflammatory disorders which are known to be associated with antineuronal antibodies. We similarly identified immune-mediated and inflammatory markers

  13. Measurement of mandibular movements in parafunctional patient using occlusal splint with Bragg gratings: pilot study

    NASA Astrophysics Data System (ADS)

    Franco, Ana Paula G. O.; Gebert, Andréa. O.; Souza, Mauren A.; Jeranoski, Lorena; Kalinowski, Hypolito J.; Abe, Ilda

    2016-05-01

    The aim of the study is to demonstrate the potential of the fibre Braggs grating (FBG) in the measurement of different jaw movements that are performed for patients with occlusal parafunction using occlusal splints. Two silicon plates each 2mm are used, the fibre optic sensor is positioned in the maxillary left first molar region above the point of contact with opposing tooth after pressing the first plate on the model. Then the second silicon plate is pressed. The device has a final thickness of 2 mm. The occlusal splint is installed in the mouth of the patient who underwent different movements on occlusal splint. The maximum frequency bite is monitored. The results demonstrate that the bite shows a difference between grinding and clenching movements. The curves behaviour patterns are presented in order to show these different comparisons. Therefore, it is concluded that the fibre Braggs grating consists in an efficient method for monitoring the mechanical behaviour bite of patients with occlusal splints.

  14. Functional asymmetries in the movement kinematics of patients with Tourette's syndrome

    PubMed Central

    Georgiou, N.; Bradshaw, J.; Phillips, J.; Cunnington, R.; Rogers, M.

    1997-01-01

    OBJECTIVES—This study adopted a concurrent task design and aimed to quantify the efficiency and smoothness of voluntary movement in Tourette's syndrome via the use of a graphics tablet which permits analysis of movement profiles. In particular, the aim was to ascertain whether a concurrent task (digit span) would affect the kinematics of goal directed movements, and whether patients with Tourette's syndrome would exhibit abnormal functional asymmetries compared with their matched controls.
Methods—Twelve patients with Tourette's syndrome and their matched controls performed 12 vertical zig zag movements, with both left and right hands (with and without the concurrent task), to large or small targets over long or short extents. 
Results—With short strokes, controls showed the predicted right hand superiority in movement time more strongly than patients with Tourette's syndrome, who instead showed greater hand symmetry with short strokes. The right hand of controls was less force efficient with long strokes and more force efficient with short strokes, whereas either hand of patients with Tourette's syndrome was equally force efficient, irrespective of stroke length, with an overall performance profile similar to but better than that of the controls' left hand. The concurrent task, however, increased the force efficiency of the right hand in patients with Tourette's syndrome and the left hand in controls.
Conclusions—Patients with Tourette's syndrome, compared with controls, were not impaired in the performance of fast, goal directed movements such as aiming at targets; they performed in certain respects better than controls. The findings clearly add to the growing literature on anomalous lateralisation in Tourette's syndrome, which may be explained by the recently reported loss of normal basal ganglia asymmetries in that disorder.

 PMID:9285457

  15. [An electric exercycle for rehabilitation of patients with movement disorders].

    PubMed

    Semenov, A G; Elizov, A D; Sychev, A S

    2006-01-01

    The design, construction, performance, and results of clinical testing of an electric exercycle are described. Medical recommendations for its use are given. The electric exercycle is based on electric motor and mechanical gearbox. It has adjustable velocity and load characteristics and provides monitoring of motion parameters and safety monitoring. The electric exercycle is intended for training, rehabilitation, and maintenance of functional capabilities of lower extremities in patients with complete or partial immobilization of lower extremities.

  16. Machine learning classification of medication adherence in patients with movement disorders using non-wearable sensors.

    PubMed

    Tucker, Conrad S; Behoora, Ishan; Nembhard, Harriet Black; Lewis, Mechelle; Sterling, Nicholas W; Huang, Xuemei

    2015-11-01

    Medication non-adherence is a major concern in the healthcare industry and has led to increases in health risks and medical costs. For many neurological diseases, adherence to medication regimens can be assessed by observing movement patterns. However, physician observations are typically assessed based on visual inspection of movement and are limited to clinical testing procedures. Consequently, medication adherence is difficult to measure when patients are away from the clinical setting. The authors propose a data mining driven methodology that uses low cost, non-wearable multimodal sensors to model and predict patients' adherence to medication protocols, based on variations in their gait. The authors conduct a study involving Parkinson's disease patients that are "on" and "off" their medication in order to determine the statistical validity of the methodology. The data acquired can then be used to quantify patients' adherence while away from the clinic. Accordingly, this data-driven system may allow for early warnings regarding patient safety. Using whole-body movement data readings from the patients, the authors were able to discriminate between PD patients on and off medication, with accuracies greater than 97% for some patients using an individually customized model and accuracies of 78% for a generalized model containing multiple patient gait data. The proposed methodology and study demonstrate the potential and effectiveness of using low cost, non-wearable hardware and data mining models to monitor medication adherence outside of the traditional healthcare facility. These innovations may allow for cost effective, remote monitoring of treatment of neurological diseases.

  17. Saccadic eye movements and face recognition performance in patients with central glaucomatous visual field defects.

    PubMed

    Glen, Fiona C; Smith, Nicholas D; Crabb, David P

    2013-04-19

    Patients with more advanced glaucoma are likely to experience problems with everyday visual tasks such as face recognition. However, some patients still perform well at face recognition despite their visual field (VF) defects. This study investigated whether certain eye movement patterns are associated with better performance in the Cambridge Face Memory Test. For patients with bilateral VF defects in their central 10° of VF, making larger saccades appeared to be associated with better face recognition performance (rho=0.60, p=0.001). Associations were less apparent for the patients without significant 10° defects. There were no significant associations between saccade amplitude and task performance in people with healthy vision (rho=-0.24; p=0.13). These findings suggest that some patients with likely symptomatic glaucomatous damage manifest eye movements to adapt to VF loss during certain visual activities.

  18. The effects of bilateral movement training on upper limb function in chronic stroke patients

    PubMed Central

    Han, Kyoung Ju; Kim, Jin Young

    2016-01-01

    [Purpose] This study compared the functional and kinematic changes associated with two rehabilitation protocols: bilateral and unilateral movement training. [Subjects and Methods] Twenty-five patients with chronic stroke were randomly assigned to two training protocols for four weeks of training. Each training session consisted of three tasks. The tasks were performed with either the impaired and unimpaired arms moving synchronously (bilateral training) or with the impaired arm alone (unilateral training). To compare the changes associated with each rehabilitation protocol, functional and kinematic assessments were performed before and after the interventions. The functional state of each patient was measured by the Box and Block Test, and the kinematic variables were assessed by three-dimensional motion analysis. The Box and Block Test was used to assess the functional abilities of the affected upper limb. Kinematic measurements of upper limb movement were measured with a 3-dimensional motion analysis system. [Results] Results showed that the bilateral movement group had significantly improved motion of the shoulder compared to the unilateral movement group. [Conclusion] Bilateral movement training should be used to improve upper limb function in patients with chronic stroke. PMID:27630418

  19. The effects of bilateral movement training on upper limb function in chronic stroke patients

    PubMed Central

    Han, Kyoung Ju; Kim, Jin Young

    2016-01-01

    [Purpose] This study compared the functional and kinematic changes associated with two rehabilitation protocols: bilateral and unilateral movement training. [Subjects and Methods] Twenty-five patients with chronic stroke were randomly assigned to two training protocols for four weeks of training. Each training session consisted of three tasks. The tasks were performed with either the impaired and unimpaired arms moving synchronously (bilateral training) or with the impaired arm alone (unilateral training). To compare the changes associated with each rehabilitation protocol, functional and kinematic assessments were performed before and after the interventions. The functional state of each patient was measured by the Box and Block Test, and the kinematic variables were assessed by three-dimensional motion analysis. The Box and Block Test was used to assess the functional abilities of the affected upper limb. Kinematic measurements of upper limb movement were measured with a 3-dimensional motion analysis system. [Results] Results showed that the bilateral movement group had significantly improved motion of the shoulder compared to the unilateral movement group. [Conclusion] Bilateral movement training should be used to improve upper limb function in patients with chronic stroke.

  20. Patients' rights or patients' neglect: the impact of the patients' rights movement on delivery systems.

    PubMed

    Sehdev, H S

    1976-10-01

    This paper offers a clinician's perspective on the complex and controversial issues related to "patients' rights." It is suggested that such "rights" interpreted and applied literally may contravene the basic right of the individual to receive needed treatment. Related issues are discussed, and a mechanism for exploring resolutions to the conflict between psychiatry and the law is suggested.

  1. Movement disorder profile and treatment outcomes in a one-year study of patients with schizophrenia

    PubMed Central

    Chen, Lei; Ascher-Svanum, Haya; Lawson, Anthony; Stauffer, Virginia L; Nyhuis, Allen; Haynes, Virginia; Schuh, Kory; Kinon, Bruce J

    2013-01-01

    Background This study identified subgroups of patients with schizophrenia who differed on their movement disorder profile and compared their treatment outcomes. Methods Data from a randomized, open-label, one-year study of patients with schizophrenia who were treated with antipsychotics in usual clinical care settings were analyzed (n = 640). Five measures of movement disorder were incorporated into a single Movement Disorder Index (MDI). Subgroups that differed in their movement disorder profile over the one-year study period were compared on clinical and functional outcomes. Results Three subgroups were identified: a worsening of MDI in 15% of patients, an improvement in 33%, and no change in 53%. Compared with the other two subgroups, the MDI-worsened subgroup had poorer symptom improvement measured by the Positive and Negative Syndrome Scale (PANSS) total score (mean changes of −11.0, −18.4, and −16.8 for the patients who had a worsening of MDI, no change, and an improvement, respectively), poorer symptom improvement on the PANSS positive and anxiety/depression subscale scores, worsening on the 36-Item Short Form Health Survey (SF-36) physical component summary score, and a higher rate of hospitalization (P < 0.05). Conclusion Patients with schizophrenia who experience worsening of their MDI score appear to have poorer clinical and functional outcomes, suggesting that such worsening may be a marker of poorer prognosis. PMID:23807848

  2. Litigation as TB Rights Advocacy

    PubMed Central

    2016-01-01

    Abstract One thousand people die every day in India as a result of TB, a preventable and treatable disease, even though the Constitution of India, government schemes, and international law guarantee available, accessible, acceptable, quality health care. Failure to address the spread of TB and to provide quality treatment to all affected populations constitutes a public health and human rights emergency that demands action and accountability. As part of a broader strategy, health activists in India employ Public Interest Litigation (PIL) to hold the state accountable for rights violations and to demand new legislation, standards for patient care, accountability for under-spending, improvements in services at individual facilities, and access to government entitlements in marginalized communities. Taking inspiration from right to health PIL cases (PILs), lawyers in a New Delhi-based rights organization used desk research, fact-findings, and the Right To Information Act to build a TB PIL for the Delhi High Court, Sanjai Sharma v. NCT of Delhi and Others (2015). The case argues that inadequate implementation of government TB schemes violates the Constitutional rights to life, health, food, and equality. Although PILs face substantial challenges, this paper concludes that litigation can be a crucial advocacy and accountability tool for people living with TB and their allies. PMID:27781000

  3. Constraint Induced Movement Techniques To Facilitate Upper Extremity Use in Stroke Patients.

    PubMed

    Taub, E; Wolf, S L

    1997-01-01

    A new therapeutic approach to the rehabilitation of movement after stroke, termed constraint-induced (CI) movement therapy, has been derived from basic research with monkeys given somatosensory deafferentation. CI movement therapy consists of a family of therapies; their common element is that they induce stroke patients to greatly increase the use of an affected upper extremity for many hours a day over a period of 10 to 14 consecutive days. The signature intervention involves motor restriction of the contralateral upper extremity in a sling and training of the affected arm. The therapies result in large changes in amount of use of the affected arm in the activities of daily living outside of the clinic that have persisted for the 2 years measured to date. Patients who will benefit from Cl therapy can be identified before the beginning of treatment. PMID:27620374

  4. Identification of trunk and pelvis movement compensations in patients with transtibial amputation using angular momentum separation.

    PubMed

    Gaffney, Brecca M; Murray, Amanda M; Christiansen, Cory L; Davidson, Bradley S

    2016-03-01

    Patients with unilateral dysvascular transtibial amputation (TTA) have a higher risk of developing low back pain than their healthy counterparts, which may be related to movement compensations used in the absence of ankle function. Assessing components of segmental angular momentum provides a unique framework to identify and interpret these movement compensations alongside traditional observational analyses. Angular momentum separation indicates two components of total angular momentum: (1) transfer momentum and (2) rotational momentum. The objective of this investigation was to assess movement compensations in patients with dysvascular TTA, patients with diabetes mellitus (DM), and healthy controls (HC) by examining patterns of generating and arresting trunk and pelvis segmental angular momenta during gait. We hypothesized that all groups would demonstrate similar patterns of generating/arresting total momentum and transfer momentum in the trunk and pelvis in reference to the groups (patients with DM and HC). We also hypothesized that patients with amputation would demonstrate different (larger) patterns of generating/arresting rotational angular momentum in the trunk. Patients with amputation demonstrated differences in trunk and pelvis transfer angular momentum in the sagittal and transverse planes in comparison to the reference groups, which indicates postural compensations adopted during walking. However, patients with amputation demonstrated larger patterns of generating and arresting of trunk and pelvis rotational angular momentum in comparison to the reference groups. These segmental rotational angular momentum patterns correspond with high eccentric muscle demands needed to arrest the angular momentum, and may lead to consequential long-term effects such as low back pain.

  5. Identification of trunk and pelvis movement compensations in patients with transtibial amputation using angular momentum separation.

    PubMed

    Gaffney, Brecca M; Murray, Amanda M; Christiansen, Cory L; Davidson, Bradley S

    2016-03-01

    Patients with unilateral dysvascular transtibial amputation (TTA) have a higher risk of developing low back pain than their healthy counterparts, which may be related to movement compensations used in the absence of ankle function. Assessing components of segmental angular momentum provides a unique framework to identify and interpret these movement compensations alongside traditional observational analyses. Angular momentum separation indicates two components of total angular momentum: (1) transfer momentum and (2) rotational momentum. The objective of this investigation was to assess movement compensations in patients with dysvascular TTA, patients with diabetes mellitus (DM), and healthy controls (HC) by examining patterns of generating and arresting trunk and pelvis segmental angular momenta during gait. We hypothesized that all groups would demonstrate similar patterns of generating/arresting total momentum and transfer momentum in the trunk and pelvis in reference to the groups (patients with DM and HC). We also hypothesized that patients with amputation would demonstrate different (larger) patterns of generating/arresting rotational angular momentum in the trunk. Patients with amputation demonstrated differences in trunk and pelvis transfer angular momentum in the sagittal and transverse planes in comparison to the reference groups, which indicates postural compensations adopted during walking. However, patients with amputation demonstrated larger patterns of generating and arresting of trunk and pelvis rotational angular momentum in comparison to the reference groups. These segmental rotational angular momentum patterns correspond with high eccentric muscle demands needed to arrest the angular momentum, and may lead to consequential long-term effects such as low back pain. PMID:26979898

  6. Reliability of lumbar movement dysfunction tests for chronic low back pain patients.

    PubMed

    Bauer, Christoph Michael; Heimgartner, Martin; Rast, Fabian Marcel; Ernst, Markus Josef; Oetiker, Sarah; Kool, Jan

    2016-08-01

    Assessment of lumbar movement dysfunction commonly comprises trunk range of motion (ROM), movement or control impairment (MCI), and reposition error (RE). Those assessments are typically based on visual observation. Consequently it is not possible to reliably quantify back movements for intersubject comparisons, or for monitoring changes before and after an intervention. Inertial measurement unit (IMU)-systems could be used to quantify these movement dysfunctions in clinical settings. The aim of this study was to evaluate the reliability of movement dysfunction tests when measured with a novel IMU-system. The reliability of eleven movement dysfunction tests (four ROM, six MCI and one RE tests) were analysed using generalizability-theory and minimal detectable change, measuring 21 chronic low back pain patients in seven trials on two days. Reliability varied across tests and variables. Four ROM and selected MCI tests and variables were identified as reliable. On average, ROM test were more reliable, compared to MCI and RE tests. An attempt should be made to improve the reliability of MCI and RE measures, for example through better standardizations. Subsequently these measures should be studied further for intersubject comparisons and monitoring changes after an intervention. PMID:26980560

  7. How do cancer patients navigate the public information environment? Understanding patterns and motivations for movement among information sources.

    PubMed

    Nagler, Rebekah H; Romantan, Anca; Kelly, Bridget J; Stevens, Robin S; Gray, Stacy W; Hull, Shawnika J; Ramirez, A Susana; Hornik, Robert C

    2010-09-01

    Little is known about how patients move among information sources to fulfill unmet needs. We interviewed 43 breast, prostate, and colorectal cancer patients. Using a grounded theory approach, we identified patterns and motivations for movement among information sources. Overall, patients reported using one source (e.g., newspaper) followed by the use of another source (e.g., Internet), and five key motivations for such cross-source movement emerged. Patients' social networks often played a central role in this movement. Understanding how patients navigate an increasingly complex information environment may help clinicians and educators to guide patients to appropriate, high-quality sources.

  8. Discrete and dynamic scaling of the size of continuous graphic movements of parkinsonian patients and elderly controls

    PubMed Central

    Longstaff, M; Mahant, P; Stacy, M; Van Gemmert, A W A; Leis, B; Stelmach, G

    2003-01-01

    Objectives: To systematically investigate the ability of Parkinson's disease patients to discretely and dynamically scale the size of continuous movements and to assess the impact of movement size on outcome variability. Methods: Ten patients with Parkinson's disease (mean age 72 years) were compared with 12 healthy elderly controls (mean age 70 years). The subjects wrote with a stylus on a graphics tablet. In experiment 1 they drew circles, matching the size of five target circles ranging in magnitude from a radius of 0.5 cm up to 2.5 cm. In experiment 2 they drew spirals with a radius of at least 2 cm. In both experiments the drawings were initially performed as accurately as possible then as fast and accurately as possible. Results: In both experiments the patients and controls drew at a similar speed. The within trial variability of the pen trajectory was greater for patients than controls, and increased disproportionately with the size of the movement. When the emphasis was on size rather than variability (circles), the patients' drawing movements were the same size as controls. When the emphasis was on accuracy of pen trajectory (that is, minimum variability) rather than size (spirals), the patients' drawing movements were smaller than controls. Conclusions: The movements made by Parkinson's disease patients are hypometric partly as an adaptive strategy used to reduce movement variability. This strategy is used primarily when the requirement to make accurate movements outweighs the need to make large movements. PMID:12588912

  9. The patients' library movement: an overview of early efforts in the United States to establish organized libraries for hospital patients.

    PubMed

    Panella, N M

    1996-01-01

    The patients' library movement in the United States, a dynamic, cohesive drive begun and sustained by librarians and physicians, strove to promote placement of organized libraries for patients in hospitals. It took shape in the early years of this century, evolving from its proponents' deeply held conviction that books and reading foster the rehabilitation of sick people. The American Library Association's World War I service to hospitalized military personnel dramatically reinforced the conviction; the post-World War I institution of public library extension services to general hospitals explicitly reflected it. Enormous energy was infused into the patients' library movement. Throughout the first half of this century, there were sustained efforts not only to establish organized libraries for hospitalized people but also to expand and systematically study bibliotherapy and to shape patients' librarianship as a professional specialty. The movement's achievements include the establishment of patients' library committees within national and international associations; impetus for development of academic programs to train patients' librarians; and publication, from 1944 through 1970, of successive sets of standards for hospital patients' libraries. The first of these remain the first standards written and issued by a professional library association for a hospital library.

  10. Eye movements in patients with glaucoma when viewing images of everyday scenes.

    PubMed

    Smith, Nicholas D; Crabb, David P; Glen, Fiona C; Burton, Robyn; Garway-Heath, David F

    2012-01-01

    This study tests the hypothesis that patients with bilateral glaucoma exhibit different eye movements compared to normally-sighted people when viewing computer displayed photographs of everyday scenes. Thirty glaucomatous patients and 30 age-related controls with normal vision viewed images on a computer monitor whilst eye movements were simultaneously recorded using an eye tracking system. The patients demonstrated a significant reduction in the average number of saccades compared to controls (P = 0.02; mean reduction of 7% (95% confidence interval (CI): 3-11%)). There was no difference in average saccade amplitude between groups but there was between-person variability in patients. The average elliptical region scanned by the patients by a bivariate contour ellipse area (BCEA) analysis, was more restricted compared to controls (P = 0.004; mean reduction of 23% (95% (CI): 11-35%)). A novel analysis mapping areas of interest in the images indicated a weak association between severity of functional deficit and a tendency to not view regions typically viewed by the controls. In conclusion, some eye movements in some patients with bilateral glaucomatous defects differ from normal-sighted people of a similar age when viewing images of everyday scenes, providing evidence for a potential new window for looking into the functional consequences of the disease. PMID:23193606

  11. Single-joint rapid arm movements in normal subjects and in patients with motor disorders.

    PubMed

    Berardelli, A; Hallett, M; Rothwell, J C; Agostino, R; Manfredi, M; Thompson, P D; Marsden, C D

    1996-04-01

    In normal subjects the execution of single rapid one-joint movements is characterized by an electromyographic (EMG) pattern composed of three discrete bursts of activity; two bursts (first and second agonist bursts, or AG1 and AG2) are present in the agonist muscle separated by an almost complete period of electrical silence. During this pause, another burst (antagonist burst, or ANT) occurs in the antagonist muscle. If a rapid movement is executed during tonic activation of the agonist muscle, tonic activity is inhibited just prior to AG1 onset (agonist inhibition). Similarly, if the movement is performed during tonic activation of the antagonist muscle, such activity is also inhibited prior to AG1 onset (antagonist inhibition). Antagonist inhibition also starts prior to AG1 onset and lasts until ANT onset. A general descriptor of the kinematic features related to the EMG pattern described above is a symmetrical and unimodal velocity profile that is bell-shaped and shows an acceleration time roughly equal to the deceleration time. This holds true for movements performed under low accuracy constraints; as accuracy demands become stricter and stricter, the peak velocity decreases but, as long as the movement is made with one continuous trajectory, the velocity profile remains roughly symmetrical. In general terms, the function of AG1 is to provide the impulsive force to start the movement; the function of ANT is to halt the movement at the desired end-point; and the function of AG2 is to dampen out the oscillations which might occur at the end of the movement. The timing and size of the bursts vary according to the speed and amplitude of the movement. The origin of the EMG pattern is a central programme, but afferent inputs can modulate the voluntary activity. In this paper, we also review the EMG and kinematic abnormalities that are present during the execution of single-joint, rapid arm movements in patients with Parkinson's disease, Huntington's disease, Sydenham

  12. Finger tapping movements of Parkinson's disease patients automatically rated using nonlinear delay differential equations

    NASA Astrophysics Data System (ADS)

    Lainscsek, C.; Rowat, P.; Schettino, L.; Lee, D.; Song, D.; Letellier, C.; Poizner, H.

    2012-03-01

    Parkinson's disease is a degenerative condition whose severity is assessed by clinical observations of motor behaviors. These are performed by a neurological specialist through subjective ratings of a variety of movements including 10-s bouts of repetitive finger-tapping movements. We present here an algorithmic rating of these movements which may be beneficial for uniformly assessing the progression of the disease. Finger-tapping movements were digitally recorded from Parkinson's patients and controls, obtaining one time series for every 10 s bout. A nonlinear delay differential equation, whose structure was selected using a genetic algorithm, was fitted to each time series and its coefficients were used as a six-dimensional numerical descriptor. The algorithm was applied to time-series from two different groups of Parkinson's patients and controls. The algorithmic scores compared favorably with the unified Parkinson's disease rating scale scores, at least when the latter adequately matched with ratings from the Hoehn and Yahr scale. Moreover, when the two sets of mean scores for all patients are compared, there is a strong (r = 0.785) and significant (p <0.0015) correlation between them.

  13. Decoding movement intent of patient with multiple sclerosis for the powered lower extremity exoskeleton.

    PubMed

    Zhang, Fan; Huang, He

    2013-01-01

    This study aims to recognize movement intent of patients with multiple sclerosis (MS) by decoding neuromuscular control signals fused with mechanical measurements as a method of powered lower extremity exoskeleton control. Surface electromyographic (EMG) signals recorded from the lower extremity muscles, ground reaction forces measured from beneath both feet, and kinematics from both thigh segments of a single MS patient were used to identify three activities (level-ground walking, sitting, and standing). Our study showed that during activity performance clear modulation of muscle activity in the lower extremities was observed for the MS patient, whose Kurtzke Expanded Disability Status Scale (EDSS) was 6. The designed intent recognition algorithm can accurately classify the subject's intended movements with 98.73% accuracy in static states and correctly predict the activity transitions about 100 to 130 ms before the actual transitions were made. These promising results indicate the potential of designed intent recognition interface for volitional control of powered lower extremity exoskeletons. PMID:24110847

  14. Topiramate-induced periodic limb movement disorder in a patient affected by focal epilepsy

    PubMed Central

    Romigi, Andrea; Vitrani, Giuseppe; D'Aniello, Alfredo; Di Gennaro, Giancarlo

    2014-01-01

    Periodic limb movement disorder (PLMD) is characterized by pathological periodic limb movements during sleep, insomnia and/or diurnal sleepiness, and the absence of another primary sleep disorder. We report a patient with complex partial seizures who developed PLMD while taking topiramate (TPM). He had no evidence of metabolic and/or other conditions inducing PLMD. He also had fragmented sleep and disruptive PLMS on polysomnography, and PLMS subsided with change of antiepileptic drug. Topiramate may modulate the dopaminergic pathway by inhibition of glutamate release, thereby inducing PLMD as observed in our patient. Although a single case does not allow any generalization, PLMD should be considered in patients complaining of insomnia and treated with TPM. PMID:25667887

  15. What's the role of topiramate in the management of patients with hyperkinetic movement disorders?

    PubMed

    Siniscalchi, Antonio; Gallelli, Luca; Giofrè, Chiara; De Sarro, Giovambattista

    2012-01-01

    Topiramate (TPM) is an O-alkyl sulfamate derivative of the naturally occurring monosaccharide D-fructose with an epileptic activity. However, it has been suggested that, in addition to its use in epilepsy, TPM could also be used in the treatment of neurological disorders, psychiatric conditions and hyperkinetic movement disorders. The clinical applications of TPM in hyperkinetic movement disorders is consistent with the multiple pharmacodynamic mechanisms e.g., the modulation of both γ-aminobutyric acidergic or glutamatergic neurotransmission and the modulation of voltage-gated ion channels or intracellular signalling pathways. The purpose of the present review is to describe the mechanisms of action of TPM and its clinical efficacy in patients with hyperkinetic movement disorders. PMID:22580517

  16. Predicting Levels of Policy Advocacy Engagement Among Acute-Care Health Professionals.

    PubMed

    Jansson, Bruce S; Nyamathi, Adeline; Heidemann, Gretchen; Bird, Melissa; Ward, Cathy Rogers; Brown-Saltzman, Katherine; Duan, Lei; Kaplan, Charles

    2016-02-01

    This study aims to describe the factors that predict health professionals' engagement in policy advocacy. The researchers used a cross-sectional research design with a sample of 97 nurses, 94 social workers, and 104 medical residents from eight hospitals in Los Angeles. Bivariate correlations explored whether seven predictor scales were associated with health professionals' policy advocacy engagement and revealed that five of the eight factors were significantly associated with it (p < .05). The factors include patient advocacy engagement, eagerness, skills, tangible support, and organizational receptivity. Regression analysis examined whether the seven scales, when controlling for sociodemographic variables and hospital site, predicted levels of policy advocacy engagement. Results revealed that patient advocacy engagement (p < .001), eagerness (p < .001), skills (p < .01), tangible support (p < .01), perceived effectiveness (p < .05), and organizational receptivity (p < .05) all predicted health professional's policy advocacy engagement. Ethical commitment did not predict policy advocacy engagement. The model explained 36% of the variance in policy advocacy engagement. Limitations of the study and its implications for future research, practice, and policy are discussed.

  17. Predicting Levels of Policy Advocacy Engagement Among Acute-Care Health Professionals.

    PubMed

    Jansson, Bruce S; Nyamathi, Adeline; Heidemann, Gretchen; Bird, Melissa; Ward, Cathy Rogers; Brown-Saltzman, Katherine; Duan, Lei; Kaplan, Charles

    2016-02-01

    This study aims to describe the factors that predict health professionals' engagement in policy advocacy. The researchers used a cross-sectional research design with a sample of 97 nurses, 94 social workers, and 104 medical residents from eight hospitals in Los Angeles. Bivariate correlations explored whether seven predictor scales were associated with health professionals' policy advocacy engagement and revealed that five of the eight factors were significantly associated with it (p < .05). The factors include patient advocacy engagement, eagerness, skills, tangible support, and organizational receptivity. Regression analysis examined whether the seven scales, when controlling for sociodemographic variables and hospital site, predicted levels of policy advocacy engagement. Results revealed that patient advocacy engagement (p < .001), eagerness (p < .001), skills (p < .01), tangible support (p < .01), perceived effectiveness (p < .05), and organizational receptivity (p < .05) all predicted health professional's policy advocacy engagement. Ethical commitment did not predict policy advocacy engagement. The model explained 36% of the variance in policy advocacy engagement. Limitations of the study and its implications for future research, practice, and policy are discussed. PMID:27151835

  18. Machine learning classification of medication adherence in patients with movement disorders using non-wearable sensors.

    PubMed

    Tucker, Conrad S; Behoora, Ishan; Nembhard, Harriet Black; Lewis, Mechelle; Sterling, Nicholas W; Huang, Xuemei

    2015-11-01

    Medication non-adherence is a major concern in the healthcare industry and has led to increases in health risks and medical costs. For many neurological diseases, adherence to medication regimens can be assessed by observing movement patterns. However, physician observations are typically assessed based on visual inspection of movement and are limited to clinical testing procedures. Consequently, medication adherence is difficult to measure when patients are away from the clinical setting. The authors propose a data mining driven methodology that uses low cost, non-wearable multimodal sensors to model and predict patients' adherence to medication protocols, based on variations in their gait. The authors conduct a study involving Parkinson's disease patients that are "on" and "off" their medication in order to determine the statistical validity of the methodology. The data acquired can then be used to quantify patients' adherence while away from the clinic. Accordingly, this data-driven system may allow for early warnings regarding patient safety. Using whole-body movement data readings from the patients, the authors were able to discriminate between PD patients on and off medication, with accuracies greater than 97% for some patients using an individually customized model and accuracies of 78% for a generalized model containing multiple patient gait data. The proposed methodology and study demonstrate the potential and effectiveness of using low cost, non-wearable hardware and data mining models to monitor medication adherence outside of the traditional healthcare facility. These innovations may allow for cost effective, remote monitoring of treatment of neurological diseases. PMID:26406881

  19. Pregnancy and infant loss support: a new, feminist, American, patient movement?

    PubMed

    Layne, Linda L

    2006-02-01

    Using as examples three of the earliest pregnancy and infant loss organizations and multiple recent initiatives, I argue this is a unique patient movement, in part due to the particularities of pregnant patienthood. Although during the first 20 years of this distinctively US movement, pregnancy and infant loss support was hospital-based, there was remarkably little attention to the "medical" dimensions of these losses, e.g. etiology, diagnosis, prevention, and treatment. The thrust was instead on changing ideas and feelings. It is only since the turn of the century that bereaved parents have started to forge collaborations with physicians to work toward prevention. During the first phase (mid-1970s to mid-1990s), it was a women's movement, though it did not present itself as such, and although it was indebted to the feminist movement and included some feminist initiatives, the movement was dominated by a traditionally feminine ethos and included pro-life elements. During the second phase, as physicians and researchers have become more involved, leadership has become somewhat less female-centric while at the same time, more initiatives are explicitly feminist. PMID:16194590

  20. Pregnancy and infant loss support: a new, feminist, American, patient movement?

    PubMed

    Layne, Linda L

    2006-02-01

    Using as examples three of the earliest pregnancy and infant loss organizations and multiple recent initiatives, I argue this is a unique patient movement, in part due to the particularities of pregnant patienthood. Although during the first 20 years of this distinctively US movement, pregnancy and infant loss support was hospital-based, there was remarkably little attention to the "medical" dimensions of these losses, e.g. etiology, diagnosis, prevention, and treatment. The thrust was instead on changing ideas and feelings. It is only since the turn of the century that bereaved parents have started to forge collaborations with physicians to work toward prevention. During the first phase (mid-1970s to mid-1990s), it was a women's movement, though it did not present itself as such, and although it was indebted to the feminist movement and included some feminist initiatives, the movement was dominated by a traditionally feminine ethos and included pro-life elements. During the second phase, as physicians and researchers have become more involved, leadership has become somewhat less female-centric while at the same time, more initiatives are explicitly feminist.

  1. Advocacy and Age: Issues, Experiences, Strategies.

    ERIC Educational Resources Information Center

    Kerschner, Paul A., Ed.

    This monograph seeks to bring understanding to one component of the advocacy field, that of advocacy and the aged, by overviewing this component through a series of articles. (Advocacy is an activity by which changes can be effected in a power structure to improve a subgroup's situation.) There are four parts to the document: part 1, entitled…

  2. Practitioner Perceptions of School Library Advocacy

    ERIC Educational Resources Information Center

    Burns, Elizabeth

    2015-01-01

    School library advocacy is increasingly important due to decreases in funding and staff. National organizations attempt to engage school librarians in advocacy and have developed resources and tools to assist with this task. However, there is little research examining how practicing school librarians engage in advocacy and how their advocacy…

  3. Approaches to Advocacy for Health Educators.

    ERIC Educational Resources Information Center

    Mahoney, Beverly Saxton, Ed.; Brown, Kelli McCormack, Ed.

    1999-01-01

    This monograph provides a collection of articles on health educators' approaches to advocacy: "The Role of Health Education Advocacy in Removing Disparities in Health Care" (John P. Allegrante, Donald E. Morisky, and Behjat A. Sharif); "The Role of Health Education Associations in Advocacy" (M. Elaine Auld and Eleanor Dixon-Terry); "What…

  4. Every Voice Matters: The Importance of Advocacy

    ERIC Educational Resources Information Center

    Royea, Amber J.; Appl, Dolores J.

    2009-01-01

    Over the years parents, professionals, and politicians have come together to advocate on behalf of children's rights. Advocacy can occur individually, collectively, or a combination of both. Although some advocacy efforts are more successful than others, it is the process of the advocacy and voices behind it that matter most. In this guest…

  5. A Novel Education and Training Program to Enhance Student Advocacy.

    PubMed

    Adams, Alex J; Matzke, Gary R; McCall, Kenneth L

    2015-09-25

    Objective. To develop and implement a unique student advocacy program to train student pharmacists to be effective advocates for the profession of pharmacy and the patients it serves. Design. The Academy is a 2-day program hosted annually in Washington, DC, that combines didactic presentations on the legislative process, communication with policymakers, current legislation, and active-learning exercises such as mock congressional visits. The Academy culminates with visits to Capitol Hill where students meet with legislators and their staff to discuss pending legislation. Assessment. Nearly 350 students from 43 schools and colleges of pharmacy completed the program in its 4 years. Students are assessed following the active-learning exercises and meetings with legislators. Conclusion. Advocacy has been listed as a competency that requires more attention in pharmacy education. The Academy provides a model that schools may replicate to enhance their advocacy offerings.

  6. Breast cancer advocacy internships: student motivations, intentions, and perceptions.

    PubMed

    Trump, Tasha; Henderson, Jessica

    2011-03-01

    Currently, there are no published studies about the impact on students of a structured, breast-cancer-specific advocacy internship. Our goal was to provide the student perspective of participation in a national breast cancer advocacy conference in Washington, D.C. as part of an internship. Both qualitative and quantitative data were collected in three waves: 1 month before the training, during the training, and 1 month post-training. Four themes emerged: (1) empowerment, (2) connection with breast cancer patients and advocates, (3) learning outside the classroom, and (4) action through advocacy and civilian lobbying. This study found strong support for the internship model described here and is recommended for replication at other universities and institutions.

  7. A Novel Education and Training Program to Enhance Student Advocacy.

    PubMed

    Adams, Alex J; Matzke, Gary R; McCall, Kenneth L

    2015-09-25

    Objective. To develop and implement a unique student advocacy program to train student pharmacists to be effective advocates for the profession of pharmacy and the patients it serves. Design. The Academy is a 2-day program hosted annually in Washington, DC, that combines didactic presentations on the legislative process, communication with policymakers, current legislation, and active-learning exercises such as mock congressional visits. The Academy culminates with visits to Capitol Hill where students meet with legislators and their staff to discuss pending legislation. Assessment. Nearly 350 students from 43 schools and colleges of pharmacy completed the program in its 4 years. Students are assessed following the active-learning exercises and meetings with legislators. Conclusion. Advocacy has been listed as a competency that requires more attention in pharmacy education. The Academy provides a model that schools may replicate to enhance their advocacy offerings. PMID:27168608

  8. Natural and nosocomial infection in a patient with West Nile encephalitis and extrapyramidal movement disorders.

    PubMed

    Solomon, Tom; Fisher, Ann F; Beasley, David W C; Mandava, Pitchaiah; Granwehr, Bruno P; Langsjoen, Hans; Travassos Da Rosa, Amelia P; Barrett, Alan D T; Tesh, Robert B

    2003-06-01

    Since its first recognition in North America in 1999, West Nile virus (WNV) has spread rapidly across the continent, but in many communities, rapid diagnostic tests for detection of WNV infection are not fully available. We describe a patient with extrapyramidal movement disorders and changes in the basal ganglia noted on magnetic resonance images that are characteristic of other flavivirus encephalitides and may help in the recognition of patients with West Nile encephalitis. Detailed molecular analysis suggested that, although our patient received a blood transfusion infected with WNV, the virus that caused his initial infection and encephalitis was probably acquired naturally from a mosquito.

