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After the resulting damage to medications may be administered in which of the following ways generic sinemet 125 mg fast delivery the the population medications known to cause pancreatitis buy sinemet 300mg low price, the incidence is expected to treatment 6th feb cardiff purchase sinemet with american express increase treatment for hemorrhoids order 125 mg sinemet fast delivery, mainly microvasculature, progressive edema develops, ongoing isch due to fall-related injuries. Direct lifetime costs can be as high emia worsens and a pro-apoptotic signaling is initiated. Tese events promote thrombosis and spasm of the Search strategy microvessels, leading to further hypoxia. An energetic crisis A PubMed search for articles published up to September is installed, there is production of oxygen free radicals, and 2016 was performed using the terms “Spinal Cord Injury” [Mesh] excitotoxicity and cytotoxic edema develop. With loss of the and (“traumatic” [Title/Abstract]), which returned 4,346 articles. Two review of the structural framework, regenerative attempts do not ers independently screened the article titles and abstracts. Proliferation of astrocytes and deposition of fbro with at least one abstract in English or Portuguese were searched. The strength should be Together, all those mechanisms contribute to the restriction graded according to the Medical Research Council grading of regeneration1,2. The fnal extent of spinal cord damage results from With that, the neurological level of injury is determined primary and secondary mechanisms that start at the as the most caudal segment of the cord with intact sensation moment of the injury and go on for days and even weeks. No sensory or motor functions in sacral erative therapies act to promote axonal regrowth after the segments S4-S5. Sensory but not motor function is preserved below the neurological level of injury including Neurological classifcation S4-S5 and no motor function is preserved more than three After initial general stabilization, it is important to per levels below the motor level on each side of the body. Sensation and motor functions are normal in a key point in each of the 28 dermatomes (from C2 to S4-5) all segments tested. Of the 15% who will The motor examination encompasses testing of key improve, only 3% will have useful motor function. When possible, awake, fberoptic have complaints of neck pain, spinal tenderness, symptoms intubation is preferred. In-line stabilization without traction or signs of a neurological defcit related to the spine, and is an alternative when a fber optic laryngoscope or broncho scope is unavailable. It inspiratory pressure and carbon dioxide partial pressure lev consists of fve criteria: no posterior midline cervical tender els. Some studies col has a sensitivity of 99% and a negative predictive value of advocate that early tracheostomy (within 10 days) in these 99. It may be due to hypo thesias in extremities), the presence of low risk factors allow volemia in a context of polytrauma, or due to the direct cer ing safe assessment of the range of motion, and the ability to vical or thoracic spinal trauma itself, leading to neurogenic actively rotate the neck 45 to the left and right. Neurogenic shock results from the interruption of the Canadian C-Spine Rule protocol resulted in 100% sensi sympathetic tone due to disruption in supraspinal control, tivity for cervical spinal injury with a 42. If it is not available, a three-view spine x-ray is recom therefore, loss of peripheral vascular tone and bradycardia11. Based on this, the current recommendation is particularly useful for ligamentous lesions. Intraspinal hemorrhages (> 1cm long) as well as treatment is intravenous fuid therapy (mainly with crystal longitudinal T2 signal changes > 3cm, are associated with poor loids) to maintain a euvolemic or slightly hypervolemic status, prognosis. A normal initial magnetic resonance image is usu in association with vasopressors. The main predictors of poor cardiovascular function Airway management requiring resuscitation and support are high cervical and Respiratory complications are the main cause of mor complete lesions12. Up to two thirds of patients will have complications The last guideline does not address this controversy. A sys such as atelectasis, pneumonia, or respiratory failure that tematic review tried to answer several questions regarding require mechanical ventilation9. It reduces edema, prevents intracellular complications was found, with up to 70% of patients experi potassium depletion and inhibits lipid peroxidation. No diference in motor or sensitive neu especially in the population older than 55–60 years15,16,17. A subanalysis found that the sub intrathecal pressure and correspondingly higher spinal cord set of patients who received the corticosteroid within eight pressure perfusion18. In a post hoc analysis, in patients treated between three to eight hours from