Dr. Sara Mulroy Chosen for Marian Williams Award

Sara Mulroy, PT, PhD (1989 DTRG)  receives the prestigious Marian Williams Award for Research in Physical Therapy.

The Marian Williams Award for Research in Physical Therapy was established to recognize individuals who have performed sustained and outstanding basic, clinical, and/or educational research pertaining to physical therapy.  

Sara is Co-Director of the Southern California Spinal Cord Injury Model System and lead on the site-specific project entitled "A Randomized Clinical Trial to Evaluate Two Prevention Programs for Maintenance of Shoulder Health and Function after Spinal Cord Injury ."

 

Congratulations Dr. Mulroy for yet again being honored by your colleagues and peers in the  American Physical Therapy Association. 

Sara is consistently cited as one of the therapist members of the association whose contributions to the physical therapy profession through leadership, influence, and achievements have demonstrated frequent and sustained efforts to advance the profession

 

Nutrition and SCI

Why is nutrition important after a spinal cord injury? 

Nutrition is important for individuals with SCI both because  of the increased risks of developing several specific medical complications as  well as the physical challenges of shopping and meal preparation. Medical  concerns include:

  • Increased  risk for diabetes, elevated cholesterol and obesity.
  • Increased  tendency to gain weight, which affects mobility and independence and may  require hiring more assistants and buying a larger wheelchair.
  • Risk  for developing pressure sores.
  • Increased  risk for osteoporosis (loss of bone density).

To stay as healthy as possible, we encourage you to read the guide to nutrition for those with SCI here, courtesy of the University of Washington:
http://sci.washington.edu/info/forums/reports/nutrition_2011.asp

Coming now to the Sundance Channel: Rancho Research and Push-Girls partner to show the possibilities of State-of-the-Art Technology on Sundance Channel

The standard way of thinking about wheelchair users has it that they are permanently confined to their chairs. This may be true for some, however, as science and technology progress this way of thinking is becoming history. Rancho Research is at the forefront of this paradigm shift, as the first hospital on the west coast to offer REWALK™ devices. Remarkably the devices were donated to Rancho because of our mission to serve the indigent.  Argomed Technologies is not only innovative, but has a commitment to deeds of kindness..

With the support of other generous financial donors, this has allowed Rancho Research to pursue rigorous research in the areas of: cardiovascular health, bone density, complications, emotional impacts, and more. 

The REWALK™ will be featured in the new second season of PushGirls on the Sundance channel! We encourage you to watch the second season, especially those which feature Rancho Los Amigos! A list of the shows which feature Rancho are provided below: 

Episode 203 - Monday, June 10th, 10 pm - Featuring the ReWalk
Episode 204 - Monday, June 17th, 10 pm
Episode 206 - Monday, July 1st - 10 pm
Episode 207 - Monday, July 8th - 10 pm

The Push Girls

The Push Girls




Drs. Philip Requejo and Sara Mulroy: Rancho's first Smartphone APP

RanchoGait by LAREI
https://itunes.apple.com/us/app/ranchogait/id648279272?mt=8

Try our new smart phone app! Now rehabilitation clinicians have the opportunity to download gait analysis software anywhere in the world!

Rancho researchers and clinicians have long been recognized as leaders in the field of Pathokinesiology and Gait Analysis....for decades: initiated by the late great Dr Jacquelin Perry. She mentored many many orthopedic surgeons, physical therapists, occupational therapists, engineering and more..........

Here is a new legacy......gait analysis from Rancho.....available worldwide in seconds!

Let us know what you think and what you need.......

Dr. Amytis Towfighi Leads an Effort Make Downey the Healthiest City in the USA!

When it comes to a stroke, every minute is critical

More than 200 local residents receive free stroke screenings from Rancho doctors.

DOWNEY - As a seemingly endless line of participants for Wednesday's Primary Stroke Prevention Seminar snaked outside the door and past the fountain at the Rio Hondo Event Center, a white-haired woman walking gingerly with a cane was slowly moving nearer to the ballroom, unaware that her life was about to be saved.

She was one of more than 200 Downey-area residents who attended the second Primary Stroke Prevention Seminar to be offered free this year by the team of the RTH Stroke Foundation, Rancho Los Amigos Foundation, Rio Hondo Event Center and The Downey Patriot.

During the morning event, participants heard a compelling presentation on the causes of strokes and strategies to prevent them from Rancho Los Amigos National Rehabilitation Center's Amytis Towfighi, MD. Dr. Towfighi is Chair of Rancho's Neurology Department and Director of its Acute Neurology/Acute Stroke Unit.