  9. Applying Buddhist Practices to Advocacy: The Advocacy-Serving Model

    ERIC Educational Resources Information Center

    Warren, Jane; Klepper, Konja K.; Lambert, Serena; Nunez, Johnna; Williams, Susan

    2011-01-01

    Creating and retaining empathic connections with the most disenfranchised among us can take a toll on the wellness of counselor advocates. The Advocacy-Serving Model is introduced as a creative approach to strengthening the ability of advocates to serve through enhancing awareness, focusing actions, and connecting to community. The model…

  10. Front-Line Advocacy: Advocacy Based on Effective Relationships

    ERIC Educational Resources Information Center

    Gooden, Benny L.

    2012-01-01

    When American Association of School Administrators (AASA) and other membership organizations try to engage individuals in advocacy, a frequent exhortation is "Contact your representatives in Congress." Professional membership groups also stress that written communication is more powerful than phone calls to a representative's office, and they…

  11. Dysfunctional putamen modulation during bimanual finger-to-thumb movement in patients with Parkinson's disease.

    PubMed

    Yan, Li-Rong; Wu, Yi-Bo; Zeng, Xiao-Hua; Gao, Li-Chen

    2015-01-01

    Parkinson's disease (PD) is a neurodegenerative disorder affecting middle-aged and elderly people. PD can be viewed as "circuit disorder," indicating that large scale cortico-subcortical pathways were involved in its pathophysiology. The brain network in an experimental context is emerging as an important biomarker in disease diagnosis and prognosis prediction. This context-dependent network for PD and the underling functional mechanism remains unclear. In this paper, the brain network profiles in 11 PD patients without dementia were studied and compared with 12 healthy controls. The functional magnetic resonance imaging (fMRI) data were acquired when the subjects were performing a pseudorandomized unimanual or bimanual finger-to-thumb movement task. The activation was detected and the network profiles were analyzed by psychophysiological interaction (PPI) toolbox. For the controls and PD patients, the motor areas including the primary motor and premotor areas, supplementary motor area, the cerebellum and parts of the frontal, temporal and parietal gyrus were activated. The right putamen exhibited significant control > PD activation and weaker activity during the bimanual movement relative to the unimanual movement in the control group. The decreased putamen modulation on some nucleus in basal ganglia, such as putamen, thalamus and caudate, and some cortical areas, such as cingulate, parietal, angular, frontal, temporal and occipital gyrus was detected in the bimanual movement condition relative to the unimanual movement condition. Between-group PPI difference was detected in cingulate gyrus, angular gyrus and precuneus (control > PD) and inferior frontal gyrus (PD > control). The deficient putamen activation and its enhanced connectivity with the frontal gyrus could be a correlate of impaired basal ganglia inhibition and frontal gyrus compensation to maintain the task performance during the motor programs of PD patients. PMID:26483652

  12. Dysfunctional putamen modulation during bimanual finger-to-thumb movement in patients with Parkinson's disease

    PubMed Central

    Yan, Li-rong; Wu, Yi-bo; Zeng, Xiao-hua; Gao, Li-chen

    2015-01-01

    Parkinson's disease (PD) is a neurodegenerative disorder affecting middle-aged and elderly people. PD can be viewed as “circuit disorder,” indicating that large scale cortico-subcortical pathways were involved in its pathophysiology. The brain network in an experimental context is emerging as an important biomarker in disease diagnosis and prognosis prediction. This context-dependent network for PD and the underling functional mechanism remains unclear. In this paper, the brain network profiles in 11 PD patients without dementia were studied and compared with 12 healthy controls. The functional magnetic resonance imaging (fMRI) data were acquired when the subjects were performing a pseudorandomized unimanual or bimanual finger-to-thumb movement task. The activation was detected and the network profiles were analyzed by psychophysiological interaction (PPI) toolbox. For the controls and PD patients, the motor areas including the primary motor and premotor areas, supplementary motor area, the cerebellum and parts of the frontal, temporal and parietal gyrus were activated. The right putamen exhibited significant control > PD activation and weaker activity during the bimanual movement relative to the unimanual movement in the control group. The decreased putamen modulation on some nucleus in basal ganglia, such as putamen, thalamus and caudate, and some cortical areas, such as cingulate, parietal, angular, frontal, temporal and occipital gyrus was detected in the bimanual movement condition relative to the unimanual movement condition. Between-group PPI difference was detected in cingulate gyrus, angular gyrus and precuneus (control > PD) and inferior frontal gyrus (PD > control). The deficient putamen activation and its enhanced connectivity with the frontal gyrus could be a correlate of impaired basal ganglia inhibition and frontal gyrus compensation to maintain the task performance during the motor programs of PD patients. PMID:26483652

  13. Neural control of movement stability: Lessons from studies of neurological patients

    PubMed Central

    Latash, Mark L.; Huang, Xuemei

    2015-01-01

    The concept of synergy provides a theoretical framework for movement stability resulting from the neural organization of multiple elements (digits, muscles, etc.) that all contribute to salient performance variables. Although stability of performance is obviously important for steady-state tasks leading to high synergy indices, a feed-forward drop in synergy indices is seen in preparation to a quick action (i.e., anticipatory synergy adjustments, ASAs). We review recent studies of multi-finger and multi-muscle synergies that show decreased indices of synergies and ASAs in patients with Parkinson’s disease (PD) or multisystem atrophy. In PD, the impairments in synergies and ASAs are partially reversed by dopaminergic drugs, and changes in synergy indices are present even in PD patients at earliest diagnosis. Taken together, these results point at subcortical structures that are crucial for proper control of movement stability. It is timely to introduce the concept of impaired control of stability as an objective, quantifiable, and theory-based clinical descriptor of movement disorders that can increase our understanding of the neural control of movement with all of its implications for clinical practice. PMID:26047732

  14. Neural control of movement stability: Lessons from studies of neurological patients.

    PubMed

    Latash, M L; Huang, X

    2015-08-20

    The concept of synergy provides a theoretical framework for movement stability resulting from the neural organization of multiple elements (digits, muscles, etc.) that all contribute to salient performance variables. Although stability of performance is obviously important for steady-state tasks leading to high synergy indices, a feed-forward drop in synergy indices is seen in preparation to a quick action (i.e., anticipatory synergy adjustments, ASAs). We review recent studies of multi-finger and multi-muscle synergies that show decreased indices of synergies and ASAs in patients with Parkinson's disease (PD) or multisystem atrophy. In PD, the impairments in synergies and ASAs are partially reversed by dopaminergic drugs, and changes in synergy indices are present even in PD patients at earliest diagnosis. Taken together, these results point at subcortical structures that are crucial for proper control of movement stability. It is timely to introduce the concept of impaired control of stability as an objective, quantifiable, and theory-based clinical descriptor of movement disorders that can increase our understanding of the neural control of movement with all of its implications for clinical practice. PMID:26047732

  15. Effects of eye movement with functional electrical stimulation on balance in stroke patients with neglect syndrome

    PubMed Central

    Park, Si-Eun

    2016-01-01

    [Purpose] The aim of the present study was to determine whether eye movement in conjunction with functional electrical stimulation (FES) could improve balance ability in stroke patients with neglect syndrome. [Subjects and Methods] The subjects consisted of 15 stroke patients with neglect syndrome. The intervention was eye movement in conjunction with FES. The program was conducted 5 times per week, for 6 weeks. Static balance (eyes-open and eyes-closed) and dynamic balance were measured before and after testing. [Results] In measurement of static balance, subjects showed significant differences in sway length and sway area when examined in the eyes-open condition, but not the eyes-closed condition. In measurement of dynamic balance, the subjects showed significant differences in limit of stability (forward/backward and left/right). [Conclusion] These results indicate that eye movement in conjunction with FES had a positive effect on the static and dynamic balance in the eyes-open condition, but not in the eyes-closed condition of stroke patients with neglect syndrome. Further studies should therefore investigate various interventions in stroke patients with neglect syndrome. PMID:27313375

  16. The effect of video-guidance on passive movement in patients with cerebral palsy: fMRI study.

    PubMed

    Dinomais, Mickael; Chinier, Eva; Lignon, Gregoire; Richard, Isabelle; Ter Minassian, Aram; Tich, Sylvie Nguyen The

    2013-10-01

    In patients with cerebral palsy (CP), neuroimaging studies have demonstrated that passive movement and action-observation tasks have in common to share neuronal activation in all or part of areas involved in motor system. Action observation with simultaneous congruent passive movements may have additional effects in the recruitment of brain motor areas. The aim of this functional magnetic resonance imaging (fMRI) study was to examine brain activation in patients with unilateral CP during passive movement with and without simultaneous observation of simple hand movement. Eighteen patients with unilateral CP (fourteen male, mean age 14 years and 2 months) participated in the study. Using fMRI block design, brain activation following passive simple opening-closing hand movement of either the paretic or nonparetic hand with and without simultaneous observation of a similar movement performed by either the left or right hand of an actor was compared. Passive movement of the paretic hand performed simultaneously to the observation of congruent movement activated more "higher motor areas" including contralesional pre-supplementary motor area, superior frontal gyrus (extending to premotor cortex), and superior and inferior parietal regions than nonvideo-guided passive movement of the paretic hand. Passive movement of the paretic hand recruited more ipsilesional sensorimotor areas compared to passive movement of the nonparetic hand. Our study showed that the combination of observation of congruent hand movement simultaneously to passive movement of the paretic hand recruits more motor areas, giving neuronal substrate to propose video-guided passive movement of paretic hand in CP rehabilitation. PMID:23927991

  17. The effect of video-guidance on passive movement in patients with cerebral palsy: fMRI study.

    PubMed

    Dinomais, Mickael; Chinier, Eva; Lignon, Gregoire; Richard, Isabelle; Ter Minassian, Aram; Tich, Sylvie Nguyen The

    2013-10-01

    In patients with cerebral palsy (CP), neuroimaging studies have demonstrated that passive movement and action-observation tasks have in common to share neuronal activation in all or part of areas involved in motor system. Action observation with simultaneous congruent passive movements may have additional effects in the recruitment of brain motor areas. The aim of this functional magnetic resonance imaging (fMRI) study was to examine brain activation in patients with unilateral CP during passive movement with and without simultaneous observation of simple hand movement. Eighteen patients with unilateral CP (fourteen male, mean age 14 years and 2 months) participated in the study. Using fMRI block design, brain activation following passive simple opening-closing hand movement of either the paretic or nonparetic hand with and without simultaneous observation of a similar movement performed by either the left or right hand of an actor was compared. Passive movement of the paretic hand performed simultaneously to the observation of congruent movement activated more "higher motor areas" including contralesional pre-supplementary motor area, superior frontal gyrus (extending to premotor cortex), and superior and inferior parietal regions than nonvideo-guided passive movement of the paretic hand. Passive movement of the paretic hand recruited more ipsilesional sensorimotor areas compared to passive movement of the nonparetic hand. Our study showed that the combination of observation of congruent hand movement simultaneously to passive movement of the paretic hand recruits more motor areas, giving neuronal substrate to propose video-guided passive movement of paretic hand in CP rehabilitation.

  18. Correlation between automated writing movements and striatal dopaminergic innervation in patients with Wilson's disease.

    PubMed

    Hermann, Wieland; Eggers, Birk; Barthel, Henryk; Clark, Daniel; Villmann, Thomas; Hesse, Swen; Grahmann, Friedrich; Kühn, Hans-Jürgen; Sabri, Osama; Wagner, Armin

    2002-08-01

    Handwriting defects are an early sign of motor impairment in patients with Wilson's disease. The basal ganglia being the primary site of copper accumulation in the brain suggests a correlation with lesions in the nigrostiatal dopaminergic system. We have analysed and correlated striatal dopaminergic innervation using [(123)I]beta-CIT-SPECT and automated handwriting movements in 37 patients with Wilson's disease. There was a significant correlation of putaminal dopaminergic innervation with fine motor ability (p < 0,05 for NIV [number of inversion in velocity], NIA [number of inversion in acceleration], frequency). These data suggest that loss of dorsolateral striatal dopaminergic innervation has a pathophysiological function for decreased automated motor control in Wilson's disease. Furthermore analysis of automated handwriting movements could be useful for therapy monitoring and evaluation of striatal dopaminergic innervation. PMID:12195459

  19. Perspective of an advocate: a case and framework for research advocacy in Africa

    PubMed Central

    2013-01-01

    In making an experience-based case for research advocacy in Africa and suggesting a framework for building it, this paper covers factors such as basic tenets of patient advocacy, key components and urgent needs in building strong research advocacy, concepts and approaches from which guidance might be taken, and the feasibility of its development and growth throughout the continent. Research advocacy is defined as the meaningful engagement of patient advocates and their representatives in the research system. As the clinical research system in Africa is developing and gaining strength, this is an opportune time for research advocacy to form and take root as an embedded component in the research structures on the continent. That is, the current state of development of the research system and the simultaneous interest in and rise of patient advocacy bode well for the likelihood of developing robust research advocacy, suggesting its feasibility. Even so, several developments are urgently needed to build, shore up, and sustain a framework receptive to maximizing the influence of an active network of patient advocates—many training in the subspecialty of research advocacy—and a research structure that supports and embeds advocate engagement. PMID:23902629

  20. Teacher Advocacy in Bilingual Programs

    ERIC Educational Resources Information Center

    Dubetz, Nancy E.; de Jong, Ester J.

    2011-01-01

    As a consequence of changes in federal and state policies in education, educators who believe in the value and importance of bilingualism find themselves in a contested environment where their notions of best practices for emergent bilinguals contradict those espoused in such policies. In this context, acts of advocacy that support bilingual…

  1. CEC Special Education Advocacy Handbook.

    ERIC Educational Resources Information Center

    Bootel, Jaclyn A.

    This handbook, for individuals working with people who have disabilities, is designed to empower them to be a force for meeting the policy challenges in the communities in which they live and work. It is designed to help in channeling one's strength, commitment, and knowledge of the special education field into effective advocacy efforts. The…

  2. Dynamic Scapular Movement Analysis: Is It Feasible and Reliable in Stroke Patients during Arm Elevation?

    PubMed Central

    De Baets, Liesbet; Van Deun, Sara; Desloovere, Kaat; Jaspers, Ellen

    2013-01-01

    Knowledge of three-dimensional scapular movements is essential to understand post-stroke shoulder pain. The goal of the present work is to determine the feasibility and the within and between session reliability of a movement protocol for three-dimensional scapular movement analysis in stroke patients with mild to moderate impairment, using an optoelectronic measurement system. Scapular kinematics of 10 stroke patients and 10 healthy controls was recorded on two occasions during active anteflexion and abduction from 0° to 60° and from 0° to 120°. All tasks were executed unilaterally and bilaterally. The protocol’s feasibility was first assessed, followed by within and between session reliability of scapular total range of motion (ROM), joint angles at start position and of angular waveforms. Additionally, measurement errors were calculated for all parameters. Results indicated that the protocol was generally feasible for this group of patients and assessors. Within session reliability was very good for all tasks. Between sessions, scapular angles at start position were measured reliably for most tasks, while scapular ROM was more reliable during the 120° tasks. In general, scapular angles showed higher reliability during anteflexion compared to abduction, especially for protraction. Scapular lateral rotations resulted in smallest measurement errors. This study indicates that scapular kinematics can be measured reliably and with precision within one measurement session. In case of multiple test sessions, further methodological optimization is required for this protocol to be suitable for clinical decision-making and evaluation of treatment efficacy. PMID:24244414

  3. Stay Focused! The Effects of Internal and External Focus of Attention on Movement Automaticity in Patients with Stroke.

    PubMed

    Kal, E C; van der Kamp, J; Houdijk, H; Groet, E; van Bennekom, C A M; Scherder, E J A

    2015-01-01

    Dual-task performance is often impaired after stroke. This may be resolved by enhancing patients' automaticity of movement. This study sets out to test the constrained action hypothesis, which holds that automaticity of movement is enhanced by triggering an external focus (on movement effects), rather than an internal focus (on movement execution). Thirty-nine individuals with chronic, unilateral stroke performed a one-leg-stepping task with both legs in single- and dual-task conditions. Attentional focus was manipulated with instructions. Motor performance (movement speed), movement automaticity (fluency of movement), and dual-task performance (dual-task costs) were assessed. The effects of focus on movement speed, single- and dual-task movement fluency, and dual-task costs were analysed with generalized estimating equations. Results showed that, overall, single-task performance was unaffected by focus (p = .341). Regarding movement fluency, no main effects of focus were found in single- or dual-task conditions (p's ≥ .13). However, focus by leg interactions suggested that an external focus reduced movement fluency of the paretic leg compared to an internal focus (single-task conditions: p = .068; dual-task conditions: p = .084). An external focus also tended to result in inferior dual-task performance (β = -2.38, p = .065). Finally, a near-significant interaction (β = 2.36, p = .055) suggested that dual-task performance was more constrained by patients' attentional capacity in external focus conditions. We conclude that, compared to an internal focus, an external focus did not result in more automated movements in chronic stroke patients. Contrary to expectations, trends were found for enhanced automaticity with an internal focus. These findings might be due to patients' strong preference to use an internal focus in daily life. Future work needs to establish the more permanent effects of learning with different attentional foci on re-automating motor control

  4. Antiscience and ethical concerns associated with advocacy of Lyme disease

    PubMed Central

    Auwaerter, Paul G; Bakken, Johan S; Dattwyler, Raymond J; Dumler, J Stephen; Halperin, John J; McSweegan, Edward; Nadelman, Robert B; O’Connell, Susan; Shapiro, Eugene D; Sood, Sunil K; Steere, Allen C; Weinstein, Arthur; Wormser, Gary P

    2015-01-01

    Advocacy for Lyme disease has become an increasingly important part of an antiscience movement that denies both the viral cause of AIDS and the benefits of vaccines and that supports unproven (sometimes dangerous) alternative medical treatments. Some activists portray Lyme disease, a geographically limited tick-borne infection, as a disease that is insidious, ubiquitous, difficult to diagnose, and almost incurable; they also propose that the disease causes mainly non-specific symptoms that can be treated only with long-term antibiotics and other unorthodox and unvalidated treatments. Similar to other antiscience groups, these advocates have created a pseudoscientific and alternative selection of practitioners, research, and publications and have coordinated public protests, accused opponents of both corruption and conspiracy, and spurred legislative efforts to subvert evidence-based medicine and peer-reviewed science. The relations and actions of some activists, medical practitioners, and commercial bodies involved in Lyme disease advocacy pose a threat to public health. PMID:21867956

  5. Antiscience and ethical concerns associated with advocacy of Lyme disease.

    PubMed

    Auwaerter, Paul G; Bakken, Johan S; Dattwyler, Raymond J; Dumler, J Stephen; Halperin, John J; McSweegan, Edward; Nadelman, Robert B; O'Connell, Susan; Shapiro, Eugene D; Sood, Sunil K; Steere, Allen C; Weinstein, Arthur; Wormser, Gary P

    2011-09-01

    Advocacy for Lyme disease has become an increasingly important part of an antiscience movement that denies both the viral cause of AIDS and the benefits of vaccines and that supports unproven (sometimes dangerous) alternative medical treatments. Some activists portray Lyme disease, a geographically limited tick-borne infection, as a disease that is insidious, ubiquitous, difficult to diagnose, and almost incurable; they also propose that the disease causes mainly non-specific symptoms that can be treated only with long-term antibiotics and other unorthodox and unvalidated treatments. Similar to other antiscience groups, these advocates have created a pseudoscientific and alternative selection of practitioners, research, and publications and have coordinated public protests, accused opponents of both corruption and conspiracy, and spurred legislative efforts to subvert evidence-based medicine and peer-reviewed science. The relations and actions of some activists, medical practitioners, and commercial bodies involved in Lyme disease advocacy pose a threat to public health.

  6. [A complex study of the movement biomechanics in patients with post-stroke hemiparesis].

    PubMed

    Skvortsov, D V; Bulatova, M A; Kovrazhkina, E A; Suvorov, A Iu; Ivanova, G E; Skvortsova, V I

    2012-01-01

    The authors present results of a pilot study on biomechanics of non-cyclic movements of the human consequent verticalization in the ontogenesis of patients with post-stroke hemiparesis (10 patients in the acute stage of cerebral stroke) and 10 healthy volunteers without neurologic and orthopedic pathology. Some movements of therapeutic exercises Balance (a model of ontogenetic kinesitherapy) have been selected for the study. Cinematic parameters have been recorded using a system of motion 3D video analysis, a kinematic model was build in accordance to standard protocols. The skin (native and straightened) electromyogram (EMG) was recorded synchronously with kinematic data using 16-channel electromyography from the following pairs of muscles: mm. sternocleido-mastoideus, trapezius (горизонтальная порция), biceps brachii, triceps brachii, rectus femoris, adductor magnus. Major differences in the EMG picture between patients and controls were: 1) the EMG "monotony" with the involvement of multiple additional muscles in locomotions with the prevalence of the peculiar "tonic" muscle activity (low amplitudes without distinct peaks), stretching along the whole cycle of movement. In controls, EMG demonstrated variability and had mostly "phasic" character with distinct 1 or 2 peaks; 2) the asymmetry of EMG profile in symmetric movements. i.e. when performed simultaneously from the right and from the left sides. The latter feature may be considered as predictive because it was never found in healthy people. It allows to identify objectively weak muscles even in the absence of visible parethis during the routine neurological examination.

  7. Smartphone derived movement profiles to detect changes in health status in COPD patients - A preliminary investigation.

    PubMed

    Kelly, Daniel; Donnelly, Seamas; Caulfield, Brian

    2015-08-01

    Over 3.2 million people in the UK alone have the lung disease Chronic Obstructive Pulmonary Disease. Identifying when COPD patients are at risk of an exacerbation is a major problem and there is a need for smart solutions that provide us with a means of tracking patient health status. Smart-phone sensor technology provides us with an opportunity to automatically monitor patients. With sensors providing the ability to measure aspects of a patient's daily life, such a motion, methods to interpret these signals and infer health related information are needed. In this work we aim to investigate the feasibility of utilizing motion sensors, built within smartphones, to measure patient movement and to infer the health related information about the patient. We perform experiments, based on 7 COPD patients using data collected over a 12 week period for each patient, and identify a measure to distinguish between periods when a patient feels well Vs periods when a patient feels unwell. PMID:26736299

  8. Research Advocacy at NCI

    Cancer.gov

    The patient perspective research advocates brings into NCI’s research enterprise helps to inform research focus and support the dissemination of results that lead to new and better cancer prevention, detection, and treatment methods.

  9. Automated Movement Correction for Dynamic PET/CT Images: Evaluation with Phantom and Patient Data

    PubMed Central

    Ye, Hu; Wong, Koon-Pong; Wardak, Mirwais; Dahlbom, Magnus; Kepe, Vladimir; Barrio, Jorge R.; Nelson, Linda D.; Small, Gary W.; Huang, Sung-Cheng

    2014-01-01

    Head movement during a dynamic brain PET/CT imaging results in mismatch between CT and dynamic PET images. It can cause artifacts in CT-based attenuation corrected PET images, thus affecting both the qualitative and quantitative aspects of the dynamic PET images and the derived parametric images. In this study, we developed an automated retrospective image-based movement correction (MC) procedure. The MC method first registered the CT image to each dynamic PET frames, then re-reconstructed the PET frames with CT-based attenuation correction, and finally re-aligned all the PET frames to the same position. We evaluated the MC method's performance on the Hoffman phantom and dynamic FDDNP and FDG PET/CT images of patients with neurodegenerative disease or with poor compliance. Dynamic FDDNP PET/CT images (65 min) were obtained from 12 patients and dynamic FDG PET/CT images (60 min) were obtained from 6 patients. Logan analysis with cerebellum as the reference region was used to generate regional distribution volume ratio (DVR) for FDDNP scan before and after MC. For FDG studies, the image derived input function was used to generate parametric image of FDG uptake constant (Ki) before and after MC. Phantom study showed high accuracy of registration between PET and CT and improved PET images after MC. In patient study, head movement was observed in all subjects, especially in late PET frames with an average displacement of 6.92 mm. The z-direction translation (average maximum = 5.32 mm) and x-axis rotation (average maximum = 5.19 degrees) occurred most frequently. Image artifacts were significantly diminished after MC. There were significant differences (P<0.05) in the FDDNP DVR and FDG Ki values in the parietal and temporal regions after MC. In conclusion, MC applied to dynamic brain FDDNP and FDG PET/CT scans could improve the qualitative and quantitative aspects of images of both tracers. PMID:25111700

  10. Movement-related cortical potentials in paraplegic patients: abnormal patterns and considerations for BCI-rehabilitation.

    PubMed

    Xu, Ren; Jiang, Ning; Vuckovic, Aleksandra; Hasan, Muhammad; Mrachacz-Kersting, Natalie; Allan, David; Fraser, Matthew; Nasseroleslami, Bahman; Conway, Bernie; Dremstrup, Kim; Farina, Dario

    2014-01-01

    Non-invasive EEG-based Brain-Computer Interfaces (BCI) can be promising for the motor neuro-rehabilitation of paraplegic patients. However, this shall require detailed knowledge of the abnormalities in the EEG signatures of paraplegic patients. The association of abnormalities in different subgroups of patients and their relation to the sensorimotor integration are relevant for the design, implementation and use of BCI systems in patient populations. This study explores the patterns of abnormalities of movement related cortical potentials (MRCP) during motor imagery tasks of feet and right hand in patients with paraplegia (including the subgroups with/without central neuropathic pain (CNP) and complete/incomplete injury patients) and the level of distinctiveness of abnormalities in these groups using pattern classification. The most notable observed abnormalities were the amplified execution negativity and its slower rebound in the patient group. The potential underlying mechanisms behind these changes and other minor dissimilarities in patients' subgroups, as well as the relevance to BCI applications, are discussed. The findings are of interest from a neurological perspective as well as for BCI-assisted neuro-rehabilitation and therapy.

  11. 3D kinematic analysis and clinical evaluation of neck movements in patients with whiplash injury.

    PubMed

    Antonaci, F; Bulgheroni, M; Ghirmai, S; Lanfranchi, S; Dalla Toffola, E; Sandrini, G; Nappi, G

    2002-09-01

    In recent decades whiplash injuries, being a major reason for compensation claims, have become increasingly important in forensic medicine. In view of this, a reliable diagnostic method of assessing cervical range of motion (ROM) is needed. The aim of the present study was to evaluate neck function with a 3D kinematic method compared with clinical evaluation in whiplash injury. Seventy consecutive patients (M/F = 18/52) with a history of whiplash injury (WH) and 46 healthy volunteers (M/F = 24/22), mean age, respectively 33 +/- 9 and 28 +/- 6 years (mean+/-SD) entered the study. Patients suffered from neck pain and/or unilateral headache. A computerized kinematic analysis of the ROM (Elite system) using passive markers and two infrared TV cameras was used. Clinical evaluation of active ROM was also performed both in patients and in 61 controls (M/F = 23/38; mean age 47 +/- 18 years). Thirty out of 70 patients were tested at the time of their first consultation (T0) and 6 months later (T6), and 12 were also followed up after a year (T12). All neck movements, except extension, were significantly reduced in WH subjects compared with controls, in particular lateral bending. Comparing ROM at T0, T6 and T12, no significant differences were found. A global index of motion (GIM), obtained by calculating the sum of ROM in absolute value for all the movements acquired, was significantly reduced in WH compared with control subjects. The interobserver reliability of the clinical evaluation was globally acceptable. On the basis of the clinical evaluation, a significantly reduced ROM was found in all movements in WH subjects compared with an age-matched population. Computing the number of impaired cervical movements (ICMs), a significantly higher number was observed in WH patients than in controls, showing a decreasing trend at T6 and T12, with a significant improvement at T6 vs. T0. The computerized study of neck ROM may constitute a useful tool in the evaluation of WH at

  12. EEG Event-Related Desynchronization of patients with stroke during motor imagery of hand movement

    NASA Astrophysics Data System (ADS)

    Tabernig, Carolina B.; Carrere, Lucía C.; Lopez, Camila A.; Ballario, Carlos

    2016-04-01

    Brain Computer Interfaces (BCI) can be used for therapeutic purposes to improve voluntary motor control that has been affected post stroke. For this purpose, desynchronization of sensorimotor rhythms of the electroencephalographic signal (EEG) can be used. But it is necessary to study what happens in the affected motor cortex of this people. In this article, we analyse EEG recordings of hemiplegic stroke patients to determine if it is possible to detect desynchronization in the affected motor cortex during the imagination of movements of the affected hand. Six patients were included in the study; four evidenced desynchronization in the affected hemisphere, one of them showed no results and the EEG recordings of the last patient presented high noise level. These results suggest that we could use the desynchronization of sensorimotor rhythms of the EEG signal as a BCI paradigm in a rehabilitation programme.

  13. Client-Centered Advocacy: Every Occupational Therapy Practitioner's Responsibility to Understand Medical Necessity.

    PubMed

    Stover, Alyson D

    2016-01-01

    Occupational therapy practitioners must advocate for clients in multiple ways. The Occupational Therapy Practice Framework: Domain and Process as well as the Occupational Therapy Code of Ethics lend support to advocacy. Recognizing one's responsibility to provide advocacy for clients is different from knowing how to provide that advocacy. One aspect of health care affected by the Patient Protection and Affordable Care Act (ACA) is the definition and implementation of medical necessity. This article outlines some major concepts around medical necessity, particularly in relation to the passage of the ACA, and outlines guidance on how to advocate effectively to meet both individual and community needs.

  14. Client-Centered Advocacy: Every Occupational Therapy Practitioner's Responsibility to Understand Medical Necessity.

    PubMed

    Stover, Alyson D

    2016-01-01

    Occupational therapy practitioners must advocate for clients in multiple ways. The Occupational Therapy Practice Framework: Domain and Process as well as the Occupational Therapy Code of Ethics lend support to advocacy. Recognizing one's responsibility to provide advocacy for clients is different from knowing how to provide that advocacy. One aspect of health care affected by the Patient Protection and Affordable Care Act (ACA) is the definition and implementation of medical necessity. This article outlines some major concepts around medical necessity, particularly in relation to the passage of the ACA, and outlines guidance on how to advocate effectively to meet both individual and community needs. PMID:27548855

  15. Deep brain stimulation suppresses pallidal low frequency activity in patients with phasic dystonic movements.

    PubMed

    Barow, Ewgenia; Neumann, Wolf-Julian; Brücke, Christof; Huebl, Julius; Horn, Andreas; Brown, Peter; Krauss, Joachim K; Schneider, Gerd-Helge; Kühn, Andrea A

    2014-11-01

    Deep brain stimulation of the globus pallidus internus alleviates involuntary movements in patients with dystonia. However, the mechanism is still not entirely understood. One hypothesis is that deep brain stimulation suppresses abnormally enhanced synchronized oscillatory activity within the motor cortico-basal ganglia network. Here, we explore deep brain stimulation-induced modulation of pathological low frequency (4-12 Hz) pallidal activity that has been described in local field potential recordings in patients with dystonia. Therefore, local field potentials were recorded from 16 hemispheres in 12 patients undergoing deep brain stimulation for severe dystonia using a specially designed amplifier allowing simultaneous high frequency stimulation at therapeutic parameter settings and local field potential recordings. For coherence analysis electroencephalographic activity (EEG) over motor areas and electromyographic activity (EMG) from affected neck muscles were recorded before and immediately after cessation of high frequency stimulation. High frequency stimulation led to a significant reduction of mean power in the 4-12 Hz band by 24.8 ± 7.0% in patients with predominantly phasic dystonia. A significant decrease of coherence between cortical EEG and pallidal local field potential activity in the 4-12 Hz range was revealed for the time period of 30 s after switching off high frequency stimulation. Coherence between EMG activity and pallidal activity was mainly found in patients with phasic dystonic movements where it was suppressed after high frequency stimulation. Our findings suggest that high frequency stimulation may suppress pathologically enhanced low frequency activity in patients with phasic dystonia. These dystonic features are the quickest to respond to high frequency stimulation and may thus directly relate to modulation of pathological basal ganglia activity, whereas improvement in tonic features may depend on long-term plastic changes within the

  16. Differences in performance on the functional movement screen between chronic low back pain patients and healthy control subjects.

    PubMed

    Ko, Min-Joo; Noh, Kyung-Hee; Kang, Min-Hyeok; Oh, Jae-Seop

    2016-07-01

    [Purpose] Differences in scores on the Functional Movement Screen between patients with chronic lower back pain and healthy control subjects were investigated. [Subjects and Methods] In all, 20 chronic lower back pain patients and 20 healthy control subjects were recruited. Chronic lower back pain patients and healthy controls performed the Functional Movement Screen (deep squat, hurdle step, inline lunge, shoulder mobility, active straight leg raise, trunk stability pushup, and rotary stability). The Mann-Whitney test was used to analyze differences in Functional Movement Screen scores between the two groups. [Results] Chronic lower back pain patients scored lower on the Functional Movement Screen total composite compared with healthy control subjects. Chronic lower back pain patients scored lower on Functional Movement Screen subtests including the deep squat, hurdle step, active straight leg raise, and rotary stability tests. [Conclusion] The deep squat, hurdle step, active straight leg raise, and rotary stability tasks of the Functional Movement Screen can be recommended as a functional assessment tools to identify functional deficits in chronic lower back pain patients. PMID:27512272

  17. Differences in performance on the functional movement screen between chronic low back pain patients and healthy control subjects

    PubMed Central

    Ko, Min-Joo; Noh, Kyung-Hee; Kang, Min-Hyeok; Oh, Jae-Seop

    2016-01-01

    [Purpose] Differences in scores on the Functional Movement Screen between patients with chronic lower back pain and healthy control subjects were investigated. [Subjects and Methods] In all, 20 chronic lower back pain patients and 20 healthy control subjects were recruited. Chronic lower back pain patients and healthy controls performed the Functional Movement Screen (deep squat, hurdle step, inline lunge, shoulder mobility, active straight leg raise, trunk stability pushup, and rotary stability). The Mann-Whitney test was used to analyze differences in Functional Movement Screen scores between the two groups. [Results] Chronic lower back pain patients scored lower on the Functional Movement Screen total composite compared with healthy control subjects. Chronic lower back pain patients scored lower on Functional Movement Screen subtests including the deep squat, hurdle step, active straight leg raise, and rotary stability tests. [Conclusion] The deep squat, hurdle step, active straight leg raise, and rotary stability tasks of the Functional Movement Screen can be recommended as a functional assessment tools to identify functional deficits in chronic lower back pain patients. PMID:27512272

  18. Performance adaptive training control strategy for recovering wrist movements in stroke patients: a preliminary, feasibility study

    PubMed Central

    2009-01-01

    Background In the last two decades robot training in neuromotor rehabilitation was mainly focused on shoulder-elbow movements. Few devices were designed and clinically tested for training coordinated movements of the wrist, which are crucial for achieving even the basic level of motor competence that is necessary for carrying out ADLs (activities of daily life). Moreover, most systems of robot therapy use point-to-point reaching movements which tend to emphasize the pathological tendency of stroke patients to break down goal-directed movements into a number of jerky sub-movements. For this reason we designed a wrist robot with a range of motion comparable to that of normal subjects and implemented a self-adapting training protocol for tracking smoothly moving targets in order to facilitate the emergence of smoothness in the motor control patterns and maximize the recovery of the normal RoM (range of motion) of the different DoFs (degrees of Freedom). Methods The IIT-wrist robot is a 3 DoFs light exoskeleton device, with direct-drive of each DoF and a human-like range of motion for Flexion/Extension (FE), Abduction/Adduction (AA) and Pronation/Supination (PS). Subjects were asked to track a variable-frequency oscillating target using only one wrist DoF at time, in such a way to carry out a progressive splinting therapy. The RoM of each DoF was angularly scanned in a staircase-like fashion, from the "easier" to the "more difficult" angular position. An Adaptive Controller evaluated online performance parameters and modulated both the assistance and the difficulty of the task in order to facilitate smoother and more precise motor command patterns. Results Three stroke subjects volunteered to participate in a preliminary test session aimed at verify the acceptability of the device and the feasibility of the designed protocol. All of them were able to perform the required task. The wrist active RoM of motion was evaluated for each patient at the beginning and at the end

  19. Advocacy 201: Incorporating Advocacy Training in Health Education Professional Preparation Programs

    ERIC Educational Resources Information Center

    Thompson, Amy; Kerr, Dianne; Dowling, Jamie; Wagner, Laurie

    2012-01-01

    Involvement in advocacy is a responsibility of health educators, as identified by the National Commission on Health Education Credentialing. Of all the professional responsibilities, participation in advocacy-related activity is often neglected. This lack of participation may be due to the absence of advocacy and policy skills training in health…

  20. Analysis of diaphragmatic movement before and after pulmonary rehabilitation using fluoroscopy imaging in patients with COPD

    PubMed Central

    Chun, Eun Mi; Han, Soo Jeong; Modi, Hitesh N

    2015-01-01

    Background The diaphragm is the principal inspiratory muscle. The purpose of this study was to assess improvements in diaphragmatic movement before and after pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD), using a fluoroscopy-guided chest X-ray. Patients and methods Among 117 patients with COPD receiving pulmonary rehabilitation who underwent the initial fluoroscopy-guided chest X-ray and pulmonary function test, 37 of those patients who underwent both initial and follow-up fluoroscopy and pulmonary function tests were enrolled in this study. After hospital education, participants received pulmonary rehabilitation through regular home-based training for at least 3 months by the same physiatrist. We assessed the changes in diaphragm area with fluoroscopy-guided posteroanterior chest X-rays between pre- and postpulmonary rehabilitation. To minimize radiation hazards for subjects, the exposure time for fluoroscopy to take chest X-rays was limited to less than 5 seconds. Results There were significant improvements (2,022.8±1,548.3 mm2 to 3,010.7±1,495.6 mm2 and 2,382.4±1,475.9 mm2 to 3,315.9±1,883.5 mm2; right side P=0.001 and left side P=0.019, respectively) in diaphragmatic motion area during full inspiration and expiration in both lungs after pulmonary rehabilitation. Pulmonary function tests showed no statistically significant difference between pre- and postpulmonary rehabilitation. Conclusion The study suggests that the strategy to assess diaphragm movement using fluoroscopy is a relatively effective tool for the evaluation of pulmonary rehabilitation in COPD patients in terms of cost and time savings compared with computed tomography or magnetic resonance imaging. PMID:25670895

  1. 78 FR 73587 - Taxpayer Advocacy Panel; Meeting Cancellation.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-06

    ... Internal Revenue Service Taxpayer Advocacy Panel; Meeting Cancellation. AGENCY: Internal Revenue Service... cancellation of the open meeting of the Taxpayer Advocacy Panel Taxpayer Communications Project Committee..., Acting Director, Taxpayer Advocacy Panel. BILLING CODE 4830-01-P...