trauma, the Decompressive Surgery 48-hour regimen was associated with a greater motor, but Progressive edema and hemorrhage contribute to the not functional, recovery. In addition, the group with the lon ongoing mechanical pressure on the microvascular circula ger duration had more severe sepsis and pneumonia25. Surgical decompression aims to relieve this pressure, Recently, a meta-analysis and systematic review con thereby reducing secondary hypoxia and ischemia. Besides, it increases gastrointestinal hemorrhage as unstable vertebral fractures. Tose fndings were confrmed in a prospective Canadian Gangliosides are glycolipid molecules present in neuro cohort study even after adjusting for preoperative status and nal membranes. In comparison with pla cebo, however, no diference in neurological status at one Neuroregeneration year was noted29. In the closed some degree of improvement, with no major adverse remaining patients, 35. Terefore, con “The Acute Rapid Cooling Terapy for Injuries of the Spinal founding factors cannot be excluded from these results. This study (which is not yet recruiting) plans to evalu Embryonic and induced pluripotent stem cells are ate diferent durations of hypothermia, starting within six capable of remyelinate axons, modulate the inflammatory hours post-trauma. Olfactory ensheathing cells are phago in motor scores in patients treated with the drug33. In animals, they enhanced ing, to evaluate the aforementioned drug in cervical lesions. Mesenchymal cells can differentiate along their Minocycline is an antibiotic with anti-infammatory connective tissue lineages and modulate inflammatory properties including inhibition of tumor necrosis factor response at systemic and local environment levels. They alpha, interleukin 1 beta, cyclooxygenase-2 and nitric oxide have been shown to decrease inflammatory cell infiltra synthase. In pre-clinical models, it decreased lesions sizes tion, increase pro-survival trophic factor levels and pro and neuron loss. Key early interventions are increas impact on the standard of care, given that even small ingly being recognized, as well as the need to better study motor or sensory improvements can have profound effects these patients. Vasopressor administration in spinal cord injury: acute traumatic spinal cord injury. Methylprednisolone for the treatment of patients in adults with spinal cord injury: a clinical practice guideline for with acute spinal cord injuries: a systematic review health-care professionals. Study to evaluate the effcacy, safety, and application of modest hypothermia after spinal cord injury. A prospective, multicenter, phase I with methylprednisolone as a hystorical control. Childhood absence, West syndrome, Familial temporal lobe epilepsy, Juvenile Myoclonic Epilepsy Distinctive Constellations i. Tumor, Infection, Trauma, Stroke, Cortical Malformations Unknown cause (cryptogenic) Epilepsia 2010; 51: 676-685. Chris Sackellares Gainesville Malcolm R 150 (352) 376-1611 Alfred Frontera Tampa J. Haley 673 (813) 972-2000 x7633 Northwest Centers * Paul Rutecki Madison William S. S eiz ure term s • Ictal= seiz ure • C om plex= consciousness im paired • P ost-ictal= confusion following seiz ure • S im ple= consciousness unim paired • A ura= abnorm alsensation preceding loc • P artial= focalregion involved • A utom atism s= nonsensical • G eneraliz ed= wh ole brain involuntary m ovem ents • C onvulsions= sh aking • Tonic= toniccontraction • G rand m aland petite m al=“ street producing extension and term s”forconvulsive and arch ing non-convulsive seiz ure • C lonic= alternating m uscle respectively contraction-relaxation Etiology • C N S • S ystem ic • H ead traum a • H ypo/h yperglycem ia • S eiz ure in1 week ofinjury • H ypo/h ypernatrem ia notpredictive ofepilepsy • H ypocalcem ia • S troke • U rem ia • Vascularm alform ations • H epatic enceph alopath y • M ass (tum or/abscess) • H ypoxia • M eningitis/enceph alitis • H yperth erm ia • C ongenital • Drug overdose or m alform ations/cortical with drawal dysplasias • EtO H with drawalsz occurs • Idiopath ic with in48h C lassificationofseiz ure types • P artial(focal) • G eneraliz ed • S im ple partial • A bsence • M otor • Tonic • S om atosensory • C lonic • A utonom ic • Tonic-clonic • P sych ological • A tonic • C om plex partial • M yoclonic • S im ple partialwith im paired consciousness • P artialseiz ures with secondary generaliz ation C lassification • P artialseiz ures (focalonset) • S im ple partial(with outim paired consciousness) • M otorsym ptom s (focalm otorseiz ure) • Involves m otorstrip • M anifested by abnorm alm ovem entofanextrem ity • Jacksonianm arch spread to involve contiguous regions • Todd’s paralysis-postictaltransienth em ibody weakness • S om atosensory sym ptom s • Involves sensory strip,tem poral(h earing and sm ell) oroccipital(visual)lobe • A utonom icsym ptom s • Involves tem porallobe (tach ycardia,pallor,flush ing,sweating) • P sych icsym ptom s • Involve