She conducts important research concerning post stroke prevention and is the recipient of numerous grants and awards.

In addition, she is an Assistant Professor of Neurology at USC's Keck School of Medicine.

As one of the world's preeminent neurological researchers and physicians, Dr. Towfighi has spent her entire adult life working to reduce the incidence of stroke in underserved communities.

"Stroke is the number four cause of death and the leading cause of disability in the United States," she said. "Every year, about 800,000 Americans will suffer a stroke. That's one every 40 seconds."
Dr. Towfighi said that strokes kill about 140,000 Americans each year. "That means that on average, someone dies of stroke every four minutes," she said. The doctor also pointed out that about 60 percent of stroke deaths occur in women and 40 percent in men.

"It's important for everyone to learn the warning signs of a stroke," Dr. Towfighi said. "It's critical to call 911 as soon as a stroke occurs, because there is a three-hour window from the time someone has a stroke to the time they can receive the clot-dissolving drug called tPA.

Dr. Towfighi said that every minute is critical, because a person loses more brain function each minute a stroke goes untreated. As the audience listened in rapt attention, she listed the five warning signs of stroke, including:

* Sudden numbness or weakness of the leg
* Sudden confusion or trouble understanding
* Sudden trouble seeing in one or both eyes
* Sudden trouble walking, dizziness, loss of balance or coordination
* Sudden severe headache with no known cause

"If you or someone you know has any of these symptoms, call 911 and tell the emergency operator you think someone is having a stroke," Dr. Towfighi said.

She emphasized that an easy and effective way for people to deal with a potential stroke is to remember the "FAST" acronym. "The 'F' stands for face drooping," she said. "If you believe someone may have had a stroke, first ask the person to smile. If one side of the face droops or appears numb, call 911 because it's likely they are having a stroke."

Dr. Towfighi pointed out that the "A" stands for arm weakness. "If one arm appears weak or numb, ask the person to raise both arms," she said. "If one arm drifts downward, they may be having a stroke. Call 911."

The 'S' stands for 'Speech Difficulty. "Is the person's speech slurred, are they unable to speak or are they hard to understand?" Dr. Towfighi asked. "Ask the person to repeat a simple sentence, such as 'the sky is blue'. If the person can't repeat the sentence correctly, or they have slurred speech, are unable to speak or hard to understand, they may be having a stroke. Call 911.

"The 'T' stands for time to call 911," Dr. Towfighi said. If the person shows any of these symptoms, or even if the symptoms go away, call 911 to help get them to the hospital immediately."

After she finished her wide-ranging presentation, Dr. Towfighi stayed at the seminar for nearly an hour, speaking individually to more than 30 attendees about their individual health issues and answering questions.

"Dr. Towfighi's dedication and her passion for caring for stroke patients is amazing," said RTH Stroke Foundation President Deborah Massaglia. "She delivered a very powerful message to those who attended today's seminar. It's hard to find a doctor who's as talented, as caring and as dedicated as Dr. Towfighi. She is simply remarkable."

In addition to hearing Dr. Towfighi, attendees also received free screenings for Abdominal Aortic Aneurysm (AAA) and blood pressure provided by the RTH Stroke Foundation, and cholesterol and blood glucose screenings administered by staff from the Los Angeles County Department of Health Services' Hubert H. Humphrey Comprehensive Health Center in Los Angeles. The total value of these screenings was estimated at approximately $100,000.

"The ultrasound AAA screening is especially important, because by the time symptoms are noticeable for Abdominal Aortic Aneurysm, it is usually too late to save the patient," Deborah said. "Each year, more than 15,000 Americans die from AAAs," she said.

Earlier this year, famed record producer Phil Ramone was killed by an Abdominal Aortic Aneurysm. Other notable deaths from AAA include scientist Albert Einstein, statesman Charles De Gaulle, country singer Conway Twitty and actors Lucille Ball, Harvey Korman, Walter Huston, George C. Scott, Jack Oakie and Betty Garrett.

But with early detection through ultrasound screenings, AAAs can be surgically repaired and lives can be saved. As the white-haired woman with the cane advanced to the table where she would be screened, she had no idea her life was about to change less than a minute later.

When the ultrasound detected a major aneurysm, Deborah went into action. "It's by far the largest aneurysm we have ever detected in 15 years of doing AAA screenings," she said. "But because we caught it at this stage, her life can be saved by surgery. Without this screening, she would have never known about life-threatening condition and she would surely have died."

Deborah spent more than a half hour with the white-haired woman, explaining her situation in detail and arranging immediate medical care for her.

