Thursday, September 27, 2007

Tel-Aviv University details research in aphasia

( -- According to recent research from Tel Aviv, Israel, "Recent studies have indicated that working memory is not a unitary resource and that different types of working memory are used for different types of linguistic processing: syntactic, semantic, and phonological. Phonological working memory was found to support the comprehension of sentences that require re-access to the word-form of a word that appeared earlier in the sentence."

"This study explored the relation between phonological working memory and sentence comprehension by testing the comprehension of garden path sentences in individuals with conduction
Loss or impairment of the power of speech or writing, or of the ability to understand written or spoken language or signs, due to a brain injury or disease',250)" onmouseout="hideddrivetip()">aphasia
who have very limited phonological working memory. Our prediction was that if phonological working memory limitation hampers word-form reactivation, only the comprehension of garden paths that require wordform reactivation will be impaired, whereas garden paths that require only structural reanalysis will be better preserved. & Procedures: Five individuals with conduction aphasia and 15 matched controls participated in working memory tests and a garden path comprehension test. The phonological working memory assessment
An appraisal or evaluation (e.g., assessment of the degree of success of a remediation procedure at a contamination site).',250)" onmouseout="hideddrivetip()">assessment
included a battery of 10 tests, which showed that four of the individuals, who had input conduction aphasia, had very limited phonological working memory, and one individual, with output conduction aphasia, had unimpaired working memory. The comprehension study included 60 garden path sentences of three types: structural garden paths, which require only structural reanalysis, lexical garden paths, which require lexical re-access in addition to structural reanalysis, and optional-complement garden paths, which require re-access to the lexical-syntactic frame of the verb in addition to the structural reanalysis. Outcomes & The main result was that the individuals with input conduction aphasia showed different degrees of impairment in different types of garden path sentences. The lexical garden paths were exceptionally hard for them, with a mere 10% correct, and significantly more difficult than the structural garden paths. The individual with output conduction aphasia whose working memory was intact comprehended the lexical garden paths similarly to the normal controls. These findings indicate that phonological working memory impairment only affects the comprehension of sentences that require phonological, word-form re-access. The type of sentence and the type of processing it requires should be taken into account when trying to predict the effect of working memory limitation on a patient's ability to understand sentences," wrote N. Friedmann and colleagues, Tel-Aviv University.....NEXT.........

When Barking Dogs Don't

A patient was telling me about the 15-year-old Canine American who shares her home. While she was on vacation, the dog had a seizure. Or maybe a stroke. According to the vets, it can be hard (ie, impossible) to tell the difference in a dog.

I can understand.

Scrubs-style fantasy of a doggie neuro exam: "Follow my finger. Can you hear this? Stick your tongue out. Hold your leg up and don't let me push it down.")

But then she added, "I haven't heard her bark since it happened."

Whoa! Aphasia in a dog? Do doggie
brains have a speech center? What about a Broca's area?

More: "It's kind of sad. She just stands outside the door when she wants to come in, but doesn't bark anymore."

Financial Aphasia: What happens when Mortgages, Credit and the Economy lose Meaning

The first time I spoke about the subject of sub-prime mortgages and the potential for this seemingly endless fallout came during a live television show in February of 2006. Granted, the demographic for that medium market audience was not the same as those watching the more affluent Bloomberg network or even the rowdy bunch who tune in to CNBC. Yet it was the very audience that needed to hear what must have seemed at the time like a “sky is falling” report.

As I revisited these thoughts over the next eighteen months, one simple fact always seemed to remain constant: we, not the investor class but the average person, continues to suffer from financial aphasia. Closely related to semantic aphasia, a mental disorder that does not allow the individual to understand the meaning of the words being spoken even as they understand what the words are, the financial form of this malady leaves the listener doing one thing while believing something wholly different. It has been best described as a little like hearing a love song - only without knowing why those words were used or what the singer meant by them.

Financial aphasia, by my definition, offers a look at the mounting storm surge that the housing market has become and the fact that, with so many people speaking about it, affected by it, and promising to reform the system, the words have lost their meaning. We hear them but we no longer understand them.

Ben Bernanke, the Federal Reserve Chairman wrote a letter recently to Senator Charles Schumer that offered some form of agreement with the outspoken lawmaker's fear. “ I share your concern about the potential impact of scheduled payment resets on homeowners with variable-rate sub-prime mortgages,” he wrote suggesting a little further along that perhaps “developing a broader range of mortgage products” might help those who are in the deepest trouble. Really?