frontalortem porallobe (lim bicsystem):deja vu,jam ais vu,affective disturbances,cognitive deficits,h allucinations H om unculus N eurology and N eurosurgery Illustrated. P eers noticed “ staring spells”with loss ofspeech and eyes looking to th e righ t. During th e daytim e,patientis noticed by fam ily to appearagitated with alterationofconsciousness. C ase 3 • S eiz ure Type: • C om plex partialseiz ures with onsetoverth e righ tfrontallobe • A lterationofconsciousness=com plex partial • A gitated beh avior=frontal/tem poralonset C ase 4 • 23 yearold fem ale with h istory ofdaily episodes of“ blurry vision”and righ tsided tingling lasting “ few seconds”. N o loss ofconsciousness • P M H: • N one • S ocialH x: • C ollege student • Exam: • P ost-ictalpatienth as a righ tfield cutwith righ tarm >leg weakness. C ase 4 • S eiz ure Type: • S im ple partialseiz ure with onsetoverth e leftparietal/occipital region • N o loss ofconsiousness=sim ple partialseiz ure • V isualsym ptom s=occipitallobe • R igh tarm >leg tingling=leftparietalregion • P ost-ictalsym ptom s=suggestive ofa Todd’s paralysis C ase 5 • 22 yearold fem ale w ith h istory ofconvulsive seiz ures th atoccuraround 1 every 3 m onth s. Dekker, 1994 Reprint © Epicadec 1998 © World Health Organization 2002 All rights reserved. Publications of the World Health Organization can be obtained from Marketing and Dissemination, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 2476; fax: +41 22 791 4857; email: bookorders@who.
Treatment Approaches Treatment in ulcerative colitis is individualized to treatment 2 discount sinemet 125mg otc the specific needs of the patient and alterations in treatment strategies are made according to medicine 8 letters 300 mg sinemet with visa the response attained medications with weight loss side effects purchase sinemet 125 mg otc. Nevertheless medicine to increase appetite order sinemet 110 mg on-line, we present a guide to the most common approaches used with our patients. Mild Acute Relapsing Ulcerative Colitis Mild disease is associated with four or fewer loose bowel movements daily with occasional blood, abdominal cramps, and, infrequently, tenesmus. Moderate Acute Relapsing Ulcerative Colitis In patients with moderate disease, bowel movements range from 4–8 daily with urgency, a nocturnal pattern, blood in the stool, abdominal discomfort, and some systemic symptoms such as weight loss, mild anemia and low-grade fever (less than 100 F). Proctitis or protosigmoiditis is treated symptomatically (antidiarrheals, bulk agents). Severe Acute Relapsing Ulcerative Colitis Severe attacks are characterized by the passage of six or more bloody stools daily accompanied by systemic symptoms such as fevers of 100 F or greater, weight loss, tachycardia, anemia with hemoglobin count of 10 g/dl or less, and hypoalbuminemia. The usual dose is 4 mg/kg given in a four-hour intravenous infusion (2–6 pm) for a period of 5–7 days. Trough levels are followed (normal range 100–250 mg/dl) as well as renal (kidney) function while on intravenous cyclosporine. If there is no major improvement of symptoms within one week after the initiation of intravenous cyclosporine, the patient is usually referred for surgery. Surgical Therapy Surgery in ulcerative colitis should be reserved for those patients with refractory disease, complications associated with the medical therapy, or complications of colitis. Colectomy may be used in pediatric patients for amelioration of growth retardation in prepubescent children affected by ulcerative colitis. Current surgical alternatives include total proctocolectomy (Figure 16A) with Brooke ileostomy (Figure 16B), the intra-abdominal Koch pouch (Figure 16C), and restorative proctocolectomy with ileal pouch-anal anastomosis (Figure 16D). Surgical options for the treatment of ulcerative colitis; A, proctocolectomy; B, Brooke ileostomy; C, Koch pouch ileostomy; D, restorative proctocolectomy. Elective colectomy cures ulcerative colitis and has a very low mortality rate (less than 1%). The procedure should almost always be a total colectomy (Figure 17A) with ileostomy or one of two internal ileal pouch alternatives. The Brooke ileostomy (standard) is a half-dollar–sized segment of terminal ileum that protrudes and is spouted from the right lower quadrant of the abdomen (Figure 17B). The patient attaches a double-faced adhesive ring to the skin and then to an opaque sack (which can be emptied) that collects the 750-1000 ml of material that the ileum produces daily (Figure 17C). Ostomy societies can be very helpful in adjusting to the inconvenience and psychological issues of an ileostomy. An internal reservoir is created from reshaped ileum with a nickel-sized nipple valve opening onto the lower abdominal wall. The patient catheterizes the pouch through a nipple valve to remove ileal contents. The main disadvantage of this approach is that the valve may become incontinent within 2–5 years in 25–30% of patients, necessitating surgical