This document discusses the role of speech-language pathologists in assessing and treating traumatic brain injury (TBI). It notes that TBI affects over 1.7 million people annually in the US and costs $76 billion per year. Children are particularly vulnerable to TBI. The document outlines common types of brain injuries and describes tools used to measure TBI severity, such as the Glasgow Coma Scale. It discusses dysphagia associated with TBI and assessment/treatment approaches. The roles and responsibilities of SLPs are provided, along with information on cognitive-communication deficits post-TBI and evidence-based treatment strategies.
Auditory brainstem response (ABR)
Approximately 1 of every 1000 children is born deaf. Many more are born with less severe degrees of hearing impairment, while others may acquire hearing loss during early childhood.
combination of technological advances in ABR and otoacoustic emissions (OAE) testing methods are used for evaluation of hearing in newborns.
An electroencephalogram (EEG) is a test used to evaluate the electrical activity in the brain. Brain cells communicate with each other through electrical impulses. An EEG can be used to help detect potential problems associated with this activity.
Auditory brainstem response (ABR)
Approximately 1 of every 1000 children is born deaf. Many more are born with less severe degrees of hearing impairment, while others may acquire hearing loss during early childhood.
combination of technological advances in ABR and otoacoustic emissions (OAE) testing methods are used for evaluation of hearing in newborns.
An electroencephalogram (EEG) is a test used to evaluate the electrical activity in the brain. Brain cells communicate with each other through electrical impulses. An EEG can be used to help detect potential problems associated with this activity.
Electroencephalography (eeg),electrical activity recorded via electrodes on the scalp,Neurophysiological Basis of EEG,Scalp EEG Recordings,Wearable EEG Devices,Recording EEG Signals,EEG Rhythms,
u can read in this PPT about Audiometer , types of audiometer and parts of audiometer.
hope this ppt will help you. u can suggest me through mail , my maild is anantarun27@gmail.com
Neurodevelopmental Treatment and Cerebral Palsy- Researchda5884
An alternative description of my Critically Appraised Topic on Neurodevelopmental treatment when used on children with cerebral palsy. This presentation focuses more on the process of the research.
Electroencephalography (eeg),electrical activity recorded via electrodes on the scalp,Neurophysiological Basis of EEG,Scalp EEG Recordings,Wearable EEG Devices,Recording EEG Signals,EEG Rhythms,
u can read in this PPT about Audiometer , types of audiometer and parts of audiometer.
hope this ppt will help you. u can suggest me through mail , my maild is anantarun27@gmail.com
Neurodevelopmental Treatment and Cerebral Palsy- Researchda5884
An alternative description of my Critically Appraised Topic on Neurodevelopmental treatment when used on children with cerebral palsy. This presentation focuses more on the process of the research.
Responding to Mental Health Needs of HIV-Positive Pediatric Patients in Resou...jehill3
Responding to Mental Health Needs of HIV-Positive Pediatric Patients in Resource-Poor Communities
Vicki Tepper, University of Maryland School of Medicine
CORE Group Spring Meeting, April 29, 2010
Educational needs for Children with EpilepsyA.J. Lawrence
In order to make well thought out decisions for children with epilepsy, it is necessary to acknowledge all objective data including scores from testing, observations, outside therapists, history, emotional and personality variables, family and school data. One must pay close attention to their child and look for early signs of epilepsy in order to address specific educational needs and prevent hindered development.
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KEYNOTE abstract by professor Sally Rogers (UC Davis MIND Institute, Sacramento) titled 'How malleable is autism? Outcome studies from the youngest children with ASD', held at the ESCAP 2015 Congress in Madrid, Monday June 22nd 2015
According to the World Health Organization, mental health is defined as “a state of well-being in which every individual realizes his or her own potential, can cope with the normal stress of life, can work productively and fruitfully, and is able to make a contribution to her or his community.”
This presentation is to be paired with the TBI Learning Module: Children with Traumatic Brain Injury apart of the West Virginia State Traumatic Brain Injury Program.
This slide is for the Community Integration After TBI training for the WV TBI program at the Center for Excellence in Disabilities at West Virginia University.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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The Role of the Speech Language Pathologist in the Assessment & Treatment of TBI
1. The Role of the Speech-
Language Pathologist in
the Assessment &
Treatment of TBI
Cassaundra N. Miller, MS, CCC/SLP
West Virginia University Center for Excellence in Disabilities
2. According to the CDC…..
1.7 million people sustain a TBI every year
TBI is a factor in 30% of injury-related deaths
Medical costs for TBI total $76 billion a year
3. Children and TBI
Half a million ED visits yearly for ages birth-14 years
Children under 4 year at highest risk
Limited insight into impact on adult milestones
History of childhood TBI results in lower educational
attainment & higher incarceration rates
Difficulty accessing appropriate services
5. According to The American Speech Language Hearing
Association’s (ASHA) Evidence Map for Pediatric Brain Injury…
“SLPs and medical specialists are essential for
the management of speech, language, and
swallowing disorders, and should be referred
during the acute stage.”