Didn't the problem begin with mortgage products, Mr. Bernanke? The end result of the unceasing ingenuity and creativity of Wall Street to cater to risk seeking investors who saw the mortgage market as the new potential rainmaker is at the heart of this problem. More mortgage products Mr. Bernanke, are not the solution.

Even if the Fed has no direct impact on mortgage rates as many assume they do, shouldn't this traumatic event have been apparent at some point before now on their economic radar? As they sift through reams of data, is it possible that they suffer from financial aphasia?

That letter made Wall Street happy with anticipation. The possibility that Bernanke has refocused his attention on the economy, one in which he pronounced was doing just fine a month or so ago, sent stocks soaring - again. Despite what Wall Street wants and even lobbies so strongly for, and at the risk of repeating myself, an interest rate cut would not be in this economy's best interest.

Many of the newsworthy suggestions on how approach .....NEXT............

Wednesday, September 19, 2007

CIGNA Group Insurance Celebrates Return to Work Success During National Rehabilitation Awareness Week

  PHILADELPHIA, Sept. 19 /PRNewswire-FirstCall/ -- On a routine stop at
the supermarket in November 2006, Leah Freesmeier fell to the ground,
hitting the left side of her head on the cement floor and leaving her with
a severe injury to her brain. The injury left her with language and hearing
impairments, aphasia and right cranial nerve/facial palsy. She doesn't
remember falling, or most of the three weeks she was in the hospital, but
she does remember the rehabilitation she went through that enabled her to
return to her job as a customer support specialist.
"I was lucky to have CIGNA during this ordeal," said Freesmeier. "Not
only was the company great at assisting me with the overwhelming process of
understanding the various administrative aspects I had to take care of, but
my rehabilitation counselor worked very closely with me to ensure I had the
best care possible to enable me to get back to work, which was my ultimate
After intense physical and speech therapy, Freesmeier worked with a
CIGNA vocational rehabilitation counselor and was ready to return to work
six months after her injury. CIGNA's vocational rehabilitation counselors
are educated and skilled in helping individuals with disabilities make
career plans, learn new skills and face their fears. They understand and
anticipate these fears and provide support, education and resources to
overcome them.
Freesmeier's CIGNA vocational rehabilitation counselor began the
process of helping her plan her return to work. This included assessing
factors that could potentially impact the success of her return-to-work
plan and determining how some challenges could be reduced or avoided
altogether. Additionally, the counselor worked with all of Freesmeier's
treating physicians to facilitate easing her back into the workplace. Based
on their recommendations, the counselor worked with the local state
rehabilitation agency to arrange for Freesmeier to be accompanied by an
onsite coach for the first two months back on the job. The onsite coach
helped Freesmeier with things such as ensuring she was taking appropriate
notes and following processes.
"Having the onsite coach during my first few months back on the job was
very beneficial for me," says Freesmeier. "It made my transition back into
my routine a lot easier."
Freesmeier's rehabilitation experience is one of several successes
CIGNA Group Insurance is highlighting next week during a series of employee
and customer gatherings in the company's disability claim offices in
Pittsburgh, Dallas and Glendale, Calif. Through these events, CIGNA will
focus on vocational rehabilitation, celebrated each September as part of
National Rehabilitation Awareness Week, with a mission to educate people
about the benefits and impact of rehabilitation. CIGNA Group Insurance, and
sister company Intracorp, are the national sponsors of this observance,
celebrated from Sept. 16-22, in cooperation with the National
Rehabilitation Awareness Foundation (NRAF) of Scranton, PA.
CIGNA will be awarding employers, including Toyota, McKesson
Corporation and Henry Ford Health System, with a Return-to-Work Award for
their success in implementing return-to-work programs for their employees.
In addition, claimants, such as Freesmeier, will be visiting the offices to
share their successful return-to-work stories with CIGNA employees.
"CIGNA works to assist our employer customers, and their disabled
employees, in the shared goal of returning to productive work," said Mark
Marsters, senior vice president, CIGNA Group Insurance. "Many employers are
committed to ensuring return-to-work programs are in place. These efforts
not only contribute to productivity, but they also enable employees to
regain independent living."
"I never imagined something like this would ever happen to me," says
Freesmeier. "I am fortunate to be alive and I am grateful to have been able
to return to work after my rehabilitation."
For more information on National Rehabilitation Awareness Week, visit
the NRAF website at
For more information about CIGNA Group Insurance's disability programs
and services, visit
About CIGNA Group Insurance
"CIGNA," the "Tree of Life" logo and "CIGNA Group Insurance" are
registered service marks of CIGNA Intellectual Property, Inc., licensed for
use by CIGNA Corporation and its operating subsidiaries. Products and
services are provided by such operating subsidiaries and not by CIGNA
Corporation. Such operating subsidiaries include Life Insurance Company of
North America and CIGNA Life Insurance Company of New York. CIGNA Group
Insurance is one of the top five providers in disability management and
insurance with solutions that focus on helping employees return to a
productive work life as quickly and safely as possible.
CIGNA Group Insurance is also one of the top five providers of group
term life and group universal life, and the second leading provider of
group accident insurance, including voluntary accident and business travel
accident insurance.