repair (Figure 18 A-C). The surgery involves creation of a new rectum from the small bowel and attaching the pouch of ileum to the anal canal (Figure 19). The pouch-anal anastomosis may be performed using a hand-sewn or stapled technique (Figure 20). In patients with persistent disease activity or the development of dysplasia or cancer, a mucosectomy (stripping) may be performed before the anastomosis. Those who do not advocate anal stripping believe that preservation of a few centimeters of rectal mucosa produces better functional results (Figure 21). In the patient with fulminant colitis, the colon may be removed first, leaving the creation of the pouch, restoration, and the removal of the rectum for a time when the patient has recovered from the colitis and is in better nutritional condition. This is a three-stage procedure, as a temporary ileostomy is made above the pelvic pouch to allow healing. In patients with more chronic and stable disease, the procedure may be performed in two stages (with a temporary ileostomy). Select patients are candidates for a restorative proctocolectomy performed in a single step. After a temporary protective ileostomy is closed, patients can defecate through their anus. Although pouchitis is a complication in 25% of patients, the ileoanal pouch is an acceptable and successful alternative to standard ileostomy. Overview the complications of ulcerative colitis can be divided into those that affect the colon and those that are extracolonic. Toxic Megacolon Overview the most feared complication of ulcerative colitis is the development of toxic megacolon. It occurs as a result of extension of the inflammation beyond the submucosa into the muscularis, causing loss of contractility and ultimately resulting in a dilated colon. Dilation of the colon is associated with a worsening of the clinical condition and development of fever and prostration. Diagnosis this diagnosis is based on radiographic evidence of colonic distention in addition to at least three of the four following conditions: fever higher than 38. At least one sign of toxicity must also be present (dehydration, electrolyte disturbance, hypotension, or mental changes). There may be rebound tenderness, abdominal distention, and hypoactive or absent bowel sounds. However, perforation can also present in severe ulcerative colitis even in the absence of toxic megacolon. Steroid therapy has been suggested to be a risk factor for colonic perforation, but this is controversial. Radiography X-rays of the abdomen reveal colonic dilation, usually maximal in the transverse colon, which tends to exceed 6 cm in diameter. Serial plain abdominal x-rays of the abdomen taken at 12–24-hour intervals are useful in following the clinical course. Medical Therapy the goal of medical therapy is to reduce the likelihood of perforation and to return the colon to normal motor activity. A nasogastric tube is placed in the stomach for suction and decompression of the upper gastrointestinal tract. The use of the rolling technique, during which the patient lies on the abdomen for 10–15 minutes every 2 hours while awake, allows for passage of gas and easier decompression of the dilated colon. Broad-spectrum antibiotic coverage is instituted in anticipation of peritonitis resulting from perforation. Intravenous steroids are usually administered in doses equivalent to more than 40 mg of prednisone per day. Surgical Therapy Colectomy occurs in about 25% of patients and is required in almost 50% of patients with pancolitis. Surgical intervention is undertaken if the patient does not begin to show signs of improvement during the first 24–48 hours of medical therapy, as the risk of perforation increases markedly. Colectomy with creation of an ileostomy is the standard procedure, although single-stage proctocolectomy is done occasionally. If surgical therapy is performed before there is colonic perforation, the mortality is approximately 2%. In cases in which there has been bowel perforation, however, the mortality risk increases to 44%. However, some degree of narrowing may be seen in approximately 12% of surgical specimens. Histologically, strictures present with hypertrophy and thickening of the muscularis mucosa without evidence of fibrosis. Strictures tend to occur late in the course of disease, usually 10–20 years after onset of disease. Most strictures occur in the sigmoid and rectum, with an approximate length of 2–3 cm. Strictures have been associated with malignancy, and biopsy of the strictures is warranted. In fact, in patients with long-standing history of ulcerative colitis, a stricture should be considered potentially malignant. Primary Sclerosing Cholangitis Primary sclerosing cholangitis is a chronic cholestatic liver disease characterized by fibrosing inflammation of extra and intrahepatic bile ducts. Patients may have symptoms of fatigue, pruritis, abdominal pain, fever, or jaundice.
