The work was done to explore the effectiveness of prophylactic antiepileptic drugs for acute traumatic brain injury and assess risk: benefit ratios. The author asked if this intervention helped... Show More

The work was done to explore the effectiveness of prophylactic antiepileptic drugs for acute traumatic brain injury and assess risk: benefit ratios. The author asked if this intervention helped sort-term survivors avoid seizures after injury and assessed the influence of such medication on death and disability which result in seizures in long term survivors of TBI. Finally, the work assessed the benefits given potential adverse reactions to these drugs. The author found that using anti-epileptic drugs in the early stages after traumatic brain injury does decrease seizures. This review found that anti-epileptic drugs were effective for decreasing seizures in the first week after a TBI. Available pooled data failed to demonstrate reductions in overall mortality, late onset seizures, or the development of persistent vegetative states. However, the conclusions are limited by the scarcity of clear data collected to investigate cognitive/behavioural, neurological, or hematopoietic adverse effects thought to result from the anti seizure medications.

The Cochrane Students’ Journal Club is an online learning journal club which aims at creating a secondary learning resource for gathering and appraising evidence. This article illustrates an example... Show More

The Cochrane Students’ Journal Club is an online learning journal club which aims at creating a secondary learning resource for gathering and appraising evidence. This article illustrates an example of how an interactive discussion, on the use of anti-epileptic drugs for the prevention of seizures in patients with acute traumatic brain injury, can be used by students to formulate a plan for managing such patients in actual clinical practice.

Traumatic Brain Injury (TBI) survivors frequently experience headaches, often labeled as a psycho-social aftermath of poor adjustment to the reality of decreased brain function, but they may be the... Show More

Traumatic Brain Injury (TBI) survivors frequently experience headaches, often labeled as a psycho-social aftermath of poor adjustment to the reality of decreased brain function, but they may be the result of actual physical sequelae of the TBI. This article illustrates an active experiential learning exercise set in a in a user-driven learning environment using a web interface. Using a conversational learning approach, the discussion was centered around a neurological problem on the topic of chronic persistent headache, which generates a considerable amount of diagnostic uncertainty and interventional dilemma among physicians. The physician members of an online forum shared their viewpoints and insights regarding the topic. By utilizing a blend of experiential and empirical evidence, they collaboratively reached a solution. User-driven learning can serve as a potential learning tool in continuing medical education and also as a valuable educational resource to medical students, helping them develop empathy and real-life problem solving skills. Also, when such conversations involve multiple stakeholders (patients and their relatives, physicians and other health-care providers, medical students, etc.) it can foster a collaborative interface which is the essence of user-driven healthcare.

This paper is a review of cognitive aging research centred on the Scaffolding Theory of Aging and Cognition (STAC), a theory which brings together much of the previous research into cognitive aging... Show More

This paper is a review of cognitive aging research centred on the Scaffolding Theory of Aging and Cognition (STAC), a theory which brings together much of the previous research into cognitive aging over the past century and suggests directions for future work. From Santiago Ramon y Cajal, with his microscope and talented drawings, to today’s researchers with psychological and neurobiological methods and technology, particularly neuroimaging techniques, such as fMRI, sMRI, PET, etc., enormous progress has been made, through cognitive reserve, dedifferentiation, compensation, hemispherical asymmetry, inhibition and neurotransmission, to the Scaffolding theory of aging and cognition and beyond. Prior to 1990, research was almost entirely behavioural, but the advent of neuroimaging has boosted research and given rise to a new domain known as cognitive neuroscience, combining behavioural and neurobiological approaches to investigate structural and functional changes in the aging brain. Having reviewed the existing literature on cognitive aging research, the author concludes that although the scaffolding theory brings together a significant body of work and ideas, it is not yet the single, unifying theory for researchers. However, it does represent a giant step toward that theory.

Uncompassionate attitudes of doctors can have adverse impact on the already shattered emotional health of a person with disability. The medical conditions or disabilities are seen in isolation from... Show More

Uncompassionate attitudes of doctors can have adverse impact on the already shattered emotional health of a person with disability. The medical conditions or disabilities are seen in isolation from their daily lives. The quality health care is thus compromised. Disability Studies can increase the understanding of the disabled population. The curriculum offered to medical students has an impact on their learning potential. Medical practice influences social conditions and is also influenced by society. The social background of diseases and their causation must be understood within a holistic framework. Disability studies can bring together various disciplines dealing with human pain, pathology treatment, rehabilitation, and coping skills. Medical students must have comprehensive training about complex human behaviour, ethics, and social justice. They must learn the relationships among disease, distress, and disability. Co-existence of disability studies with medicine can transform medical practice, leading to high quality healthcare. Including Disability Studies in medical curriculum would bring Medical Humanities into classrooms.

The Johns Hopkins Home Care Group (JHHCG) developed standard protocols for management of patients with chronic heart failure (CHF) and chronic obstructive pulmonary disorder (COPD) in an effort to... Show More

The Johns Hopkins Home Care Group (JHHCG) developed standard protocols for management of patients with chronic heart failure (CHF) and chronic obstructive pulmonary disorder (COPD) in an effort to improve patient outcomes and reduce preventable hospital readmissions. JHHCG implemented Remote Patient Monitoring (RPM), a telemonitoring program customized for the CHF/COPD patient that provides real-time, daily reporting of qualitative and quantitative data as well as patient education/reinforcement. Patient data is trended on a web-based program and overseen by the Disease Management Nurse. Emerging trends are easily identified, allowing for early and appropriate intervention. This program sets itself apart because of the constant communication and aggressive management of the patient as a team (patient, RPM disease manager, field nurse, and physician). Key to the success of home care and RPM is access to and collaboration with a responsive, managing physician that oversees the patient based on their plan of care.