  2. 78 FR 73586 - Taxpayer Advocacy Panel Meeting Cancellation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-06

    ... Internal Revenue Service Taxpayer Advocacy Panel Meeting Cancellation AGENCY: Internal Revenue Service (IRS... the open meeting of the Taxpayer Advocacy Panel Taxpayer Assistance Center Improvements Project..., Taxpayer Advocacy Panel. BILLING CODE 4830-01-P...

  3. 78 FR 73587 - Taxpayer Advocacy Panel Meeting Cancellation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-06

    ... Internal Revenue Service Taxpayer Advocacy Panel Meeting Cancellation AGENCY: Internal Revenue Service (IRS... the open meeting of the Taxpayer Advocacy Panel Tax Forms and Publications Project Committee scheduled... Advocacy Panel. BILLING CODE 4830-01-P...

  4. 78 FR 73587 - Taxpayer Advocacy Panel Meeting Cancellation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-06

    ... Internal Revenue Service Taxpayer Advocacy Panel Meeting Cancellation AGENCY: Internal Revenue Service (IRS... the open meeting of the Taxpayer Advocacy Panel Notices and Correspondence Project Committee scheduled... Advocacy Panel. BILLING CODE 4830-01-P...

  5. 78 FR 73587 - Taxpayer Advocacy Panel Meeting Cancellation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-06

    ... Internal Revenue Service Taxpayer Advocacy Panel Meeting Cancellation AGENCY: Internal Revenue Service (IRS... the open meeting of the Taxpayer Advocacy Panel Toll-Free Phone Line Project Committee scheduled for... Advocacy Panel. BILLING CODE 4830-01-P...

  6. A qualitative motion analysis study of voluntary hand movement induced by music in patients with Rett syndrome

    PubMed Central

    Go, Tohshin; Mitani, Asako

    2009-01-01

    Patients with Rett syndrome are known to respond well to music irrespective of their physical and verbal disabilities. Therefore, the relationship between auditory rhythm and their behavior was investigated employing a two-dimensional motion analysis system. Ten female patients aged from three to 17 years were included. When music with a simple regular rhythm started, body rocking appeared automatically in a back and forth direction in all four patients who showed the same rocking motion as their stereotyped movement. Through this body rocking, voluntary movement of the hand increased gradually, and finally became sufficient to beat a tambourine. However, the induction of body rocking by music was not observed in the other six patients who did not show stereotyped body rocking in a back and forth direction. When the music stopped suddenly, voluntary movement of the hand disappeared. When the music changed from a simple regular rhythm to a continuous tone without an auditory rhythm, the periodic movement of both the hand and body prolonged. Auditory rhythm shows a close relationship with body movement and facilitates synchronized body movement. This mechanism was demonstrated to be preserved in some patients with Rett syndrome, and stimulation with music could be utilized for their rehabilitation. PMID:19851517

  7. Stay Focused! The Effects of Internal and External Focus of Attention on Movement Automaticity in Patients with Stroke

    PubMed Central

    Kal, E. C.; van der Kamp, J.; Houdijk, H.; Groet, E.; van Bennekom, C. A. M.; Scherder, E. J. A.

    2015-01-01

    Dual-task performance is often impaired after stroke. This may be resolved by enhancing patients’ automaticity of movement. This study sets out to test the constrained action hypothesis, which holds that automaticity of movement is enhanced by triggering an external focus (on movement effects), rather than an internal focus (on movement execution). Thirty-nine individuals with chronic, unilateral stroke performed a one-leg-stepping task with both legs in single- and dual-task conditions. Attentional focus was manipulated with instructions. Motor performance (movement speed), movement automaticity (fluency of movement), and dual-task performance (dual-task costs) were assessed. The effects of focus on movement speed, single- and dual-task movement fluency, and dual-task costs were analysed with generalized estimating equations. Results showed that, overall, single-task performance was unaffected by focus (p = .341). Regarding movement fluency, no main effects of focus were found in single- or dual-task conditions (p’s ≥ .13). However, focus by leg interactions suggested that an external focus reduced movement fluency of the paretic leg compared to an internal focus (single-task conditions: p = .068; dual-task conditions: p = .084). An external focus also tended to result in inferior dual-task performance (β = -2.38, p = .065). Finally, a near-significant interaction (β = 2.36, p = .055) suggested that dual-task performance was more constrained by patients’ attentional capacity in external focus conditions. We conclude that, compared to an internal focus, an external focus did not result in more automated movements in chronic stroke patients. Contrary to expectations, trends were found for enhanced automaticity with an internal focus. These findings might be due to patients’ strong preference to use an internal focus in daily life. Future work needs to establish the more permanent effects of learning with different attentional foci on re-automating motor

  8. Cherenkoscopy based patient positioning validation and movement tracking during post-lumpectomy whole breast radiation therapy

    NASA Astrophysics Data System (ADS)

    Zhang, Rongxiao; Andreozzi, Jacqueline M.; Gladstone, David J.; Hitchcock, Whitney L.; Glaser, Adam K.; Jiang, Shudong; Pogue, Brian W.; Jarvis, Lesley A.

    2015-01-01

    To investigate Cherenkov imaging (Cherenkoscopy) based patient positioning and movement tracking during external beam radiation therapy (EBRT). In a phase 1 clinical trial, including 12 patients undergoing post-lumpectomy whole breast irradiation, Cherenkov emission was imaged with a time-gated ICCD camera synchronized to the LINAC pulse output, during different fractions of the treatment. Patients were positioned with the aid of the AlignRT system in the beginning of each treatment session. Inter-fraction setup variation was studied by rigid image registrations between images acquired at individual treatments to the average image from all imaged treatment fractions. The amplitude of respiratory motion was calculated from the registration of each frame of Cherenkov images to the reference. A Canny edge detection algorithm was utilized to highlight the beam field edges and biological features provided by major blood vessels apparent in the images. Real-time Cherenkoscopy can monitor the treatment delivery, patient motion and alignment of the beam edge to the treatment region simultaneously. For all the imaged fractions, the patient positioning discrepancies were within our clinical tolerances (3 mm in shifts and 3 degree in pitch angle rotation), with 4.6% exceeding 3 mm but still within 4 mm in shifts. The average discrepancy of repetitive patient positioning was 1.22 mm in linear shift and 0.34 degrees in rotational pitch, consistent with the accuracy reported by the AlignRT system. The edge detection algorithm enhanced features such as field edges and blood vessels. Patient positioning discrepancies and respiratory motion retrieved from rigid image registration were consistent with the edge enhanced images. Besides positioning discrepancies caused by globally inaccurate setups, edge enhanced blood vessels indicate the existence of deformations within the treatment region, especially for large patients. Real-time Cherenkoscopy imaging during EBRT is a

  9. Cherenkoscopy based patient positioning validation and movement tracking during post-lumpectomy whole breast radiation therapy.

    PubMed

    Zhang, Rongxiao; Andreozzi, Jacqueline M; Gladstone, David J; Hitchcock, Whitney L; Glaser, Adam K; Jiang, Shudong; Pogue, Brian W; Jarvis, Lesley A

    2015-01-01

    To investigate Cherenkov imaging (Cherenkoscopy) based patient positioning and movement tracking during external beam radiation therapy (EBRT). In a phase 1 clinical trial, including 12 patients undergoing post-lumpectomy whole breast irradiation, Cherenkov emission was imaged with a time-gated ICCD camera synchronized to the LINAC pulse output, during different fractions of the treatment. Patients were positioned with the aid of the AlignRT system in the beginning of each treatment session. Inter-fraction setup variation was studied by rigid image registrations between images acquired at individual treatments to the average image from all imaged treatment fractions. The amplitude of respiratory motion was calculated from the registration of each frame of Cherenkov images to the reference. A Canny edge detection algorithm was utilized to highlight the beam field edges and biological features provided by major blood vessels apparent in the images. Real-time Cherenkoscopy can monitor the treatment delivery, patient motion and alignment of the beam edge to the treatment region simultaneously. For all the imaged fractions, the patient positioning discrepancies were within our clinical tolerances (3 mm in shifts and 3 degree in pitch angle rotation), with 4.6% exceeding 3 mm but still within 4 mm in shifts. The average discrepancy of repetitive patient positioning was 1.22 mm in linear shift and 0.34 degrees in rotational pitch, consistent with the accuracy reported by the AlignRT system. The edge detection algorithm enhanced features such as field edges and blood vessels. Patient positioning discrepancies and respiratory motion retrieved from rigid image registration were consistent with the edge enhanced images. Besides positioning discrepancies caused by globally inaccurate setups, edge enhanced blood vessels indicate the existence of deformations within the treatment region, especially for large patients. Real-time Cherenkoscopy imaging during EBRT is a

  10. Sleep disorders frequency in post-polio syndrome patients caused by periodic limb movements.

    PubMed

    Araujo, Maria Auxiliadora de Paiva; Silva, Tatiana Mesquita e; Moreira, Gustavo Antonio; Pradella-Hallinan, Márcia; Tufik, Sergio; Oliveira, Acary Souza Bulle

    2010-02-01

    Post-polio syndrome (PPS) in individuals with polio longer than 15 years is characterized by weakness and/or muscle fatigue, deficit of deglutition and breath and periodic limb movements (PLM) during sleep. We undertook a review of 99 patients with PPS, and assessed the frequency of PLM through polysomnographic recordings at our sleep disorders unit. The total number of PLM, total time of sleep (TTS), efficiency of sleep (EfS), awaking index (AI) and apnea-hypopnea index (AHI) were analyzed. Sixteen patients presented PLM in excess of 5 for the entire night. When comparing these with the group without PLM, a correlation was found (p=0.001). Significant difference was found for the correlation of the parameters: IAH, ID, TTS and EfS when compared the two groups. There is a close relationship between PPS and PLM.

  11. Opiate sensitivity test in patients with stereotypic movement disorder and trichotillomania.

    PubMed

    Frecska, Ede; Arato, Mihaly

    2002-06-01

    Preliminary data about the therapeutic effect of opiate receptor manipulation in self-injurious behavior (SIB) suggest that endogenous opioid mechanisms may have a pathophysiological role in that condition and their involvement may be dependent on the severity of the SIB. The aim of this study was to use fentanyl-induced prolactin response as an opiate receptor sensitivity test in patients with stereotypic movement disorder (SMD) manifesting SIB (skin picking). Healthy volunteers and trichotillomanic patients were enrolled as comparison subjects. Individuals with trichotillomania (TTM) manifest repetitive, less serious self-mutilation (hair pulling) and are classified under different DSM-IV category than SMD. Therefore, they were considered as patient controls. Ten healthy subjects received 0.05 mg/70 kg and another 10 were given 0.1 mg/70 kg dose of fentanyl intravenously in the AM hours. Five of them had placebo trials. A dose of 0.05 mg/70 kg fentanyl was administered to patients with SMD (n = 10) and TTM (n = 12). Serial blood sampling was performed for prolactin measurements. Fentanyl elevated plasma prolactin in a dose-dependent manner. Patients with skin picking, but not with hair pulling, showed significantly increased responses. This finding supports the involvement of endogenous opioids in the pathomechanism of serious SIB.

  12. [Neuronal mechanisms of voluntary and involuntary movements in parafascicular (CM-PF) thalamic complex in spasmodic torticollis patients].

    PubMed

    Sedov, A S; Medvednik, R S; Raeva, S N

    2010-05-01

    Activity of 144 parafascicular CM-Pf thalamic neurons was studied and recorded by means of microelectrodes during 18 stereotactical neurosurgical operations in spasmodic torticollis patients. High reactivity of two previously classified neurons with single sporadic activity (A-type) and bursts of Ca2(+)-dependent activity (B-type) were found during verbally ordered voluntary movements. There are coordinated reciprocal activation-inhibition A-type and B-type neuronal responses at the stage of verbal command presentation and synergic activation responses on the high of movement and in the aftereffect. Voluntary movement realization was accompanied by short-term local synchronization and stabilization of oscillatory (3-5 Hz) neuronal activity. The neuronal response differences between voluntary movements with and without neck muscle exertion and involuntary pathological movements prove the CM-Pf involvement in the pathology of spasmodic torticollis desease. PMID:20583573

  13. Increasing aging and advocacy competency: the intergenerational advocacy pilot project.

    PubMed

    Hermoso, Joyce; Rosen, Anita L; Overly, Libby; Tompkins, Catherine J

    2006-01-01

    The Council on Social Work Education's (CSWE) Strengthening Aging and Gerontology Education for Social Work (SAGE-SW) project, funded by the John A. Hartford Foundation partnered with the National Committee to Preserve Social Security and Medicare (NCPSSM) to develop an Intergenerational Policy and Advocacy Project (IAP). This curriculum pilot project, based on a community organization model, was conducted with 13 baccalaureate social work (BSW) and master's social work (MSW) programs across the country and 122 students. The project was one method to pursue CSWE SAGE-SW's efforts to infuse aging content into social work foundation curricula, to support intergenerational teaching, to strengthen social work advocacy skills, and to provide social work students with positive experiences working with older adults. Pilot sites were asked to carry out the project as part of an existing course foundation or field practicum course. Project activities included collaboration with a variety of community agencies, holding issues or "town hall" forums in order to educate community members about critical policy issues affecting older adults; making contacts and establishing relationships with local, state and/or federal legislators; and conducting assessments of the service needs of older adults in the students' communities. Questionnaires, feedback, pre-post evaluations as well as brief accounts of each project are presented. Participants considered the IAP to be a successful project in terms of the objectives of increasing awareness and competency among social work students of aging issues and of promoting intergenerational linkages between older people and social work students. PMID:17200078

  14. Anti-aging medicine: a patient/practitioner movement to redefine aging.

    PubMed

    Mykytyn, Courtney Everts

    2006-02-01

    Having enjoyed tremendous growth for the past 5 years, the anti-aging medicine movement is redefining aging so that it becomes a target for biomedical intervention. Targeting aging for intervention dislodges popular understandings of aging: for anti-aging practitioners it no longer matters if aging is natural since it can be itself the target of therapy. So-called "age-associated" diseases like cancer are, in this framework, conceived of as symptoms of aging. Anti-aging medicine is a broad term that may comprise groups selling remedies over the Internet, companies touting the "anti-aging"ness of their products, practitioners who work outside of scientific medicine, and practitioners of anti-aging medicine in clinics who believe that their work is strictly scientific. This article, drawing from more than 3 years of ethnographic interviews, participant observation in clinics and conferences, and a review of the literature, considers the last group. It examines the involvement stories of anti-aging medicine practitioners in two Western United States metropolitan cities. These stories reflect the practices of anti-aging medicine practitioners and the accompanying rationale for involvement. Often originally patients themselves, practitioners frame their involvement with the anti-aging movement in three ways. First, they describe aging as it is currently experienced as a time of decline, suffering, and weakness. This anguish is not inevitable, they argue, and their work toward treating aging biomedically is situated as clearly moral. Secondly, intense frustration with the current biomedical environment has motivated practitioners to look for other ways in which to practice: anti-aging medicine is their chosen alternative. Finally, with dramatic expectations of future biotechnologies and disdain for current medical treatments of old age, anti-aging practitioners embrace a scientific revolutionary identity. These stories of migrations from patient to practitioner reveal

  15. Professor Brand Advocacy: Do Brand Relationships Matter?

    ERIC Educational Resources Information Center

    Jillapalli, Ravi K.; Wilcox, James B.

    2010-01-01

    The trend among students to advocate their professors online continues to generate interest within marketing academia. Brand advocacy in products and services has played a vital role in marketing. However, no known research to date has embraced the idea of brand advocacy in marketing education. This research builds on the recent human brand…

  16. Autism Advocacy: A Network Striving for Equity

    ERIC Educational Resources Information Center

    Itkonen, Tiina; Ream, Robert

    2013-01-01

    In this exploratory case study, we examine the rise of autism on the policy agenda and the new generation of autism advocacy. We focus especially on interconnections between the rhetoric about autism in the media and the emergence and political effectiveness of Autism Speaks, the nation's largest autism advocacy group. We portray how…

  17. Broadening the Discussion about Evaluator Advocacy

    ERIC Educational Resources Information Center

    Hendricks, Michael

    2014-01-01

    This issue of "American Journal of Evaluation" presents commentaries by evaluation leaders, George Grob and Rakesh Mohan, which draw upon their wealth of practical experience to address questions about evaluator advocacy, including What is meant by the word "advocacy"? Should evaluators ever advocate? If so, when and how? What…

  18. Health Advocacy--Counting the Costs

    ERIC Educational Resources Information Center

    Dyall, Lorna; Marama, Maria

    2010-01-01

    Access to, and delivery of, safe and culturally appropriate health services is increasingly important in New Zealand. This paper will focus on counting the costs of health advocacy through the experience of a small non government charitable organisation, the Health Advocates Trust, (HAT) which aimed to provide advocacy services for a wide range of…

  19. Corporate Advocacy Advertising and Political Influence.

    ERIC Educational Resources Information Center

    Waltzer, Herbert

    1988-01-01

    Offers an operational definition and typology of advocacy and image advertising as complementary forms of institutional advertising. Examines two of the more important forms of advocacy advertising--paid print editorials appearing on the "op-ed" page of the "New York Times" and the "advertorials" in two principal professional journals of the…

  20. Advocacy in Counseling: Counselors, Clients, & Community.

    ERIC Educational Resources Information Center

    Lewis, Judy, Ed.; Bradley, Loretta, Ed.

    The sixteen chapters in this volume were selected from advocacy theme papers written by members of the American Counseling Association. They examine the role of the counselor as advocate for different groups of people, as follows: (1) "Developing a Common Language and Framework for Understanding Advocacy in Counseling," (R. L. Toporek); (2)…

  1. School Board Advocacy: Ready, Aim, Inspire!

    ERIC Educational Resources Information Center

    Dowd, Karen

    2010-01-01

    It is said that "all politics are local," and the same can be said about advocacy and school boards. Advocacy is essential for retaining the progress that's been made in the past, and for building a foundation and network for the future. Advocating for preferred programs, curricula and initiatives has always been important. As a starting point,…

  2. Effective Advocacy and Communication with Legislators.

    ERIC Educational Resources Information Center

    American Counseling Association, Office of Public Policy and Information, Alexandria, VA.

    This pamphlet attempts to make communicating with legislators easy. Each section includes a brief paragraph and several bullet points that present techniques or advice for simplifying communication. It begins with "Rules for Effective Advocacy," which presents a core set of basic advocacy principles, followed by "What Makes Politicians Tick?" and…

  3. Advocacy: AASL Puts the Puzzle Together

    ERIC Educational Resources Information Center

    Johns, Sara Kelly

    2007-01-01

    School librarians work with people of all ages, abilities, and personalities; those people are the puzzle pieces that make advocacy for libraries effective. School librarians contribute to and use the resources of their state and national organizations' advocacy efforts. The completed picture of the puzzle is an excellent program with…

  4. Building Evidence for Music Education Advocacy

    ERIC Educational Resources Information Center

    Shorner-Johnson, Kevin

    2013-01-01

    The economic challenges facing public schools and music education are immense. In this context, music teachers and supporters will need to engage in persuasive advocacy to protect resource allocations to music programs. It is worthwhile to consider the model of music education advocacy that allowed music to be adopted into the Boston Public…

  5. Political Advocacy Handbook: Activating Grassroots Involvement.

    ERIC Educational Resources Information Center

    Bootel, Jaclyn A.; Warger, Cynthia L.

    This handbook is designed to assist special education advocates in developing the capacity to mount an effective advocacy campaign at the state and federal levels. It is divided into the following four separate training modules: (1) "Introduction to Advocacy"; (2) "Understanding the Governmental Process"; (3) "Changing Public Policy"; and (4)…

  6. Increased Saccadic Rate during Smooth Pursuit Eye Movements in Patients at Ultra High Risk for Developing a Psychosis

    ERIC Educational Resources Information Center

    van Tricht, M. J.; Nieman, D. H.; Bour, L. J.; Boeree, T.; Koelman, J. H. T. M.; de Haan, L.; Linszen, D. H.

    2010-01-01

    Abnormalities in eye tracking are consistently observed in schizophrenia patients and their relatives and have been proposed as an endophenotype of the disease. The aim of this study was to investigate the performance of patients at Ultra High Risk (UHR) for developing psychosis on a task of smooth pursuit eye movement (SPEM). Forty-six UHR…

  7. Water and Solute Movement in the Small Intestine of Patients with Sprue*

    PubMed Central

    Fordtran, John S.; Rector, Floyd C.; Locklear, T. Ward; Ewton, Maynard F.

    1967-01-01

    Water and electrolyte movement in the jejunum of normal subjects and patients with sprue was measured during perfusion with isotonic electrolyte solutions. Normal subjects absorbed water, sodium, and potassium. By contrast, in patients with sprue (seven with adult celiac sprue and one with tropical sprue) who had diarrhea and steatorrhea, these substances were secreted into the intestinal lumen. This indicates that the jejunal mucosa of these patients was in a secretory state with respect to water and electrolytes. A method is presented for detecting abnormalities in the effective pore size in disease states. The method is based on the principle of restrictive diffusion and involves measuring the simultaneous diffusion rates of solutes of different molecular size. Since the method does not depend on measurement of water flow in response to osmotic pressure gradients, it can be used in disease states in which absorption and secretory processes involving water may be abnormal. The ratio of urea to tritiated water diffusion in the jejunum of normal subjects averaged 0.8, compared to 0.2 in patients with sprue. This indicates a marked decrease in the effective pore size of the jejunal mucosa in sprue. This conclusion was strengthened by the finding that erythritol and L-xylose, which are somewhat larger solutes than urea, are essentially non-absorbable in small bowel involved with sprue. PMID:6023768

  8. Kinematics of the Reach-to-Grasp Movement in Vascular Parkinsonism: A Comparison with Idiopathic Parkinson's Disease Patients.

    PubMed

    Parma, Valentina; Zanatto, Debora; Straulino, Elisa; Scaravilli, Tomaso; Castiello, Umberto

    2014-01-01

    The performance of patients with vascular parkinsonism (VPD) on a reach-to-grasp task was compared with that of patients affected by idiopathic Parkinson's disease (IPD) and age-matched control subjects. The aim of the study was to determine how patients with VPD and IPD compare at the level of the kinematic organization of prehensile actions. We examined how subjects concurrently executed the transport and grasp components of reach-to-grasp movements when grasping differently sized objects. When comparing both VPD and IPD groups to control subjects, all patients showed longer movement duration and smaller hand opening, reflecting bradykinesia and hypometria, respectively. Furthermore, for all patients, the onset of the manipulation component was delayed with respect to the onset of the transport component. However, for patients with VPD this delay was significantly smaller than that found for the IPD group. It is proposed that this reflects a deficit - which is moderate for VPD as compared to IPD patients - in the simultaneous (or sequential) implementation of different segments of a complex movement. Altogether these findings suggest that kinematic analysis of reach-to-grasp movement has the ability to provide potential instruments to characterize different forms of parkinsonism. PMID:24904519

  9. Mindfulness meditation training combined with eye movement desensitization and reprocessing in psychotherapy of an elderly patient.

    PubMed

    Sun, Tzan-Fu; Wu, Ching-Kuan; Chiu, Nien-Mu

    2004-06-01

    We present our experiences with an elderly patient with depression that was attributed to a surge of physical ailments who also had trauma-derived fear of having to undergo a tracheotomy. He refused pharmacotherapy and was offered intensive training in Mindfulness Meditation (MM) plus Eye Movement Desensitization and Reprocessing (EMDR) therapy during the 2 weeks of hospitalization. This treatment combination had not been used previously. We suggest that EMDR eliminated his fear of surgery, whereas MM relieved his depression and attendant anxiety. However, the two techniques appeared to work synergistically. Following his discharge, he continued to practice MM, which prevented the recurrence of emotional distress, and even helped to reduce its causative physical symptoms. We offer an explanation for the success of our combined treatments and discuss the potential usefulness in specific psychotherapeutic situations. We also propose a place for MM within general geriatric care, and point out the reluctance to consider the therapeutic value of meditation.

  10. Mindfulness meditation training combined with eye movement desensitization and reprocessing in psychotherapy of an elderly patient.

    PubMed

    Sun, Tzan-Fu; Wu, Ching-Kuan; Chiu, Nien-Mu

    2004-06-01

    We present our experiences with an elderly patient with depression that was attributed to a surge of physical ailments who also had trauma-derived fear of having to undergo a tracheotomy. He refused pharmacotherapy and was offered intensive training in Mindfulness Meditation (MM) plus Eye Movement Desensitization and Reprocessing (EMDR) therapy during the 2 weeks of hospitalization. This treatment combination had not been used previously. We suggest that EMDR eliminated his fear of surgery, whereas MM relieved his depression and attendant anxiety. However, the two techniques appeared to work synergistically. Following his discharge, he continued to practice MM, which prevented the recurrence of emotional distress, and even helped to reduce its causative physical symptoms. We offer an explanation for the success of our combined treatments and discuss the potential usefulness in specific psychotherapeutic situations. We also propose a place for MM within general geriatric care, and point out the reluctance to consider the therapeutic value of meditation. PMID:15455549

  11. Impact of perception of socioeconomic burden on advocacy for patient autonomy in end-of-life decision making: a study of societal attitudes.

    PubMed

    Kwon, Y C; Shin, D W; Lee, J H; Heo, D S; Hong, Y S; Kim, S-Y; Yun, Y H

    2009-01-01

    We investigated the impact of perception of socioeconomic burden on beliefs regarding a patient's autonomy in end-of-life (EOL) decision making. We also sought to identify the characteristics of individuals who advocate patient autonomy and their attitudes toward other EOL issues. A total of 1055 individuals from the Korean general population were interviewed through a telephone survey using a structured questionnaire that was designed to investigate public attitudes toward various EOL issues. Of 1019 individuals included in the analysis, 635 (62.3%) specified the patient and 221 (21.7%) the family, when asked who is the appropriate decision maker in terms of EOL decisions in the absence of perception of socioeconomic burden. In contrast, the numbers were 458 (44.9%) and 500 (49.1%), respectively, if substantial burden was assumed. Respondents who favoured the patient's right to make decisions regardless of perception of socioeconomic burden numbered only 312 (30.6%) and were likely to be younger and have knowledge of hospice than who favoured family decision. Former group also favoured the disclosure of terminal illness to patients, withholding life-sustaining treatment, and preparation of advanced directives. Societal attitudes toward patient autonomy were significantly influenced by perception of socioeconomic burden. Open and balanced discussion about burden to family and adequate welfare support are thus suggested. PMID:18996980

  12. Effect of micro lesions of the basal ganglia on ballistic movements in patients with deep brain stimulation.

    PubMed

    Singh, Arun; Mehrkens, Jan H; Bötzel, Kai

    2012-03-15

    Bradykinesia and hypokinesia are the prominent symptoms of substantia nigra degeneration in Parkinson's disease (PD). In segmental dystonia, movements of not affected limbs are not impaired. Here we studied the impact of the mere implantation of stimulation electrodes on the performance of fast movements in these two groups. We investigated 9 PD patients with subthalamic electrodes and 9 patients with segmental dystonia with electrodes in the globus pallidus internum. Patients were studied on the first postoperative day without electrical stimulation of the electrodes. Subjects had to perform boxing movements with either touching the target or stopping the fist in front of the target. PD subjects performed significantly faster movements in the touch-task only as compared to dystonic patients. No difference was seen in the stopping task. In conclusion, our findings suggest that a small subthalamic lesion in individuals with PD specifically reverses bradykinesia during simple ballistic movements (touch) but not during complex ones requiring more pre-programming (no-touch paradigm).

  13. Validity of the lower extremity functional movement screen in patients with chronic ankle instability

    PubMed Central

    Choi, Ho-Suk; Shin, Won-Seob

    2015-01-01

    [Purpose] The purpose of this study was to provide evidence of construct validity for the lower extremity functional movement screen (LE-FMS) based on hypothesis testing in patients with chronic ankle instability (CAI). [Subjects] The subjects were 20 healthy subjects and 20 patients with CAI who had a history of ankle sprain with pain for more than 1 day. [Methods] All participants were measured using the Foot and Ankle Disability Index (FADI) and evaluated with the LE-FMS. The screen included the deep squat, the hurdle step (HS) and the in-line lunge (ILL). The symmetry ratios (RS) were accurately measured during the deep squat trial. [Results] Between the two groups, there were significant differences in scores on the LE-FMS, HS, ILL, RS, FADI, and FADI-sport. The FADI was strongly correlated with both LE-FMS score (r=0.807) and ILL score (r=0.896). There was a strong relationship (r=0.818) between LE-FMS score and FADI-sport. [Conclusion] These results suggest that the LE-FMS may be used to detect deficits related to CAI. Additionally, this instrument is reliable in detecting functional limitations in patients with CAI. PMID:26180349

  14. Mirror movements studied in a patient with Klippel-Feil syndrome.

    PubMed Central

    Farmer, S F; Ingram, D A; Stephens, J A

    1990-01-01

    1. Electromyographic (EMG) recordings have been made from upper limb muscles in a patient with well-defined congenital mirror movements occurring in association with Klippel-Feil syndrome and the results compared to those obtained in normal control subjects. 2. In the patient, liminal percutaneous electrical or magnetic brain stimulation applied over either hemisphere elicited bilateral and symmetrical short-latency muscle responses in relaxed intrinsic hand muscles. In the normal subjects unilateral brain stimulation only elicited contralateral muscle responses. 3. F response and H reflex studies for the patient's ulnar-supplied intrinsic hand muscles were normal. No crossed responses were recorded in the homologous muscles of the contralateral hand. 4. Scalp-recorded somatosensory-evoked responses following ulnar or median nerve stimulation were of normal latency and distribution in the patient. 5. In the patient, cross-correlation analysis of on-going single and multiunit needle EMGs recorded between muscles of left and right hands revealed a central peak in the cross-correlogram. No cross-correlogram peaks were found between left- and right-hand muscles in normal subjects. The magnitude and time course of the central peaks in the cross-correlograms constructed between the firing of motor units on opposite sides of the body in the patient were similar to those found in cross-correlograms constructed between the firing of motor units from muscles on the same side of the body in the patient and in normal subjects. 6. The magnitude of cross-correlogram peaks detected within a muscle and those detected between left and right homologous muscles showed a gradient in which the largest peaks were found in the intrinsic hand and forearm extensor muscles. The smallest peaks were observed in the forearm flexor muscles. No peaks were detected between left and right biceps brachii muscles. In intrinsic hand muscles, the size of the cross-correlogram peak detected between the

  15. Sepsis of the hip due to pressure sore in spinal cord injured patients: advocacy for a one-stage surgical procedure.

    PubMed

    Le Fort, M; Rome-Saulnier, J; Lejeune, F; Bellier-Waast, F; Touchais, S; Kieny, P; Duteille, F; Perrouin-Verbe, B

    2014-11-04

    Study design:Retrospective study reporting characteristics and management of septic arthritis of the hip due to pressure sores in spinal cord-injured patients.Objectives:To describe clinical and biological data of septic arthritis of the hip and its treating management.Setting:The database of the regional SCI referral center, Nantes, France.Methods:We retrospectively collected data from 33 cases of septic arthritis of the hip in the medical files of 26 patients.Results:We analyzed 33 cases of septic arthritis of the hip treated in one French referent center for spinal cord-injured patients from January 1988 to December 2009. Most patients had a thoracic complete paraplegia and nearly two-third (17 out of 26) had no systematic follow-up. In 25 out of 33 cases, the septic arthritis of the hip was due to a trochanteric pressure sore. The causal pressure sore was most frequently associated with a persistent drainage. The standard radiological examination led to the diagnosis in 30 cases and, in 7 questionable cases, magnetic resonance imaging was more contributory. Surgery always consisted of a wide carcinological-like excision and of a subtrochanteric proximal femoral resection including both greater and lesser trochanters. A musculocutaneous flap was realized for all cases and the choice of the muscle depended on the localization of the causal pressure sore but also of the remaining choices, as most of the patients had already undergone a prior surgery. An antibiotic treatment was adapted to multiple samples during surgery.Conclusion:We do advocate for a one-stage procedure including a subtrochanteric proximal femoral resection and a musculocutaneous flap.Spinal Cord advance online publication, 4 November 2014; doi:10.1038/sc.2014.170.

  16. Community health nursing advocacy: a concept analysis.

    PubMed

    Ezeonwu, Mabel C

    2015-01-01

    The purpose of this article is to present an in-depth analysis of the concept of community health nursing (CHN) advocacy. Walker and Avant's (2010) 8-step concept analysis methodology was used. A broad inquiry into the literature between 1994 and 2014 resulted in the identification of the uses, defining attributes, empirical referents, antecedents, and consequences, as well as the articulation of an operational definition of CHN advocacy. Model and contrary cases were identified to demonstrate the concept's application and to clarify its meaning. This analysis contributes to the advancement of knowledge of CHN advocacy and provides nurse clinicians, educators, and researchers with some conceptual clarity to help improve community health outcomes.

  17. Empowerment and the psychiatric consumer/ex-patient movement in the United States: contradictions, crisis and change.

    PubMed

    McLean, A

    1995-04-01

    A political movement in the United States by consumers and ex-patients of psychiatry has challenged the assumptions and negative consequences of traditional mental health practice and its control by professionals. In recent years, the movement has succeeded in gaining support to produce alternative programs based on a philosophy of 'consumer empowerment' and run entirely by consumers and ex-patients. In this article, I present results from an ethnographic study of one such alternative and I attempt to explain the discrepancy between the center's philosophy of empowerment and its actual practices. Utilizing this data, the consumer literature, and interviews with consumer leaders nationwide, I explain this situation in terms of conceptual problems with the terms 'empowerment' and 'consumer empowerment', local structural conditions under which the center operated, and the larger situation of the psychiatric consumer/ex-patient movement in the United States today. The case study represents a crisis in the consumer movement today, in which rapid growth of alternatives has been accompanied by a social amnesia of the emancipatory vision that originally spawned the movement.

  18. Rapid eye movement-sleep is reduced in patients with acute uncomplicated diverticulitis—an observational study

    PubMed Central

    Alamili, Mahdi; Nielsen, Claus Henrik; Rosenberg, Jacob; Gögenur, Ismail

    2015-01-01

    Introduction. Sleep disturbances are commonly found in patients in the postoperative period. Sleep disturbances may give rise to several complications including cardiopulmonary instability, transient cognitive dysfunction and prolonged convalescence. Many factors including host inflammatory responses are believed to cause postoperative sleep disturbances, as inflammatory responses can alter sleep architecture through cytokine-brain interactions. Our aim was to investigate alteration of sleep architecture during acute infection and its relationships to inflammation and clinical symptoms. Materials & Methods. In this observational study, we included patients with acute uncomplicated diverticulitis as a model to investigate the isolated effects of inflammatory responses on sleep. Eleven patients completed the study. Patients were admitted and treated with antibiotics for two nights, during which study endpoints were measured by polysomnography recordings, self-reported discomfort scores and blood samples of cytokines. One month later, the patients, who now were in complete remission, were readmitted and the endpoints were re-measured (the baseline values). Results. Total sleep time was reduced 4% and 7% the first (p = 0.006) and second (p = 0.014) nights of diverticulitis, compared to baseline, respectively. The rapid eye movement sleep was reduced 33% the first night (p = 0.016), compared to baseline. Moreover, plasma IL-6 levels were correlated to non-rapid eye movement sleep, rapid eye movement sleep and fatigue. Conclusion. Total sleep time and rapid eye movement sleep were reduced during nights with active diverticulitis and correlated with markers of inflammation. PMID:26290799

  19. Medical Advocacy and Supportive Environments for African-Americans Following Abnormal Mammograms.

    PubMed

    Molina, Yamile; Hempstead, Bridgette H; Thompson-Dodd, Jacci; Weatherby, Shauna Rae; Dunbar, Claire; Hohl, Sarah D; Malen, Rachel C; Ceballos, Rachel M

    2015-09-01

    African-American women experience disproportionately adverse outcomes relative to non-Latina White women after an abnormal mammogram result. Research has suggested medical advocacy and staff support may improve outcomes among this population. The purpose of the study was to understand reasons African-American women believe medical advocacy to be important and examine if and how staff can encourage and be supportive of medical advocacy. A convenience-based sample of 30-74-year-old women who self-identified as African-American/Black/of African descent and who had received an abnormal mammogram result was recruited from community-based organizations, mobile mammography services, and the local department of health. This qualitative study included semi-structured interviews. Patients perceived medical advocacy to be particularly important for African-Americans, given mistrust and discrimination present in medical settings and their own familiarity with their bodies and symptoms. Respondents emphasized that staff can encourage medical advocacy through offering information in general in a clear, informative, and empathic style. Cultural competency interventions that train staff how to foster medical advocacy may be a strategy to improve racial disparities following an abnormal mammogram.