Education Breakout Group: Ellen Winner (chair) treatment diabetic neuropathy purchase sinemet with visa, Dennis Dake medicine bow buy sinemet no prescription, Keith Sawyer medications jfk was on buy sinemet now, Andrea Shindler treatment kidney infection purchase sinemet on line, Thalia Goldstein, Trent Grover, Echo Wu 1. Links between Cognition/Learning in the Arts and the Sciences • What are the measurable cognitive and biological underpinnings/outcomes associated with learning in specific art forms (visual arts, music, theater, dance) Thus do scientists working in areas where visual thinking is important show heightened interests and abilities in the visual arts Learning through the Arts • When the arts are integrated with other related disciplines in schools, is there evidence that learning in these other disciplines enhanced For example, can we enhance the learning of mathematics by integrating math with music Developmental Trajectories of Creativity and the Arts in Typical Children, Prodigies, and Savants • How do skills in creating and responding to/understanding the arts, and in creativity, develop in each of these populations The participants will be encouraged to develop courses and projects exploring various aspects of this novel area. It is expected that the student participants will be inspired to conduct research studies in the ensuing topics. The workshop culminated in a Final Report, together with a White Paper focusing on the recommendations for the most productive areas in which to conduct research in the field of the enhancement of cognitive learning skills and education strategies by experience with creative pursuits in the arts. Reports of the meeting will be disseminated by its publication in Neuron, Nature Neuroscience or Science Magazine, based on the White Paper. Banai K, Nicol T, Zecker S, Kraus N (2005) Brainstem timing: Implications for cortical processing and literacy. Csikszentmihalyi M (1997) Creativity: Flow and the Psychology of Discovery and Invention. Pictures, Emotions and Make Believe: the Philosophy and Psychology of Picture Perception. Musacchia G, Sams M, Skoe E, Kraus N (2007) Musicians have enhanced subcortical auditory and audiovisual processing of speech and music. Attentional frames, frame curves and gural boundaries: the inside/outside dilemma. What makes a picture ‘art’ is its ability to go beyond mere representation to express the subtleties and contradictions of the human exploration of domains of cognitive and experiental creativity. Much of the impact of art is mediated by the flow of activation in the inner core of the brain – the limbic system, but the study of limbic system activation in artistic activities is still in its infancy. It is therefore of paramount importance to explore the role of both limbic activation and it is interactions with cortical centers in the human activities of art, creativity and learning. Musical structure and the frontal lobes: implications for creativity Daniel Levitin, McGill U, Montreal Abstract: I argue that the act of music listening is itself a creative act, involving prediction processes on the part of the listener. The implications of this work for theories of brain function, music processing, and creativity are discussed. And does a structural approach to the functioning of the brain in making art give us a fresh perspective to understanding the neurophysiology of cognitive development Vision and Art: a hands-on inter-disciplinary approach to teaching both Margaret Livingstone, Harvard Medical School and Bevil Conway, Wellesley College We will introduce some of the principles of visual neuroscience and show how artists have implicitly (and occasionally explicitly) taken advantage of these in developing works of art. We will then present a sample syllabus hi-lighting how these issues can be approached in the undergraduate classroom setting, with hands-on laboratory exercises and self-directed learning projects. The goal of such a syllabus is not only to advance an understanding of the 32 neural systems that underlie vision but also to cultivate observational skills and critical thinking. What are we trying to explain: the phenomenology of aesthetic pleasure Michael Kubovy, University of Virginia I am often concerned that cognitive scientists and neuroscientists who write about assume that there is consensus on what were talking about in this workshop. An experienced life consists of experienced strands relatively impermeable realms of experience a concept that draws upon two diverse ideas of about the nature of frames in experience (Goman, 1974; Subirana-Vilanova & Richards, 1996). An episode is a totally ordered set of experienced events, bracketed by the first event, which is experienced as the beginning event, and the last event, which is experienced as the ending event. Certain characteristics of pleasurable episodes, are related to narrative(s) they might engender, which allows one to consider not only the pleasurability of temporally extended aesthetic experiences, but also of