For RTH Stroke Foundation Executive Director Guy Navarro, this life-saving portion of the day made the entire event worthwhile. "We accomplished our goal of primary stroke prevention today," he said. "Dr. Towfighi delivered a very important message about knowing what to do when a stroke occurs, and we did more than 500 screenings that provided important information about the health status of everyone who attended."

"We especially wish to thank Mark Shelton and the Rio Hondo Event Center for hosting this very important seminar that provided life-changing information for so many people today," he added.

Deborah said that in addition to the woman whose life was saved by her screening, there were many others whose screenings detected major issues. "We counseled more than 15 people about their high cholesterol levels and we had just as many with dangerously high blood glucose levels," she said. "We are very grateful to the Los Angeles County Department of Health Services for providing these very important screenings for the community."

She said that more than 10 percent of the attendees had very high blood pressure. "We saw many individuals with systolic blood pressure readings over 160, which is very dangerous."
Systolic blood pressure is the pressure in the arteries when the heart beats and fills the arteries with blood. The ideal systolic pressure is 115 and the normal range extends up to 120. A reading between 120 and 139 is considered in the prehypertension range.

When blood pressure reaches 140 to 159, it is considered high blood pressure, known as Hypertension Stage 1 as defined by the American Heart Association. This requires medical lifestyle modifications and medical intervention, which usually includes blood pressure medication. Readings ranging from 160 to 179 indicate very high blood pressure, or Hypertension Stage 2, which requires more extensive lifestyle modifications and blood pressure medication.
When systolic blood pressure readings exceed 180, emergency medical care is required. None of those screened on Wednesday required emergency care for high blood pressure.

The lower number of a blood pressure reading is called the diastolic number. It measures the pressure in the arteries as the heart rests between beats. The ideal diastolic pressure is 75, and normal extends up to 80. Prehypertensive readings are from 80 to 89, and 90 to 99 indicates high blood pressure. Very high blood pressure is 100 or higher. Higher than 110 requires emergency care.

"We saw several individuals with diastolic readings above 100, which will require a visit to a physician," Deborah said. ""It's good we caught these issues today, because if any of the individuals we detected with very high blood pressure see it raise even a few more points, they will need to be treated at a hospital emergency room."

"Blood pressure monitoring is critical for avoiding a stroke," Guy said. "We recommend purchasing a blood pressure monitoring device at a local drug store, which usually runs about $30. As many people found out today, knowing your blood pressure is very important to your overall health."

"Each of the screenings helped people who think they're living right to realize they have a lot of adjustments they need to make to their lifestyle to stay healthy," Deborah said. "Our staff has a lot of follow-up to do with those who attended today, but by catching issues early, we are also providing them with a chance to change their lifestyle to avoid a stroke or other life-threatening illness."

"That's why we do what we do," she said, "and why we worked with the leadership of the Rancho Los Amigos Foundation to create this wonderful partnership to improve the health of people throughout the greater Downey area. We are very excited about the outstanding turnout we have had at these two seminars, and we look forward to changing more lives for the better at our next seminar."

The two Downey seminars have been the best-attended by far of the hundreds of seminars the Foundation has conducted throughout Southern California. The next Stroke Prevention Seminar will be held from 9:30 a.m. to 11:00 a.m. on July 17, 2013 at Rio Hondo Event Center in Downey, and will feature Dr. Nerses Sanossian, director of the Roxanna Todd Hodges Comprehensive Stroke Clinic and the Roxanna Todd Hodges Transient Ischemic Attack Program at the USC Keck School of Medicine. Free Carotid Artery and Abdominal Aortic Aneurysm screenings will be provided.

To register for the seminar, call (888) 794-9466.
"I would recommend that anyone who wishes to attend the July 17 seminar register immediately, because each of our previous Downey seminars were sellouts within a matter of a few days," Deborah said.

"They say the best things in life are free, and this is one of them," she said. "Attending this seminar and getting one of these critical screenings is probably one of the very best things you can do to protect your health and get the information you need to lead a healthier life."

Rancho Los Amigos is actively studying Socially Assistive Robots!

To ascertain whether they are useful for helping people with stroke, dementia, and pain HEAL more effectively. We work with Professor Mataric from USC, funded by NSF.

Here is an interesting article about other roles for SARs.......

Disruptions: Robots as Home Health Care Aides for the Elderly - NYTimes.com

Clipped from: http://bits.blogs.nytimes.com/2013/05/19/disruptions-helper-robots-are-steered-tentatively-to-elder-care/

May 19, 2013, 11:00 am 2 Comments

Disruptions: Helper Robots Are Steered, Tentatively, to Care for the Aging

By NICK BILTON

 

In the opening scene of the movie “Robot & Frank,” which takes place in the near future, Frank, an elderly man who lives alone, is arguing with his son about going to a medical center for Alzheimer’s treatment when the son interrupts him. “I brought you something,” he says to Frank. Then the son pulls a large, white humanoid robot from the trunk of his car.