  20. Medical Advocacy and Supportive Environments for African Americans following Abnormal Mammograms

    PubMed Central

    Molina, Yamile; Hempstead, Bridgette H.; Thompson-Dodd, Jacci; Weatherby, Shauna Rae; Dunbar, Claire; Hohl, Sarah D.; Malen, Rachel C.; Ceballos, Rachel M.

    2014-01-01

    African American women experience disproportionately adverse outcomes relative to non-Latina White women after an abnormal mammogram result. Research has suggested medical advocacy and staff support may improve outcomes among this population. The purpose of the study was to understand reasons African American women believe medical advocacy to be important and examine if and how staff can encourage and be supportive of medical advocacy. A convenience-based sample of 30–74 year old women who self-identified as African American/Black/of African descent and who had received an abnormal mammogram result was recruited from community-based organizations, mobile mammography services, and the local department of health. This qualitative study included semi-structured interviews. Patients perceived medical advocacy to be particularly important for African Americans, given mistrust and discrimination present in medical settings and their own familiarity with their bodies and symptoms. Respondents emphasized staff can encourage medical advocacy through offering information in general in a clear, informative, and empathic style. Cultural competency interventions that train staff how to foster medical advocacy may be a strategy to improve racial disparities following an abnormal mammogram. PMID:25270556

  1. Movement disorders and sleep.

    PubMed

    Driver-Dunckley, Erika D; Adler, Charles H

    2012-11-01

    This article summarizes what is currently known about sleep disturbances in several movement disorders including Parkinson disease, essential tremor, parkinsonism, dystonia, Huntington disease, myoclonus, and ataxias. There is an association between movement disorders and sleep. In some cases the prevalence of sleep disorders is much higher in patients with movement disorder, such as rapid eye movement sleep behavior disorder in Parkinson disease. In other cases, sleep difficulties worsen the involuntary movements. In many cases the medications used to treat patients with movement disorder disturb sleep or cause daytime sleepiness. The importance of discussing sleep issues in patients with movement disorders cannot be underestimated.

  2. The effect of house design and environment on fungal movement in homes of bronchial asthma patients.

    PubMed

    Takatori, K; Saito, A; Yasueda, H; Akiyama, K

    2001-01-01

    The effect of house building design and environment on the fungal movement in the houses of 41 bronchial asthma (BA) patients has been investigated by examining house dust. The presence and composition of fungi were determined and compared in relation to building structure, house age, size of living room, main flooring material, presence of a living-room rug or air purifier, and frequency of vacuum cleaning. Among these elements, fungal CFU apparently varied only between building structure: wooden-board houses had significantly higher numbers of fungi than reinforced concrete houses (p < 0.01), and wooden mortar or iron-framed prefabricated houses had significantly higher numbers of fungi than reinforced concrete houses (p < 0.05). Classification of the types of fungi present in the house dust of BA patients showed that, regardless of the building designs, there were high levels of osmophilic fungi (group A) and fungi that survive at relatively dry conditions (group B), whereas fungi that survive in very wet conditions (group D) were present at low frequency. PMID:11694095

  3. Advocacy in disability policy: parents and consumers as advocates.

    PubMed

    Cunconan-Lahr, R; Brotherson, M J

    1996-12-01

    Advocacy for change, which stems from commitment and vision, should be a collaborative process among parents and consumers in partnership with professionals. Using surveys, interactive focus groups, and telephone interviews, we explored the concept and activities of advocacy experienced by parents and individuals with disabilities. Participants were identified through an advocacy and leadership training program, Partners in Policymaking. Advocacy activities and supports and barriers to successful advocacy both for parents and consumers were identified. Suggestions for further research and action were proposed.

  4. Community Health Worker Professional Advocacy: Voices of Action from the 2014 National Community Health Worker Advocacy Survey.

    PubMed

    Sabo, Samantha; Wennerstrom, Ashley; Phillips, David; Haywoord, Catherine; Redondo, Floribella; Bell, Melanie L; Ingram, Maia

    2015-01-01

    This mixed-methods study explores community health worker (CHW) engagement in professional advocacy. Data from the National Community Health Worker Advocacy Survey (n = 1661) assessed the relationship between CHW professional advocacy and CHW demographics, and work characteristics. Qualitative data articulated the quality of professional advocacy efforts. Approximately, 30% of CHW respondents advocated for professional advancement or collaborated with other CHWs to advance the workforce. Advocacy was more prevalent among CHWs affiliated with a professional network. CHW advocacy targeted recognition of the field, appropriate training and compensation, and sustainable funding. CHW professional advocacy is imperative to advancement of the field.

  5. Abnormalities in myelination of the superior cerebellar peduncle in patients with schizophrenia and deficits in movement sequencing.

    PubMed

    Hüttlova, Jitka; Kikinis, Zora; Kerkovsky, Milos; Bouix, Sylvain; Vu, Mai-Anh; Makris, Nikos; Shenton, Martha; Kasparek, Tomas

    2014-08-01

    Deficits in the execution of a sequence of movements are common in schizophrenia. Previous studies reported reduced functional activity in the motor cortex and cerebellum in schizophrenic patients with deficits in movement sequencing. The corticospinal tract (CST) and superior cerebellar peduncle (SCP) are fiber tracts that are involved in movement sequencing. However, the integrity of these tracts has not been evaluated in schizophrenic patients with respect to the performance of movement sequencing yet. Diffusion tensor magnetic resonance images (DT-MRI) were acquired from 24 patients with schizophrenia and 23 matched control subjects. Tractography was applied to reconstruct the CST and SCP and DT-MRI-specific parameters such as fractional anisotropy (FA) and radial diffusivity (RD) were reported. The patient group was further subdivided based on the score of sequencing of complex motor acts subscale of the Neurological Evaluation Scale into those with deficits in sequencing motor acts, the SQ(abn) group (n = 7), and those with normal performance, the SQ(norm) group (n = 17). Schizophrenia patients of the SQ(norm) subgroup had significantly reduced FA and increased RD values in the right CST in comparison to the control group; the SQ(abn) subgroup did not differ from the controls. However, the SQ(abn) subgroup showed impaired integrity of the left SCP, whereas the SQ(norm) subgroup did not. Abnormalities in the right CST in the SQ(norm) and in the left SCP in SQ(abn) groups suggest that the patients with SQ(abn) represent subgroups with distinct deficits. Moreover, these results demonstrate the involvement of the SCP in the pathogenesis of movement sequencing in schizophrenia.

  6. 45 CFR 1321.13 - Advocacy responsibilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON AGING, OLDER AMERICANS PROGRAMS GRANTS TO STATE AND COMMUNITY PROGRAMS ON AGING State Agency Responsibilities § 1321.13 Advocacy responsibilities....

  7. 45 CFR 1321.13 - Advocacy responsibilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON AGING, OLDER AMERICANS PROGRAMS GRANTS TO STATE AND COMMUNITY PROGRAMS ON AGING State Agency Responsibilities § 1321.13 Advocacy responsibilities....

  8. 45 CFR 1321.13 - Advocacy responsibilities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON AGING, OLDER AMERICANS PROGRAMS GRANTS TO STATE AND COMMUNITY PROGRAMS ON AGING State Agency Responsibilities § 1321.13 Advocacy responsibilities....

  9. 45 CFR 1321.13 - Advocacy responsibilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON AGING, OLDER AMERICANS PROGRAMS GRANTS TO STATE AND COMMUNITY PROGRAMS ON AGING State Agency Responsibilities § 1321.13 Advocacy responsibilities....

  10. 45 CFR 1321.13 - Advocacy responsibilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON AGING, OLDER AMERICANS PROGRAMS GRANTS TO STATE AND COMMUNITY PROGRAMS ON AGING State Agency Responsibilities § 1321.13 Advocacy responsibilities....

  11. Participatory advocacy: a counter to media imperialism.

    PubMed

    Brown, M

    1996-01-01

    Western media have a history of defining news worldwide, presenting news from a Western perspective which distorts and denies the truth as perceived from developing countries. Western news coverage of developing countries seems to emphasize countries' fragility, instability, and corruption, leading people to believe that the economic problems of developing countries are due to internal failures. That view is then transferred back to indigenous peoples and communities through major Western news agencies and mass media. Participatory communication is based upon the notion that people have the right to decide how they want themselves and their situations to be portrayed, to decide what information is useful to them and their community, and to be integral players in the communication process. With regard to media imperialism, the author discusses implications for advocacy activities, participatory communication approaches, participatory advocacy, participatory advocacy in South Asia, girl child drama in Nepal, drug abuse television drama in Nepal, and the advocacy challenge.

  12. Eye Movement Dysfunction in First-Degree Relatives of Patients with Schizophrenia: A Meta-Analytic Evaluation of Candidate Endophenotypes

    ERIC Educational Resources Information Center

    Calkins, Monica E.; Iacono, William G.; Ones, Deniz S.

    2008-01-01

    Several forms of eye movement dysfunction (EMD) are regarded as promising candidate endophenotypes of schizophrenia. Discrepancies in individual study results have led to inconsistent conclusions regarding particular aspects of EMD in relatives of schizophrenia patients. To quantitatively evaluate and compare the candidacy of smooth pursuit,…

  13. Factors for success in mental health advocacy

    PubMed Central

    Hann, Katrina; Pearson, Heather; Campbell, Doris; Sesay, Daniel; Eaton, Julian

    2015-01-01

    Background Mental health advocacy groups are an effective way of pushing the mental health agenda and putting pressure on national governments to observe the right to health; however, there is limited research that highlights best practices for such groups in low-resource settings. In an effort to improve the scaling up of mental health in Sierra Leone, stakeholders came together to form the country's first mental health advocacy group: the Mental Health Coalition – Sierra Leone. Since its inception, the group has worked towards raising the profile of mental health in Sierra Leone and developing as an advocacy organisation. Design The study's aim was to investigate views on enabling factors and barriers associated with mental health advocacy in a low-income country using a community-based participatory approach and qualitative methodology. Focus groups (N=9) were held with mental health stakeholders, and key informant interviews (N=15) were conducted with advocacy targets. Investigators analysed the data collaboratively using coding techniques informed by grounded theory. Results Investigators reveal viewpoints on key factors in networking, interacting with government actors, and awareness raising that enabled mental health advocacy aims of supporting policy, service delivery, service user rights, training for service delivery, and awareness raising. The investigators outline viewpoints on barriers for advocacy aims in framing the issue of mental health, networking, interacting with government actors, resource mobilization, and awareness raising. Conclusions The findings outline enabling factors, such as networking with key stakeholders, and barriers, such as lack of political will, for achieving mental health advocacy aims within a low-resource setting, Sierra Leone. Stakeholder coalitions can further key policy development aims that are essential to strengthen mental health systems in low-resource settings. PMID:26689456

  14. Effect of eye movements and proprioceptive neuromuscular facilitation on balance and head alignment in stroke patients with neglect syndrome.

    PubMed

    Park, Si-Eun; Min, Kyung-Ok; Lee, Sang-Bin; Choi, Wan-Suk; Kim, Soon-Hee

    2016-01-01

    [Purpose] The purpose of this study was to assess the effect of eye movements and proprioceptive neuromuscular facilitation (PNF) on patients with neglect syndrome. [Subjects and Methods] The subjects were randomly allocated to 2 groups: the eye movements (EM) group; and the PNF with eye movements (PEM) group. The program was conducted five times each week for 6 weeks. Balance (both static and dynamic) and head alignment (craniovertebral angle and cranial rotation angle) were measured before and after testing. [Results] In measurements of static balance, the EM group showed significant improvement in sway length and sway area when examined in the eyes-open condition, but not when examined in the eyes-closed condition. The PEM group showed significant improvement when examined under both conditions. In the assessment of dynamic balance, both groups showed significant improvement in measurements of sway areas. With respect to head alignment, there were no significant differences pre- and post-testing in either the craniovertebral angle or the cranial rotation angle in the EM group, but the PEM group showed significant differences in both measurements. [Conclusion] These results suggest that in stroke patients with neglect syndrome, PNF with eye movements, rather than eye movements alone, has a greater positive effect on balance and head alignment.

  15. Effect of eye movements and proprioceptive neuromuscular facilitation on balance and head alignment in stroke patients with neglect syndrome

    PubMed Central

    Park, Si-Eun; Min, Kyung-Ok; Lee, Sang-Bin; Choi, Wan-Suk; Kim, Soon-Hee

    2016-01-01

    [Purpose] The purpose of this study was to assess the effect of eye movements and proprioceptive neuromuscular facilitation (PNF) on patients with neglect syndrome. [Subjects and Methods] The subjects were randomly allocated to 2 groups: the eye movements (EM) group; and the PNF with eye movements (PEM) group. The program was conducted five times each week for 6 weeks. Balance (both static and dynamic) and head alignment (craniovertebral angle and cranial rotation angle) were measured before and after testing. [Results] In measurements of static balance, the EM group showed significant improvement in sway length and sway area when examined in the eyes-open condition, but not when examined in the eyes-closed condition. The PEM group showed significant improvement when examined under both conditions. In the assessment of dynamic balance, both groups showed significant improvement in measurements of sway areas. With respect to head alignment, there were no significant differences pre- and post-testing in either the craniovertebral angle or the cranial rotation angle in the EM group, but the PEM group showed significant differences in both measurements. [Conclusion] These results suggest that in stroke patients with neglect syndrome, PNF with eye movements, rather than eye movements alone, has a greater positive effect on balance and head alignment. PMID:27065550

  16. Professional and patient perspectives of NICE guidelines to abandon maternal monitoring of fetal movements

    PubMed Central

    Hill-Smith, Ian

    2004-01-01

    Over the past 30 years, fetal movement counts have been recommended to women in the second half of pregnancy as a way of monitoring fetal wellbeing and providing an early warning of fetal distress. However, guidance from the National Institute of Clinical Excellence (NICE) recommends abandoning this. Evidence is reviewed to show that the chance of preventing physical damage to the fetus is indeed low. The activity of monitoring movements has been favoured by the majority of women. The new NICE guidance is useful to clarify professional understanding of the limitation of counting fetal movements, but women who notice decreased movements will still need referral for human factors. PMID:15527614

  17. Advocacy evaluation: challenges and emerging trends.

    PubMed

    Devlin-Foltz, David; Fagen, Michael C; Reed, Ehren; Medina, Robert; Neiger, Brad L

    2012-09-01

    Devising, promoting, and implementing changes in policies and regulations are important components of population-level health promotion. Whether advocating for changes in school meal nutrition standards or restrictions on secondhand smoke, policy change can create environments conducive to healthier choices. Such policy changes often result from complex advocacy efforts that do not lend themselves to traditional evaluation approaches. In a challenging fiscal environment, allocating scarce resources to policy advocacy may be particularly difficult. A well-designed evaluation that moves beyond inventorying advocacy activities can help make the case for funding advocacy and policy change efforts. Although it is one thing to catalog meetings held, position papers drafted, and pamphlets distributed, it is quite another to demonstrate that these outputs resulted in useful policy change outcomes. This is where the emerging field of advocacy evaluation fits in by assessing (among other things) strategic learning, capacity building, and community organizing. Based on recent developments, this article highlights several challenges advocacy evaluators are currently facing and provides new resources for addressing them. PMID:22773623

  18. The movement of patients across borders: challenges and opportunities for public health.

    PubMed

    Helble, Matthias

    2011-01-01

    In a globalizing world, public health is no longer confined to national borders. In recent years we have observed an increasing movement of patients across international borders. The full extent of this trend is yet unknown, as data are sparse and anecdotal. If this trend continues, experts are convinced that it will have major implications for public health systems around the globe. Despite the growing importance of medical travel, we still have little empirical evidence on its impact on public health, especially on health systems. This paper summarizes the most recent debates on this topic. It discusses the main forces that drive medical travel and its implications on health systems, in particular the impacts on access to health care, financing and the health workforce. This paper also offers guidance on how to define medical travel and how to improve data collection. It advocates for more scientific research that will enable countries to harness benefits and limit the potential risks to public health arising from medical travel. PMID:21346893

  19. The movement of patients across borders: challenges and opportunities for public health.

    PubMed

    Helble, Matthias

    2011-01-01

    In a globalizing world, public health is no longer confined to national borders. In recent years we have observed an increasing movement of patients across international borders. The full extent of this trend is yet unknown, as data are sparse and anecdotal. If this trend continues, experts are convinced that it will have major implications for public health systems around the globe. Despite the growing importance of medical travel, we still have little empirical evidence on its impact on public health, especially on health systems. This paper summarizes the most recent debates on this topic. It discusses the main forces that drive medical travel and its implications on health systems, in particular the impacts on access to health care, financing and the health workforce. This paper also offers guidance on how to define medical travel and how to improve data collection. It advocates for more scientific research that will enable countries to harness benefits and limit the potential risks to public health arising from medical travel.

  20. The movement of patients across borders: challenges and opportunities for public health

    PubMed Central

    2011-01-01

    Abstract In a globalizing world, public health is no longer confined to national borders. In recent years we have observed an increasing movement of patients across international borders. The full extent of this trend is yet unknown, as data are sparse and anecdotal. If this trend continues, experts are convinced that it will have major implications for public health systems around the globe. Despite the growing importance of medical travel, we still have little empirical evidence on its impact on public health, especially on health systems. This paper summarizes the most recent debates on this topic. It discusses the main forces that drive medical travel and its implications on health systems, in particular the impacts on access to health care, financing and the health workforce. This paper also offers guidance on how to define medical travel and how to improve data collection. It advocates for more scientific research that will enable countries to harness benefits and limit the potential risks to public health arising from medical travel. PMID:21346893

  1. Assessment of posture and joint movements of the upper limbs of patients after mastectomy and lymphadenectomy

    PubMed Central

    Haddad, Cinira Assad Simão; Saad, Marcelo; Perez, Maria del Carmen Janeiro; Miranda, Fausto

    2013-01-01

    ABSTRACT Objective: To evaluate alterations in posture and range of motion of the upper limbs in women after mastectomy and lymphadenectomy, submitted to radiotherapy as adjuvant treatment. Methods: Two groups were evaluated: 16 post-mastectomy women with lymphedema of the upper limb and 14 post-mastectomy women without lymphedema. Patients were submitted to analysis made by software, one for posture and the other to measure ranges of movement of the shoulder, elbow, and wrists. The results obtained were compared between the right and left sides, and operated and non-operated sides, and then were submitted to statistical tests. Results: Both groups presented with anteriorization of the trunk. The women with lymphedema had head rotation to the right, protrusion of the left shoulder, and trunk inclination angle smaller on the operated side, besides bilateral elevation of the scapula when compared to the group with no lymphedema. Changes in range of motion were also smaller on the operated side in terms of flexion, abduction, and external rotation of the shoulder for all women, and for those with lymphedema, elbow extension and wrist flexion had a smaller range of motion. Conclusion: Women submitted to mastectomy presented with asymmetries and modifications in posture, and lymphedema seemed to worsen this condition. Additionally, they had deficits in range of motion in the shoulders on the operated side. Women with lymphedema also showed deficits in the elbows and wrist. PMID:24488379

  2. Diagnosis and treatment of impulse control disorders in patients with movement disorders

    PubMed Central

    Mestre, Tiago A.; Strafella, Antonio P.; Thomsen, Teri; Voon, Valerie

    2013-01-01

    Impulse control disorders are a psychiatric condition characterized by the failure to resist an impulsive act or behavior that may be harmful to self or others. In movement disorders, impulse control disorders are associated with dopaminergic treatment, notably dopamine agonists (DAs). Impulse control disorders have been studied extensively in Parkinson’s disease, but are also recognized in restless leg syndrome and atypical Parkinsonian syndromes. Epidemiological studies suggest younger age, male sex, greater novelty seeking, impulsivity, depression and premorbid impulse control disorders as the most consistent risk factors. Such patients may warrant special monitoring after starting treatment with a DA. Various individual screening tools are available for people without Parkinson’s disease. The Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease has been developed specifically for Parkinson’s disease. The best treatment for impulse control disorders is prevention. However, after the development of impulse control disorders, the mainstay intervention is to reduce or discontinue the offending anti-Parkinsonian medication. In refractory cases, other pharmacological interventions are available, including neuroleptics, antiepileptics, amantadine, antiandrogens, lithium and opioid antagonists. Unfortunately, their use is only supported by case reports, small case series or open-label clinical studies. Prospective, controlled studies are warranted. Ongoing investigations include naltrexone and nicotine. PMID:23634190

  3. Gait profile score and movement analysis profile in patients with Parkinson's disease during concurrent cognitive load

    PubMed Central

    Speciali, Danielli S.; Oliveira, Elaine M.; Cardoso, Jefferson R.; Correa, João C. F.; Baker, Richard; Lucareli, Paulo R. G.

    2014-01-01

    Background: Gait disorders are common in individuals with Parkinson's Disease (PD) and the concurrent performance of motor and cognitive tasks can have marked effects on gait. The Gait Profile Score (GPS) and the Movement Analysis Profile (MAP) were developed in order to summarize the data of kinematics and facilitate understanding of the results of gait analysis. Objective: To investigate the effectiveness of the GPS and MAP in the quantification of changes in gait during a concurrent cognitive load while walking in adults with and without PD. Method: Fourteen patients with idiopathic PD and nine healthy subjects participated in the study. All subjects performed single and dual walking tasks. The GPS/MAP was computed from three-dimensional gait analysis data. Results: Differences were found between tasks for GPS (P<0.05) and Gait Variable Score (GVS) (pelvic rotation, knee flexion-extension and ankle dorsiflexion-plantarflexion) (P<0.05) in the PD group. An interaction between task and group was observed for GPS (P<0.01) for the right side (Cohen's ¯d=0.99), left side (Cohen's ¯d=0.91), and overall (Cohen's ¯d=0.88). No interaction was observed only for hip internal-external rotation and foot internal-external progression GVS variables in the PD group. Conclusions: The results showed gait impairment during the dual task and suggest that GPS/MAP may be used to evaluate the effects of concurrent cognitive load while walking in patients with PD. PMID:25054382

  4. Mandibular Range of Movement and Pain Intensity in Patients with Anterior Disc Displacement without Reduction

    PubMed Central

    Alajbeg, Iva Z.; Gikić, Marijana; Valentić-Peruzović, Melita

    2015-01-01

    Objective Temporomandibular disorders (TMD) are the most common source of orofacial pain of a non-dental origin. The study was performed to investigate the therapeutic effect of the conventional occlusal splint therapy and the physical therapy. The hypothesis tested was that the simultaneous use of occlusal splint and physical therapy is an effective method for treatment of anterior disc displacement without reduction. Materials and Methods Twelve patients (mean age =30.5 y) with anterior disc displacement without reduction (according to RDC/TMD and confirmed by magnetic resonance imaging) were randomly allocated into 2 groups: 6 received stabilization splint (SS) and 6 received both physical therapy and stabilization splint (SS&PT). Treatment outcomes included pain-free opening (MCO), maximum assisted opening (MAO), path of mouth opening and pain as reported on visual analogue scale (VAS). Results At baseline of treatment there were no significant differences among the groups for VAS scores, as well as for the range of mandibular movement. VAS scores improved significantly over time for the SS&PT group (F=28.964, p=0.0001, effect size =0.853) and SS group (F=8.794, p=0.001, effect size =0.638). The range of mouth opening improved significantly only in the SS&PT group (MCO: F=20.971, p=0.006; MAO: F=24.014, p=0.004) (Figure 2). Changes in path of mouth opening differ significantly between the groups (p=0.040). Only 1 patient in SS&PT group still presented deviations in mouth opening after completed therapy while in the SS group deviations were present in 5 patients after completed therapy. Conclusion This limited study gave evidence that during the treatment period lasting for 6 months, the simultaneous use of stabilization splint and physical therapy was more efficient in reducing deviations and improving range of mouth opening than the stabilization splint used alone. Both treatment options were efficient in reducing pain in patients with anterior disc

  5. Restoration of Central Programmed Movement Pattern by Temporal Electrical Stimulation-Assisted Training in Patients with Spinal Cerebellar Atrophy.

    PubMed

    Huang, Ying-Zu; Chang, Yao-Shun; Hsu, Miao-Ju; Wong, Alice M K; Chang, Ya-Ju

    2015-01-01

    Disrupted triphasic electromyography (EMG) patterns of agonist and antagonist muscle pairs during fast goal-directed movements have been found in patients with hypermetria. Since peripheral electrical stimulation (ES) and motor training may modulate motor cortical excitability through plasticity mechanisms, we aimed to investigate whether temporal ES-assisted movement training could influence premovement cortical excitability and alleviate hypermetria in patients with spinal cerebellar ataxia (SCA). The EMG of the agonist extensor carpi radialis muscle and antagonist flexor carpi radialis muscle, premovement motor evoked potentials (MEPs) of the flexor carpi radialis muscle, and the constant and variable errors of movements were assessed before and after 4 weeks of ES-assisted fast goal-directed wrist extension training in the training group and of general health education in the control group. After training, the premovement MEPs of the antagonist muscle were facilitated at 50 ms before the onset of movement. In addition, the EMG onset latency of the antagonist muscle shifted earlier and the constant error decreased significantly. In summary, temporal ES-assisted training alleviated hypermetria by restoring antagonist premovement and temporal triphasic EMG patterns in SCA patients. This technique may be applied to treat hypermetria in cerebellar disorders. (This trial is registered with NCT01983670.). PMID:26417459

  6. Restoration of Central Programmed Movement Pattern by Temporal Electrical Stimulation-Assisted Training in Patients with Spinal Cerebellar Atrophy.

    PubMed

    Huang, Ying-Zu; Chang, Yao-Shun; Hsu, Miao-Ju; Wong, Alice M K; Chang, Ya-Ju

    2015-01-01

    Disrupted triphasic electromyography (EMG) patterns of agonist and antagonist muscle pairs during fast goal-directed movements have been found in patients with hypermetria. Since peripheral electrical stimulation (ES) and motor training may modulate motor cortical excitability through plasticity mechanisms, we aimed to investigate whether temporal ES-assisted movement training could influence premovement cortical excitability and alleviate hypermetria in patients with spinal cerebellar ataxia (SCA). The EMG of the agonist extensor carpi radialis muscle and antagonist flexor carpi radialis muscle, premovement motor evoked potentials (MEPs) of the flexor carpi radialis muscle, and the constant and variable errors of movements were assessed before and after 4 weeks of ES-assisted fast goal-directed wrist extension training in the training group and of general health education in the control group. After training, the premovement MEPs of the antagonist muscle were facilitated at 50 ms before the onset of movement. In addition, the EMG onset latency of the antagonist muscle shifted earlier and the constant error decreased significantly. In summary, temporal ES-assisted training alleviated hypermetria by restoring antagonist premovement and temporal triphasic EMG patterns in SCA patients. This technique may be applied to treat hypermetria in cerebellar disorders. (This trial is registered with NCT01983670.).

  7. Use of NeuroEyeCoach™ to Improve Eye Movement Efficacy in Patients with Homonymous Visual Field Loss

    PubMed Central

    Zihl, Josef

    2016-01-01

    Visual field deficits are common in patients with damaged retinogeniculostriate pathways. The patient's eye movements are often affected leading to inefficient visual search. Systematic eye movement training also called compensatory therapy is needed to allow patients to develop effective coping strategies. There is a lack of evidence-based, clinical gold-standard registered medical device accessible to patients at home or in clinical settings and NeuroEyeCoach (NEC) is developed to address this need. In three experiments, we report on performance of patients on NEC compared to the data obtained previously on the earlier versions of the search task (n = 32); we assessed whether the self-administered computerised tasks can be used to monitor the progress (n = 24) and compared the findings in a subgroup of patients to a healthy control group. Performance on cancellation tasks, simple visual search, and self-reported responses on activities of daily living was compared, before and after training. Patients performed similarly well on NEC as on previous versions of the therapy; the inbuilt functionality for pre- and postevaluation functions was sensitive to allowing assessment of improvements; and improvements in patients were significantly greater than those in a group of healthy adults. In conclusion, NeuroEyeCoach can be used as an effective rehabilitation tool to develop compensatory strategies in patients with visual field deficits after brain injury. PMID:27703974

  8. Advocacy for Health Equity: A Synthesis Review

    PubMed Central

    Farrer, Linden; Marinetti, Claudia; Cavaco, Yoline Kuipers; Costongs, Caroline

    2015-01-01

    Context Health inequalities are systematic differences in health among social groups that are caused by unequal exposure to—and distributions of—the social determinants of health (SDH). They are persistent between and within countries despite action to reduce them. Advocacy is a means of promoting policies that improve health equity, but the literature on how to do so effectively is dispersed. The aim of this review is to synthesize the evidence in the academic and gray literature and to provide a body of knowledge for advocates to draw on to inform their efforts. Methods This article is a systematic review of the academic literature and a fixed-length systematic search of the gray literature. After applying our inclusion criteria, we analyzed our findings according to our predefined dimensions of advocacy for health equity. Last, we synthesized our findings and made a critical appraisal of the literature. Findings The policy world is complex, and scientific evidence is unlikely to be conclusive in making decisions. Timely qualitative, interdisciplinary, and mixed-methods research may be valuable in advocacy efforts. The potential impact of evidence can be increased by “packaging” it as part of knowledge transfer and translation. Increased contact between researchers and policymakers could improve the uptake of research in policy processes. Researchers can play a role in advocacy efforts, although health professionals and disadvantaged people, who have direct contact with or experience of hardship, can be particularly persuasive in advocacy efforts. Different types of advocacy messages can accompany evidence, but messages should be tailored to advocacy target. Several barriers hamper advocacy efforts. The most frequently cited in the academic literature are the current political and economic zeitgeist and related public opinion, which tend to blame disadvantaged people for their ill health, even though biomedical approaches to health and political short

  9. Advancing Your Citizenship: An Annotated Bibliography on Consumerism/Advocacy for Persons with Disabilities. Advancing Your Citizenship Series Number 2.

    ERIC Educational Resources Information Center

    Browning, Philip; And Others

    The annotated bibliography lists 289 references which relate to the advocacy consumer movement for disabled people. Initial sections contain a listing of the periodicals, books and monographs/reports/proceedings from which the annotated references are derived; an author index; and a subject index. Among the subjects covered are the following:…

  10. An Investigation of Horizontal Combined Eye-Head Tracking in Patients with Abnormal Vestibular and Smooth Pursuit Eye Movements

    NASA Technical Reports Server (NTRS)

    Huebner, William P.; Leigh, R. John; Seidman, Scott H.; Billian, Carl

    1993-01-01

    We investigated the interaction of smooth ocular pursuit (SP) and the vestibulo-ocular reflex (VOR) during horizontal, combined eye-head tracking (CEHT) in patients with abnormalities of either the VOR or SP movements. Our strategy was to apply transient stimuli that capitalized on the different latencies to onset of SP and the VOR. During CEHT of a target moving at 15 deg/sec, normal subjects and patients with VOR deficits all tracked the target with a gain close to 1.O. When the heads of normal subjects were suddenly and unexpectedly braked to a halt during CEHT, the eye promptly began to move in the orbit to track the target, but eye-in-orbit velocity transiently fell to about 60-70% of target velocity. In patients with deficient labyrinthine function, following the onset of the head brake, eye movements to track the target were absent, and SP movements were not generated until about 100 msec later. In patients with deficient SP, CEHT was superior to SP tracking with the head stationary; after the onset of the head brake, tracking eye movements were initiated promptly, but eye velocity was less than 50% of target velocity and increased only slightly thereafter. These results indicate that at least two mechanisms operate to overcome the VOR and allow gaze to track the target during CEHT: (1) the SP system provides a signal to cancel a normally-operating VOR (this cancellation signal is not needed by labyrinthine-deficient patients who have no VOR to cancel), and (2) a reduction of the gain of the VOR is achieved, an ability that is preserved even in patients with cerebral lesions that impair SP.

  11. A dance movement therapy group for depressed adult patients in a psychiatric outpatient clinic: effects of the treatment.

    PubMed

    Pylvänäinen, Päivi M; Muotka, Joona S; Lappalainen, Raimo

    2015-01-01

    We were interested in investigating the effects of dance movement therapy (DMT) in a psychiatric outpatient clinic with patients diagnosed with depression. DMT aims to engage the patients in physical and verbal exploration of their experiences generated in movement based interaction. The assumption was that DMT, which includes both physical engagement as well as emotional and social exploration, would alleviate the mood and psychiatric symptoms. All adult patients (n = 33) included in the study received treatment as usual (TAU). Twenty-one patients participated in a 12-session DMT group intervention, and the remaining 12 patients chose to take TAU only. The majority of the patients suffered from moderate or severe depression, recurrent and/or chronic type. The effects of the interventions were investigated after the intervention, and at 3-month follow-up. Compared to the TAU, adding DMT seemed to improve the effect of the treatment. The effect of the DMT was observable whether the patient was taking antidepressant medication or not. At follow-up, between group effect sizes (ES) were medium in favor for the DMT group (d = 0.60-0.79). In the DMT group, the within ES at the 3 months follow-up varied from 0.62 to 0.82 as compared to TAU 0.15-0.37. The results indicated that DMT is beneficial in the treatment of depressed patients.

  12. Assessment of Mandibular Movements in 10 to 15 Year-old Patients With and Without Temporomandibular Disorders.

    PubMed

    Cortese, Silvina G; Biondi, Ana M; Fridman, Diana E; Guitelman, Ingrid; Farah, Catalina L

    2015-12-01

    The aim of this study was to establish reference values for mandibular movements in 10- to 15-year-olds without dysfunction and compare these values to those in patients of the same age with tempromandibular disorders (TMD) and those found previously in a group of children younger than 11 years old without TMD. Children of both genders who visited the Department of Comprehensive Pediatric Dentistry at Buenos Aires University in 2013 and whose parents or guardians provided consent were evaluated using TMD/RDC by standardized pediatric dentists (Kappa 0.88). Three groups were formed according to diagnostic summary: Group C, without TMD; Group Ia, with myofascial pain, and Group Ib, pain with limited mouth opening. The following variables were analyzed: age, gender and mandibular movements. The sample included 169 patients aged 12.5±1.76 years, of whom 62.36% did not have TMD (C) while 37.27% were diagnosed with muscle disorder (29.58% Ia and 7.69% Ib). For Group C, the following values (in mm) were recorded: maximal unassisted opening: 48.28±6.14; right lateral movement 8.78±2.50; left lateral movement: 9.60±2.64; protrusion: 4.94±2.58 and overbite: 2.98 ± 2.5, with no variation associated to sex, but with differences in the values recorded for all movements compared to those obtained for mixed dentition (p=0.0001). Analysis of mean values for mandibular movements in all 3 groups only revealed differences for maximal unassisted opening (p= 0.0317). With relation to gender, TMD was more frequent in females, with significant differences between Groups C and Ia (p=0.019). In males without dysfunction, average maximal opening was 48.28±6.14mm, with lower values in patients with TMD. Mandibular movements in pediatric patients without TMD showed significant differences according to dentition type and age.

  13. Assessment of Mandibular Movements in 10 to 15 Year-old Patients With and Without Temporomandibular Disorders.

    PubMed

    Cortese, Silvina G; Biondi, Ana M; Fridman, Diana E; Guitelman, Ingrid; Farah, Catalina L

    2015-12-01

    The aim of this study was to establish reference values for mandibular movements in 10- to 15-year-olds without dysfunction and compare these values to those in patients of the same age with tempromandibular disorders (TMD) and those found previously in a group of children younger than 11 years old without TMD. Children of both genders who visited the Department of Comprehensive Pediatric Dentistry at Buenos Aires University in 2013 and whose parents or guardians provided consent were evaluated using TMD/RDC by standardized pediatric dentists (Kappa 0.88). Three groups were formed according to diagnostic summary: Group C, without TMD; Group Ia, with myofascial pain, and Group Ib, pain with limited mouth opening. The following variables were analyzed: age, gender and mandibular movements. The sample included 169 patients aged 12.5±1.76 years, of whom 62.36% did not have TMD (C) while 37.27% were diagnosed with muscle disorder (29.58% Ia and 7.69% Ib). For Group C, the following values (in mm) were recorded: maximal unassisted opening: 48.28±6.14; right lateral movement 8.78±2.50; left lateral movement: 9.60±2.64; protrusion: 4.94±2.58 and overbite: 2.98 ± 2.5, with no variation associated to sex, but with differences in the values recorded for all movements compared to those obtained for mixed dentition (p=0.0001). Analysis of mean values for mandibular movements in all 3 groups only revealed differences for maximal unassisted opening (p= 0.0317). With relation to gender, TMD was more frequent in females, with significant differences between Groups C and Ia (p=0.019). In males without dysfunction, average maximal opening was 48.28±6.14mm, with lower values in patients with TMD. Mandibular movements in pediatric patients without TMD showed significant differences according to dentition type and age. PMID:27095624

  14. Compensatory eye and head movements of patients with homonymous hemianopia in the naturalistic setting of a driving simulation.