Five years ago, the author survived a nasty car accident which brought her to the place of offering healing for others. This paper demonstrates how ‘patient users’ in web space may document a lot of... Show More

Five years ago, the author survived a nasty car accident which brought her to the place of offering healing for others. This paper demonstrates how ‘patient users’ in web space may document a lot of their health details on their own in the form of narratives, as well as meticulously prepared lists that can be shared in ‘user driven health care’ forums and commented on by health professionals who genuinely want to help them. The author’s connection with non-mainstream healing is strong. This author shares that even after getting an MRI by a neuro-radiologist, the testing was not followed up by competent care. It was not carefully explained to her so she understood the implications of the lesions for further activities of daily living by the neuro-radiologist but rather it was left to the chiropractor to explain even though he may be ill-equipped to provide post injury brain care and life skills management. Finally, the narrative points toward the fine balance between finding effective treatment options and the responsibility of providing financially for oneself and family after a debilitating injury.

In this narrative, the author shares his perspective from both sides of the spectrum. First, the author begins as a patient with traumatic brain injury (TBI) secondary to an accident, as he deals... Show More

In this narrative, the author shares his perspective from both sides of the spectrum. First, the author begins as a patient with traumatic brain injury (TBI) secondary to an accident, as he deals with post-traumatic amnesia. His view as a trained osteopath, who draws on these experiences to heal others afflicted with TBI and its sequelae, is then presented.

In this paper, the authors (a doctor and his patient) share their complex journey into cognitive rehabilitation and a relationship that propels healing in the face of complexity against all odds.... Show More

In this paper, the authors (a doctor and his patient) share their complex journey into cognitive rehabilitation and a relationship that propels healing in the face of complexity against all odds. The patient came to S.O.G. unable to walk, with unclear speech and cognitive deficits but nothing could stop the indomitable resolve that spearheaded his recovery after 2 months in a coma. The patient was to blossom as a writer, an artist and a patient volunteer. His insights and skills were gently mentored by the doctor as they traveled together on the road to success and healing. This is their story.

This article explores some of the trials and tribulations the family members of patients with traumatic brain injury go through. In the first part, Jazmin Price recounts her recollections of the... Show More

This article explores some of the trials and tribulations the family members of patients with traumatic brain injury go through. In the first part, Jazmin Price recounts her recollections of the accident which changed her grandparents’ lives and the effect which it had on her interactions with them. In the second part of the article, Dr. Amy Price, Jazmin’s grandmother shares her side of the story and shares how despite the challenges a TBI patient faces, “where there is life, there is hope”

Mild traumatic brain injury (MTBI) survivors claim advantage in retraining their brains with neuroplasticity based cognitive training after trauma. Significant growth in computer based cognitive... Show More

Mild traumatic brain injury (MTBI) survivors claim advantage in retraining their brains with neuroplasticity based cognitive training after trauma. Significant growth in computer based cognitive rehabilitation is spurred on by positive research findings on neuroplasticity and advances in accessible computer technology. Drawbacks include limitations on the part of both patient and therapist in regards to time expenditure, cost of therapy, ease of use/learning curve, and the availability of long-term studies in regards to near and far transfer of training. MTBI patients may have sustained motor, visual, auditory, and chronic pain difficulties that complicate computer use. Benefits and barriers as perceived by patients and psychologists who are using the interventions for patient rehabilitation are critical. MTBI patient and therapist feedback concerning efficacy, usability accessibility, and satisfaction are needed to realize this form of rehabilitation.

This invited commentary discusses David W. Smith’s narrative account of his experiences during recovery from his traumatic brain injury (Smith, 2012). The author discusses the available literature... Show More

This invited commentary discusses David W. Smith’s narrative account of his experiences during recovery from his traumatic brain injury (Smith, 2012). The author discusses the available literature around recovery from an ‘injured cognition state’ with particular reference to post traumatic amnesia, delirium, and other behavioral changes associated with recovery from traumatic brain injury.

In this paper, the author recounts her experience in dealing with recovery from a traumatic brain injury. She shares her insights on the dubious practice of patient labeling. The author also affirms... Show More

In this paper, the author recounts her experience in dealing with recovery from a traumatic brain injury. She shares her insights on the dubious practice of patient labeling. The author also affirms her belief in the role a positive outlook plays in recovery.

This commentary discusses the paper by Khetrapal and Singh (2012). The author expands on the current reality of disheveled care, an organ-by-organ approach to “cure,” and a disregard for the... Show More

This commentary discusses the paper by Khetrapal and Singh (2012). The author expands on the current reality of disheveled care, an organ-by-organ approach to “cure,” and a disregard for the emotional and social context of disability and shares her own experiences in trying to push victim-hood aside and take some control of the situation. The author lauds Khetrapal and Singh’s (2012) consideration of a program for disability studies in Medical Education.