putatively static works of art, such as paintings and sculptures. Art and neuroscience through the lens of perceptual organization Lora Likova, Smith-Kettlewell Institute, San Francisco Perceptual organization is so effortless that we take it for granted; science first posed the problem of perceptual organization only about a century ago. Artists, however, were fully utilizing most of the underlying laws long before the Gestalt psychologists revealed them. My focus will be on the figure/ground relationship, which play a major role in both perceptual organization and artistic composition. What neural architecture allows local and global information to be combined rapidly, as it is necessary for figure/ground The figure/ground network is widely distributed, going beyond the occipital cortex to reach to higher areas in the frontal cortex. Interestingly, visual art analysis shows that the artists had the right intuition, in understanding the importance of suppressing the background in order to allow the figure to ‘stand out’ and form the focus of attention. Shared neural resources for music and reading: Implications for learning Nina Kraus, Northwestern U, Chicago the effects of musical experience on the nervous system’s response to sound are pervasive and extend beyond music to the language domain (Musacchia et al. Music and speech sounds consist of three fundamental components: pitch, harmonics and timing, and the neural transcription of these elements can be assessed objectively, non 33 invasively and with great fidelity with scalp electrodes in humans. Musical experience and short-term auditory training can enhance subcortical representation of the acoustic elements known to be important for reading (Banai et al. The shared biological resources underlying the neural processing of music and language can be used to improve the learning of literacy and literacy-related skills. Dance and the brain Steven Brown, Simon Fraser U, Vancouver We can think of dance as a marriage of the rhythmicity of music and the representational capacity of language. The first neuroimaging studies of dance have recently been published, and have examined brain areas involved in both the production and perception of dance. Production studies have focused on two key issues, namely spatial navigation of the body, and rhythmic entrainment of movement to an external timekeeper, such as a musical beat. Perception studies have looked at neural “expertise effects”, demonstrating brain activations that occur preferentially in people who are competent to perform the dance movements being observed. Functional neuroanatomy of music perception in children Stefan Koelsch, U of Sussex, Brighton this talk presents studies using chord sequence paradigms to investigate brain responses to music-syntactically regular and irregular chords. In 10-year-old children, irregular chords activate the inferior frontal gyrus and ventrolateral premotor cortex, orbital frontolateral cortex, the anterior insula, anterior and posterior areas of the superior temporal gyrus, and the superior temporal sulcus. These structures presumably form different networks mediating cognitive aspects of music processing (such as processing of musical syntax and musical meaning, as well as auditory working memory), and possibly emotional aspects of music processing. Musical training was correlated with stronger activations in the frontal operculum and the anterior portion of the superior temporal gyrus. These results indicate that musical training can improve the processing of musical as well as of linguistic syntax, and the data corroborate the notion of a strong overlap of the neural resources underlying music and language processing. Defining art as a communicative system that conveys ideas and concepts explains why it is possible for the same brain that supports human language to support other communicative systems, art being one of them. This would presuppose millions of years of brain evolution and biological adaptive strategies. I will describe what we can surmise regarding the neuroanatomical underpinning of art production and appreciation from observations of brain damage in established artists, the relationship between art and other communicative displays by biological organisms, and explain the role that beauty plays in art. It was important to be curious, and important to explore different intellectual worlds, but it was crucial to seek connections. He admonished others to learn from nature, not from each other; to carry a small pad and describe and sketch their observations — invariably honing their observational skills. The model that worked magnificently for him will never make anyone else another Leonardo, but it cannot fail to make everyone more creative, and more effective practitioners in whatever intellectual world they inhabit. Dake, Iowa State University this presentation will survey three applied research projects in the scholarship of teaching and learning that have attempted