Tuesday, September 4, 2007

After stroke, life is one step at a time

Fast action when it occurs might help limit lasting effects.

Last update: August 31, 2007 – 5:58 PM

Halloween was only a few days away, and it was the last game of the World Series. David Whitehead and his wife, Pam Bailey, had just gone to bed when Whitehead woke up to find his wife trying to crawl to the bathroom.

"She was real confused, real lethargic. Her mouth was drooped, and she had a totally confused look on her face, and her arm was like this," Whitehead said, hanging his arm lifelessly by his side.

Whitehead rushed her to a hospital near their home in Mobile, Ala. "Of course, I knew before we got her to the hospital that she had a stroke, and when I got her there, they acted like, well no she didn't," Whitehead said.

He had described his wife to the ER staff: healthy, vibrant and only 44. Not the normal profile of a stroke victim.

Then they went to help her out of the car. "The nurse -- excuse my language -- said, 'Oh sh--,' and threw her in a wheelchair," Whitehead said.

One of the most dangerous misconceptions about stroke is that it's something that only older people have to worry about, said Dr. William Hewitt, a neurologist with the Diagnostic and Medical Clinic in Mobile.

"Stroke gets more common as you get older, but we do see young people with strokes," Hewitt said.

At the hospital, Whitehead didn't see his wife for almost two hours, and when the doctors finally got back to him, Whitehead learned that his intuition was correct: Bailey had suffered a massive stroke.

There are several types of stroke, but all occur when a blood clot blocks an artery or a blood vessel breaks, interrupting blood flow to an area of the brain. When either happens, brain cells begin to die, and the physical and mental abilities controlled by those areas are damaged or lost.

Bailey's outlook wasn't good.

The effects of stroke are many and varied, depending on the severity and location of the blockage. They can include aphasia -- speech and language problems -- along with problems with memory, partial or full paralysis and problems with spatial and perceptual abilities, among a host of other lasting and life-changing effects.

While Bailey has recovered remarkably well, the aphasia remains.

"The paralysis went away within a week or two," Whitehead said. "Within a week she had her strength back, and within a month, she was walking pretty close to normal again. But it's been nine months, and her speech is still ..." Whitehead trailed off.

"But they told us she would never talk again."

Today, Bailey is talking again, but words come out a bit jumbled, and pronouns are often switched -- "he" for "she,"him" for "her." She also uses the word "him" for several other words, especially when she means to say "stroke."

But after sitting and talking with her for a while, her speech patterns emerge, and it's easy to understand what she's saying. Humor and emotion aren't lost. She knows what she means to say, but the wiring from her brain to her mouth just won't let her do it.

"Every day's different," Whitehead said.

Bailey nodded emphatically.

"Because I feel like I could do, but I can't, and I get mad," Bailey said.

The couple attend an aphasia support group at Mobile Infirmary's PRO Health Fitness and Rehabilitation Center.

The group is designed for individuals who have aphasia -- as well as their family members, friends and caregivers -- and provides education about the disorder, encourages socialization among members and provides an opportunity to practice speech and language skills.

"At the beginning, Pam was unable to say her name, even just the simple name of Pam," said Jennifer Pettis, a speech language therapist who organized the support group and works with Bailey.

With intense speech therapy, combined with practice at home with Whitehead and special speech therapy software, Bailey's improvement has been dramatic.

Frustration is one of the major hurdles in patients with aphasia, Pettis said.

"They want you to treat them like a regular adult, like a normal person," she said. "More than likely, they can understand everything you're saying, and they don't want to be talked to like a child."

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