Frank watches in disbelief. “You have got to be kidding me,” he says as a robot helper, called the VGC-60L, stands in front of him. “I’m not this pathetic!”

But as Frank soon learns, he doesn’t have much of a choice. His new robot helper is there to cook, clean, garden and keep him company. His son, mired in family and work life, is too busy to care for his ailing father.

Just like Frank, as the baby boomer generation grows old and if the number of elderly care workers fails to grow with it, many people might end up being cared for by robots. According to the Health and Human Services Department, there will be 72.1 million Americans over the age of 65 by 2030, which is nearly double the number today. According to the Bureau of Labor Statistics, the country will need 70 percent more home aide jobs by 2020, long before that bubble of retirees. But filling those jobs is proving to be difficult because the salaries are low. In many states, in-home aides make an average of $20,820 annually.

“There are two trends that are going in opposite directions. One is the increasing number of elderly people, and the other is the decline in the number of people to take care of them,” said Jim Osborn, a roboticist and executive director of the Robotics Institute’s Quality of Life Technology Center at Carnegie Mellon University. “Part of the view we’ve already espoused is that robots will start to fill in those gaps.”

Researchers at the Georgia Institute of Technology have developed Cody, a robotic nurse the university says is “gentle enough to bathe elderly patients.” There is also HERB, which is short for Home Exploring Robot Butler. Made by researchers at Carnegie Mellon, it is designed to fetch household objects like cups and can even clean a kitchen. Hector, a robot that is being developed by the University of Reading in England, can remind patients to take their medicine, keep track of their eyeglasses and assist in the event of a fall.

The technology is nearly there. But some researchers worry that we are not asking a fundamental question: Should we entrust the care of people in their 70s and older to artificial assistants rather than doing it ourselves?

Sherry Turkle, a professor of science, technology and society at the Massachusetts Institute of Technology and author of the book “Alone Together: Why We Expect More From Technology and Less From Each Other,” did a series of studies with Paro, a therapeutic robot that looks like a baby harp seal and is meant to have a calming effect on patients with dementia, Alzheimer’s and in health care facilities. The professor said she was troubled when she saw a 76-year-old woman share stories about her life with the robot.

“I felt like this isn’t amazing; this is sad. We have been reduced to spectators of a conversation that has no meaning,” she said. “Giving old people robots to talk to is a dystopian view that is being classified as utopian.” Professor Turkle said robots did not have a capacity to listen or understand something personal, and tricking patients to think they can is unethical.

That’s the catch. Leaving the questions of ethics aside for a moment, building robots is not simply about creating smart machines; it is about making something that is not human still appear, somehow, trustworthy.

A recent Georgia Tech study found that older people were intrigued by the idea of robotic assistants in the home, but a robot’s appearance played a large role in what they will trust the machines to do. Older people want robots that look human for tasks that involve intelligence, like recommending which medicine they need to take. But they want a more sterile-looking machine for manual labor tasks, like cleaning and cooking, so they do not feel guilty bossing it about.

Wendy A. Rogers, a professor at Georgia Tech and director of the university’s Human Factors and Aging Laboratory, said concerns about older people developing relationships with their in-home helper robots were no different than the bond we develop with other inanimate objects.

Dr. Rogers has been experimenting with a large robot called the PR2, made by Willow Garage, a robotics company in Palo Alto, Calif., which can fetch and administer medicine, a seemingly simple act that demands a great deal of trust between man and machine.

“We are social beings, and we do develop social types of relationships with lots of things,” she said. “Think about the GPS in your car, you talk to it and it talks to you.” Dr. Rogers noted that people developed connections with their Roomba, the vacuum robot, by giving the machines names and buying costumes for them. “This isn’t a bad thing, it’s just what we do,” she said.

In fact, Mr. Osborn’s laboratory at Carnegie Mellon has designed a robot to work with therapists and people with autism. The machine can develop a personality and blinks and giggles as people interact with it. “Those we tested it with love it and hugged it,” he said. “You begin to think of it as something that is more than a machine with a computer.”

In the movie “Robot & Frank,” technologists have raced ahead of society’s collective conscience with their robot caregivers. But the movie still leaves its audience with a question: Will it one day be morally acceptable to unload your parents’ care to a machine?