to create a new systematic curricular frame for brain compatible visual education. Utilizing knowledge from neuroscience to focus curricular activities and modify pedagogy, these three extended educational research projects have successfully sought to simultaneously improve visual arts education and emphasize its importance as basic to general learning. In will begin my talk by summarizing research in the learning sciences that reveals the sorts of learning environments that foster deeper conceptual understanding, thinking ability, and problem solving ability. I then describe how improvisational collaborations among students can contribute to these learning outcomes. My concluding message is that collaborative improvisation should play a central role in classrooms that are designed according to learning sciences principles. Emotional intelligence, education and the brain Andrea Shindler, the Foundation for Human Potential, Chicago A brief summary of the symposium of the Foundation for Human Potential, entitled ‘Emotional Intelligence, Education and the Brain’ and presented at the Art Institute of Chicago, will be shared.
Syndromes
- Restlessness
- Heart attack
- Caregivers may try reminding the person to keep lips closed and chin up
- Have a urinary catheter
- Nausea or vomiting.
- Methanol
- Light-headedness
- Loss of function or feeling in the muscles
- Medicine to manage mental disorders (such as phenothiazine)
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Network Participation Termination and Appeals Purpose and Goal the Network Practitioner Termination and Appeals Policy and Procedure is designed to define the criteria by which Empire evaluates certain managed healthcare practitioners participating in our network for possible termination or other actions, as necessary. Policy Statement Empire contracts with various practitioners so that it can offer quality, accessible, cost-efficient healthcare to its managed care network members. Empire monitors the care provided by the practitioners participating in our network and re-credentials them every three years to ensure that such healthcare is being rendered. Participation Termination and Appeals Certain circumstances, including but not limited to, professional misconduct of a participating practitioner within our managed care network may require Empire to take certain actions with respect to the practitioner’s participation in the network. Actions may include termination of the practitioner’s network participation privileges, as set forth below. Voluntary Terminations • All providers who wish to terminate their contractual relationship with Empire must abide by the terms of the provider agreement, including but not limited provisions concerning notice and continuation of care (See Continuity of Care) Non-Renewals • Empire may elect to non-renew a provider’s agreement and will provide notice of non renewal in accordance with the terms of the provider agreement. Please note that non renewal is not considered a termination under New York Public Health Law 4406-d. Immediate Terminations • Immediate Terminations can occur in the following instances: o Sanctioned, debarred or excluded from participation in any of the following programs: Medicare, Medicaid or Federal Employee Health Benefit Plan. Hearings: • If Empire proposes to terminate a health care professional’s agreement and that health care professional is entitled to a hearing under New York law, the following process shall apply: • the termination notice shall include: o the reason(s) for the proposed termination and o Notice that the health care professional has the right to request a hearing or review, at the health care professional’s discretion, before a panel appointed by Empire; o A statement that the health care professional has 30 days to request a hearing; and o A statement that Empire will schedule a hearing date within thirty days after the date of its receipt of a request for a hearing. A health care professional’s failure to submit a request for a hearing within 30 days will be deemed a waiver of any hearing rights. The proposed contract termination will become final and you will not be afforded any additional appeal rights. The hearing panel will be comprised of a minimum of three persons, of whom at least one-third will be a clinical peer in the same discipline and the same or similar specialty as the health care professional. The panel can consist of more than three persons, provided the number of clinical peers constitutes one-third or more of the total membership. Decisions will include one of the following and will be provided in writing to the provider: reinstatement; provisional reinstatement with conditions set forth by Empire, or termination. Decisions of termination shall be effective not less than 30 days after the receipt by the health care professional of the hearing panel’s decision. In no event shall determination be effective earlier than 60 days from receipt of the notice