    PubMed

    Bahnemann, Markus; Hamel, Johanna; De Beukelaer, Sophie; Ohl, Sven; Kehrer, Stefanie; Audebert, Heinrich; Kraft, Antje; Brandt, Stephan A

    2015-02-01

    Homonymous hemianopia (HH) is a frequent deficit resulting from lesions to post-chiasmal brain structures with a significant negative impact on activities of daily living. To address the question how patients with HH may compensate their visual field defect in a naturalistic environment, we performed a driving simulation experiment and quantitatively analyzed both eye and head movements using a head-mounted pupil camera. 14 patients with HH and 14 matched healthy control subjects participated in the study. Based on the detection performance of dynamically moving obstacles, which appeared unexpectedly along the sides of the road track, we divided the patient group into a high- and a low-performance group. Then, we compared parameters of eye and head movements between the two patient groups and the matched healthy control group to identify those which mediate successful detection of potentially hazardous objects. Differences in detection rates could not be explained by demographic variables or the extent of the visual field defect. Instead, high performance of patients with HH in the naturalistic setting of our driving simulation depended on an adapted visual exploratory behavior characterized by a relative increase in the amplitude and a corresponding increase in the peak velocity of saccades, widening horizontally the distribution of eye movements, and by a shift of the overall distribution of saccades into the blind hemifield. The result of the group comparison analyses was confirmed by a subsequent stepwise regression analysis which identified the horizontal spread of eye movements as single factor predicting the detection of hazardous objects. PMID:25381457

  15. The Northland fluoridation advocacy programme: an evaluation.

    PubMed

    Gowda, Sunitha; Thomas, David R

    2008-12-01

    On 20 July 2006, the Far North District Council resolved to fluoridate Kaitaia and Kaikohe. This was the first such initiative by any Territorial Local Authority (TLA) in New Zealand for 23 years, and resulted from a fluoridation advocacy programme. This paper describes the programme implementation, assesses its consistency with the principles of the Treaty of Waitangi, and critically examines the collaboration between the fluoride advocate and the key stakeholders. Process evaluation identified three main categories of programme implementation: policy advocacy, community action projects, and media advocacy. The collaboration of iwi, Maori health providers and the community suggests that the programme was consistent with the principles (partnership, participation and protection) ofthe Treaty ofWaitangi. Media advocacy played an important role in reflecting and engaging community views on fluoridation, and it influenced decision-making by the Far North District Council. The simultaneous, combined 'top-down and bottom-up' approach was an effective and successful strategy for fluoridation advocacy in the community. Less integrated approaches implemented on their own (such as the 'top down' approach in Whangarei and the 'bottom-up' approach in Dargaville) were not effective. PMID:19180864

  16. Improvement of mood and sleep alterations in posttraumatic stress disorder patients by eye movement desensitization and reprocessing

    PubMed Central

    Raboni, Mara R.; Alonso, Fabiana F. D.; Tufik, Sergio; Suchecki, Deborah

    2014-01-01

    Posttraumatic stress disorder (PTSD) patients exhibit depressive and anxiety symptoms, in addition to nightmares, which interfere with sleep continuity. Pharmacologic treatment of these sleep problems improves PTSD symptoms, but very few studies have used psychotherapeutic interventions to treat PTSD and examined their effects on sleep quality. Therefore, in the present study, we sought to investigate the effects of Eye Movement Desensitization Reprocessing therapy on indices of mood, anxiety, subjective, and objective sleep. The sample was composed of 11 healthy controls and 13 PTSD patients that were victims of assault and/or kidnapping. All participants were assessed before, and 1 day after, the end of treatment for depressive and anxiety profile, general well-being and subjective sleep by filling out specific questionnaires. In addition, objective sleep patterns were evaluated by polysomnographic recording. Healthy volunteers were submitted to the therapy for three weekly sessions, whereas PTSD patients underwent five sessions, on average. Before treatment, PTSD patients exhibited high levels of anxiety and depression, poor quality of life and poor sleep, assessed both subjectively and objectively; the latter was reflected by increased time of waking after sleep onset. After completion of treatment, patients exhibited improvement in depression and anxiety symptoms, and in quality of life; with indices that were no longer different from control volunteers. Moreover, these patients showed more consolidated sleep, with reduction of time spent awake after sleep onset. In conclusion, Eye Movement Desensitization and Reprocessing was an effective treatment of PTSD patients and improved the associated sleep and psychological symptoms. PMID:24959123

  17. Jaw movements in patients with a history of pain: an exploratory study.

    PubMed

    Bhaskaracharya, M; Memon, S M; Whittle, T; Murray, G M

    2015-01-01

    The aims were to determine whether individuals with a past history of pain exhibit (i) altered jaw movement (e.g. reduced amplitude, increased jaw movement variability) in comparison with matched asymptomatic controls, and (ii) correlations between psychological measures (e.g. catastrophising) and altered jaw movement variables. Sixteen participants with a history of trigeminal neuropathic pain (TNP) and 15 age- and gender-matched healthy controls had jaw movements recorded during open/close, free gum chewing and chewing at standardised rates. All completed the Pain Catastrophising Scale (PCS), the Pain Self-Efficacy Questionnaire (PSEQ), and the Depression, Anxiety and Stress Scales (DASS). Velocity and amplitude for open/close and chewing, as well as variability, bias and mean square error for open/close jaw movements were compared between groups. Spearman's rank correlation coefficient was used to relate kinematic variables with psychological variables. Statistical significance: P < 0·05. There were no significant differences in mean jaw velocity and amplitude between the TNP and control groups during the open/close jaw movements or free or standardised chewing. In comparison with control, the TNP participants exhibited significantly greater variability, bias and/or mean square error during slow and/or fast opening, and significantly greater variance in velocity and/or amplitude during free and standardised chewing. There were significant negative correlations between PCS scores and velocity and/or amplitude of free and/or standardised chewing. This exploratory study suggests that individuals with a history of pain have altered patterns of jaw movements in comparison with asymptomatic control participants and that catastrophising may play a role in the manifestation of these altered jaw movements. PMID:25146890

  18. Gender and advocacy in Indonesia.

    PubMed

    Ray-ross, S

    1997-01-01

    The Centre for Development and Population Activities (CEDPA) and the Indonesian Midwives Association (IBI) have developed a two-phase training program regarding gender issues for the association's midwives. The first phase focuses on the leadership, management, and advocacy skills necessary to articulate program needs and to take part in making decisions regarding family planning and reproductive health. The second phase concerns the integration of gender into project design. Proposals developed by the midwives include the following: 1) to improve counseling services for women in a district where 70% of the women using contraception do not decide for themselves which methods to use; 2) to reduce maternal mortality in a district where it has increased by 20% and where women have died while waiting for husbands or fathers-in-law to make the decision to bring them to hospitals; 3) to develop gender-sensitive materials concerning HIV/AIDS; and 4) to expand gender training to all levels of IBI, to provide follow-up technical support, and to integrate gender into the mission statement of the organization. Dr. Nafsiah Mboi (member of Parliament and vice chair of the Global Commission on Women's Health), Dr. Widyastuti Wibisana (director of community participation in the Ministry of Health), Dr. Kokila Vaidya (WHO Medical Officer), Carla Bianpoen (gender specialist with the World Bank), and Titi Sumbung (director of the Melati Foundation) helped to develop and to conduct the program. IBI, which has 65,000 members, provides family planning, reproductive health, and maternal and child health services throughout Indonesia. PMID:12292791

  19. Advocacy Evaluation: A Model for Internal Evaluation Offices.

    ERIC Educational Resources Information Center

    Sonnichsen, Richard C.

    1988-01-01

    As evaluations are more often implemented by internal staff, internal evaluators must begin to assume decision-making and advocacy tasks. This advocacy evaluation concept is described using the Federal Bureau of Investigation evaluation staff as a model. (TJH)

  20. Community stakeholder responses to advocacy advertising

    SciTech Connect

    Miller, B.; Sinclair, J.

    2009-07-01

    Focus group research was used to examine how community stakeholders, a group with local industry experience, responded to coal industry advocacy messages. The stakeholders expressed beliefs about both the advertiser and the coal industry, and while their knowledge led to critical consideration of the industry campaign, they also expressed a desire to identify with positive messages about their community. Applying a postpositivist research perspective, a new model is introduced to integrate these beliefs in terms of advertiser trust and industry accountability under the existing theoretical framework of persuasion knowledge. Agent and topic knowledge are combined in this model based on responses to the industry advocacy campaign. In doing so, this study integrates a priori theory within a new context, extending the current theoretical framework to include an understanding of how community stakeholders - a common target for marketplace advocacy - interpret industry messages.

  1. A Pharmacy Political Advocacy Elective Course

    PubMed Central

    Powell, Patricia H.

    2011-01-01

    Objective. To develop and implement an elective course to increase pharmacy students’ awareness of legislation that might affect the pharmacy profession and to promote advocacy for the profession. Design. Students participated in class discussions regarding current legislative issues and methods to advocate for the pharmacy profession. Assignments included a student-led presentation of the advocacy agendas for various pharmacy organizations, a take-home examination, participation in class debates, and a legislative presentation. Assessment. Forty-eight students enrolled in the elective course over 3 years. Assignments and class participation were assessed using grading rubrics. At the end of the semester, students completed a questionnaire to assess the overall benefit of the course. Conclusions. Participation in an elective course devoted to pharmacy political advocacy increased awareness of legislation and the desire to become involved in pharmacy organizations to promote the pharmacy profession. PMID:21969723

  2. Measurement of torque during passive and active ankle movements in patients with muscle hypertonia. A methodological study.

    PubMed

    Broberg, C; Grimby, G

    1983-01-01

    Torque curves were recorded during passive and active ankle joint movements at three preset angular velocities (30, 60 and 120 degrees/s) with the subject in the supine position and 45 degrees hip and knee angles. Recordings were performed in normal subjects (n = 11), patients with clinical spasticity (n = 10) and patients with Parkinson's disease (n = 7). The torque curves recorded during passive dorsiflexion followed by plantar flexion showed a counterclockwise hysteresis loop with minimal area in the normal subjects and a large area in patients, especially at the highest velocity. The torque increase during dorsiflexion was proportional to the angular velocity in the patients with spasticity but not in the patients with Parkinson's disease. In the patients with spasticity, a good correlation was found between clinical assessment of hypertonia and measurements of torque during passive movements but not torque values during maximal voluntary dorsiflexion. A model for data reduction and estimation of instant slope values on different parts of the torque-angle curve is suggested. The use of ankle torque recordings for evaluation of treatment effects is exemplified.

  3. 77 FR 13390 - Recruitment Notice for the Taxpayer Advocacy Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-06

    ... Internal Revenue Service Recruitment Notice for the Taxpayer Advocacy Panel AGENCY: Internal Revenue... Advocacy Panel (TAP) Members. DATES: March 19, 2012 through April 27, 2012. FOR FURTHER INFORMATION CONTACT... nation's tax agency by applying to be members of the Taxpayer Advocacy Panel (TAP). The mission of...

  4. Promoting Self-Advocacy among Minority Students in School Counseling

    ERIC Educational Resources Information Center

    Astramovich, Randall L.; Harris, Katrina R.

    2007-01-01

    This article presents self-advocacy competencies developed to promote the academic, career, and personal/social success of minority students. The authors discuss challenges faced by minority students in today's educational environment and review principles of self advocacy. Competencies for developing self-advocacy awareness, knowledge, and skills…

  5. 76 FR 75951 - Taxpayer Advocacy Panel Meeting Cancellation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-05

    ... Internal Revenue Service Taxpayer Advocacy Panel Meeting Cancellation AGENCY: Internal Revenue Service (IRS... the open meeting of the Taxpayer Advocacy Panel scheduled for Tuesday, December 6, 2011, and Wednesday.... ] Dated: November 30, 2011. Shawn Collins, Director, Taxpayer Advocacy Panel. BILLING CODE 4830-01-P...

  6. 75 FR 9028 - Recruitment Notice for the Taxpayer Advocacy Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-26

    ... Internal Revenue Service Recruitment Notice for the Taxpayer Advocacy Panel AGENCY: Internal Revenue... Advocacy Panel (TAP) Members. DATES: March 15, 2010 through April 30, 2010. FOR FURTHER INFORMATION CONTACT... nation's tax agency by applying to be members of the Taxpayer Advocacy Panel (TAP). The mission of...

  7. 77 FR 16895 - Taxpayer Advocacy Panel Meeting Cancellation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-22

    ... Internal Revenue Service Taxpayer Advocacy Panel Meeting Cancellation AGENCY: Internal Revenue Service (IRS... the open meeting of the Taxpayer Advocacy Panel Taxpayer Burden Reduction Project Committee scheduled... cancelled pending renewal of the Taxpayer Advocacy Panel Charter. FOR FURTHER INFORMATION CONTACT: Audrey...

  8. 76 FR 12418 - Recruitment Notice for the Taxpayer Advocacy Panel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-07

    ... Internal Revenue Service Recruitment Notice for the Taxpayer Advocacy Panel AGENCY: Internal Revenue... Advocacy Panel (TAP) Members. DATES: March 14, 2011 through April 29, 2011. FOR FURTHER INFORMATION CONTACT... nation's tax agency by applying to be members of the Taxpayer Advocacy Panel (TAP). The mission of...

  9. 77 FR 16895 - Taxpayer Advocacy Panel Meeting Cancellation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-22

    ... Internal Revenue Service Taxpayer Advocacy Panel Meeting Cancellation AGENCY: Internal Revenue Service (IRS... open meeting of the Taxpayer Advocacy Panel Small Business/Self-Employed Decreasing Non-Filers Project... meeting is cancelled pending renewal of the Taxpayer Advocacy Panel Charter. FOR FURTHER...

  10. Development and Assessment of the Social Issues Advocacy Scale

    ERIC Educational Resources Information Center

    Nilsson, Johanna E.; Marszalek, Jacob M.; Linnemeyer, Rachel M.; Bahner, Angela D.; Misialek, Leah Hanson

    2011-01-01

    This article describes the development and the initial psychometric evaluation of the Social Issues Advocacy Scale in two studies. In the first study, an exploratory factor analysis (n = 278) revealed a four-factor scale, accounting for 71.4% of the variance, measuring different aspects of social issue advocacy: Political and Social Advocacy,…

  11. Examining School Counselors' Commitments to Social Justice Advocacy

    ERIC Educational Resources Information Center

    Feldwisch, Rachel P.

    2016-01-01

    Many school counselors endorse using social justice advocacy to close achievement gaps. In this study, school counselors from a single state scored in the moderate to high range on the Social Issues Advocacy Scale. Results showed alignment between school counselors' self-endorsement of social justice advocacy and scores on the Advocacy…

  12. Aging Action: A Course in Senior Advocacy in Kansas.

    ERIC Educational Resources Information Center

    Kansas State Advisory Council on Aging, Topeka.

    Skills useful in advocacy of senior citizens' needs are discussed in this manual. The topics included are: (1) the meaning of advocacy; (2) assertiveness training for aging-action; (3) identifying issues; (4) choosing issues; (5) developing a plan of action; (6) organizing; (7) legislative advocacy; (8) criteria to evaluate potential legislative…

  13. Communication breakdown or ideal speech situation: the problem of nurse advocacy.

    PubMed

    Martin, G W

    1998-03-01

    The issue of advocacy has dominated discussion of the ethical dilemmas facing nurses. However, despite this, nurses seem to be no further towards a solution of how they can be effective advocates for patients without compromising their working identity or facing conflicts of loyalty. This article considers some of the problems around advocacy and, by the use of critical incidents written by nurses involved in a diploma module, attempts to highlight where the problem could lie. A communications model is outlined, using a theoretical framework taken from the work of Jürgen Habermas, and applied to nursing practice. Finally, two examples are given from the research, which illustrate how the model could be used, highlighting the problems and pitfalls that still have to be overcome. The conclusion is a positive one, in that it suggests that advocacy is possible if nurses re-examine their practice in the light of the model proposed.

  14. Elevated PEM (Phasic Electromyographic Metric) Rates Identify Rapid Eye Movement Behavior Disorder Patients on Nights Without Behavioral Abnormalities

    PubMed Central

    Bliwise, Donald L.; Rye, David B.

    2008-01-01

    Objective: To determine the validity of the phasic electromyographic metric (PEM) to differentiate patients with a history suggestive of rapid eye movement behavior disorder (REMBD) on laboratory nights without overt dream-enactment behavior. Methods: PEM was quantified as the % of 2.5-sec intervals with phasic muscle activity of 100-msec duration with an amplitude of at least 4 times background activity in 11 patients and 31 elderly controls. Data were derived from both REM and NREM sleep from 5 muscle groups (mentalis, left/right anterior tibialis, left/right brachioradialis). Results: Relative to controls, REMBD patients had significantly higher levels of PEM activity in all recordings. The largest differences occurred during REM sleep for the mentalis and brachioradialis channels. Similar results were obtained by limiting quantification of PEM to the final REM period of the night and could be accomplished by individuals with no previous familiarity with polysomnography. Discussion: PEM may be a useful metric to characterize the REM related phasic muscle activity on patients with a history of REMBD, even when no overt dream-enactment behaviors are detected on a laboratory night. Citation: Bliwise DL; Rye DB. Elevated PEM (phasic electromyographic metric) rates identify rapid eye movement behavior disorder patients on nights without behavioral abnormalities. SLEEP 2008;31(6):853–857. PMID:18548830

  15. Are movements necessary for the sense of body ownership? Evidence from the rubber hand illusion in pure hemiplegic patients.

    PubMed

    Burin, Dalila; Livelli, Alessandro; Garbarini, Francesca; Fossataro, Carlotta; Folegatti, Alessia; Gindri, Patrizia; Pia, Lorenzo

    2015-01-01

    A question still debated within cognitive neuroscience is whether signals present during actions significantly contribute to the emergence of human's body ownership. In the present study, we aimed at answer this question by means of a neuropsychological approach. We administered the classical rubber hand illusion paradigm to a group of healthy participants and to a group of neurological patients affected by a complete left upper limb hemiplegia, but without any propriceptive/tactile deficits. The illusion strength was measured both subjectively (i.e., by a self-report questionnaire) and behaviorally (i.e., the location of one's own hand is shifted towards the rubber hand). We aimed at examining whether, and to which extent, an enduring absence of movements related signals affects body ownership. Our results showed that patients displayed, respect to healthy participants, stronger illusory effects when the left (affected) hand was stimulated and no effects when the right (unaffected) hand was stimulated. In other words, hemiplegics had a weaker/more flexible sense of body ownership for the affected hand, but an enhanced/more rigid one for the healthy hand. Possible interpretations of such asymmetrical distribution of body ownership, as well as limits of our results, are discussed. Broadly speaking, our findings suggest that the alteration of the normal flow of signals present during movements impacts on human's body ownership. This in turn, means that movements have a role per se in developing and maintaining a coherent body ownership.

  16. Are Movements Necessary for the Sense of Body Ownership? Evidence from the Rubber Hand Illusion in Pure Hemiplegic Patients

    PubMed Central

    Burin, Dalila; Livelli, Alessandro; Garbarini, Francesca; Fossataro, Carlotta; Folegatti, Alessia; Gindri, Patrizia; Pia, Lorenzo

    2015-01-01

    A question still debated within cognitive neuroscience is whether signals present during actions significantly contribute to the emergence of human’s body ownership. In the present study, we aimed at answer this question by means of a neuropsychological approach. We administered the classical rubber hand illusion paradigm to a group of healthy participants and to a group of neurological patients affected by a complete left upper limb hemiplegia, but without any propriceptive/tactile deficits. The illusion strength was measured both subjectively (i.e., by a self-report questionnaire) and behaviorally (i.e., the location of one’s own hand is shifted towards the rubber hand). We aimed at examining whether, and to which extent, an enduring absence of movements related signals affects body ownership. Our results showed that patients displayed, respect to healthy participants, stronger illusory effects when the left (affected) hand was stimulated and no effects when the right (unaffected) hand was stimulated. In other words, hemiplegics had a weaker/more flexible sense of body ownership for the affected hand, but an enhanced/more rigid one for the healthy hand. Possible interpretations of such asymmetrical distribution of body ownership, as well as limits of our results, are discussed. Broadly speaking, our findings suggest that the alteration of the normal flow of signals present during movements impacts on human’s body ownership. This in turn, means that movements have a role per se in developing and maintaining a coherent body ownership. PMID:25775041

  17. Automatic detection of CT perfusion datasets unsuitable for analysis due to head movement of acute ischemic stroke patients.

    PubMed

    Fahmi, Fahmi; Marquering, Henk A; Streekstra, Geert J; Beenen, Ludo F M; Janssen, Natasja N Y; Majoie, Charles B L; van Bavel, Ed

    2014-01-01

    Head movement during brain Computed Tomography Perfusion (CTP) can deteriorate perfusion analysis quality in acute ischemic stroke patients. We developed a method for automatic detection of CTP datasets with excessive head movement, based on 3D image-registration of CTP, with non-contrast CT providing transformation parameters. For parameter values exceeding predefined thresholds, the dataset was classified as 'severely moved'. Threshold values were determined by digital CTP phantom experiments. The automated selection was compared to manual screening by 2 experienced radiologists for 114 brain CTP datasets. Based on receiver operator characteristics, optimal thresholds were found of respectively 1.0°, 2.8° and 6.9° for pitch, roll and yaw, and 2.8 mm for z-axis translation. The proposed method had a sensitivity of 91.4% and a specificity of 82.3%. This method allows accurate automated detection of brain CTP datasets that are unsuitable for perfusion analysis. PMID:24691387

  18. Late-Onset Mania in a Patient with Movement Disorder and Basal Ganglia Calcifications: A Challenge for Diagnosis and Treatment

    PubMed Central

    Roiter, Beatrice; Pigato, Giorgio; Perugi, Giulio

    2016-01-01

    Age of onset can have a significant impact on clinical course and pathophysiological mechanism of bipolar disorder. Late-onset bipolar episodes are more likely linked to medical illnesses and so are frequently classified as “secondary” forms of mood disorder. We discuss the case of a patient who at the age of 58 presented his first delusional-manic episode. He also had mild frontal and occipital cortical atrophy, white matter posterior ischemic lesions, and small basal ganglia calcifications. Seven years later, he presented a second manic episode with new emergent hyperkinetic choreiform symptoms. Taking into account movement disturbances, the presence of basal ganglia calcification, and worsening of cortical atrophy, we performed a differential diagnosis between Fahr disease, Fahr's syndrome, calcifications due to ageing, supersensitivity psychosis, and dementia. Valproate, quetiapine, and tetrabenazine were sequentially administered and yielded a good therapeutic response as regards manic and movement symptoms. Relationship between medications and course of specific symptoms was observed. PMID:27213069

  19. Parental Advocacy for Students with Autism

    ERIC Educational Resources Information Center

    Barclift, Coriann

    2010-01-01

    Students attending schools in the United States who have autism would benefit from increased parental involvement to enhance their learning. There is a lack of research regarding parental advocacy on behalf of students with autism. The purpose of this phenomenological study was to examine the lived experiences and perceptions of parents who have…

  20. Advocacy: the role of health professional associations.

    PubMed

    Shaw, Dorothy

    2014-10-01

    The FIGO Leadership in Obstetrics and Gynecology for Impact and Change (LOGIC) Initiative in Maternal and Newborn Health was developed on the premise that organizational capacity strengthening in eight low- and middle-income countries would result in improved ability of member associations to take a leadership role in engaging a range of stakeholders in the health sector to discuss evidence and facilitate policy change and clinical practice in maternal and newborn health. Definitions of relevant terms, principles, and a framework for an advocacy plan are presented. The term advocacy is typically not well understood by health professionals, nor generally thought to be part of their role as a clinician, researcher, or educator. "Influence" based on expertise is often more consonant with a clinician's reality, especially where advocacy is perceived as a more political process that may present a barrier in some countries. The organizational capacity development of the FIGO member associations was integral to their ability to exert influence based on evidence, both internally in their associations and with other stakeholders, including the Ministry of Health. Examples of advocacy from each of the eight LOGIC countries are provided, noting that evaluation of impact can be challenging.

  1. Electronic Advocacy and Social Welfare Policy Education

    ERIC Educational Resources Information Center

    Moon, Sung Seek; DeWeaver, Kevin L.

    2005-01-01

    The rapid increase in the number of low-cost computers, the proliferation of user-friendly software, and the development of electronic networks have created the "informatics era." The Internet is a rapidly growing communication resource that is becoming mainstream in the American society. Computer-based electronic political advocacy by social…

  2. Advocacy on Issues Related to Addictions.

    ERIC Educational Resources Information Center

    Taleff, Michael J.

    Advocating for a population with an addictive disorder holds extraordinary challenges, but it also offers extraordinary rewards. The challenge is to embrace a cause with which most people in the United States hold little sympathy. The primary reward is that once advocacy has begun it can help ignite an addicted person's self-respect. This paper…

  3. Strengthening Music Programs While Avoiding Advocacy Pitfalls

    ERIC Educational Resources Information Center

    West, Chad; Clauhs, Matthew

    2015-01-01

    This article examines ways in which music education advocacy efforts have become disconnected from the unified visions and declarations of music educators espoused in the Tanglewood and Housewright declarations and are thus reifying the disconnect between what we value and what we say we value. We first analyze the policies posited by the recently…

  4. The state of advocacy in cancer.

    PubMed

    Maxwell, G Larry

    2015-12-01

    Non-profit advocacy organizations have been important in raising public awareness, promoting education, and enhancing political activism for issues related to cancer. Grassroots efforts aimed at fund-raising have substantially augmented federal funding for community outreach and research. The objective of this review was to evaluate successful accomplishments of several major non-profit organizations that are focused on cancer. A review of news media, medical literature, and financial records (using GuideStar) was performed to access the organizational structure and productivity of several successful cancer advocacy organizations. Compared to other cancer advocacy groups, the American Cancer Society is the oldest (>100years old) and worth the most with net assets of over $1.25 billion dollars and an annual total revenue of over $900 million dollars. The ACS also has the highest overhead at 41%. Most of the gynecologic cancer advocacy groups are approximately 20years old and have collective total annual revenue of over $17M dollars. The Ovarian Cancer Research Fund has been the most successful at raising funds and building net assets to date while maintaining an overhead of <10%. The most active and financially successful cancer organizations tend to be older, have higher overhead, spend less on total administration, spend more on fund-raising, have more events (rather than a limited number), and use aggressive social media strategies.

  5. Composite Indicators between Analysis and Advocacy

    ERIC Educational Resources Information Center

    Saltelli, Andrea

    2007-01-01

    We explore to what extent composite indicators, capable of aggregating multi-dimensional processes into simplified, stylised concepts, are up to the task of underpinning the development of data-based narratives for political advocacy. A recent OECD working paper (Nardo et al., 2005, Handbook on constructing composite indicators: methodology and…

  6. Organizing Your Parents for Effective Advocacy

    ERIC Educational Resources Information Center

    Elpus, Kenneth

    2008-01-01

    In today's world of restrictive school budgets and increasing property taxes, it is an unfortunate reality that many school districts will be faced with a budget crunch crisis that unenlightened school boards may try to solve by cutting or eliminating funds for music. At the crisis stage, it is often only the effective advocacy of an organized…

  7. Child Care Advocacy: Making a Difference.

    ERIC Educational Resources Information Center

    Working for Change, 1995

    1995-01-01

    This journal issue highlights examples of state and local child care advocacy strategies that have resulted in positive legislative change or increased funding for low-income child care. Legal constraints on lobbying by nonprofit or public agencies due to limitations imposed by the U.S. Internal Revenue Service and public and private funding…

  8. The Dance of Leadership and Advocacy

    ERIC Educational Resources Information Center

    Stripling, Barbara

    2007-01-01

    Leadership and advocacy often resemble a dance more than a straight-line march toward a goal. At times the leader advocate must work the process and lead the dance; at other times, the leader must stand back and let the process work, always ready to add a step or two to the dance when necessary. In this article, the author describes how librarians…

  9. Self-Advocacy Skills: A Portfolio Approach.

    ERIC Educational Resources Information Center

    Krebs, Cathryn S.

    2002-01-01

    This article describes how an educator used a portfolio approach to teach self-advocacy skills to four middle school students with visual impairments. Students wrote about their visual impairment and learning needs, compiled lists of specific words and definitions related to their individual impairments, and wrote letters to their ninth-grade…

  10. Enhancing Advocacy Skills of Teacher Candidates

    ERIC Educational Resources Information Center

    Holmes, Melissa A.; Herrera, Socorro G.

    2009-01-01

    This case study explores the dynamics of enhancing the capacities of teacher candidates in the Bilingual/Bicultural Education Students Interacting to Obtain Success (BESITOS) recruitment and retention program to advocate for culturally and linguistically diverse (CLD) students. Herrera and Murry's advocacy framework provides the theoretical…

  11. Be Proactive with Parent Advocacy Groups

    ERIC Educational Resources Information Center

    Willis, Mariam

    2012-01-01

    This article elaborates on parent advocacy groups, a key component in meeting the needs of gifted children. The case for parent groups couldn't be stronger--or more urgent. According to Nancy Green, Executive Director of the National Association for Gifted Children, "Quality gifted education exists in places where there are strong parent groups."…

  12. Obama Team's Advocacy Boosts Charter Momentum

    ERIC Educational Resources Information Center

    Maxwell, Lesli A.

    2009-01-01

    President Barack Obama and U.S. Secretary of Education Arne Duncan have been championing charter schools for months, creating what some advocates believe is the most forceful national momentum to expand the largely independent public schools since the first charter opened nearly 20 years ago. That high-profile advocacy is being matched, moreover,…

  13. Higher Education Alumni Associations and Political Advocacy

    ERIC Educational Resources Information Center

    Buchli, Richard N.

    2015-01-01

    Political advocacy is comprised of speaking on the behalf of a cause or participating as part of a political action group (Weerts, Cabrera, & Sanford, 2010). Because state financial support for public higher education has not been maintained at previous levels, higher education (HE) institutions have been recruiting alumni in an attempt to win…

  14. CEC Handbook for Strengthening Grassroots Advocacy.

    ERIC Educational Resources Information Center

    Bootel, Jaclyn A.

    This handbook is designed: (1) to empower individuals working with people who have disabilities to be a force for meeting the policy challenges in the communities in which they live and work; and (2) to help them to channel their strength, commitment, and knowledge of the special education field into effective advocacy efforts. The handbook…

  15. Science Advocacy in a Shifting Policy Landscape

    NASA Astrophysics Data System (ADS)

    Bickford, E. E.

    2013-12-01

    In the last 50 years, federal investment in research as a share of total spending has declined from a little more than 10% in 1963 to less than 4% in 2013 (AAAS, 2013). In an era of sequestration and shrinking budgets, more and more scientists are advocating directly to policymakers (and their staff) to gain support for research programs and funding. The best advocates understand the political and policy processes, and anticipate policy shifts that may affect them. While scientists are trained with the technical skills to conduct their science, teach it to others, and market their work in order to win grants and publish papers, the policy advocacy arena is unfamiliar territory to many. Acquiring yet another area of expertise mid-career can be daunting, but science advocacy need not require another academic degree. Connecting with policymakers is the first step, and then an understanding of each policymaker's issue history and top priorities will inform the sales pitch. Here, I present some experiences on both the pitching and receiving ends of science advocacy from my year in the US Senate as an AGU/AAAS Congressional Science Fellow, and some guidance for meeting with policymakers and successful science advocacy.

  16. Educational Expertise, Advocacy, and Media Influence

    ERIC Educational Resources Information Center

    Malin, Joel R.; Lubienski, Christopher

    2015-01-01

    The efforts of many advocacy organizations to advance their preferred policies despite conflicting evidence of the effectiveness of these policies raise questions about factors that shape successful policy promotion. While many may like to think that expertise on an issue in question is an essential prerequisite for influence in public policy…

  17. A new measure of movement symmetry in early Parkinson's disease patients using symbolic processing of inertial sensor data.

    PubMed

    Sant'Anna, Anita; Salarian, Arash; Wickström, Nicholas

    2011-07-01

    Movement asymmetry is one of the motor symptoms associated with Parkinson's disease (PD). Therefore, being able to detect and measure movement symmetry is important for monitoring the patient's condition. The present paper introduces a novel symbol based symmetry index calculated from inertial sensor data. The method is explained, evaluated, and compared to six other symmetry measures. These measures were used to determine the symmetry of both upper and lower limbs during walking of 11 early-to-mid-stage PD patients and 15 control subjects. The patients included in the study showed minimal motor abnormalities according to the unified Parkinson's disease rating scale (UPDRS). The symmetry indices were used to classify subjects into two different groups corresponding to PD or control. The proposed method presented high sensitivity and specificity with an area under the receiver operating characteristic (ROC) curve of 0.872, 9% greater than the second best method. The proposed method also showed an excellent intraclass correlation coefficient (ICC) of 0.949, 55% greater than the second best method. Results suggest that the proposed symmetry index is appropriate for this particular group of patients. PMID:21536527

  18. Occipital gamma-oscillations modulated during eye movement tasks: simultaneous eye tracking and electrocorticography recording in epileptic patients.

    PubMed

    Nagasawa, Tetsuro; Matsuzaki, Naoyuki; Juhász, Csaba; Hanazawa, Akitoshi; Shah, Aashit; Mittal, Sandeep; Sood, Sandeep; Asano, Eishi

    2011-10-15

    We determined the spatio-temporal dynamics of cortical gamma-oscillations modulated during eye movement tasks, using simultaneous eye tracking and intracranial electrocorticography (ECoG) recording. Patients with focal epilepsy were instructed to follow a target moving intermittently and unpredictably from one place to another either in an instantaneous or smooth fashion during extraoperative ECoG recording. Target motion elicited augmentation of gamma-oscillations in the lateral, inferior and polar occipital regions in addition to portions of parietal and frontal regions; subsequent voluntary eye movements elicited gamma-augmentation in the medial occipital region. Such occipital gamma-augmentations could not be explained by contaminations of ocular or myogenic artifacts. The degree of gamma-augmentation was generally larger during saccade compared to pursuit trials, while a portion of the polar occipital region showed pursuit-preferential gamma-augmentations. In addition to the aforementioned eye movement task, patients were asked to read a single word popping up on the screen. Gamma-augmentation was elicited in widespread occipital regions following word presentation, while gamma-augmentation in the anterior portion of the medial occipital region was elicited by an involuntary saccade following word presentation rather than word presentation itself. Gamma-augmentation in the lateral, inferior and polar occipital regions can be explained by increased attention to a moving target, whereas gamma-augmentation in the anterior-medial occipital region may be elicited by images in the peripheral field realigned following saccades. In functional studies comparing brain activation between two tasks, eye movement patterns during tasks may need to be considered as confounding factors.

  19. From loyalty to advocacy: a new metaphor for nursing.

    PubMed

    Winslow, G R

    1984-06-01

    An evolving transformation in nursing ethics is examined in terms of two basic metaphors of the nurse's role and its norms and virtues. Early discussions of nursing ethics portrayed nursing as military service in the battle against disease, associated with the virtue of loyalty and with the norms of obedience and the maintenance of patient confidence in physicians as authority figures. During the past decade, a metaphor of the nurse as advocate of patients' rights has largely replaced the older image. The author supports this change while cautioning that attention should be given to clarifying the meaning of advocacy, revising state laws to allow for expanded nursing roles, educating patients to accept the nurse as advocate, teaching nurses to cope with controversy, and identifying a legitimate place for loyalty to one's associates.

  20. Effect of observation of simple hand movement on brain activations in patients with unilateral cerebral palsy: an fMRI study.

    PubMed

    Dinomais, Mickael; Lignon, Gregoire; Chinier, Eva; Richard, Isabelle; Ter Minassian, Aram; Tich, Sylvie N'Guyen The

    2013-06-01

    The aim of this functional magnetic resonance imaging (fMRI) study was to examine and compare brain activation in patients with unilateral cerebral palsy (CP) during observation of simple hand movement performed by the paretic and nonparetic hand. Nineteen patients with clinical unilateral CP (14 male, mean age 14 years, 7-21 years) participated in the study. Hand motor impairment was assessed using the sequential finger opposition task. Using fMRI block design, brain activation was examined following observation at rest of a simple opening-closing hand movement, performed by either the left or right hand of an actor. Eighteen fMRI dataset were analyzed. Observing hand movement produced large bilateral activations in temporo-parieto-fronto-occipital network, comprising most of the nodes of the well described action-observation network. For either side, observing hand movements recruits the primary motor cortex (M1), contralateral to the viewed hand, as would be expected in healthy persons. Viewing movement performed by an actor's hand representing the paretic side of patients activated more strongly ipsilesional M1 than viewing movement performed by an actor's hand representing the nonparetic side of patients. Observation of hand movement in patients with CP engaged the motor execution network regardless of the degree of motor impairment.

  1. Independent donor ethical assessment: aiming to standardize donor advocacy.

    PubMed

    Choudhury, Devasmita; Jotterand, Fabrice; Casenave, Gerald; Smith-Morris, Carolyn

    2014-06-01

    Living organ donation has become more common across the world. To ensure an informed consent process, given the complex issues involved with organ donation, independent donor advocacy is required. The choice of how donor advocacy is administered is left up to each transplant center. This article presents the experience and process of donor advocacy at University of Texas Southwestern Medical Center administered by a multidisciplinary team consisting of physicians, surgeons, psychologists, medical ethicists and anthropologists, lawyers, a chaplain, a living kidney donor, and a kidney transplant recipient. To ensure that advocacy remains fair and consistent for all donors being considered, the donor advocacy team at University of Texas Southwestern Medical Center developed the Independent Donor Ethical Assessment, a tool that may be useful to others in rendering donor advocacy. In addition, the tool may be modified as circumstances arise to improve donor advocacy and maintain uniformity in decision making.