As the actor Frank Langella, who plays Frank in the movie, told NPR last year: “Every one of us is going to go through aging and all sorts of processes, many people suffering from dementia,” he said. “And if you put a machine in there to help, the notion of making it about love and buddy-ness and warmth is kind of scary in a way, because that’s what you should be doing with other human beings.”

In the spirit of live long and prosper....sage advice:

Living the Four Agreements: A life changing Journey

In the best selling book The Four Agreements don Miguel Ruiz gives four principles to practice in order to create love and happiness in your life.

The Four Agreements are:

1. Be Impeccable with your Word: Speak with integrity. Say only what you mean. Avoid using the Word to speak against yourself or to gossip about others. Use the power of your Word in the direction of truth and love.

2. Don’t Take Anything Personally
Nothing others do is because of you. What others say and do is a projection of their own reality, their own dream. When you are immune to the opinions and actions of others, you won’t be the victim of needless suffering.

3. Don’t Make Assumptions
Find the courage to ask questions and to express what you really want. Communicate with others as clearly as you can to avoid misunderstandings, sadness and drama. With just this one agreement, you can completely transform your life.

4. Always Do Your Best
Your best is going to change from moment to moment; it will be different when you are healthy as opposed to sick. Under any circumstance, simply do your best, and you will avoid self-judgment, self-abuse, and regret.

High Tech Prosthetic Devices in the News

As victims of the Boston Bombing leave acute care  and move in to the rehabilitation process,  many wonder if they will ever regain their independence and autonomy. NBC goes into detail about the struggle and ultimate triumphs  these people face.

The rehabilitation back into real independence  life is helped by the newest state-of-the-art prostheses which not only enable people with injuries to regain functional mobility, but allow others to experience mobility they never thought possible.

No one illustrates this more than Katy Sullivan, pictured  to the right.  

Born without legs, she first arrived at Rancho to learn to walk.....soon she learned not only how to walk, but run....and run competitively.

Katy represented the United States in The Paralympic Games last summer in London!  The iconic British designer, Zandra Rhodes said... "I have always been proud to be British, but never prouder than when I met Katy and new she would be competing in the Paralmypic Games...hosted in LONDON!"

Zandra designed a beautiful shirt commemorating the Paralympics, London, and Katy!

Rancho Research Institute is now supporting research into brain computer interface prostheses, exoskeleton robotic prostheses...to allow those with lower extremity weakness and paralysis to walk again, and plans even more exciting new technological research (in collaboration with  our academic partners at USC and Caltech.

Visit NBCNews.com for breaking news, world news, and news about the economy

Dr. Phillip Requejo Awarded Neilsen Foundation Grant

Dr. Philip Santos Requejo, one of Rancho Research Institute’s leading Spinal Cord Injury (SCI) Rehabilitation scientists was just awarded a competitive grant by the prestigious Craig H. Neilsen  Foundation.

The grant will  support the development of evidence-based therapies and rehabilitation strategies for preventing the development of shoulder dysfunction and pain (and thus maintain long term independence and improve quality of life)  for persons with SCI individuals who use a manual wheelchair.

Abstract: One of the most common secondary complaints in the SCI population is shoulder joint pain, which has been attributed to the high demand on the upper limbs during upper extremity weight bearing activities. Because individuals with SCI who use a manual wheelchair are dependent on their upper extremities for mobility and daily activities, shoulder dysfunction and pain presents an additional loss of independence and decreased quality of life. The overall objective of this project is to identify the mechanics of shoulder pain development caused by the loads experienced by individuals who use a manual wheelchair and have SCI. We will quantify the scapular and glenohumeral joint kinematics and associated muscular controls in relation to the shoulder force application during wheelchair propulsion (WCP) and independent car transfers (CT) (both high demand and most essential activities) in manual wheelchair users with paraplegia and tetraplegia. We will evaluate whether altering hand placement during WCP and CT can mitigate the scapular and glenohumeral kinematic conditions that compress the subacromial space and increase risk for shoulder impingement during WCP and CT. This research project will provide vital information about the biomechanics of the shoulder complex substructures when experiencing the weight bearing forces during two demanding (and important) functional daily activities; then recommending a strategy to positively affect them. By evaluating an evidence-based alteration to the WCP and CT task, this project directly contributes to the development of shoulder pain prevention strategies for manual wheelchair users. This project supports the mission of the foundation because it contributes to creation of evidence- based therapies and rehabilitation strategies to preserve the shoulder and maintain maximum independence and good quality of life for individuals aging with SCI.

Taking Alternative Medicines? Let Your Doctor Know!