of termination. Information reviewed during this activity may indicate that the professional conduct and competence standards are no longer being met, and Empire may wish to terminate providers. Immediate terminations may be imposed due to the practitioner’s suspension or loss of licensure, criminal conviction, or Empire’s determination that the practitioner’s continued participation poses an imminent risk of harm to Empire’s members. A practitioner whose license has been suspended or revoked has no right to Informal Review/Reconsideration or Formal Appeal. The credentialing staff will comply with all state and federal regulations in regard to the reporting of adverse determinations relating to professional conduct and competence. Medicare Advantage Provider Website Please refer to the Medicare Eligible website online for additional information at Medicare Advantage Provider Manuals are available on the Medicare Eligible website referenced above. When a conflict arises between federal and state laws and regulations, the federal laws and regulations supersede and preempt the state or local law (Public Law 105-266). Providers and Facilities agree to provide to Plan, at no cost to Empire or Member, all information necessary for Plan to determine its liability, including, without limitation, accurate and complete Claims for Covered Services, utilizing forms consistent with industry standards and approved by Plan or, if available, electronically through a medium approved by Plan. Plan is not obligated to pay Claims received after this one hundred eighty (180) calendar day period. Except where the Member did not provide Plan identification, Provider and Facility shall not bill, collect, or attempt to collect from Member for Claims Plan receives after the applicable period regardless of whether Plan pays such Claims. Such refund or adjustment may be made within five (5) years from the end of the calendar year in which the erroneous or duplicate Claim was submitted. The review procedures are designed to provide Members with a way to resolve Claim disputes as an alternative to legal actions. Providers and Facilities are required to demonstrate that the contract holder or Member has assigned all rights to the Provider or Facility for that particular Claim or Claims. When a Claim or request for Health Services, drugs or supplies – including a request for precertification or prior approval – is denied, whether in full or partially, the local Plan that denied the Claim reviews the benefit determination upon receiving a written request for review. This request must come from the Member, contract holder or their authorized representative. The request for review must be received within six months of the date of the Plan’s final decision. If the request for review is on a specific Claim(s), the Member must be financially liable in order to be eligible for the disputed Claims process. The local Plan must respond to the request in writing, affirming the benefits denial, paying the Claim, or requesting the additional information necessary to make a benefit determination, within 30 calendar days of receiving the request for review. If not previously requested, the local Plan is required to obtain all necessary medical information, such as operative reports, medical records and nurses’ notes, related to the Claim. If the additional information is not received within 60 calendar days, the Plan will make its 174 | Page decision based on the information available. Only the Member or contract holder may do so, as outlined in the Blue Cross and Blue Shield Service Benefit Plan brochure. A formal Provider or Facility appeal is a written request from the rendering Provider or Facility, to his/her local Plan, to have the local Plan re-evaluate its contractual benefit determination of their post service Claim; or to reconsider an adverse benefit determination of a pre-service request. The request must be from a Provider or Facility and must be submitted in writing within 180 days of the denial or benefit limitation. In most cases, this will be the date appearing on the Explanation of Benefits/Remittance sent by the Plan. For pre-service request denials, the date will be the date appearing on the Plan’s notification letter. The request for review may involve the Provider or Facility’s disagreement with the local Plan’s decision about any of the clinical issues listed below where the Providers or Facilities are not held harmless. Not all benefit decisions made by local Plans are subject to the formal Provider and Facility appeal process. The formal Provider and Facility appeal process does not apply to any non-clinical case. When a Claim or request for services, drugs or supplies – including a request for precertification or prior approval – is denied, whether in full or partially, the local Plan that denied the Claim reviews the benefit determination upon receiving a written request for review.
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