Why bother about clumsiness? The implications of having developmental coordination disorder (DCD).
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Developmental coordination disorder (DCD) is a common motor problem affecting--even in rather severe form--several percent of school age children. In the past, DCD has usually been called 'clumsy child syndrome' or 'non-cerebral-palsy motor-perception dysfunction'. This disorder is more common in boys than in girls and is very often associated with psychopathology, particularly with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorders/ autistic-type problems. Conversely, children with ADHD and autism spectrum problems, particularly those given a diagnosis of Asperger syndrome, have a very high rate of comorbid DCD. Psychiatrists appear to be unaware of this type of comorbidity in their young patients. Neurologists, on the other hand, usually pay little attention to the striking behavioral and emotional problems shown by so many of their 'clumsy' patients. A need exists for a much clearer focus on DCD-in child psychiatry and in child neurology-both in research and in clinical practice. (+info)
Medical ethics in the neurosciences.
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Doctors in India are heirs to a long tradition of ethics from their own forebears and from those from the West. This paper discusses ethical aspects of topics of relevance to neurological scientists such as brain death, neural transplant and whole brain transplant. Many other topics such as ethics in research, patients with AIDS, patients in a persistent vegetative state and euthanasia deserve similar consideration and debate. (+info)
Creating knowledgebases to text-mine PUBMED articles using clustering techniques.
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Knowledgebase-mediated text-mining approaches work best when processing the natural language of domain-specific text. To enhance the utility of our successfully tested program-NeuroText, and to extend its methodologies to other domains, we have designed clustering algorithms, which is the principal step in automatically creating a knowledgebase. Our algorithms are designed to improve the quality of clustering by parsing the test corpus to include semantic and syntactic parsing (+info)
Evaluating a digital Resident Diagnosis Log: reasons for limited acceptance of a PDA solution.
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Personal digital assistants (PDAs) offer opportunities to speed the process of data collection and analysis. We developed a PDA-based program, the Resident Diagnosis Assistant, which allows neurology residents to collect key diagnostic information about patients seen and treated and the upload this data into a departmental computer. Physicians often use the expenditure of their time to decide whether to accept a new device. (+info)
A workflow model for adapting e-charts in specialty clinics.
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Modeling of health professionals' activities and matching of these processes to applied information technologies are necessary for acceptance and optimal utilization of a clinical information system. The overall objective of this study was to describe the different processes involved in current clinical practice of neurologists and to estimate the extent by which these processes are standardised across neurologists. Results from this study will be used to optimise the deployment of a stroke e-record and provide insight on some of the characteristics that will need to be addressed. (+info)
Provision of 24 hour acute neurology care by neurologists: manpower requirements in the UK.
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OBJECTIVES: The ABN has published standards of care for patients with acute neurological disease. Derriford Hospital provides a 24 hour neurology intake service to a population of 500,000 with the equivalent of four consultants, three specialist registrars (SpRs), and four senior house officers (SHOs) with a 37 bed ward. The authors undertook a prospective study of all neurology admissions to enable calculation of manpower necessary to meet the ABN guidelines. METHODS: All admissions to the neurology department were analysed prospectively for a three month period (March to May 2002). RESULTS: There were 629 admissions (equating to 2500 per year); data were collected for 93%. 78% of admissions were emergency, 16% elective. The mean number of neurology inpatients at any time was 76, with three (4%) being elective. The main diagnostic categories were stroke (29%), headache syndrome (13%), and epilepsy or seizures (12%). With regard to emergency admissions, 94% were seen by a neurology SHO within 6 hours and 81% by an SpR or consultant within 24 hours. Twenty five percent of emergency admissions were not seen by a consultant. 55% of patients were cared for on non-neurological wards for their entire admission. Median length of stay for stroke patients was 9.5 days, compared with 4 days for other patients. 37% of patients received a neurology follow up appointment. Currently each SpR spends 18 hours per week involved in the care of acute neurology admissions. CONCLUSION: Meeting the ABN guidelines will require an increase in total neurology bed provision to at least 15 per 100,000 population, with the equivalent of 3 consultant sessions (11 hours/week). Meeting the European Working Time Directive will require a minimum of 8-10 SpRs working a full shift system, which will have a significant impact on training and other aspects of service delivery. (+info)
Child psychiatry training for paediatric neurology trainees; a personal view.
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The authors describe their experience to support the view that training in child psychiatry is an effective way for the paediatrician in training to gain an understanding of that specialty. It is also an efficient way to acquire certain skills, which will be helpful in the future, either in hospital or community paediatrics. (+info)
Anatomic dissection tractography: a new method for precise MR localization of white matter tracts.
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BACKGROUND AND PURPOSE: Several white matter tracts in the brain cannot be identified on MR studies because they are indistinguishable from the surrounding white matter. We sought to develop a method to precisely localize white matter tracts by correlating anatomic dissections with corresponding MR images. METHODS: MR imaging was used to guide anatomic dissection of the uncinate fasciculus. Formalin-preserved brains were imaged before and after several stages of dissection. Progressive dissection was guided by using volume-rendered and cross-sectional images of the dissected specimens. To precisely define the location of a tract, its surface was traced on the corresponding three-dimensional MR image of the dissected specimen. MR images of the dissected and intact specimens were coregistered to allow the tracings to be projected onto multiplanar reformatted images of the intact specimen. RESULTS: The uncinate fasciculus in the anterior temporal lobe and external and extreme capsules was dissected without destroying adjacent structures. Coregistration of the MR images from intact and dissected specimens permitted precise MR identification of the surface of this tract. These methods were successful for two additional tracts. (The dissected anatomy, MR anatomy, and clinical examples of the three tracts are described in a companion article.) CONCLUSION: MR-assisted anatomic dissection permits limited removal of brain tissue so that important anatomic and surgical relationships can be demonstrated on correlated MR studies. This method can be applied to other white matter tracts that are indistinguishable on MR studies and to situations in which anatomic validation of normal and abnormal diffusion tractographic studies is needed. (+info)