Taking alternative or complementary medicines in addition to those which are prescribed is typical for most patients, most of which are looking to supplement their current regimen. Complementary medicine may provide a means for many to better control a condition, or help alleviate side effects of other medications. Most complementary medicines are in the form of vitamins, or supplements (fish oil or vitamins, for example). While there is nothing wrong with complementary medicine, we strongly encourage all who take complementary medicines, whether they're multivitamins or herbal supplements, to notify your doctor of what you are taking and how often.

While there may be many benefits in taking complementary medications, potential interactions may occur between complementary medications and the prescribed medications. A doctor knows the interactions, which is why we strongly suggest you inform your doctor of all medications being taken.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2410154/

Online Sales Tax

Did you know that online shopping could get pricier? A bill is currently going though the Senate which could impose a sales tax on online shopping! Rancho Research encourages you get your shopping on before this bill passes! By clicking the following link, not only will you save money on Amazon, all purchases will have a small amount donated to Rancho Research at no extra cost!!!

http://www.amazon.com/?&tag=l05a2-20&camp=216797&creative=394565&linkCode=ur1&adid=0AH2KP8YVMZC6PYYMHXA&ref-refURL=http%3A%2F%2Flarei.org%2F

Boston Bombing Victims Begin Rehab

As the patients from the recent Boston continue to recover, the long process of rehabilitation begins. As specialists in rehabilitation, we here at Rancho Los Amigos understand the process which many will go through and send our best wishes for a speedy and effective recovery. We rest assured that our fellow rehabilitation doctors in Boston will do their best to ensure recovery.

Read about what lies ahead for those injured:http://www.businessweek.com/news/2013-04-22/boston-bombing-victims-start-rehab-meet-amputee-veterans#p1

Dr. Susan Shaw's reports on the risks of anticonvulsant medications.

Are enough neurologists fully cognizant of all the risks of prescribing antiepileptic medications? Our Dr. Shaw comments on the findings of her recent survey distributed to 4,627 AAN members. While most neurologists were aware of four recent FDA safety alerts, significantly less were aware of the specifics of the alerts. To see how Dr. Shaw is actively working for the best possible care for patients, go to the link listed below!

American Academy of Neurology 2013

Survey shows mixed AED safety knowledge among neurologists

By: DOUG BRUNK, Clinical Neurology News Digital Network

SAN DIEGO – Most neurologists are aware of recent Food and Drug Administration safety warnings regarding the use of antiepileptic medications, but about 20% do not recognize these risks, results from a large membership survey demonstrated.

"FDA drug safety warnings are not systematically delivered to neurologists," Dr. Susan Shaw said at the annual meeting of the American Academy of Neurology. "The sources of information are numerous and varied. We also feel that the FDA drug safety warnings are not effectively delivered to neurologists."

Courtesy Dr. Susan Shaw


Dr. Susan Shaw

She based her remarks on an Internet-based survey distributed to 4,627 AAN members in 2012. Although the FDA issues drug safety communications and MedWatch alert e-mails, "these are only sent to those who are registered to receive the notifications," explained Dr. Shaw, a neurologist who is director of the epilepsy service line at Rancho Los Amigos National Rehabilitation Center, Downey, Calif., and is with the department of neurology at the University of Southern California, Los Angeles. The FDA may send alerts to physician specialty organizations such as the AAN, "which may then transmit the information to their members, but not all neurologists are members of the AAN," she noted. "The FDA may require drug manufacturers to update product inserts or highlight severe actions with ‘black box’ warnings or ‘dear health care provider’ letters. Still other neurologists rely on published articles or continuing medical education. Therefore, it is unknown whether the FDA’s alerts are effectively reaching neurologists."

Dr. Shaw and her associates set out to determine whether neurologists are aware of four recent FDA warnings regarding antiepileptic drugs (AEDs) and to determine whether neurologists are implementing recommended screening. Safety alert No. 1 was issued by the FDA on Dec. 12, 2007, and recommended screening for HLA-B*1502 in patients of Asian descent prior to treatment with carbamazepine, because of the risk of Stevens-Johnson syndrome and toxic epidermal necrolysis. "The risk of this haplotype is up to 10 times higher in some Asian countries than in countries with mostly Caucasian populations," Dr. Shaw said.

Safety alert No. 2 was the FDA announcement on Dec. 16, 2008, that required makers of AEDs to add labeling information warning that their use increases the risk of suicidal thoughts and behaviors. Safety alert No. 3 was the FDA healthcare provider notice released on Dec. 3, 2009, which recommended counseling for women of childbearing age who are taking valproate and labeling change for the drug because of the risk of congenital malformations in offspring of women treated with the drug during pregnancy. Safety alert No. 4 was the FDA drug safety communication and labeling change released on June 30, 2011, regarding the risk of impaired cognitive development in children exposed to valproate in utero.