  2. Independent donor ethical assessment: aiming to standardize donor advocacy.

    PubMed

    Choudhury, Devasmita; Jotterand, Fabrice; Casenave, Gerald; Smith-Morris, Carolyn

    2014-06-01

    Living organ donation has become more common across the world. To ensure an informed consent process, given the complex issues involved with organ donation, independent donor advocacy is required. The choice of how donor advocacy is administered is left up to each transplant center. This article presents the experience and process of donor advocacy at University of Texas Southwestern Medical Center administered by a multidisciplinary team consisting of physicians, surgeons, psychologists, medical ethicists and anthropologists, lawyers, a chaplain, a living kidney donor, and a kidney transplant recipient. To ensure that advocacy remains fair and consistent for all donors being considered, the donor advocacy team at University of Texas Southwestern Medical Center developed the Independent Donor Ethical Assessment, a tool that may be useful to others in rendering donor advocacy. In addition, the tool may be modified as circumstances arise to improve donor advocacy and maintain uniformity in decision making. PMID:24919733

  3. Recognizing new opportunities: reconceptualizing policy advocacy in everyday organizational practice.

    PubMed

    Mosley, Jennifer

    2013-07-01

    Policy advocacy is a concept that is of both practical and historical importance to the profession of social work. To keep up with developments in how advocacy is practiced at the ground level, however, social work research on advocacy needs to expand in scope. Changes in government contracting and public management practices have reshaped the opportunity structure for policy advocacy, incentivizing a kind of advocacy that is routine, professionalized, and collaborative. At the same time, these practices have raised questions about democratic representation and the degree to which social work advocacy adequately reflects client concerns. This article presents a model for how policy advocacy can be usefully reconceptualized to account for changes in the policy and funding environment and concludes by suggesting ways that social work research and theory can better reflect practice realities.

  4. Recognizing new opportunities: reconceptualizing policy advocacy in everyday organizational practice.

    PubMed

    Mosley, Jennifer

    2013-07-01

    Policy advocacy is a concept that is of both practical and historical importance to the profession of social work. To keep up with developments in how advocacy is practiced at the ground level, however, social work research on advocacy needs to expand in scope. Changes in government contracting and public management practices have reshaped the opportunity structure for policy advocacy, incentivizing a kind of advocacy that is routine, professionalized, and collaborative. At the same time, these practices have raised questions about democratic representation and the degree to which social work advocacy adequately reflects client concerns. This article presents a model for how policy advocacy can be usefully reconceptualized to account for changes in the policy and funding environment and concludes by suggesting ways that social work research and theory can better reflect practice realities. PMID:24032304

  5. Evaluation of oral-motor movements and facial mimic in patients with head and neck burns by a public service in Brazil

    PubMed Central

    Magnani, Dicarla Motta; Sassi, Fernanda Chiarion; Vana, Luiz Philipe Molina; Alonso, Nivaldo; de Andrade, Claudia Regina Furquim

    2015-01-01

    OBJECTIVES: The purpose of this study was to analyze the characteristics of oral-motor movements and facial mimic in patients with head and neck burns. METHODS: An observational descriptive cross-sectional study was conducted with patients who suffered burns to the head and neck and who were referred to the Division of Orofacial Myology of a public hospital for assessment and rehabilitation. Only patients presenting deep partial-thickness and full-thickness burns to areas of the face and neck were included in the study. Patients underwent clinical assessment that involved an oral-motor evaluation, mandibular range of movement assessment, and facial mimic assessment. Patients were divided into two groups: G1 - patients with deep partial-thickness burns; G2 - patients with full-thickness burns. RESULTS: Our final study sample comprised 40 patients: G1 with 19 individuals and G2 with 21 individuals. The overall scores obtained in the clinical assessment of oral-motor organs indicated that patients with both second- and third-degree burns presented deficits related to posture, position and mobility of the oral-motor organs. Considering facial mimic, groups significantly differed when performing voluntary facial movements. Patients also presented limited maximal incisor opening. Deficits were greater for individuals in G2 in all assessments. CONCLUSION: Patients with head and neck burns present significant deficits related to posture, position and mobility of the oral myofunctional structures, including facial movements. PMID:26039950

  6. Sleep laboratory studies in periodic limb movement disorder (PLMD) patients as compared with normals and acute effects of ropinirole.

    PubMed

    Saletu, M.; Anderer, P.; Saletu, B.; Hauer, C.; Mandl, M.; Semler, B.; Saletu-Zyhlarz, G.

    2001-03-01

    Periodic limb movement disorder (PLMD) occurs in a variety of sleep disorders and can cause insomnia as well as hypersomnia with daytime somnolence. The aim of this study was to investigate 12 untreated PLMD patients as compared with 12 normal controls and to measure the acute effects of 0.5 mg ropinirole (Requip((R))) - a non-ergoline dopamine agonist - as compared with placebo. In three nights (adaptation, placebo, ropinirole night) objective and subjective sleep and awakening quality were evaluated. In the target variable 'periodic leg movements per hour of sleep' (PLM/(hTST)) PLMD patients showed an increased value of 42/h (normal 0-5/h) with a greater number of arousals due to periodic leg movements (PLM) in sleep. They further demonstrated an increased number of awakenings, sleep stage S1, S4, stage shifts and decreased S2, but there were no significant differences concerning total sleep time, sleep efficiency (SE), subjective sleep quality and morning measures of mood, drive and drowsiness. However, measures of attention variability, numerical memory, fine motor activity and reaction time performance were impaired. Ropinirole 0.5 mg was shown to significantly improve the index PLM/(hTST) by 64% and arousals due to PLM, increase spontaneous arousals, REM-latency, stage 2 and stage shifts and decrease SREM. In the morning attention variability was attenuated and numerical memory augmented. Thus, ropinirole improved some sleep architecture and early morning measures of performance but specifically all PLM variables, which suggests a dopaminergic pathogenesis in PLMD. Copyright 2001 John Wiley & Sons, Ltd.

  7. Thymectomy: Common Questions Patients Ask about Thymectomies

    MedlinePlus

    ... and to improve their lives through programs of patient services, public information, medical research, professional education, advocacy and patient care. This publication is intended to provide the ...

  8. Ictal movements mimicking Islamic praying rituals: localizing value in a series of 12 patients.

    PubMed

    Vural, Gonul; Irsel Tezer, F; Saygi, Serap

    2015-12-01

    The aim of this study was to determine the lateralizing value of the ictal praying gesture and of ictal religious speech in patients who are candidates for epilepsy surgery. We retrospectively searched video/EEG data of 1430 patients who were evaluated at an epilepsy center from 1999 to 2014. Twelve patients were found to have demonstrated ictal praying during their complex partial seizures. Among all patients, the ictal focus was in the right temporal region. Ictal behavior simulating prayer, which includes both hands as in the Islamic ritual tradition is a rare automatism that lateralizes the ictal focus. PMID:26520882

  9. Prison health advocacy and its changing boundaries.

    PubMed

    Awofeso, Niyi

    2008-01-01

    Advocacy is an important tool for translating population health objectives and research findings into policy and practice, as well as for enhancing stakeholder support for programmes and activities with a potential to improve the health of populations. At the inception of modern prisons, health advocacy approaches focused on appealing to humanitarian and religious sentiments of stakeholders to improve the well-being of prisoners. This approach achieved limited results, not least because of persistent apathy of custodial authorities and the public to prisoners' wellbeing. From the mid twentieth century onwards, a constitutional and human rights approach evolved, with courts becoming actively involved in mandating minimum health standards in prisons. Penal populism eroded public support for a judicial recourse to improving prison health services, and encouraged governments to institute procedural barriers to prisoner-initiated litigation. The author proposes an approach premised on public health principles as an appropriate platform to advocate for improvements in prison health services in this era. Such an advocacy platform combines the altruistic goals of the humanitarian and constitutional rights approaches with an appeal to community's self-interest by alerting the public to the social, financial and health implications inherent in released prisoners suffering from major communicable and chronic diseases re-entering the community. PMID:19061060

  10. Prison health advocacy and its changing boundaries.

    PubMed

    Awofeso, Niyi

    2008-01-01

    Advocacy is an important tool for translating population health objectives and research findings into policy and practice, as well as for enhancing stakeholder support for programmes and activities with a potential to improve the health of populations. At the inception of modern prisons, health advocacy approaches focused on appealing to humanitarian and religious sentiments of stakeholders to improve the well-being of prisoners. This approach achieved limited results, not least because of persistent apathy of custodial authorities and the public to prisoners' wellbeing. From the mid twentieth century onwards, a constitutional and human rights approach evolved, with courts becoming actively involved in mandating minimum health standards in prisons. Penal populism eroded public support for a judicial recourse to improving prison health services, and encouraged governments to institute procedural barriers to prisoner-initiated litigation. The author proposes an approach premised on public health principles as an appropriate platform to advocate for improvements in prison health services in this era. Such an advocacy platform combines the altruistic goals of the humanitarian and constitutional rights approaches with an appeal to community's self-interest by alerting the public to the social, financial and health implications inherent in released prisoners suffering from major communicable and chronic diseases re-entering the community.

  11. The Clinical Phenotype of Idiopathic Rapid Eye Movement Sleep Behavior Disorder at Presentation: A Study in 203 Consecutive Patients

    PubMed Central

    Fernández-Arcos, Ana; Iranzo, Alex; Serradell, Mónica; Gaig, Carles; Santamaria, Joan

    2016-01-01

    Objective: To describe the clinical phenotype of idiopathic rapid eye movement (REM) sleep behavior disorder (IRBD) at presentation in a sleep center. Methods: Clinical history review of 203 consecutive patients with IRBD identified between 1990 and 2014. IRBD was diagnosed by clinical history plus video-polysomnographic demonstration of REM sleep with increased electromyographic activity linked to abnormal behaviors. Results: Patients were 80% men with median age at IRBD diagnosis of 68 y (range, 50–85 y). In addition to the already known clinical picture of IRBD, other important features were apparent: 44% of the patients were not aware of their dream-enactment behaviors and 70% reported good sleep quality. In most of these cases bed partners were essential to convince patients to seek medical help. In 11% IRBD was elicited only after specific questioning when patients consulted for other reasons. Seven percent did not recall unpleasant dreams. Leaving the bed occurred occasionally in 24% of subjects in whom dementia with Lewy bodies often developed eventually. For the correct diagnosis of IRBD, video-polysomnography had to be repeated in 16% because of insufficient REM sleep or electromyographic artifacts from coexistent apneas. Some subjects with comorbid obstructive sleep apnea reported partial improvement of RBD symptoms following continuous positive airway pressure therapy. Lack of therapy with clonazepam resulted in an increased risk of sleep related injuries. Synucleinopathy was frequently diagnosed, even in patients with mild severity or uncommon IRBD presentations (e.g., patients who reported sleeping well, onset triggered by a life event, nocturnal ambulation) indicating that the development of a neurodegenerative disease is independent of the clinical presentation of IRBD. Conclusions: We report the largest IRBD cohort observed in a single center to date and highlight frequent features that were not reported or not sufficiently emphasized in previous

  12. Advocacy to address disabling diseases: TDR holds brainstorming session.

    PubMed

    1998-06-01

    The UN Development Program/World Bank/World Health Organization's Special Program for Research and Training in Tropical Diseases hosted a meeting in January 1998 to discuss new ways of generating sustained commitment to combat disabling tropical diseases, such as filariasis and onchocerciasis. The participants agreed that advocacy should be targeted to a wider audience than the health sector, including international donors, industry, national governments, and endemic communities themselves. Advocacy efforts will be supported by development of a standard protocol that will 1) identify and present the type of evidence that generates sustainable commitment, 2) develop and use appropriate messages for each audience, 3) evaluate new advocacy approaches for their impact on behavioral change and disease control, and 4) evaluate advocacy campaigns. Advocacy about lymphatic filariasis will target all levels, while advocacy about onchocerciasis will target national and local levels.

  13. Derived Arterial Stiffness is Increased in Patients with Obstructive Sleep Apnea and Periodic Limb Movements during Sleep

    PubMed Central

    Drakatos, Panagis; Higgins, Sean; Pengo, Martino F.; Kent, Brian D.; Muza, Rex; Karkoulias, Kiriakos; Leschziner, Guy; Williams, Adrian

    2016-01-01

    Study Objectives: Both periodic limb movements during sleep (PLMS) and obstructive sleep apnea (OSA) have been associated with increased risk of cardiovascular disease (CVD). OSA has also been linked to increased large arterial stiffness, which is considered an independent risk factor for CVD. We utilized a previously validated index of large artery stiffness (SIDVP) derived from the digital volume pulse (DVP) to seek comparison in patients with PLMS and OSA. Methods: Forty-nine adult male subjects, without known comorbidities that could affect arterial stiffness or on vasoactive medication, were retrospectively identified and categorized into controls (n = 8), PLMS (n = 13), OSA (n = 17), and OSA/PLMS (n = 11). The cutoff for PLMS was a periodic limb movement index (PLMI) > 15 events/h, and for OSA an apnea-hypopnea index (AHI) > 10 events/h. SIDVP was derived from the raw data of photoplethysmography of the nocturnal polysomnography, averaged for 2 min prior to sleep study initiation (baseline), after completion in the morning, and every half hour after sleep onset. Results: The groups were age/body mass index-matched. Controls showed lower baseline, morning, and overall SIDVP compared to the other groups (p < 0.01). Patients with PLMS (PLMI: 50.69 ± 9.7 events/h) and the OSA group (AHI: 29.7 ± 2 events/h) demonstrated similar overall SIDVP (6.78 ± 0.08 versus 6.94 ± 0.04, respectively, p = 0.5), whereas the OSA/PLMS (AHI: 29.35 ± 8, PLMI: 50.63 ± 7.2) group demonstrated the highest (7.40 ± 0.06, p < 0.001). Conclusions: Based on an easily reproducible and applicable marker of large arterial stiffness, patients with significant PLMS had higher SIDVP when compared to controls and comparable to those with moderate/severe OSA. The OSA/PLMS group had the highest SIDVP, implying a possible additive effect of OSA and PLMS on arterial stiffness. Citation: Drakatos P, Higgins S, Pengo MF, Kent BD, Muza R, Karkoulias K, Leschziner G, Williams A. Derived arterial

  14. Comparison of spatial filters and features for the detection and classification of movement-related cortical potentials in healthy individuals and stroke patients

    NASA Astrophysics Data System (ADS)

    Jochumsen, Mads; Niazi, Imran Khan; Mrachacz-Kersting, Natalie; Jiang, Ning; Farina, Dario; Dremstrup, Kim

    2015-10-01

    Objective. The possibility of detecting movement-related cortical potentials (MRCPs) at the single trial level has been explored for closing the motor control loop with brain-computer interfaces (BCIs) for neurorehabilitation. A distinct feature of MRCPs is that the movement kinetic information is encoded in the brain potential prior to the onset of the movement, which makes it possible to timely drive external devices to provide sensory feedback according to the efferent activity from the brain. The aim of this study was to compare methods for the detection (different spatial filters) and classification (features extracted from various domains) of MRCPs from continuous electroencephalography recordings from executed and imagined movements from healthy subjects (n = 24) and attempted movements from stroke patients (n = 6) to optimize the performance of MRCP-based BCIs for neurorehabilitation. Approach. The MRCPs from four cue-based tasks were detected with a template matching approach and a set of spatial filters, and classified with a linear support vector machine using the combination of temporal, spectral, time-scale, or entropy-based features. Main results. The best spatial filter (large Laplacian spatial filter (LLSF)) resulted in a true positive rate of 82 ± 9%, 78 ± 12% and 72 ± 9% (with detections occurring ˜200 ms before the onset of the movement) for executed, imagined and attempted movements (stroke patients). The best feature combination (temporal and spectral) led to pairwise classification of 73 ± 9%, 64 ± 10% and 80 ± 12%. When the detection was combined with classification, 60 ± 10%, 49 ± 10% and 58 ± 10% of the movements were both correctly detected and classified for executed, imagined and attempted movements. A similar performance for detection and classification was obtained with optimized spatial filtering. Significance. A simple setup with an LLSF is useful for detecting cued movements while the combination of features from the time

  15. New focus on advocacy in South Asia. Advocacy for reproductive health: South Asia.

    PubMed

    Kapoor, I

    1996-01-01

    Initiatives like Vision 2000, the International Conference on Population and Development in Cairo, and the Fourth World Conference on Women in Beijing have focused attention on the activities of regional family planning associations (FPAs) in South Asia. These activities include male acceptance of the responsibility for family life, youth involvement in program design and implementation, the promotion of gender equality, and increased public awareness about the value of the female child. The Beijing conference also directed attention to the problem of not allocating resources to problems recognized by governments. In the South Asia region funding levels have been falling, which impacts the maintenance of current programs. The South Asia Regional Bureau began to coordinate an information, education, and communication (IEC) and Advocacy Working Group in the region with the participation of IEC officers from all regional FPAs. The group will be planning IEC and advocacy activities based on the regional FPAs' goals and aspirations. The IEC and advocacy activities will be examined to identify existing skills and experiences of group participants. The group will also try to identify the activities of each FPA. The information gathered will point out the similarities in IEC and advocacy activities serving as a common ground for the region. Problems of IEC and advocacy comprise their subordinate structure and the failure to evaluate to show the impact of the activities. Better planning and organization and more holistic evaluation of program components should be achieved. The group will be self-directed responding to the IEC and advocacy needs, while also developing the professional and personal capacity of FPA staff to meet these needs.

  16. Effects of ankle plantar flexors stretching with closed kinetic chain on pelvic movements and gait speed in hemiplegia patients: a case study

    PubMed Central

    Moon, Sang-Hyun; Boo, Jung-A; Park, Si-Eun

    2016-01-01

    [Purpose] The purpose of this study was to identify the effects of ankle plantar flexors stretching with closed kinetic chain (CKC) in hemiplegia patients. [Methods] This study used a reversal design (A-B-A’) for a stroke with hemiplagia. The intervention program consisted of 30 min sessions, once a day, for 15 days. The subjects were trained for 15 sessions in total. Pelvic movements (anterior ·posterior tilting, elevation, depression, forward·backward rotation) during walking and gait speed were measured in hemiplegia patients. [Results] Overall, the angle of pelvic movements was increased in Treatment and, Baseline II compared with Baseline I. The gait speed was maximally increased in Baseline II, followed by Treatment and Baseline I. [Conclusion] These results suggest that ankle plantar flexors stretching with closed kinetic chain had a positive effect on pelvic movements and gait speed in hemiplegia patients. Also, after treatment, its effect on gait of hemiplegia patients was maintained. PMID:26957780

  17. The effects of game-based virtual reality movement therapy plus mental practice on upper extremity function in chronic stroke patients with hemiparesis: a randomized controlled trial.

    PubMed

    Park, Jin-Hyuck; Park, Ji-Hyuk

    2016-03-01

    [Purpose] The purpose of this study was to investigate the effects of game-based virtual reality movement therapy plus mental practice on upper extremity function in chronic stroke patients with hemiparesis. [Subjects] The subjects were chronic stroke patients with hemiparesis. [Methods] Thirty subjects were randomly assigned to either the control group or experimental group. All subjects received 20 sessions (5 days in a week) of virtual reality movement therapy using the Nintendo Wii. In addition to Wii-based virtual reality movement therapy, experimental group subjects performed mental practice consisting of 5 minutes of relaxation, Wii games imagination, and normalization phases before the beginning of Wii games. To compare the two groups, the upper extremity subtest of the Fugl-Meyer Assessment, Box and Block Test, and quality of movement subscale of the Motor Activity Log were performed. [Results] Both groups showed statistically significant improvement in the Fugl-Meyer Assessment, Box and Block Test, and quality of the movement subscale of Motor Activity Log after the interventions. Also, there were significant differences in the Fugl-Meyer Assessment, Box and Block Test, and quality of movement subscale of the Motor Activity Log between the two groups. [Conclusion] Game-based virtual reality movement therapy alone may be helpful to improve functional recovery of the upper extremity, but the addition of MP produces a lager improvement.

  18. The effects of game-based virtual reality movement therapy plus mental practice on upper extremity function in chronic stroke patients with hemiparesis: a randomized controlled trial

    PubMed Central

    Park, Jin-Hyuck; Park, Ji-Hyuk

    2016-01-01

    [Purpose] The purpose of this study was to investigate the effects of game-based virtual reality movement therapy plus mental practice on upper extremity function in chronic stroke patients with hemiparesis. [Subjects] The subjects were chronic stroke patients with hemiparesis. [Methods] Thirty subjects were randomly assigned to either the control group or experimental group. All subjects received 20 sessions (5 days in a week) of virtual reality movement therapy using the Nintendo Wii. In addition to Wii-based virtual reality movement therapy, experimental group subjects performed mental practice consisting of 5 minutes of relaxation, Wii games imagination, and normalization phases before the beginning of Wii games. To compare the two groups, the upper extremity subtest of the Fugl-Meyer Assessment, Box and Block Test, and quality of movement subscale of the Motor Activity Log were performed. [Results] Both groups showed statistically significant improvement in the Fugl-Meyer Assessment, Box and Block Test, and quality of the movement subscale of Motor Activity Log after the interventions. Also, there were significant differences in the Fugl-Meyer Assessment, Box and Block Test, and quality of movement subscale of the Motor Activity Log between the two groups. [Conclusion] Game-based virtual reality movement therapy alone may be helpful to improve functional recovery of the upper extremity, but the addition of MP produces a lager improvement. PMID:27134363

  19. The effects of game-based virtual reality movement therapy plus mental practice on upper extremity function in chronic stroke patients with hemiparesis: a randomized controlled trial.

    PubMed

    Park, Jin-Hyuck; Park, Ji-Hyuk

    2016-03-01

    [Purpose] The purpose of this study was to investigate the effects of game-based virtual reality movement therapy plus mental practice on upper extremity function in chronic stroke patients with hemiparesis. [Subjects] The subjects were chronic stroke patients with hemiparesis. [Methods] Thirty subjects were randomly assigned to either the control group or experimental group. All subjects received 20 sessions (5 days in a week) of virtual reality movement therapy using the Nintendo Wii. In addition to Wii-based virtual reality movement therapy, experimental group subjects performed mental practice consisting of 5 minutes of relaxation, Wii games imagination, and normalization phases before the beginning of Wii games. To compare the two groups, the upper extremity subtest of the Fugl-Meyer Assessment, Box and Block Test, and quality of movement subscale of the Motor Activity Log were performed. [Results] Both groups showed statistically significant improvement in the Fugl-Meyer Assessment, Box and Block Test, and quality of the movement subscale of Motor Activity Log after the interventions. Also, there were significant differences in the Fugl-Meyer Assessment, Box and Block Test, and quality of movement subscale of the Motor Activity Log between the two groups. [Conclusion] Game-based virtual reality movement therapy alone may be helpful to improve functional recovery of the upper extremity, but the addition of MP produces a lager improvement. PMID:27134363

  20. Failure of Arm Movement Control in Stroke Patients, Characterized by Loss of Complexity.

    PubMed

    Goh, Segun; Han, Kyungreem; Ryu, Jehkwang; Kim, Seonjin; Choi, MooYoung

    2015-01-01

    We study the mechanism of human arm-posture control by means of nonlinear dynamics and quantitative time series analysis methods. Utilizing linear and nonlinear measures in combination, we find that pathological tremors emerge in patient dynamics and serve as a main feature discriminating between normal and patient groups. The deterministic structure accompanied with loss of complexity inherent in the tremor dynamics is also revealed. To probe the underlying mechanism of the arm-posture dynamics, we further analyze the coupling patterns between joints and components, and discuss their roles in breaking of the organization structure. As a result, we elucidate the mechanisms in the arm-posture dynamics of normal subjects responding to the gravitational force and for the reduction of the dynamic degrees of freedom in the patient dynamics. This study provides an integrated framework for the origin of the loss of complexity in the dynamics of patients as well as the coupling structure in the arm-posture dynamics.

  1. Effect of Observation of Simple Hand Movement on Brain Activations in Patients with Unilateral Cerebral Palsy: An fMRI Study

    ERIC Educational Resources Information Center

    Dinomais, Mickael; Lignon, Gregoire; Chinier, Eva; Richard, Isabelle; Minassian, Aram Ter; The Tich, Sylvie N'Guyen

    2013-01-01

    The aim of this functional magnetic resonance imaging (fMRI) study was to examine and compare brain activation in patients with unilateral cerebral palsy (CP) during observation of simple hand movement performed by the paretic and nonparetic hand. Nineteen patients with clinical unilateral CP (14 male, mean age 14 years, 7-21 years) participated…

  2. The Influence of Visual and Auditory Information on the Perception of Speech and Non-Speech Oral Movements in Patients with Left Hemisphere Lesions

    ERIC Educational Resources Information Center

    Schmid, Gabriele; Thielmann, Anke; Ziegler, Wolfram

    2009-01-01

    Patients with lesions of the left hemisphere often suffer from oral-facial apraxia, apraxia of speech, and aphasia. In these patients, visual features often play a critical role in speech and language therapy, when pictured lip shapes or the therapist's visible mouth movements are used to facilitate speech production and articulation. This demands…

  3. Diaphragmatic movements in ankylosing spondylitis patients and their association with clinical factors: an ultrasonographic study.

    PubMed

    Ünlü, Ercüment; Pamuk, Ömer Nuri; Erer, Burak; Dönmez, Salim; Çakir, Necati

    2012-02-01

    We compared diaphragmatic motion between ankylosing spondylitis (AS) patients and controls, as assessed by the ultrasonographic method. We included 33 consecutive AS patients (19 males, 14 females) followed up at our center and 14 apparently healthy controls (8 males, 6 females) into our study. AS patients fulfilled the modified New York classification criteria for AS. Patients' demographic and clinical data, functional parameters, and radiographic findings were recorded down. By evaluating the motion of right and left diaphragm during deep expirium and inspirium, the mean diaphragmatic motion was determined by ultrasonography. Diaphragmatic motion in AS patients was less than in controls, but the difference was not significant (68.9 ± 17 mm vs. 77.8 ± 22.4 mm, P = 0.14). Diaphragmatic motion in AS patients who were active according to BASDAI score (>4) was not different from inactive patients (70.4 ± 20.5 vs. 67.5 ± 13.5, P > 0.05). The mean diaphragmatic motion had a positive correlation with occiput-to-wall distance (r = 0.35, P = 0.048); and negative correlations with cervical rotation (r = -0.45, P = 0.01) and modified Schober test (r = -0.34, P = 0.05) in AS patients. We did not detect any association of mean diaphragmatic motion with thoracic expansion on deep expiration. Diaphragmatic motion in AS does not differ significantly from the control group. Factors like disease activation, chest expansion, and the severity of radiographic findings do not affect diaphragmatic motion. There is no compensatory increase in diaphragmatic motion in AS.

  4. Comprehension of Co-Speech Gestures in Aphasic Patients: An Eye Movement Study

    PubMed Central

    Eggenberger, Noëmi; Preisig, Basil C.; Schumacher, Rahel; Hopfner, Simone; Vanbellingen, Tim; Nyffeler, Thomas; Gutbrod, Klemens; Annoni, Jean-Marie; Bohlhalter, Stephan; Cazzoli, Dario; Müri, René M.

    2016-01-01

    Background Co-speech gestures are omnipresent and a crucial element of human interaction by facilitating language comprehension. However, it is unclear whether gestures also support language comprehension in aphasic patients. Using visual exploration behavior analysis, the present study aimed to investigate the influence of congruence between speech and co-speech gestures on comprehension in terms of accuracy in a decision task. Method Twenty aphasic patients and 30 healthy controls watched videos in which speech was either combined with meaningless (baseline condition), congruent, or incongruent gestures. Comprehension was assessed with a decision task, while remote eye-tracking allowed analysis of visual exploration. Results In aphasic patients, the incongruent condition resulted in a significant decrease of accuracy, while the congruent condition led to a significant increase in accuracy compared to baseline accuracy. In the control group, the incongruent condition resulted in a decrease in accuracy, while the congruent condition did not significantly increase the accuracy. Visual exploration analysis showed that patients fixated significantly less on the face and tended to fixate more on the gesturing hands compared to controls. Conclusion Co-speech gestures play an important role for aphasic patients as they modulate comprehension. Incongruent gestures evoke significant interference and deteriorate patients’ comprehension. In contrast, congruent gestures enhance comprehension in aphasic patients, which might be valuable for clinical and therapeutic purposes. PMID:26735917

  5. Congenital mirror movements.

    PubMed Central

    Schott, G D; Wyke, M A

    1981-01-01

    In this report are described seven patients assessed clinically and neuropsychologically in whom mirror movements affecting predominantly the hands occurred as a congenital disorder. These mirror movements, representing a specific type of abnormal synkinesia, may arise as a hereditary condition, in the presence of a recognisable underlying neurological abnormality, and sporadically, and the seven patients provide more or less satisfactory examples of each of these three groups. Despite the apparent uniformity of the disorder, the heterogeneity and variability may be marked, examples in some of our patients including the pronounced increase in tone that developed with arm movement, and the capacity for modulation of the associated movement by alteration of neck position and bio-feedback. Various possible mechanisms are considered; these include impaired cerebral inhibition of unwanted movements, and functioning of abnormal motor pathways. Emphasis has been placed on the putative role of the direct, crossed corticomotoneurone pathways and on the unilateral and bilateral cerebral events that precede movement. PMID:7288446

  6. 75 FR 33893 - Open Meeting of Taxpayer Advocacy Panel Notice Improvement Project Committee

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  12. Cultural carrying capacity: Organ donation advocacy, discursive framing, and social media engagement.

    PubMed

    Bail, Christopher A

    2016-09-01

    Social media sites such as Facebook have become a powerful tool for public health outreach because they enable advocacy organizations to influence the rapidly increasing number of people who frequent these forums. Yet the very open-ness of social media sites creates fierce competition for public attention. The vast majority of social media messages provoke little or no reaction because of the sheer volume of information that confronts the typical social media user each day. In this article, I present a theory of the "cultural carrying capacity" of social media messaging campaigns. I argue that advocacy organizations inspire more endorsements, comments, and shares by social media users if they diversify the discursive content of their messages. Yet too much diversification creates large, disconnected audiences that lack the sense of shared purpose necessary to sustain an online movement. To evaluate this theory, I created a Facebook application that collects social media posts produced by forty-two organ donation advocacy organizations over 1.5 years, as well as supplemental information about the organization, its audience, and the broader social context in which they interact. Time series models provide strong evidence for my theory net of demographic characteristics of social media users, the resources and tactics of each organization, and broader external factors. I conclude by discussing the implications of these findings for public health, cultural sociology, and the nascent field of computational social science. PMID:26879407

  13. Cultural carrying capacity: Organ donation advocacy, discursive framing, and social media engagement.

    PubMed

    Bail, Christopher A

    2016-09-01

    Social media sites such as Facebook have become a powerful tool for public health outreach because they enable advocacy organizations to influence the rapidly increasing number of people who frequent these forums. Yet the very open-ness of social media sites creates fierce competition for public attention. The vast majority of social media messages provoke little or no reaction because of the sheer volume of information that confronts the typical social media user each day. In this article, I present a theory of the "cultural carrying capacity" of social media messaging campaigns. I argue that advocacy organizations inspire more endorsements, comments, and shares by social media users if they diversify the discursive content of their messages. Yet too much diversification creates large, disconnected audiences that lack the sense of shared purpose necessary to sustain an online movement. To evaluate this theory, I created a Facebook application that collects social media posts produced by forty-two organ donation advocacy organizations over 1.5 years, as well as supplemental information about the organization, its audience, and the broader social context in which they interact. Time series models provide strong evidence for my theory net of demographic characteristics of social media users, the resources and tactics of each organization, and broader external factors. I conclude by discussing the implications of these findings for public health, cultural sociology, and the nascent field of computational social science.

  14. Movement Disorders

    MedlinePlus

    ... want them to. If you have a movement disorder, you experience these kinds of impaired movement. Dyskinesia ... and is a common symptom of many movement disorders. Tremors are a type of dyskinesia. Nerve diseases ...

  15. A surface electromyography based objective method to identify patients with nonspecific chronic low back pain, presenting a flexion related movement control impairment.

    PubMed

    Van Damme, Benedicte; Stevens, Veerle; Perneel, Christiaan; Van Tiggelen, Damien; Neyens, Ellen; Duvigneaud, Nathalie; Moerman, Luc; Danneels, Lieven

    2014-12-01

    Movement control impairments (MCI) are often present in patients with non-specific chronic low back pain (NS-CLBP). Therefore, movement control exercises are widely used to rehabilitate patients. However, the objective assessment remains difficult. The purpose of this study was to develop a statistical model, based on logistic regression analysis, to differentiate patients with NS-CLBP presenting a flexion-related MCI from healthy subjects. This model is based on trunk muscle activation patterns measured by surface electromyography (sEMG), during movement control exercises. Sixty-three healthy male subjects and 36 male patients with a flexion-related MCI participated in this study. Muscle activity of the internal obliques, the external obliques, the lumbar multifidus and the thoracic part of the iliocostalis was registered. Ratios of deep stabilizing to superficial torque producing muscle activity were calculated to examine trunk muscle recruitment patterns during 6 different exercises. Logistic regression analyses were performed (1) to define the ratios and exercises that were most discriminating between patients and non-patients, (2) to make a predictive model. K-Fold cross-validation was used to assess the performance of the predictive model. This study demonstrated that sEMG trunk muscle recruitment patterns during movement control tests, allows differentiating NSCLBP patients with a flexion-related MCI from healthy subjects.

  16. Free movement of patients: Directive 2011/24 on the application of patients' rights in cross-border healthcare.

    PubMed

    Peeters, Miek

    2012-03-01

    This contribution comments on Directive 2011/24, providing a legal framework for cross border healthcare 13 years after the famous Kohll and Decker case law. The Directive contains provisions concerning the reimbursement of costs, the responsibilities of the Member States and their mutual cooperation in healthcare. Analysing the (potential) impact of the Directive 2011/24 on EU healthcare systems, patients and healthcare providers, it becomes clear that the impact of the Directives reaches far beyond patient mobility. The Directive creates patients' rights, pays attention to the quality and safety of healthcare services and creates an excessive structure of cooperation in the field of healthcare. The European Union seems ready to use its economies of scale to improve healthcare for all European patients. PMID:22428388

  17. Clause structure and verb movement in a Greek-English speaking bilingual patient with Broca's aphasia: evidence from adverb placement.

    PubMed

    Alexiadou, Artemis; Stavrakaki, Stavroula

    2006-02-01

    In this paper, we investigate the performance of a Greek-English bilingual patient with Broca's aphasia and mild agrammatism on the placement of CP, MoodP, AspectP, and NegP-related adverbs, labeled specifier-type adverbs, and VP-related adverbs, labeled complement-type adverbs, by means of a constituent ordering task and a grammaticality judgment task. Based on the results derived by means of these two different tasks in both Greek and English, we argue that (i) the CP layer causes great difficulties to aphasic performance in both languages but it is not missing from aphasic grammar, whereas the VP layer remains intact in both languages; (ii) the MoodP, AspectP, and NegP-related adverbs cause more difficulties in English that in Greek. We attribute this to the independent differences between English and Greek that relate to properties of verbal morphology and syntactic head movement. PMID:15935462

  18. Clause structure and verb movement in a Greek-English speaking bilingual patient with Broca's aphasia: evidence from adverb placement.

    PubMed

    Alexiadou, Artemis; Stavrakaki, Stavroula

    2006-02-01

    In this paper, we investigate the performance of a Greek-English bilingual patient with Broca's aphasia and mild agrammatism on the placement of CP, MoodP, AspectP, and NegP-related adverbs, labeled specifier-type adverbs, and VP-related adverbs, labeled complement-type adverbs, by means of a constituent ordering task and a grammaticality judgment task. Based on the results derived by means of these two different tasks in both Greek and English, we argue that (i) the CP layer causes great difficulties to aphasic performance in both languages but it is not missing from aphasic grammar, whereas the VP layer remains intact in both languages; (ii) the MoodP, AspectP, and NegP-related adverbs cause more difficulties in English that in Greek. We attribute this to the independent differences between English and Greek that relate to properties of verbal morphology and syntactic head movement.