6. Roles and Responsibilities of the SLP
Screenings
Comprehensive evaluations
Development & implementation of treatment
Counseling regarding SLP specific impairments
Collaboration with interdisciplinary team
Knowledgeable on recent research
Advocating
Risk management & quality control
8. Loss of Consciousness (LOC)
TBI Classification Coma Duration
Mild < 20 minutes
Moderate < 6 hours
Severe > 6 hours after admission
9. Glasgow Coma Scale (GSC)
“Cornerstone of physical examination”
Consistent, numeric way to describe TBI
Guides initial treatment
Monitors responsiveness
Modified Pediatric Glasgow Coma Scale for children under age 5
Glasgow Coma Scale-Pupils Score developed in 2018 and includes
Pupil Reactivity Score
10. Glasgow Coma Scale Scoring
Eye Opening Response Verbal Response Motor Response
Spontaneous 4 pts Oriented 5 pts Obeys commands 6 pts
To verbal stim 3 pts Confused, but answers
questions
4 pts Purposeful movement in
response to pain
5 pts
To pain only 2 pts Inappropriate words 3 pts Withdraws from pain 4 pts
No response 1 pt Incomprehensible 2 pts Flexion in response to pain 3 pts
No response 1 pt Extension in response to pain 2 pts
No response 1 pt
11. Glasgow Coma Scale Severity Ratings
Glasgow Score Severity Rating
13 to 15 Mild
9 to 12 Moderate
8 or less Severe
12. Post-Traumatic Amnesia
Impaired recall of events surrounding TBI
Time surrounding a TBI that patient is
confused
Assessed by orientation
Longer period of confusion associated with
worse immediate outcomes & slower
recovery
13. RANCHO LOS AMIGOS
Scale of Cognitive Functioning
Measures & identifies recovery patterns of TBI
No specific training
Administered multiple times throughout recovery
Insight into executive functioning, behavior, and
safety awareness
Impacts treatment and discharge planning
14. Rancho Level Behavior Description
I No response
II Generalized response, non-purposeful
III Localized Response, purposeful
IV Confused, agitated, aggressive
V Confused, inappropriate, highly distractible
VI Confused, appropriate, severe memory difficulties
VII Automatic, appropriate, lacking insight
VIII Purposeful, oriented, decreased premorbid reasoning
15.
16. Dysphagia & TBI
Dysphagia occurs in
33% of patients with
TBI
60% of patients with
severe TBI have
dysphagia
Relationship
between…
Length of coma
Tracheostomy tube/
ventilator
Severity of
dysphagia
17. Tracheostomy Tube
Tube inserted into stoma in
neck
Assists with breathing
Can be used with or without
ventilator
Speaking valve allows talking
Eating can occur
21. Fiberoptic Endoscopic
Evaluation of Swallow
Flexible scope passed
through the nose
Camera with light
attached to the scope
Can be performed most
patients
Short whiteout period
24. Diet Modifications
Solids and liquids are modified
for safety
Helps to decrease fatigue
Reduces aspiration risk
Previously based on National
Dysphagia Diet
Moving towards IDDSI
25. Alternative Nutrition
Not all patients can
tolerate food by
mouth
Very impaired
swallow
Decreased
arousal level
On ventilator
Alternative
Nutrition Methods
TPN
NG tube
G tube
Mixed
29. Pediatric Specific Testing
Pediatric Test of Brain Injury
Only standardized pediatric
assessment for brain injury
FAVRES
Adolescent specific portion
CELF-5
Includes metalinguistic component
30.
31. Speech & Language Deficits
in Patients with TBI
Expressive Language
Receptive Language
Reading & Writing
Pragmatics/Social Language
32. Discourse Analysis & Conversational Speech
Discourse deficits are a hallmark of TBI
Socially isolating
Discourse analysis best evidence based
practice
Intervention should be based on cognitive
deficits
33. Cognitive Deficits in Patients with TBI
Memory
Attention
Executive functioning
Insight
37. Metacognitive Skill Training
Patients “think” about “thinking”
Increases problem-solving skills
Tasks are broken down into small steps
1. Setting Goals
2. Self-monitoring of performance
3. Evaluation
38. Augmentative & Alternative
Communication
Supplements communication
Changes throughout treatment
No-tech, low-tech or high-tech
Decreases agitation or frustration
Increases independence
Can support speech development
39. Motor Speech Intervention
Increase speech & speech intelligibility
Targets apraxia & dysarthria
Tactile, visual, auditory cues
Modalities such as massage
40. Caregiver Stressors
Time off work
Decreased income
Caregiver burden
Concern for loved one
Increased anxiety & depression
Parental distress increases child behaviors
42. References
• ASHA www.asha.org
- AAC Practice Portal
- Pediatric Brain Injury Evidence Map
- Pediatric Brain Injury Practice Portal
- Adult Traumatic Brain Injury Practice Portal
• Centers for Disease Control www.cdc.gov
- Traumatic Brain Injury & Concussion
- Report to Congress. The Management of Traumatic Brain Injury in
Children: Opportunities for Action
- Mass Trauma Resources Glasgow Coma Scale
43. References
• Glasgow Structured Approach to Assessment of the Glasgow Coma
Scale www.glasgowcomascale.org
• Narad, M.; Yeates, K.; Taylor, H.; Stancin, T.; Wade, S. (2016)
“Maternal and Paternal Distress and Coping Over Time Following
Pediatric Traumatic Brain Injury”
• Le, K.; Mozeiko, J.; Coelho, C. (2011). “Discourse Analyses:
Characterizing Cognitive-Communication Disorders following TBI”
• Ness, B. & Sohlberg, M. (2009). “Implementing Metacognitive
Strategies Targeting Self-Regulation for Adolescents in Resource
Settings”
• Patterson, F.; Fleming, J.; Doig, E. (2016) “Group-based Delivery of
Interventions in Traumatic Brain Injury Rehabilitation: A Scoping
Review”
44. References
• YouTube
• “My X Ray Swallows”
• “Intra Swallow Aspiration”
• “Fiberoptic Endoscopic Evaluation of Swallowing”
• “Aspiration Before the Swallow with Thin Liquids by Cup”
• “IDDSI Flow Test”
• Zollman, Felise S. (2011). Manual of Traumatic Brain Injury
Management