"We do know that some of the FDA warnings, especially regarding suicidality, are controversial, but we think that it is important for providers to be aware of warnings and recommendations made by the FDA," Dr. Shaw said.  click link for more!

http://webcache.googleusercontent.com/search?q=cache:S0xtaJg8cH0J:www.clinicalneurologynews.com/news/conference-news/american-academy-of-neurology-2013/singleview-enewsletter/survey-shows-mixed-aed-safety-knowledge-among-neurologists/27708dbd1616d2c3cb2a3a4b0d755ae8.html+&cd=1&hl=en&ct=clnk&gl=us

Healthy Living

For those who strive to live a healthy lifestyle, here are some tips from the our Federal government's Department of Veterans Affairs.

 Second Chance for Those New Year’s Resolutions

Whether we vow to lose weight, get fit, or quit smoking, the promises we make to ourselves are sometimes the hardest to keep. Forty-five percent of American adults make one or more New Year’s resolutions each year but only 8 percent will achieve them.

If you made a resolution and failed to maintain it, you are not alone. Only 64 percent of resolutions are maintained after one month and 46 percent after 6 months. If you are having trouble maintaining your resolutions, don’t be discouraged by these numbers.

Your second chance is here: National Public Health Week, April 1-7, is the perfect time to recommit yourself to your goal or to start fresh with a new one. The week is dedicated to raising awareness and changing behaviors so we all can live healthier, safer, and better lives.

Start out by making just one positive change to improve your health. Small actions like getting routine health screenings or keeping your immunizations current can lead to big health benefits for you, your family, and your community.

Revolutionizing Prosthetics

The New York Times reviews the extraordinary research activities that are going on right now to help people with limb loss and paralysis. Soon Rancho will be offering brain computer interface technologies and world class robotics to our patients, collaborating with partners at Caltech and USC.

By John Markoff
Published: March 29, 2013

As part of a national research project to develop low-cost artificial hands, the Pentagon has released a video of a robot that can change a tire — almost. In the video, the two-armed robot uses a tool to remove a tire from a car.    

“We’re almost on the stage where we can put the the nuts back onto the bolts,” said Gill Pratt, a program manager at the Pentagon’s Defense Advanced Research Projects Agency, or Darpa.

The goal of the program, now in its third phase, is to develop robots and prosthetic devices for wide use. Until now, high cost as well as limits on dexterity and machine vision have been major obstacles to advanced robotic systems.

Robotic hands that mimic the capabilities of the human hand have cost $10,000 or more, and computer vision systems have worked only in highly structured environments on a very limited set of objects.

The Pentagon, in an effort to develop low-cost artificial hands, has built a robot that can take a tire off a car. Putting it back on is another problem altogether.

But it is becoming feasible to make hands that will cost less than $3,000 in quantities of 1,000. Two teams — from iRobot, a robot maker in Bedford, Mass., and the government’s Sandia National Laboratories in New Mexico — are working on the hand project; they employ a variety of widely available technologies, like cellphone cameras and sensors, to help lower costs.

“We’re definitely watching their progress,” said Rodney Brooks, founder of Rethink Robotics, a Boston-based maker of low-cost manufacturing robot systems.

The Darpa research has been vital in keeping the United States in the forefront of robotic technology, he said. He likened the current work to Darpa projects in the 1980s and 1990s that led to the robotic navigation technologies crucial to the development of self-driving automobiles.

One of the hands under development comes with three fingers and the other comes with four, and they are able to do a variety of delicate operations. In one Darpa video, a robot hand picks up chopsticks and then a piece of sushi, Dr. Pratt said.

The various hands are still a work in progress, he noted. The tire-changing video was made when “we were using the old hands and not the new hands, and they did not quite have the dexterity to thread the nut onto the bolt in a way that it doesn’t cross the thread.”

Darpa also set out tasks that it hopes to accomplish during the next phase. One example is to design a robot arm and hand that can search for an improvised explosive device, or I.E.D., by touch. The challenge would be to program a hand that could open the zipper on a gym bag and then go through the bag and recognize objects by touch.

The agency is also financing research groups in two other categories. It has selected the National Robotics Engineering Center at Carnegie Mellon University, NASA’s Jet Propulsion Laboratory and the University of Southern California to continue development of high-level software for the next generation of robot arms.