  19. Failure of Arm Movement Control in Stroke Patients, Characterized by Loss of Complexity

    PubMed Central

    Goh, Segun; Han, Kyungreem; Ryu, Jehkwang; Kim, Seonjin; Choi, MooYoung

    2015-01-01

    We study the mechanism of human arm-posture control by means of nonlinear dynamics and quantitative time series analysis methods. Utilizing linear and nonlinear measures in combination, we find that pathological tremors emerge in patient dynamics and serve as a main feature discriminating between normal and patient groups. The deterministic structure accompanied with loss of complexity inherent in the tremor dynamics is also revealed. To probe the underlying mechanism of the arm-posture dynamics, we further analyze the coupling patterns between joints and components, and discuss their roles in breaking of the organization structure. As a result, we elucidate the mechanisms in the arm-posture dynamics of normal subjects responding to the gravitational force and for the reduction of the dynamic degrees of freedom in the patient dynamics. This study provides an integrated framework for the origin of the loss of complexity in the dynamics of patients as well as the coupling structure in the arm-posture dynamics. PMID:26536132

  20. Effect of Eye Movement Desensitization and Reprocessing (EMDR) on Depression in Patients With Myocardial Infarction (MI)

    PubMed Central

    Behnammoghadam, Mohammad; Alamdari, Ali Karam; Behnammoghadam, Aziz; Darban, Fatemeh

    2015-01-01

    Background: Coronary heart disease is the most important cause of death and inability in all communities. Depressive symptoms are frequent among post-myocardial infarction (MI) patients and may cause negative effects on cardiac prognosis. This study was conducted to identify efficacy of EMDR on depression of patients with MI. Methods: This study is a clinical trial. Sixty patients with MI were selected by simple sampling, and were separated randomly into experimental and control groups. To collect data, demographic questionnaire and Beck Depression Questionnaire were used. In experimental group, EMDR therapy were performed in three sessions alternate days for 45–90 minutes, during four months after their MI. Depression level of patients was measured before, and a week after EMDR therapy. Data were analyzed using paired –t- test, t–test, and Chi-square. Results: The mean depression level in experimental group 27.26± 6.41 before intervention, and it was 11.76 ± 3.71 after intervention. Hence, it showed a statistically significant difference (P<0.001). The mean depression level in control group was 24.53 ± 5.81 before intervention, and it was 31.66± 6.09 after intervention, so it showed statistically significant difference (P<0.001). The comparison of mean depression level at post treatment, in both groups showed statistically significant difference (P<0.001). Conclusion: EMDR is an effective, useful, efficient, and non-invasive method for treatment and reducing depression in patients with MI. PMID:26153191

  1. Restoration of shoulder movement in quadriplegic and hemiplegic patients by functional electrical stimulation using percutaneous multiple electrodes.

    PubMed

    Kameyama, J; Handa, Y; Hoshimiya, N; Sakurai, M

    1999-04-01

    The purpose of this study is to restore the motion of the paralyzed shoulder caused by upper motor neuron disorders using functional electrical stimulation (FES). Percutaneous wire electrodes were implanted into twelve muscles of the shoulder in six patients with stroke or cervical spinal cord injury. The motion of the paralyzed shoulder was controlled by a portable FES computer system, with the three standard stimulation patterns for restoring motion of 90 degrees flexion to 90 degrees horizontal abduction, 90 degrees flexion to 20 degrees horizontal adduction, and 90 degrees abduction to 90 degrees horizontal adduction. Shoulder movements were repeatedly controlled according to the created stimulation patterns in five of the patients. The two dimensional motion analyzer also confirmed shoulder control over a satisfactorily broad range of excursion. One hemiplegic patient, who was a signboard painter, had his paretic left upper extremity improved by FES, and he drew a large picture on a board with his normal right hand and, with his affected left arm against the wall, to support his trunk. This may be a world first case of producing shoulder motion through FES.

  2. Who's Who in a Growing Education Reform Movement

    ERIC Educational Resources Information Center

    Policy Innovators in Education Network, 2012

    2012-01-01

    Education reform advocacy organizations have been working at the state-level for more than twenty-five years, but the last decade has seen a significant increase in their number and in the intensity of their focus and methods. It's no coincidence that as reform organizations proliferate the movement accelerates: the mission of such organizations…

  3. Professionalizing a Global Social Movement: Universities and Human Rights

    ERIC Educational Resources Information Center

    Suarez, David; Bromley, Patricia

    2012-01-01

    Research on the human rights movement emphasizes direct changes in nation-states, focusing on the efficacy of treaties and the role of advocacy in mitigating immediate violations. However, more than 140 universities in 59 countries established academic chairs, research centers, and programs for human rights from 1968-2000, a development that…

  4. Lives Worth Living: Religious Education and Social Movements

    ERIC Educational Resources Information Center

    Ayres, Jennifer R.

    2013-01-01

    When people of faith participate in movements for social change, how are their religious and moral identities formed, challenged, and transformed? Although they have explicit and tangible goals as they participate in advocacy, protest, and boycotts, religious social activists also, James Jasper argues, craft "lives worth living" (1997).…

  5. Nursing advocacy for women veterans and suicide.

    PubMed

    Conard, Patricia L; Armstrong, Myrna L; Young, Cathy; Hogan, La Micha

    2015-03-01

    Little is known about suicide variables in women Veterans. The authors reviewed numerous applicable health care and military literary sources regarding suicide in this population. The current article describes the surrounding circumstances, military war/conflict culture, and potential effects on women Veterans, including major collection problems with current Veteran data. Women Veterans are increasingly reporting more behavioral health issues (e.g., posttraumatic stress disorder) and attempting suicide upon civilian reintegration. Outcomes from this literature review suggest the importance of nursing advocacy to create better rapport and communication with women Veterans from Vietnam, Gulf I, Iraq, and Afghanistan wars seeking care at civilian health facilities, as some may present with suicidal ideologies.

  6. Having a Voice: An Exploration of Children's Rights and Advocacy.

    ERIC Educational Resources Information Center

    Dalrymple, Jane, Ed.; Hough, Jan, Ed.

    This book explores the concept of advocacy in British society with regard to children and young people, examining advocacy from a number of different perspectives, and taking into account the UN Convention on the Rights of the Child and legislation that affects children and young people. The three parts of the book examine why young people need an…

  7. Social Justice Advocacy in Rural Communities: Practical Issues and Implications

    ERIC Educational Resources Information Center

    Bradley, Joshua M.; Werth, James L., Jr.; Hastings, Sarah L.

    2012-01-01

    The professional literature related to social justice has increased, but there has been little discussion of the practical issues and implications associated with social advocacy. However, adding new roles will result in new considerations for counseling psychologists. The need to be attuned to how the practical aspects of advocacy intersect with…

  8. Exploring Nonoffending Caregiver Satisfaction with a Children's Advocacy Center

    ERIC Educational Resources Information Center

    Bonach, Kathryn; Mabry, J. Beth; Potts-Henry, Candice

    2010-01-01

    This study is a case evaluation research report on one Children's Advocacy Center that provides a coordinated response to allegations of child maltreatment, particularly sexual abuse. The data come from a mailed survey of nonoffending caregivers measuring their satisfaction with services provided through the Children's Advocacy Center. The results…

  9. Promoting Systemic Change through the ACA Advocacy Competencies

    ERIC Educational Resources Information Center

    Toporek, Rebecca L.; Lewis, Judith A.; Crethar, Hugh C.

    2009-01-01

    In 2003, the American Counseling Association (ACA) adopted the ACA Advocacy Competencies (J. A. Lewis, M. S. Arnold, R. House, & R. L. Toporek, 2002) to provide guidance to counselors and acknowledge advocacy as an ethical aspect of service to clients. This article provides a foundation for this special section by sharing a historical perspective…

  10. Participation, Decentralization, and Advocacy Planning, Resource Paper No. 25.

    ERIC Educational Resources Information Center

    Kasperson, Roger E.; Breitbart, Myrna

    This resource paper on the subject of citizen participation, decentralization, and advocacy planning is part of a series designed to supplement undergraduate geography courses. The approach of the paper de-emphasizes inventory or case study reviews of specific participation or advocacy planning projects for a more general conceptual discussion of…

  11. Advocacy for Child Wellness in High-Poverty Environments

    ERIC Educational Resources Information Center

    Mullen, Carol A.

    2014-01-01

    Child wellness needs to be understood holistically so that children and youth from high-poverty environments can succeed in schooling and life. Teachers who foster advocacy in themselves are well equipped to teach students to take ownership of their own well-being. Such advocacy can enrich the classroom curriculum and mitigate the negative effects…

  12. A Media Advocacy Intervention Linking Health Disparities and Food Insecurity

    ERIC Educational Resources Information Center

    Rock, Melanie J.; McIntyre, Lynn; Persaud, Steven A.; Thomas, Karen L.

    2011-01-01

    Media advocacy is a well-established strategy for transmitting health messages to the public. This paper discusses a media advocacy intervention that raised issues about how the public interprets messages about the negative effects of poverty on population health. In conjunction with the publication of a manuscript illustrating how income-related…

  13. Using Week of the Young Child as an Advocacy Event

    ERIC Educational Resources Information Center

    Young Children, 2009

    2009-01-01

    The Week of the Young Child 2009, April 19-25, presents a public policy advocacy opportunity for early childhood programs, faculty, and families. This article offers some ways one can use Week of the Young Child (WOYC) events specifically to further advocacy efforts.

  14. Using the Decision Case Method to Teach Legislative Policy Advocacy

    ERIC Educational Resources Information Center

    Wolfer, Terry A.; Gray, Karen A.

    2007-01-01

    Social work educators have long struggled with making policy practice real "more", especially to micro-oriented students (Sundet & Kelly, 2002). The decision case method can generate excitement about social policy advocacy while educating students about current advocacy work, particularly if the case involves state or local efforts to influence…

  15. Treatments for Neurodevelopmental Disorders: Evidence, Advocacy, and the Internet

    ERIC Educational Resources Information Center

    Di Pietro, Nina C.; Whiteley, Louise; Mizgalewicz, Ania; Illes, Judy

    2013-01-01

    The Internet is a major source of health-related information for parents of sick children despite concerns surrounding quality. For neurodevelopmental disorders, the websites of advocacy groups are a largely unexamined source of information. We evaluated treatment information posted on nine highly-trafficked advocacy websites for autism, cerebral…

  16. Kids Speaking Up for Kids: Advocacy by Children, for Children

    ERIC Educational Resources Information Center

    Zygmunt-Fillwalk, Eva; Staley, Lynn; Kumar, Rashmi; Lin, Cecilia Lingfen; Moore, Catherine; Salakaya, Manana; Szecsi, Tunde

    2007-01-01

    This article describes a project called "Kids Speaking Up for Kids: Advocacy by Children, for Children". The project was simple in scope. The authors sought to collect stories of child advocacy--ways in which children were working on behalf of other children. They also sought to collect and profile children's voices and vision and so they issued a…

  17. Speaking up about Advocacy: Findings from a Partnership Research Project

    ERIC Educational Resources Information Center

    Chapman, Melanie; Bannister, Susan; Davies, Julie; Fleming, Simon; Graham, Claire; Mcmaster, Andrea; Seddon, Angela; Wheldon, Anita; Whittell, Bridget

    2012-01-01

    This article describes a partnership research project carried out by a research team consisting of people with learning disabilities and people without learning disabilities. The research explored people's understandings of advocacy and identified gaps in advocacy provision for people with learning disabilities and their families. Four focus…

  18. Working for Change in Education: A Handbook for Planning Advocacy.

    ERIC Educational Resources Information Center

    Save the Children, London (England).

    This handbook is for those seeking to improve children's education, especially those organizations that work closely with children, parents, and teachers. It sets out a way of approaching advocacy work with the understanding that advocacy groups have a greater impact on the direction of educational change if they have a well-thought-out advocacy…

  19. Protective Services and Citizen Advocacy. Monograph No. 3.

    ERIC Educational Resources Information Center

    Sigelman, Carol K., Ed.

    Presented are seven papers given at a conference on deinstitutionalization of the mentally handicapped which focus on protective services and citizen advocacy. Carol Sigelman stresses the following four concepts: follow-along (the monitoring of the developmentally disabled person in the community), advocacy, protection, and shelter, Alternatives…

  20. Social Justice Advocacy among Graduate Students: An Empirical Investigation

    ERIC Educational Resources Information Center

    Linnemeyer, Rachel McQuown

    2009-01-01

    Although social justice advocacy has increasingly been acknowledged as important in the field of psychology (e.g., Goodman et al., 2004; Toporek et al., 2006a, Vera & Speight, 2003), there is a dearth of empirical research examining social justice advocacy across graduate psychology students. This mixed-methods study examined demographic and…

  1. School Counselors United in Professional Advocacy: A Systems Model

    ERIC Educational Resources Information Center

    Cigrand, Dawnette L.; Havlik, Stacey Gaenzle; Malott, Krista M.; Jones, SaDohl Goldsmith

    2015-01-01

    Limited budgets may place educational positions in jeopardy and if school counseling positions become jeopardized, then school counselors must communicate their role and impact more effectively. However, school counselors may lack training and experience in professional self-advocacy practices, and advocacy efforts may be undermined by role…

  2. Evaluating a Human Rights-Based Advocacy Approach to Expanding Access to Pain Medicines and Palliative Care: Global Advocacy and Case Studies from India, Kenya, and Ukraine.

    PubMed

    Lohman, Diederik; Amon, Joseph J

    2015-12-10

    Palliative care has been defined as care that is person-centered and attentive to physical symptoms and psychological, social, and existential distress in patients with severe or life-threatening illness. The identification of access to palliative care and pain treatment as a human rights issue first emerged among palliative care advocates, physicians, and lawyers in the 1990s, with a basis in the right to health and the right to be free from cruel, inhuman, and degrading treatment. Using a case study approach, we evaluate the results of a human rights-based advocacy approach on access to pain medicine and palliative care in India, Kenya, and Ukraine. In each country, human rights advocacy helped raise awareness of the issue, identify structural barriers to care, define government obligations, and contribute to the reform of laws, policies, and practices impeding the availability of palliative care services. In addition, advocacy efforts stimulated civil society engagement and high-level political leadership that fostered the implementation of human rights-based palliative care programs. Globally, access to palliative care was increasingly recognized by human rights bodies and within global health and drug policy organizations as a government obligation central to the right to health.

  3. Axial movements in ideomotor apraxia

    PubMed Central

    Poeck, K; Lehmkuhl, G; Willmes, K

    1982-01-01

    Non-symbolic axial movements were examined and compared to oral and limb movements in a group of 60 aphasic patients (15 of each major subgroup) with exclusively left-sided brain damage. The contention in the literature that axial movements are preserved in patients with ideomotor limb apraxia was not confirmed. PMID:6186771

  4. On modeling the neuronal activity in movement disorder patients by using the Ornstein Uhlenbeck process.

    PubMed

    Shukla, Pitamber; Basu, Ishita; Tuninetti, Daniela; Graupe, Daniel; Slavin, Konstantin V

    2014-01-01

    Mathematical models of the neuronal activity in the affected brain regions of Essential Tremor (ET) and Parkinson's Disease (PD) patients could shed light into the underlying pathophysiology of these diseases, which in turn could help develop personalized treatments including adaptive Deep Brain Stimulation (DBS). In this paper, we use an Ornstein Uhlenbeck Process (OUP) to model the neuronal spiking activity recorded from the brain of ET and PD patients during DBS stereotactic surgery. The parameters of the OUP are estimated based on Inter Spike Interval (ISI) measurements, i.e., the time interval between two consecutive neuronal firings, by means of the Fortet Integral Equation (FIE). The OUP model parameters identified with the FIE method (OUP-FIE) are then used to simulate the ISI distribution resulting from the OUP. Other widely used neuronal activity models, such as the Poisson Process (PP), the Brownian Motion (BM), and the OUP whose parameters are extracted by matching the first two moments of the ISI (OUP-MOM), are also considered. To quantify how close the simulated ISI distribution is to the measured ISI distribution, the Integral Square Error (ISE) criterion is adopted. Amongst all considered stochastic processes, the ISI distribution generated by the OUP-FIE method is shown to produce the least ISE. Finally, a directional Wilcoxon signed rank test is used to show statistically significant reduction in the ISE value obtained from the OUP-FIE compared to the other stochastic processes.

  5. Neural Correlates of Fear of Movement in Patients with Chronic Low Back Pain vs. Pain-Free Individuals

    PubMed Central

    Meier, Michael L.; Stämpfli, Philipp; Vrana, Andrea; Humphreys, Barry K.; Seifritz, Erich; Hotz-Boendermaker, Sabina

    2016-01-01

    Fear of movement (FOM) can be acquired by a direct aversive experience such as pain or by social learning through observation and instruction. Excessive FOM results in heightened disability and is an obstacle for recovery from acute, subacute, and chronic low back pain (cLBP). FOM has further been identified as a significant explanatory factor in the Fear Avoidance (FA) model of cLBP that describes how individuals experiencing acute back pain may become trapped into a vicious circle of chronic disability and suffering. Despite a wealth of evidence emphasizing the importance of FOM in cLBP, to date, no related neural correlates in patients were found and this therefore has initiated a debate about the precise contribution of fear in the FA model. In the current fMRI study, we applied a novel approach encompassing: (1) video clips of potentially harmful activities for the back as FOM inducing stimuli; and (2) the assessment of FOM in both, cLBP patients (N = 20) and age- and gender-matched pain-free subjects (N = 20). Derived from the FA model, we hypothesized that FOM differentially affects brain regions involved in fear processing in patients with cLBP compared to pain-free individuals due to the recurrent pain and subsequent avoidance behavior. The results of the whole brain voxel-wise regression analysis revealed that: (1) FOM positively correlated with brain activity in fear-related brain regions such as the amygdala and the insula; and (2) differential effects of FOM between patients with cLBP and pain-free subjects were found in the extended amygdala and in its connectivity to the anterior insula. Current findings support the FOM component of the FA model in cLBP. PMID:27507941

  6. Neural Correlates of Fear of Movement in Patients with Chronic Low Back Pain vs. Pain-Free Individuals.

    PubMed

    Meier, Michael L; Stämpfli, Philipp; Vrana, Andrea; Humphreys, Barry K; Seifritz, Erich; Hotz-Boendermaker, Sabina

    2016-01-01

    Fear of movement (FOM) can be acquired by a direct aversive experience such as pain or by social learning through observation and instruction. Excessive FOM results in heightened disability and is an obstacle for recovery from acute, subacute, and chronic low back pain (cLBP). FOM has further been identified as a significant explanatory factor in the Fear Avoidance (FA) model of cLBP that describes how individuals experiencing acute back pain may become trapped into a vicious circle of chronic disability and suffering. Despite a wealth of evidence emphasizing the importance of FOM in cLBP, to date, no related neural correlates in patients were found and this therefore has initiated a debate about the precise contribution of fear in the FA model. In the current fMRI study, we applied a novel approach encompassing: (1) video clips of potentially harmful activities for the back as FOM inducing stimuli; and (2) the assessment of FOM in both, cLBP patients (N = 20) and age- and gender-matched pain-free subjects (N = 20). Derived from the FA model, we hypothesized that FOM differentially affects brain regions involved in fear processing in patients with cLBP compared to pain-free individuals due to the recurrent pain and subsequent avoidance behavior. The results of the whole brain voxel-wise regression analysis revealed that: (1) FOM positively correlated with brain activity in fear-related brain regions such as the amygdala and the insula; and (2) differential effects of FOM between patients with cLBP and pain-free subjects were found in the extended amygdala and in its connectivity to the anterior insula. Current findings support the FOM component of the FA model in cLBP. PMID:27507941

  7. Psychogenic Movement Disorders

    PubMed Central

    Morgante, Francesca; Edwards, Mark J.; Espay, Alberto J.

    2013-01-01

    Purpose of Review This review describes the main clinical features of psychogenic (functional) movement disorders and reports recent advances in diagnosis, pathophysiology, and treatment. Recent Findings The terminology and definition of patients with psychogenic movement disorders remain subjects of controversy; the term “functional” has been used more frequently in the literature in recent years regarding the neurobiological substrate underpinning these disorders. Correct diagnosis of psychogenic movement disorders should rely not on the exclusion of organic disorders or the sole presence of psychological factors but on the observation or elicitation of clinical features related to the specific movement disorder (ie, a positive or inclusionary rather than exclusionary diagnosis). Sudden onset, spontaneous remissions, and variability over time or during clinical examination are useful “red flags” suggestive of a psychogenic movement disorder. Imaging studies have demonstrated impaired connectivity between limbic and motor areas involved in movement programming and hypoactivity of a brain region that compares expected data with actual sensory data occurring during voluntary movement. Treatment of psychogenic movement disorders begins with ensuring the patient’s acceptance of the diagnosis during the initial debriefing and includes nonpharmacologic (cognitive-behavioral therapy, physiotherapy) and pharmacologic options. Summary Psychogenic movement disorders represent a challenging disorder for neurologists to diagnose and treat. Recent advances have increased understanding of the neurobiological mechanism of psychogenic movement disorders. Treatment with cognitive strategies and physical rehabilitation can benefit some patients. As short duration of disease correlates with better prognosis, early diagnosis and initiation of treatment are critical. PMID:24092294

  8. Eye movement desensitization and reprocessing therapy in subsyndromal bipolar patients with a history of traumatic events: a randomized, controlled pilot-study.

    PubMed

    Novo, Patricia; Landin-Romero, Ramon; Radua, Joaquim; Vicens, Victor; Fernandez, Isabel; Garcia, Francisca; Pomarol-Clotet, Edith; McKenna, Peter J; Shapiro, Francine; Amann, Benedikt L

    2014-09-30

    Traumatic events are frequent in bipolar patients and can worsen the course of the disease. Psychotherapeutic interventions for these events have not been studied so far. Twenty DSM-IV bipolar I and II patients with subsyndromal mood symptoms and a history of traumatic events were randomly assigned to Eye Movement Desensitization and Reprocessing therapy (n=10) or treatment as usual (n=10). The treatment group received between 14 and 18 Eye Movement Desensitization and Reprocessing sessions during 12 weeks. Evaluations of affective symptoms, symptoms of trauma and trauma impact were carried out by a blind rater at baseline, 2 weeks, 5 weeks, 8 weeks, 12 weeks and at 24 weeks follow-up. Patients in the treatment group showed a statistically significant improvement in depressive and hypomanic symptoms, symptoms of trauma and trauma impact compared to the treatment as usual group after intervention. This effect was only partly maintained in trauma impact at the 24 weeks follow-up visit. One patient dropped from Eye Movement Desensitization and Reprocessing group whereas four from the treatment as usual group. This pilot study suggests that Eye Movement Desensitization and Reprocessing therapy may be an effective and safe intervention to treat subsyndromal mood and trauma symptoms in traumatized bipolar patients.

  9. Protection and advocacy: an ethics practice in mental health.

    PubMed

    Olsen, D P

    2001-04-01

    This paper reports the findings of investigations into allegations of patient abuse and the implications for policy and practice. These investigations were carried out by a nurse with a background in ethics for the office of Protection and Advocacy for Individuals with Mental Illness (PAIMI), a state agency operating under a United States federal law entitling it to investigate complaints by psychiatric patients. PAIMI uses investigations both to help individuals and to provide an avenue for broader change. There are four steps in the investigation process: (1) definition of the problem; (2) gathering information; (3) synthesis; and (4) addressing the problem. Cases are presented to illustrate the investigation process and identify ethical issues arising in mental health treatment. Among the issues raised are autonomy and forced treatment, deinstitutionalization, bias against the mentally ill, privacy, and surrogate treatment decisions. Resolutions range from providing individual advice to clients or clinicians, to changes in institutional policy and the publication of guidelines for specific situations. The following lessons were learnt from the investigations: (1) tell patients what to expect; (2) pay attention to the process of giving care; (3) allow patients to feel ambivalent about treatment; and (4) work to develop good relationships; underlying every investigation has been a poor relationship. PMID:11882117

  10. Credibility and advocacy in conservation science

    PubMed Central

    Horton, Cristi C.; Peterson, Tarla Rai; Banerjee, Paulami

    2015-01-01

    Abstract Conservation policy sits at the nexus of natural science and politics. On the one hand, conservation scientists strive to maintain scientific credibility by emphasizing that their research findings are the result of disinterested observations of reality. On the other hand, conservation scientists are committed to conservation even if they do not advocate a particular policy. The professional conservation literature offers guidance on negotiating the relationship between scientific objectivity and political advocacy without damaging conservation science's credibility. The value of this guidance, however, may be restricted by limited recognition of credibility's multidimensionality and emergent nature: it emerges through perceptions of expertise, goodwill, and trustworthiness. We used content analysis of the literature to determine how credibility is framed in conservation science as it relates to apparent contradictions between science and advocacy. Credibility typically was framed as a static entity lacking dimensionality. Authors identified expertise or trustworthiness as important, but rarely mentioned goodwill. They usually did not identify expertise, goodwill, or trustworthiness as dimensions of credibility or recognize interactions among these 3 dimensions of credibility. This oversimplification may limit the ability of conservation scientists to contribute to biodiversity conservation. Accounting for the emergent quality and multidimensionality of credibility should enable conservation scientists to advance biodiversity conservation more effectively. PMID:26041036

  11. Reducing violent injuries: priorities for pediatrician advocacy.

    PubMed

    Dolins, J C; Christoffel, K K

    1994-10-01

    A basic framework for developing an advocacy plan must systematically break down the large task of policy development implementation into manageable components. The basic framework described in detail in this paper includes three steps: Setting policy objectives by narrowing the scope of policy, by reviewing policy options, and by examining options against selected criteria. Developing strategies for educating the public and for approaching legislative/regulatory bodies. Evaluating the effectiveness of the advocacy action plan as a process and as an agent for change. To illustrate the variety of ways in which pediatricians can be involved in the policy process to reduce violent injuries among children and adolescents, we apply this systematic approach to three priority areas. Prohibiting the use of corporal punishment in schools is intended to curb the institutionalized legitimacy of violence that has been associated with future use of violence. Efforts to remove handguns from the environments of children and adolescents are aimed at reducing the numbers of firearm injuries inflicted upon and by minors. Comprehensive treatment of adolescent victims of assault is intended to decrease the reoccurrence of violent injuries.

  12. Medical advocacy on behalf of detained immigrants.

    PubMed

    Venters, Homer D; Foote, Mary; Keller, Allen S

    2011-06-01

    Detention of immigrants by Immigration and Customs Enforcement (ICE) is a rapidly growing form of incarceration in the U.S. with almost 400,000 people detained in 2008 (Schriro in Immigration and Customs Enforcement, 2009, http://www.ice.gov/doclib/091005_ice_detention_report-final.pdf ). ICE detainees are predominantly from Mexico and Latin America and only a small minority of detainees are asylum seekers. Immigrant detainees lack a legal guarantee of medical care (unlike criminal arrestees and prisoners) and face challenges in receiving medical care, particularly those with chronic medical conditions (Venters and Keller in J Health Care Poor Underserved 20:951-957, 2009). Although we and others have long been involved in advocating for detained asylum seekers, few resources are dedicated to medical advocacy for the broader population of ICE detainees. At the NYU Center for Health and Human Rights (CHHR), a program of medical advocacy was initiated in 2007 on behalf of ICE detainees focused on improvement of care in detention and medical parole. Our preliminary efforts reveal a pressing need for more involvement by physicians and other health advocates in this area.

  13. Credibility and advocacy in conservation science.

    PubMed

    Horton, Cristi C; Peterson, Tarla Rai; Banerjee, Paulami; Peterson, Markus J

    2016-02-01

    Conservation policy sits at the nexus of natural science and politics. On the one hand, conservation scientists strive to maintain scientific credibility by emphasizing that their research findings are the result of disinterested observations of reality. On the other hand, conservation scientists are committed to conservation even if they do not advocate a particular policy. The professional conservation literature offers guidance on negotiating the relationship between scientific objectivity and political advocacy without damaging conservation science's credibility. The value of this guidance, however, may be restricted by limited recognition of credibility's multidimensionality and emergent nature: it emerges through perceptions of expertise, goodwill, and trustworthiness. We used content analysis of the literature to determine how credibility is framed in conservation science as it relates to apparent contradictions between science and advocacy. Credibility typically was framed as a static entity lacking dimensionality. Authors identified expertise or trustworthiness as important, but rarely mentioned goodwill. They usually did not identify expertise, goodwill, or trustworthiness as dimensions of credibility or recognize interactions among these 3 dimensions of credibility. This oversimplification may limit the ability of conservation scientists to contribute to biodiversity conservation. Accounting for the emergent quality and multidimensionality of credibility should enable conservation scientists to advance biodiversity conservation more effectively. PMID:26041036

  14. Credibility and advocacy in conservation science.

    PubMed

    Horton, Cristi C; Peterson, Tarla Rai; Banerjee, Paulami; Peterson, Markus J

    2016-02-01

    Conservation policy sits at the nexus of natural science and politics. On the one hand, conservation scientists strive to maintain scientific credibility by emphasizing that their research findings are the result of disinterested observations of reality. On the other hand, conservation scientists are committed to conservation even if they do not advocate a particular policy. The professional conservation literature offers guidance on negotiating the relationship between scientific objectivity and political advocacy without damaging conservation science's credibility. The value of this guidance, however, may be restricted by limited recognition of credibility's multidimensionality and emergent nature: it emerges through perceptions of expertise, goodwill, and trustworthiness. We used content analysis of the literature to determine how credibility is framed in conservation science as it relates to apparent contradictions between science and advocacy. Credibility typically was framed as a static entity lacking dimensionality. Authors identified expertise or trustworthiness as important, but rarely mentioned goodwill. They usually did not identify expertise, goodwill, or trustworthiness as dimensions of credibility or recognize interactions among these 3 dimensions of credibility. This oversimplification may limit the ability of conservation scientists to contribute to biodiversity conservation. Accounting for the emergent quality and multidimensionality of credibility should enable conservation scientists to advance biodiversity conservation more effectively.

  15. Kinematic analysis of arm and trunk movements in the gait of Parkinson's disease patients based on external signals.

    PubMed

    Son, Hohee; Kim, Eunjung

    2015-12-01

    [Purpose] To investigate the role of external cues on arm swing amplitude and trunk rotation in Parkinson's disease. [Subjects and Methods] The subjects were 13 elderly patients with Parkinson's disease. Subjects walked under four different conditions in a random order: no cue, visual cue, auditory cue, and combined cue. The auditory cue velocity consisted of a metronome beat 20% greater than the subject's general gait speed. For the visual cue condition, bright yellow colored strips of tape placed on the floor at intervals equal to 40% of each subject's height. A motion analysis system was used to measure arm swing amplitude and trunk rotation during walking. [Results] There was a significant difference in the kinematic variables (arm swing amplitude) between different cues, but there was not a significant difference in the kinematic variables with respect to the trunk rotation. [Conclusion] The findings of this study indicate that patients with Parkinson's disease are likely to focus attention on auditory cues. The measurement of arm and trunk kinematics during gait by auditory cues can increase the available methods for the analysis of complex motor programs in movement disorders. PMID:26834352

  16. Motion analysis of wheelchair propulsion movements in hemiplegic patients: effect of a wheelchair cushion on suppressing posterior pelvic tilt.

    PubMed

    Kawada, Kyohei; Matsuda, Tadamitsu; Takanashi, Akira; Miyazima, Shigeki; Yamamoto, Sumiko

    2015-03-01

    [Purpose] This study sought to ascertain whether, in hemiplegic patients, the effect of a wheelchair cushion to suppress pelvic posterior tilt when initiating wheelchair propulsion would continue in subsequent propulsions. [Subjects] Eighteen hemiplegic patients who were able to propel a wheelchair in a seated position participated in this study. [Methods] An adjustable wheelchair was fitted with a cushion that had an anchoring function, and a thigh pad on the propulsion side was removed. Propulsion movements from the seated position without moving through three propulsion cycles were measured using a three-dimensional motion analysis system, and electromyography was used to determine the angle of pelvic posterior tilt, muscle activity of the biceps femoris long head, and propulsion speed. [Results] Pelvic posterior tilt could be suppressed through the three propulsion cycles, which served to increase propulsion speed. Muscle activity of the biceps femoris long head was highest when initiating propulsion and decreased thereafter. [Conclusion] The effect of the wheelchair cushion on suppressing pelvic posterior tilt continued through three propulsion cycles.

  17. From Preservice Leaders to Advocacy Leaders: Exploring Intersections in Standards for Advocacy in Educational Leadership and School Counselling

    ERIC Educational Resources Information Center

    Crawford, Emily R.; Arnold, Noelle Witherspoon; Brown, Andre

    2014-01-01

    In this empirically based paper, we discuss educational leadership preparation as it relates to social justice, the concept of advocacy and the standards that guide leadership and counselling, respectively. To reveal how preservice leaders conceptualize advocacy as understood in professional standards, we draw on our research with 11 preservice…

  18. The Movement Disorders Society criteria for the diagnosis of Parkinson's disease dementia: their usefulness and limitations in elderly patients.

    PubMed

    Kiesmann, Michèle; Chanson, Jean-Baptiste; Godet, Julien; Vogel, Thomas; Schweiger, Laetitia; Chayer, Saïd; Kaltenbach, Georges

    2013-10-01

    The aim of this study was to assess the performance of the Movement Disorders Society (MDS) criteria for the diagnosis of Parkinson's disease dementia (PDD) in the elderly, and also to evaluate the relevance of applying other tests in this patient population. The MDS criteria include a first short part in checklist form, and a second part which is used as a basis for reference and consists of an in-depth neuropsychological examination. Forty consecutive PD patients presenting with cognitive complaints were enrolled. An assessment was made of the performances of the MDS checklist compared with the MDS exhaustive cognitive examination which was used as a basis for reference, and with other cognitive tests including the Mattis Dementia Rating Scale (MDRS), the French version of the Grober and Buschke test, the verbal fluency test, the Rey-Osterreith complex figure and the paced auditory serial addition test. Out of a total of 40 PD subjects (mean age: 80.5 ± 4.9 years), 20 were diagnosed with PDD according to the checklist and 31 on the basis of the exhaustive examination, i.e. with 11 more patients diagnosed via the latter. The sensitivity of the checklist for the diagnosis of PDD was 0.64, with a specificity of 1.00. The use of the MDRS for PDD diagnosis with a cut-off at ≤ 120 showed a sensitivity of 0.80 and a specificity of 1.00, while at ≤ 132 it displayed a sensitivity of 1.00 and a specificity of 0.444. The specificity of the checklist for the diagnosis of PDD in the elderly was confirmed, but it was lacking in sensitivity. It was also found that the MDRS could be helpful in the diagnosis and screening of PDD. PMID:23835635

  19. The effects of arm movement on reaction time in patients with latent and active upper trapezius myofascial trigger point

    PubMed Central

    Yassin, Marzieh; Talebian, Saeed; Ebrahimi Takamjani, Ismail; Maroufi, Nader; Ahmadi, Amir; Sarrafzadeh, Javad; Emrani, Anita

    2015-01-01

    Background: Myofascial pain syndrome is a significant source of mechanical pain. The aim of this study was to investigate the effects of arm movement on reaction time in females with latent and active upper trapezius myofascial trigger point. Methods: In this interventional study, a convenience sample of fifteen women with one active MTP, fifteen women with one latent MTP in the upper trapezius, and fifteen normal healthy women were participated. Participants were asked to stand for 10 seconds in an erect standing position. Muscle reaction times were recorded including anterior deltoid (AD), cervical paraspinal (CP) lumbar paraspinal (LP), both of upper trapezius (UT), sternocleidomastoid (SCM) and medial head of gastrocnemius (GcM). Participants were asked to flex their arms in response to a sound stimulus preceded by a warning sound stimulus. Data were analyzed using one-way ANOVA Test. Results: There was significant differences in motor time and reaction time between active and control groups (p< 0.05) except for GcM. There was no significant difference in motor time between active and passive groups except for UT without MTP and SCM (p< 0.05). Also, there were no significant differences in motor times between latent MTP and control groups. Furthermore, there was no significant difference in premotor times between the three groups. Conclusion: The present study shows that patients with active MTP need more time to react to stimulus, but patients with latent MTP are similar to healthy subjects in the reaction time. Patients with active MTP had less compatibility with environmental stimulations, and they responded to a specific stimulation with variability in Surface Electromyography (SEMG). PMID:26913258

  20. Pediatric behavior guidance in the 21st century workshop C report - advocacy and policy.

    PubMed

    Quinonez, Rocio B; Nelson, Travis

    2014-01-01

    This report outlines a series of recommendations derived from an advocacy and policy workshop at the 2013 American Academy of Pediatric Dentistry (AAPD) Behavior Guidance Symposium. The committee charge was to address two questions: (1) what should be done to change public and media perception of behavior guidance, if anything, and: (2) what should be done to insure that needed behavior guidance techniques will be available for practicing pediatric dentists in the future. Members of the workshop voiced a wide variety of opinions and impressions of how public perception and media promotion of behavior guidance affect the practice of pediatric dentistry. A diverse assortment of strategies to promote the availability of these techniques in the future was suggested. This report will serve to inform policy and advocacy efforts by AAPD to improve children's oral health and promote excellence in patient care.

  1. To What Question(s) Is Music Education Advocacy the Answer?

    ERIC Educational Resources Information Center

    Bowman, Wayne

    2005-01-01

    Advocacy can be a useful tool. But like all tools it has its limitations and potential dangers, its proper and improper uses. Understanding the difference is critical. Advocacy and philosophy are very different processes, serving very divergent ends. Philosophy is suited poorly to advocacy's political purposes, and advocacy arguments are seldom of…

  2. 75 FR 40033 - Proposed Collection; Comment Request for Taxpayer Advocacy Panel (TAP) Tax Check Waiver

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-13

    ... Internal Revenue Service Proposed Collection; Comment Request for Taxpayer Advocacy Panel (TAP) Tax Check...(c)(2)(A)). Currently, the IRS is soliciting comments concerning Taxpayer Advocacy Panel (TAP) Tax...: Taxpayer Advocacy Panel (TAP) Tax Check Waiver. OMB Number: 1545-2092. Abstract: Taxpayer Advocacy...

  3. 45 CFR 1386.23 - Periodic reports: Protection and Advocacy System.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 4 2013-10-01 2013-10-01 false Periodic reports: Protection and Advocacy System... Advocacy of the Rights of Individuals with Developmental Disabilities § 1386.23 Periodic reports: Protection and Advocacy System. (a) By January 1 of each year the Protection and Advocacy System shall...