Until recently, the agency asked software developers to develop robotic programs for generic individual motions, like moving forward or backward; now it has set out to simply have the robots perform a specific task.

“You could say things like pick up the bottle, unlock the door, tasks like that,” Dr. Pratt said. The agency began with six teams and held a “bake-off” in which it chose three teams to continue in the last phase of the project.

In the software project, Darpa supplied each team with a standard hand that it then programmed.

“The grasping tasks were done so well that we believe that for the kinds of objects we had them pick up — ranging from a ball to a rock to tools like hammers — we don’t need to do further work in grasping,” Dr. Pratt said.

Manipulating grasped objects was a more challenging task, he said, and one on which the teams would continue to do research. The program is financed for 18 more months.

Darpa is also continuing to finance the development of low-cost arms at Barrett Technologies, a robotics research firm in Cambridge, Mass.; Sandia; iRobot; and SRI International, a research organization in Menlo Park, Calif.

The agency is also planning to create a joint project to transfer some of the low-cost technology advances it has made in the project into a related effort to develop prosthetic limbs for wounded soldiers.

Johns Hopkins University has received funds to develop a neural interface — a direct link from a robot arm to the human brain — and DEKA Research, an independent development laboratory headed by Dean Kamen in Manchester, N.H., has developed a separate wearable arm now being considered for approval by the Food and Drug Administration.

That robotic arm is close to commercialization, said Geoffrey Liang, acting deputy director of Darpa’s Defense Sciences Office.

“We have pictures of young men doing rock climbing and one of the patients using chopsticks, which is really extraordinary,” he said. “It provides a high degree of functionality, and the patients who have it are using it.”

Source: http://www.nytimes.com/2013/03/30/science/making-robots-mimic-the-human-hand.html?hpw

National Nutrition Month

March is National Nutrition Month, an annual nutrition education and information campaign spearheaded by the Academy of Nutrition and Dietetics that highlights how important it is to make informed food choices and develop health eating and exercise habits.

In 2013 – the commemoration’s 40th anniversary – the month’s theme is “Eat Right, Your Way, Every Day,” which aims to encourage “personalized healthy eating styles and recognizes that food preferences, lifestyle, cultural and ethnic traditions and health concerns all impact individual food choices.”

Nutrition deficiency contributes to many serious health conditions such as heart disease, stroke, hypertension, diabetes and certain cancers. Many of the low-income populations served by NAPH members do not have access to nutritious food, cannot afford it, or are not aware of the crucial role it plays in their health. To address this health care crisis, NAPH members are finding innovative ways to boost access to and awareness of proper nutrition in the populations they serve.

For example, after discovering that 78 percent of its adult patient population is overweight or obese, Texas-based Harris Health System partnered with local nonprofit Veggie Pals, Inc., to set up fresh produce markets at five of its community health centers in underserved areas. At “Healthy Harvest” markets, customers can buy fresh fruits and vegetables from a selection that caters to their cultural preferences. Market staff also educate patients about the importance of fruit and vegetable consumption and offer recipe tips. 

Thus far, the response has been overwhelming: Harris Health already has expanded Healthy Harvest to 11 clinics, each of which serves 50 to 150 customers per week and sells between 200 and 500 pounds of produce per week. 

This is just one example of how NAPH hospitals are helping to create healthy communities and increasing access to nutritious foods for their patients. To read more about nutrition programs at NAPH hospitals during National Nutrition Month, visit NAPH’s Innovations webpage.

Nutrition deficiency contributes to many serious health conditions such as heart disease, stroke, hypertension, diabetes and certain cancers, increasing high health care costs and reduced productivity and chronic absence from work. Many of the low-income populations served by NAPH members do not have access to nutritious food, cannot afford it or are not aware of the crucial role it plays in their health. To address this health care crisis, NAPH members are finding innovative ways to boost access to and awareness of proper nutrition in the populations they serve. 

 

Cloud Computing and People with Disabilities

Webcast: Cloud Computing and People with Disabilities

NIDRR consultant Clayton Lewis, PhD, Professor of Computer Science, Fellow of the Institute of Cognitive Science, and Scientist in Residence at the Coleman Institute for Cognitive Disabilities at the University of Colorado, will present Cloud Computing and People with Disabilities, March 26th, 12:30-1:30pm EDT, at the National Science Foundation, Stafford I-1235. Dr. Lewis will explore efforts in the US and abroad to realize the Global Public Inclusive Infrastructure (GPII), using the cloud to make it easier for people to access online content and services in a way that meets their individual needs and preferences. Advanced registration/RSVP is required to attend in person. The presentation will also be available via WebEx stream and phone with no pre-registration required.