  4. 42 CFR 476.110 - Use of immediate advocacy to resolve oral beneficiary complaints.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Use of immediate advocacy to resolve oral... § 476.110 Use of immediate advocacy to resolve oral beneficiary complaints. (a) Immediate advocacy. A QIO may offer the option of resolving an oral complaint through the use of immediate advocacy if:...

  5. 45 CFR 1386.23 - Periodic reports: Protection and Advocacy System.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 4 2014-10-01 2014-10-01 false Periodic reports: Protection and Advocacy System... Advocacy of the Rights of Individuals with Developmental Disabilities § 1386.23 Periodic reports: Protection and Advocacy System. (a) By January 1 of each year the Protection and Advocacy System shall...

  6. 75 FR 18957 - Open Meeting of Taxpayer Advocacy Panel Notice Improvement Issue Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-13

    ... Internal Revenue Service Open Meeting of Taxpayer Advocacy Panel Notice Improvement Issue Committee AGENCY... Taxpayer Advocacy Panel Notice Improvement Issue Committee will be conducted. The Taxpayer Advocacy Panel....C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel Notice Improvement...

  7. 45 CFR 1386.23 - Periodic reports: Protection and Advocacy System.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 4 2012-10-01 2012-10-01 false Periodic reports: Protection and Advocacy System... Advocacy of the Rights of Individuals with Developmental Disabilities § 1386.23 Periodic reports: Protection and Advocacy System. (a) By January 1 of each year the Protection and Advocacy System shall...

  8. Self-Advocacy and Cancer: A Concept Analysis

    PubMed Central

    Hagan, Teresa L.; Donovan, Heidi S.

    2013-01-01

    Aim This paper is a report of an analysis of the concept of self-advocacy among individuals with cancer to clarify its meaning, to differentiate this meaning with related concepts and to unify understanding of the concept in cancer research and practice. Background Cancer survivors are increasingly required to assume an active role in their healthcare. A thorough analysis of how survivors advocate for themselves is a crucial aspect in supporting survivors’ ability to engage and manage their care throughout all stages of cancer survivorship. Design Walker and Avant’s eight-step process of conducting a concept analysis was used. Data Sources PubMed, PsycINFO and CINAHL databases were searched for articles, reviews, editorials and gray literature directly addressing self-advocacy. Review Methods A broad inquiry into the literature from 1960 – 2012 that produces a definition of self-advocacy. Model and contrary cases of self-advocacy demonstrate the concept’s application and intricacies. Results Antecedents to self-advocacy include particular personal characteristics, learned skills and attainable support. The essential element of self-advocacy and what differentiates it from related concepts, is the internalization of these antecedent resources into self-advocacy thoughts and actions while incorporating personal values and priorities in a way that upholds the survivors’ goals and beliefs. A full realization of self-advocacy facilitates a cancer survivor attaining a strong self-concept, sense of control and adaptation to a life with cancer. Conclusions Self-advocacy is a process of internalizing skills and resources to act in a way that supports survivors’ needs and goals. PMID:23347224

  9. Bowel Movement

    MedlinePlus

    A bowel movement is the last stop in the movement of food through your digestive tract. Your stool passes out ... rectum and anus. Another name for stool is feces. It is made of what is left after ...

  10. Effective citizen advocacy of beneficial nuclear technologies

    SciTech Connect

    McKibben, J. Malvyn; Wood, Susan

    2007-07-01

    In 1991, a small group of citizens from communities near the Savannah River Site (SRS) formed a pro-nuclear education and advocacy group, Citizens for Nuclear Technology Awareness (CNTA). Their purpose was to: (1) counter nuclear misinformation that dominated the nation's news outlets, (2) provide education on nuclear subjects to area citizens, students, elected officials, and (3) provide informed citizen support for potential new missions for SRS when needed. To effectively accomplish these objectives it is also essential to establish and maintain good relations with community leaders and reporters that cover energy and nuclear subjects. The organization has grown considerably since its inception and has expanded its sphere of influence. We believe that our experiences over these fifteen years are a good model for effectively communicating nuclear subjects with the public. This paper describes the structure, operation and some of the results of CNTA. (authors)

  11. Nursing advocacy for women veterans and suicide.

    PubMed

    Conard, Patricia L; Armstrong, Myrna L; Young, Cathy; Hogan, La Micha

    2015-03-01

    Little is known about suicide variables in women Veterans. The authors reviewed numerous applicable health care and military literary sources regarding suicide in this population. The current article describes the surrounding circumstances, military war/conflict culture, and potential effects on women Veterans, including major collection problems with current Veteran data. Women Veterans are increasingly reporting more behavioral health issues (e.g., posttraumatic stress disorder) and attempting suicide upon civilian reintegration. Outcomes from this literature review suggest the importance of nursing advocacy to create better rapport and communication with women Veterans from Vietnam, Gulf I, Iraq, and Afghanistan wars seeking care at civilian health facilities, as some may present with suicidal ideologies. PMID:25751826

  12. Climate Change: On Scientists and Advocacy

    NASA Technical Reports Server (NTRS)

    Schmidt, Gavin A.

    2014-01-01

    Last year, I asked a crowd of a few hundred geoscientists from around the world what positions related to climate science and policy they would be comfortable publicly advocating. I presented a list of recommendations that included increased research funding, greater resources for education, and specific emission reduction technologies. In almost every case, a majority of the audience felt comfortable arguing for them. The only clear exceptions were related to geo-engineering research and nuclear power. I had queried the researchers because the relationship between science and advocacy is marked by many assumptions and little clarity. This despite the fact that the basic question of how scientists can be responsible advocates on issues related to their expertise has been discussed for decades most notably in the case of climate change by the late Stephen Schneider.

  13. Eye Movement Dysfunction in First-Degree Relatives of Patients with Schizophrenia: A Meta-analytic Evaluation of Candidate Endophenotypes

    PubMed Central

    Calkins, Monica E.; Iacono, William G.; Ones, Deniz S.

    2015-01-01

    Several forms of eye movement dysfunction (EMD) are regarded as promising candidate endophenotypes of schizophrenia. Discrepancies in individual study results have led to inconsistent conclusions regarding particular aspects of EMD in relatives of schizophrenia patients. To quantitatively evaluate and compare the candidacy of smooth pursuit, saccade and fixation deficits in first-degree biological relatives, we conducted a set of meta-analytic investigations. Among 16 measures of EMD, memory-guided saccade accuracy and error rate, global smooth pursuit dysfunction, intrusive saccades during fixation, antisaccade error rate and smooth pursuit closed loop gain emerged as best differentiating relatives from controls (standardized mean differences ranged from .46 to .66), with no significant differences among these measures. Anticipatory saccades, but no other smooth pursuit component measures were also increased in relatives. Visually-guided reflexive saccades were largely normal. Moderator analyses examining design characteristics revealed few variables affecting the magnitude of the meta-analytically observed effects. Moderate effect sizes of relatives v. controls in selective aspects of EMD supports their endophenotype potential. Future work should focus on facilitating endophenotype utility through attention to heterogeneity of EMD performance, relationships among forms of EMD, and application in molecular genetics studies. PMID:18930572

  14. Three-dimensional morphology and bony range of movement in hip joints in patients with hip dysplasia.

    PubMed

    Nakahara, I; Takao, M; Sakai, T; Miki, H; Nishii, T; Sugano, N

    2014-05-01

    To confirm whether developmental dysplasia of the hip has a risk of hip impingement, we analysed maximum ranges of movement to the point of bony impingement, and impingement location using three-dimensional (3D) surface models of the pelvis and femur in combination with 3D morphology of the hip joint using computer-assisted methods. Results of computed tomography were examined for 52 hip joints with DDH and 73 normal healthy hip joints. DDH shows larger maximum extension (p = 0.001) and internal rotation at 90° flexion (p < 0.001). Similar maximum flexion (p = 0.835) and external rotation (p = 0.713) were observed between groups, while high rates of extra-articular impingement were noticed in these directions in DDH (p < 0.001). Smaller cranial acetabular anteversion (p = 0.048), centre-edge angles (p < 0.001), a circumferentially shallower acetabulum, larger femoral neck anteversion (p < 0.001), and larger alpha angle were identified in DDH. Risk of anterior impingement in retroverted DDH hips is similar to that in retroverted normal hips in excessive adduction but minimal in less adduction. These findings might be borne in mind when considering the possibility of extra-articular posterior impingement in DDH being a source of pain, particularly for patients with a highly anteverted femoral neck.

  15. Three-dimensional localization of SMA activity preceding voluntary movement. A study of electric and magnetic fields in a patient with infarction of the right supplementary motor area.

    PubMed

    Lang, W; Cheyne, D; Kristeva, R; Beisteiner, R; Lindinger, G; Deecke, L

    1991-01-01

    Previous studies by magnetoencephalography (MEG) failed to consistently localize the activity of the supplementary motor area (SMA) prior to voluntary movements in healthy human subjects. Based on the assumption that the SMA of either hemisphere is active prior to voluntary movements, the negative findings of previous studies could be explained by the hypothesis that magnetic fields of current dipole sources in the two SMAs may cancel each other. The present MEG study was performed in a patient with a complete vascular lesion of the right SMA. In this case it was possible to consistently localize a current dipole source in the intact left SMA starting about 1200 msec prior to the initiation of voluntary movements of the right thumb. Starting at about 600 msec prior to movement onset the assumption of a current dipole source in the left primary motor cortex was needed to account for the observed fields. Measurements of brain potentials were consistent with MEG findings of activity of the left SMA starting about 1200 msec prior to movement onset.

  16. Advocacy for strengthening civil registration and vital statistics.

    PubMed

    Upham, Susan; Mikkelsen, Lene

    2012-04-01

    This article has presented the key elements of the advocacy process and the steps to consider in developing an advocacy campaign. There are compelling reasons for engaging in advocacy, particularly as civil registration systems in many countries have progressed very little over the past 50 years. Lack of awareness of the benefits for individuals and governments has contributed to a vicious cycle of under development of civil registration and vital statistics systems. Advocates are needed across a range of sectors to persuade governments to make CRVS a priority and to work towards a greater political commitment and allocation of resources for establishing and improving systems. Advocating for better legal frameworks and policies that fully support a functioning and well-used CRVS system is needed. A selection of tools and resources has been included in this module to get you started in advocating for improvements in your CRVS system. Box 4 summarises some key considerations when developing your advocacy campaign.

  17. Vocational Rehabilitation Counseling and Advocacy: An Analysis of Dissonant Concepts.

    ERIC Educational Resources Information Center

    Murphy, Stephen T.

    1980-01-01

    The article identifies and discusses the inherent differences that exist between vocational rehabilitation practice and client advocacy for the handicapped, and provides some recommendations as to how rehabilitation professionals may legitimately serve as advocates for handicapped persons. (DLS)

  18. Handicapped Infants and Euthanasia: A Challenge to Our Advocacy.

    ERIC Educational Resources Information Center

    Smith, J. David

    1985-01-01

    The issue of pediatric euthanasia for handicapped newborns is examined and contrasting viewpoints emphasizing the quality and the sanctity of life are considered. The author asserts that advocacy for handicapped children involves decisions regarding the euthanasia question. (CL)

  19. An exploratory study of HIV-prevention advocacy by persons in HIV care in Uganda

    PubMed Central

    Tumwine, Christopher; Nannungi, Annet; Ssegujja, Eric; Nekesa, Nicolate; Ssali, Sarah; Atuyambe, Lynn; Ryan, Gery; Wagner, Glenn

    2013-01-01

    To explore how people living with HIV (PLHIV) and in care encourage others to adopt HIV-protective behaviours, we conducted in-depth interviews with a purposive sample of 40 HIV clinic patients in Kampala, Uganda. Content analysis was used to examine the message content, trigger events, and outcomes of HIV-prevention advocacy events initiated by the HIV clients with members of their social networks. The content themes included encouraging specific behaviours, such as HIV testing and treatment, condom use and non-promiscuity, as well as more general cautionary messages about protecting oneself from HIV infection. Common triggers for bringing up HIV-prevention advocacy information in a discussion or conversation included: wanting to prevent the targeted person from ‘falling into the same problems,’ wanting to benefit oneself with regard to avoiding re-infection, out of concern that the target would engage in higher-risk behaviour, due to observed changes in the target’s health, and to convey information after receiving treatment at the clinic. The participants mostly reported positive or neutral responses to these advocacy events; negative responses were rare. Interventions to empower PLHIV to be agents of change could represent a new frontier for HIV prevention. PMID:24910590

  20. Movement - uncontrolled or slow

    MedlinePlus

    Dystonia; Involuntary slow and twisting movements; Choreoathetosis; Leg and arm movements - uncontrollable; Arm and leg movements - uncontrollable; Slow involuntary movements of large muscle groups; Athetoid movements

  1. [Stereotypic movements].

    PubMed

    Fernández-Alvarez, E

    2003-02-01

    Stereotypic movements are repetitive patterns of movement with certain peculiar features that make them especially interesting. Their physiopathology and their relationship with the neurobehavioural disorders they are frequently associated with are unknown. In this paper our aim is to offer a simple analysis of their dominant characteristics, their differentiation from other processes and a hypothesis of the properties of stereotypic movements, which could all set the foundations for research work into their physiopathology.

  2. American Science Advocacy Organizations: Examining Their Strategies and Engagements with Religion

    NASA Astrophysics Data System (ADS)

    Rodriguez, Jason T.

    Over the past several decades, science advocacy organizations have increasingly participated in discussions of the relationship between science and religion to the public, mainly to counteract the resurgence of anti-evolution activities across the country, to address misconceptions and misunderstandings about science and religion, and to help make science more palatable and less threatening to religious believers. These engagements with religion have primarily involved four organizations: the American Association for the Advancement of Science (AAAS), the National Academy of Sciences (NAS), the National Center for Science Education (NCSE), and the Smithsonian National Museum of Natural History (SNMNH). In their engagements with religion, each of these organizations has simultaneously employed two distinct lines of operation: (1) defending science against anti-science religions and movements and (2) engaging science-friendly religions and the religious public. These lines of operation are driven by key objectives and supported by specific strategies and tactics to achieve those objectives, which this paper seeks to explore and analyze. Key findings and recommendations for science advocacy organizations' ongoing and future engagements with religion are provided.

  3. Effectiveness of applying continuous positive airway pressure in a patient with paradoxical vocal fold movement after endotracheal extubation: a case report

    PubMed Central

    Song, Keu La Me; Ko, Dong Chan; Pin, Jung Woo; Ryu, Kyong Ho; Kim, Hyun Soo

    2016-01-01

    Paradoxical vocal fold movement (PVFM) is an uncommon upper airway disorder defined as paradoxical adduction of the vocal folds during inspiration. The etiology and treatment of PVFM are unclear. The physician should manage this condition because of the possibility of near complete airway obstruction in severe case of PVFM. We report a case of successful airway management in a patient with PVFM by applying continuous positive airway pressure (CPAP). In this case, PVFM was detected after removing an endotracheal tube from a 67-year-old male who underwent excision of a laryngeal mass. The patient recovered without complications in 1 day with support by CPAP. PMID:26885309

  4. Does fear of movement mediate the relationship between pain intensity and disability in patients following whiplash injury? A prospective longitudinal study.

    PubMed

    Kamper, Steven J; Maher, Christopher G; Menezes Costa, Luciola da C; McAuley, James H; Hush, Julia M; Sterling, Michele

    2012-01-01

    The aim of this study was to test the capacity of the Fear Avoidance Model to explain the relationship between pain and disability in patients with whiplash-associated disorders. Using the method of Baron and Kenny, we assessed the mediating effect of fear of movement on the cross-sectional and longitudinal relationships between pain and disability. Two hundred and five subjects with neck pain due to a motor vehicle accident provided pain intensity (0 to 10 numerical rating scale), fear of movement (Tampa Scale of Kinesiophobia and Pictorial Fear of Activity Scale) and disability (Neck Disability Index) scores within 4 weeks of their accident, after 3 months, and after 6 months. The analyses were consistent with the Fear Avoidance Model mediating approximately 20% to 40% of the relationship between pain and disability. Contrary to our initial hypothesis, the proportion of the total effect of pain on disability that was mediated by fear of movement did not substantially change as increasing time elapsed after the accident. The proportion mediated was slightly higher when fear of movement was measured by Tampa Scale of Kinesiophobia as compared with Pictorial Fear of Activity Scale. The findings of this study suggest that the Fear Avoidance Model plays a role in explaining a moderate proportion of the relationship between pain and disability after whiplash injury.

  5. Clearing the airways: advocacy and regulation for smoke-free airlines

    PubMed Central

    Holm, A; Davis, R

    2004-01-01

    Objective: To examine the advocacy and regulatory history surrounding bans on smoking in commercial airliners. Methods: Review of historical documents, popular press articles, and other sources to trace the timeline of events leading up to the US ban on smoking in airliners and subsequent efforts by airlines and other nations. Results: In early years, efforts by flight attendants and health advocates to make commercial airliners smoke-free were not productive. Advocacy efforts between 1969 and 1984 resulted in maintenance of the status quo, with modest exceptions (creation of smoking and non-smoking sections of aircraft, and a ban on cigar and pipe smoking). Several breakthrough events in the mid 1980s, however, led to an abrupt turnaround in regulatory efforts. The first watershed event was the publication in 1986 of the National Academy of Science's report on the airliner cabin environment, which recommended banning smoking on all commercial flights. Subsequently, following concerted lobbying efforts by health advocates, Congress passed legislation banning smoking on US domestic flights of less than two hours, which became effective in 1988. The law was made permanent and extended to flights of less than six hours in 1990. This landmark legislation propelled the adoption of similar rules internationally, both by airlines and their industry's governing bodies. Though the tobacco industry succeeded in stalling efforts to create smoke-free airways, it was ultimately unable to muster sufficient grassroots support or scientific evidence to convince the general public or policymakers that smoking should continue to be allowed on airlines. Conclusions: The movement to ban smoking in aircraft represents a case study in effective advocacy for smoke-free workplaces. Health advocates, with crucial assistance from flight attendants, used an incremental advocacy process to push for smoking and non-smoking sections on US commercial flights, then for smoking bans on short

  6. fMRI evidence of improved visual function in patients with progressive retinitis pigmentosa by eye-movement training.

    PubMed

    Yoshida, Masako; Origuchi, Maki; Urayama, Shin-Ichi; Takatsuki, Akira; Kan, Shigeyuki; Aso, Toshihiko; Shiose, Takayuki; Sawamoto, Nobukatsu; Miyauchi, Satoru; Fukuyama, Hidenao; Seiyama, Akitoshi

    2014-01-01

    To evaluate changes in the visual processing of patients with progressive retinitis pigmentosa (RP) who acquired improved reading capability by eye-movement training (EMT), we performed functional magnetic resonance imaging (fMRI) before and after EMT. Six patients with bilateral concentric contraction caused by pigmentary degeneration of the retina and 6 normal volunteers were recruited. Patients were given EMT for 5 min every day for 8-10 months. fMRI data were acquired on a 3.0-Tesla scanner while subjects were performing reading tasks. In separate experiments (before fMRI scanning), visual performances for readings were measured by the number of letters read correctly in 5 min. Before EMT, activation areas of the primary visual cortex of patients were 48.8% of those of the controls. The number of letters read correctly in 5 min was 36.6% of those by the normal volunteers. After EMT, the activation areas of patients were not changed or slightly decreased; however, reading performance increased in 5 of 6 patients, which was 46.6% of that of the normal volunteers (p< 0.05). After EMT, increased activity was observed in the frontal eye fields (FEFs) of all patients; however, increases in the activity of the parietal eye fields (PEFs) were observed only in patients who showed greater improvement in reading capability. The improvement in reading ability of the patients after EMT is regarded as an effect of the increased activity of FEF and PEF, which play important roles in attention and working memory as well as the regulation of eye movements. PMID:25068106

  7. Parents' perception of self-advocacy of children with myositis: an anonymous online survey

    PubMed Central

    2011-01-01

    Background Children with complex medical issues experience barriers to the transition of care from pediatric to adult providers. We sought to identify these barriers by elucidating the experiences of patients with idiopathic inflammatory muscle disorders. Methods We collected anonymous survey data using an online website. Patients and their families were solicited from the US and Canada through established clinics for children with idiopathic inflammatory muscle diseases as well as with the aid of a nonprofit organization for the benefit of such individuals. The parents of 45 older children/young adults suffering from idiopathic inflammatory muscle diseases were surveyed. As a basis of comparison, we similarly collected data from the parents of 207 younger children with inflammatory muscle diseases. The survey assessed transition of care issues confronting families of children and young adults with chronic juvenile myositis. Results Regardless of age of the patient, respondents were unlikely to have a designated health care provider assigned to aid in transition of care and were unlikely to be aware of a posted policy concerning transition of care at their pediatrician's office. Additionally, regardless of age, patients and their families were unlikely to have a written plan for moving to adult care. Conclusions We identified deficiencies in the health care experiences of families as pertain to knowledge, self-advocacy, policy, and vocational readiness. Moreover, as children with complex medical issues grow up, parents attribute less self-advocacy to their children's level of independence. PMID:21649897

  8. The effects of total contact insole with forefoot medial posting on rearfoot movement and foot pressure distributions in patients with flexible flatfoot.

    PubMed

    Tang, Simon Fuk-Tan; Chen, Chien-Hung; Wu, Chih-Kuan; Hong, Wei-Hsien; Chen, Kuan-Jung; Chen, Chih-Kuang

    2015-02-01

    The purpose of this study is to evaluate the therapeutic effect of total contact insole with forefoot medial posting (TCIFMP) orthosis in patients with flexible flatfoot. The TCIFMP insole was custom- mode, made from semi-rigid plastazote and PPT. Using the gait analysis and the plantar-pressure measure systems, we investigate rearfoot motion and plantar pressure redistribution in these patients. The results of this study showed that the excessive valgus movement of the rearfoot can be reduced significantly by the TCIFMP insole in these patients. Besides, there were significant decreases in the peak pressure under the toe, lateral metatarsal, lateral foot and heel areas. Therefore, we suggested that the TCIFMP insole is an effective orthotic device for rearfoot motion control, plantar pressure reduction and re-distribution in patients with flexible flatfoot.

  9. Patient's Bill of Rights Act 1998.

    PubMed

    Fisher, P S

    1999-01-01

    For nurses, patient advocacy has always been a responsibility of practice. Advocacy is rooted in the concept of individual rights. Consumers of the product of health care now have increased protection because of the Patients' Bill of Rights Act of 1998. Legislation has created a template to outline important rights and processes to assure quality health care.

  10. SaludableOmaha: Development of a Youth Advocacy Initiative to Increase Community Readiness for Obesity Prevention, 2011–2012

    PubMed Central

    Frerichs, Leah; Brittin, Jeri; Stewart, Catherine; Robbins, Regina; Riggs, Cara; Mayberger, Susan; Cervantes, Alberto

    2012-01-01

    Background Childhood obesity rates in minority populations continue to rise despite leveling national trends. Although interventions that address social and environmental factors exist, processes that create demand for policy and environmental change within communities have not been identified. Community Context We developed a pilot program in South Omaha, a Nebraska Latino community, based on the community readiness model (CRM), called SaludableOmaha. We used CRM to explore the potential of youth advocacy to shift individual and community norms regarding obesity prevention in South Omaha and to advocate for health-promoting community environments. Methods We used CRM to assess supply and demand for health programs, engage the community, determine the community’s baseline readiness to address childhood obesity, and guide youth advocacy program development. We conducted our project in 2 phases. In the first, we trained a cohort of youth. In the second, the youth cohort created and launched a Latino health movement, branded as SaludableOmaha. A third phase, which is currently under way, is directed at institutionalizing youth advocacy in communities. Outcome At baseline, the community studied was at a low stage of readiness for change. Our program generated infrastructure and materials to support the growth and institutionalization of youth advocacy as a means of increasing community readiness for addressing obesity prevention. Interpretation CRM is an important tool for addressing issues such as childhood obesity in underserved communities because it provides a framework for matching interventions to the community. Community partnerships such as SaludableOmaha can aid the adoption of obesity prevention programs. PMID:23217590

  11. Individual rights advocacy in tobacco control policies: an assessment and recommendation

    PubMed Central

    Katz, J

    2005-01-01

    Efforts to control environmental tobacco smoke (ETS) could be assisted if the tobacco control movement gave greater emphasis to the issue of individual rights. Benefits that may accrue from the promotion of a clear individual rights perspective in tobacco control include adding coherence to the tobacco control advocacy agenda and winning support from those who may have been concerned about loss of personal freedom, excessive governmental power, use of social coercion, or the rights of smokers. Risks also attend to such a policy. It might inadvertently assist the tobacco industry, stir resistance to ETS limitation efforts, or confuse tobacco control supporters. On balance, though, liabilities are outweighed by the ethical and operational merits in tobacco control of a heightened pro-individual rights stance. PMID:16046700

  12. The challenge of evaluating complex interventions: a framework for evaluating media advocacy.

    PubMed

    Stead, Martine; Hastings, Gerard; Eadie, Douglas

    2002-06-01

    New health promotion and public health approaches such as media advocacy pose particular evaluation challenges. Evaluation is important to provide feedback to media advocacy practitioners on how to enhance their efforts, and to funders and researchers seeking to assess media advocacy's effectiveness as a health promotion strategy. The media advocacy evaluation literature contains some examples of promising evaluation approaches but is still evolving. A comprehensive framework for the evaluation of media advocacy is presented. Building on existing approaches to evaluation in media advocacy and on current thinking regarding evaluation in health promotion, it proposes a series of indicators and research methods for evaluating media advocacy at the levels of formative, process and outcome evaluation. The framework can be used to encourage strategic reflection on the media advocacy process, to guide evaluation of specific interventions, and to demonstrate to funders the importance and complexity of evaluation in this promising field.

  13. 77 FR 55525 - Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-10

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project... meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee will be conducted....

  14. 77 FR 2611 - Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-18

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project... meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee will be conducted....

  15. 77 FR 37101 - Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-20

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project... meeting of the Taxpayer Advocacy Panel Bankruptcy Compliance Project Committee will be conducted....

  16. 78 FR 11277 - Open Meeting of the Taxpayer Advocacy Panel Taxpayer Communications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-15

    ...An open meeting of the Taxpayer Advocacy Panel Taxpayer Communications Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and suggestions on improving customer service at the Internal Revenue...

  17. 77 FR 21158 - Open Meeting of the Taxpayer Advocacy Panel Refund Processing Communications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-09

    ...An open meeting of the Taxpayer Advocacy Panel Refund Processing Communications Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and suggestions on improving customer service at the Internal Revenue...

  18. 76 FR 77892 - Open Meeting of the Taxpayer Advocacy Panel Refund Processing Communications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-14

    ...An open meeting of the Taxpayer Advocacy Panel Refund Processing Communications Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and suggestions on improving customer service at the Internal Revenue...

  19. 78 FR 69940 - Open Meeting of the Taxpayer Advocacy Panel Taxpayer Communications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-21

    ...An open meeting of the Taxpayer Advocacy Panel Taxpayer Communications Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and suggestions on improving customer service at the Internal Revenue...

  20. 77 FR 61053 - Open Meeting of the Taxpayer Advocacy Panel Refund Processing Communications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-05

    ...An open meeting of the Taxpayer Advocacy Panel Refund Processing Communications Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and suggestions on improving customer service at the Internal Revenue...

  1. 77 FR 8327 - Open Meeting of the Taxpayer Advocacy Panel Refund Processing Communications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-14

    ...An open meeting of the Taxpayer Advocacy Panel Refund Processing Communications Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and suggestions on improving customer service at the Internal Revenue...

  2. 78 FR 48230 - Open Meeting of the Taxpayer Advocacy Panel Taxpayer Communications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-07

    ...An open meeting of the Taxpayer Advocacy Panel Taxpayer Communications Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and suggestions on improving customer service at the Internal Revenue...

  3. 78 FR 15125 - Open Meeting of the Taxpayer Advocacy Panel Taxpayer Communications Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-08

    ...An open meeting of the Taxpayer Advocacy Panel Taxpayer Communications Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and suggestions on improving customer service at the Internal Revenue...

  4. 77 FR 21157 - Internal Revenue Service; Open Meeting of the Taxpayer Advocacy Panel Refund Processing...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-09

    ...An open meeting of the Taxpayer Advocacy Panel Refund Processing Communications Project Committee will be conducted. The Taxpayer Advocacy Panel is soliciting public comments, ideas, and suggestions on improving customer service at the Internal Revenue...

  5. A multimedia electronic patient record (ePR) system to improve decision support in pre- and rehabilitation through clinical and movement analysis

    NASA Astrophysics Data System (ADS)

    Liu, Brent; Documet, Jorge; McNitt-Gray, Sarah; Requejo, Phil; McNitt-Gray, Jill

    2011-03-01

    Clinical decisions for improving motor function in patients both with disability as well as improving an athlete's performance are made through clinical and movement analysis. Currently, this analysis facilitates identifying abnormalities in a patient's motor function for a large amount of neuro-musculoskeletal pathologies. However definitively identifying the underlying cause or long-term consequences of a specific abnormality in the patient's movement pattern is difficult since this requires information from multiple sources and formats across different times and currently relies on the experience and intuition of the expert clinician. In addition, this data must be persistent for longitudinal outcomes studies. Therefore a multimedia ePR system integrating imaging informatics data could have a significant impact on decision support within this clinical workflow. We present the design and architecture of such an ePR system as well as the data types that need integration in order to develop relevant decision support tools. Specifically, we will present two data model examples: 1) A performance improvement project involving volleyball athletes and 2) Wheelchair propulsion evaluation of patients with disabilities. The end result is a new frontier area of imaging informatics research within rehabilitation engineering and biomechanics.

  6. Movement - uncoordinated

    MedlinePlus

    Lack of coordination; Loss of coordination; Coordination impairment; Ataxia; Clumsiness; Uncoordinated movement ... are passed through families (such as congenital cerebellar ataxia, Friedreich ataxia , ataxia - telangiectasia , or Wilson disease ) Multiple ...

  7. Psychogenic Movement

    MedlinePlus

    ... also look for marked improvement in symptoms following psychotherapy, use of a placebo (a medicine with no ... multi-therapy approach to treating psychogenic movement includes psychotherapy, placebo, or suggestion; antidepressants for symptoms related to ...

  8. International Dengue Vaccine Communication and Advocacy: Challenges and Way Forward.

    PubMed

    Carvalho, Ana; Van Roy, Rebecca; Andrus, Jon

    2016-01-01

    Dengue vaccine introduction will likely occur soon. However, little has been published on international dengue vaccine communication and advocacy. More effort at the international level is required to review, unify and strategically disseminate dengue vaccine knowledge to endemic countries' decision makers and potential donors. Waiting to plan for the introduction of new vaccines until licensure may delay access in developing countries. Concerted efforts to communicate and advocate for vaccines prior to licensure are likely challenged by unknowns of the use of dengue vaccines and the disease, including uncertainties of vaccine impact, vaccine access and dengue's complex pathogenesis and epidemiology. Nevertheless, the international community has the opportunity to apply previous best practices for vaccine communication and advocacy. The following key strategies will strengthen international dengue vaccine communication and advocacy: consolidating existing coalitions under one strategic umbrella, urgently convening stakeholders to formulate the roadmap for integrated dengue prevention and control, and improving the dissemination of dengue scientific knowledge.

  9. Evaluating Human Rights Advocacy on Criminal Justice and Sex Work.

    PubMed

    Amon, Joseph; Wurth, Margaret; McLemore, Megan

    2015-06-11

    Between October 2011 and September 2013, we conducted research on the use, by police and/or prosecutors, of condom possession as evidence of intent to engage in prostitution-related offenses. We studied the practice in five large, geographically diverse cities in the U.S. To facilitate our advocacy on this issue, conducted concurrent to and following our research, we developed an advocacy framework consisting of six dimensions: (1) raising awareness, (2) building and engaging coalitions, (3) framing debate, (4) securing rhetorical commitments, (5) reforming law and policy, and (6) changing practice. Using a case study approach, we describe how this framework also provided a basis for the evaluation of our work, and discuss additional considerations and values related to the measurement and evaluation of human rights advocacy.

  10. Engaging health professionals in advocacy against gun violence.

    PubMed

    Pinto, Andrew D

    2008-01-01

    Health professionals have long been involved with advocacy around the social determinants of health, including protesting against war and mitigating the production, trade and use of specific weapon systems. Small arms and light weapons are a key area on which to focus, as they are responsible for the majority of injuries and deaths in war and their availability is related to increased levels of crime and suicide. Challenges for health professionals hoping to engage in such advocacy include a lack of adequate data, the need to confront political questions and the gun-lobby, and difficulty in measuring the effectiveness of campaigns. This article discusses some examples of successful advocacy and suggests future directions for health professionals in this area.

  11. International Dengue Vaccine Communication and Advocacy: Challenges and Way Forward.

    PubMed

    Carvalho, Ana; Van Roy, Rebecca; Andrus, Jon

    2016-01-01

    Dengue vaccine introduction will likely occur soon. However, little has been published on international dengue vaccine communication and advocacy. More effort at the international level is required to review, unify and strategically disseminate dengue vaccine knowledge to endemic countries' decision makers and potential donors. Waiting to plan for the introduction of new vaccines until licensure may delay access in developing countries. Concerted efforts to communicate and advocate for vaccines prior to licensure are likely challenged by unknowns of the use of dengue vaccines and the disease, including uncertainties of vaccine impact, vaccine access and dengue's complex pathogenesis and epidemiology. Nevertheless, the international community has the opportunity to apply previous best practices for vaccine communication and advocacy. The following key strategies will strengthen international dengue vaccine communication and advocacy: consolidating existing coalitions under one strategic umbrella, urgently convening stakeholders to formulate the roadmap for integrated dengue prevention and control, and improving the dissemination of dengue scientific knowledge. PMID:26855170

  12. 76 FR 17995 - Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-31

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project... meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will be conducted. The...) that an open meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will...

  13. 76 FR 56879 - Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-14

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project... meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will be conducted. The....C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit...

  14. 75 FR 10864 - Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Issue Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-09

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Issue... meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Issue Committee will be conducted. The...) that a meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Issue Committee will be held...

  15. 75 FR 18955 - Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-13

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project... meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will be conducted. The...) that an open meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will...

  16. 75 FR 33894 - Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-15

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project... meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will be conducted. The...) that an open meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will...

  17. 76 FR 2196 - Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-12

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance... open meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Project Committee will be....C. App. (1988) that a meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance...

  18. 76 FR 63716 - Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-13

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project... meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will be conducted. The....C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit...

  19. 75 FR 7540 - Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Issue Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-19

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Issue... meeting of the Taxpayer Advocacy Panel Volunteer ] Income Tax Issue Committee will be conducted. The...) that a meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Issue Committee will be held...

  20. 76 FR 45006 - Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-27

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project... meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will be conducted. The.... (1988) that an open meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project...

  1. 75 FR 7540 - Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-19

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project... meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will be conducted. The...) that an open meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will...

  2. 76 FR 10942 - Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-28

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance... meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Project Committee will be conducted....C. App. (1988) that a meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance...

  3. 75 FR 25316 - Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project... meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will be conducted. The...) that an open meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will...

  4. 75 FR 39332 - Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Issue Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-08

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Issue... meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Issue Committee will be conducted. The.... (1988) that a meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Issue Committee will be...

  5. 76 FR 17996 - Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-31

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance... open meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Project Committee will be... Advocacy Panel Volunteer Income Tax Assistance Project Committee will be held Wednesday, May 18, 2011...

  6. 75 FR 11998 - Open meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Issue Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-12

    ... Internal Revenue Service Open meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Issue... meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Issue Committee will be conducted. The... Act, 5 U.S.C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel Earned Income Tax...

  7. 75 FR 18955 - Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Issue Committee.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-13

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Issue... open meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Issue Committee will be... Act, 5 U.S.C. App. (1988) that an open meeting of the Taxpayer Advocacy Panel Volunteer Income...

  8. 75 FR 47348 - Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Issue Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-05

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Issue... meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Issue Committee will be conducted. The.... (1988) that a meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Issue Committee will be...

  9. 76 FR 32021 - Open meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-02

    ... Internal Revenue Service Open meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance... open meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Project Committee will be....C. App. (1988) that a meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance...

  10. 76 FR 6189 - Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-03

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance... open meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Project Committee will be....C. App. (1988) that a meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance...

  11. 76 FR 22171 - Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-20

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance... open meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Project Committee will be....C. App. (1988) that a meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance...

  12. 76 FR 37199 - Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project... meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will be conducted. The...) that an open meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will...

  13. 75 FR 33895 - Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Issue Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-15

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Issue... meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Issue Committee will be conducted. The...) that a meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Issue Committee will be held...

  14. 76 FR 22171 - Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-20

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project... meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will be conducted. The...) that an open meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will...

  15. 76 FR 63716 - Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-13

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance... open meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Project Committee will be....C. App. (1988) that a meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance...

  16. 75 FR 47349 - Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-05

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project... meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will be conducted. The.... (1988) that an open meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project...

  17. 75 FR 4140 - Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-26

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project... meeting of the Taxpayer Advocacy Panel Earned ] Income Tax Credit Project Committee will be conducted. The...) that an open meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will...

  18. 75 FR 39333 - Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-08

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project... meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will be conducted. The...) that an open meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will...

  19. 75 FR 55406 - Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Issue Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-10

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Assistance Issue... meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Issue Committee will be conducted. The.... (1988) that a meeting of the Taxpayer Advocacy Panel Volunteer Income Tax Issue Committee will be...

  20. 76 FR 32024 - Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-02

    ... Internal Revenue Service Open Meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project... meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will be conducted. The...) that an open meeting of the Taxpayer Advocacy Panel Earned Income Tax Credit Project Committee will...