Sniffing Can Help Communications and Steer Wheelchairs

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A new health gadget will allow disabled persons steer their wheelchairs or communicate with loved ones through sniffing-inhaling and exhaling through the nose.

Professor Noam Sobel, engineers Dr. Anton Plotkin and Aharon Weissbrod, along with research student Lee Sela of Weizmann Institute of Science’s Department of Neurobiology created the new system which identifies changes in air pressure inside the nose’s nostrils. The gadget then translates these changes into electrical signals. The device was tested on healthy individuals as well as quadriplegics and the data showed that the device is easily learned.

Patients who have “locked-in syndromes” (unimpaired cognitive abilities while being completely paralyzed) have the ability to finally communicate with others and to even initiate communication. Caretakers the world over will rejoice once this technology spreads to common use. Many parents of paralyzed children have longed for the day to hear their child speak… and with the new sniffing technology, they may get that chance.

Even those patients on respirators can control the muscles involved in the soft palate to sniff. Researchers were able to devise a device that bypasses the airflow into the nostrils. About 75% of these patients were able to use the device. For the healthy patients, the device was favorable such as a mouse or joystick used to play video games.

One woman who had been locked-in for 18 years after a traffic accident says the device is easier to use than a blink-based device. About 13 patients were able to use sniffing to operate a computer and write messages. For most, it only took days to learn the device and how to sniff to operate.

Further fascinating results included the case of steering wheelchairs. After 15 minutes of practice time, a patient was able to navigate a route with sharp turns as well as a non-disabled volunteer. This could also lead to other uses such as for pilots or even surgeons. Because the device can detect in or out directions of sniffing, and long or short sniffs, there exists the possibility of creating a “language” with multiple signals.

The best news is that it’s relatively inexpensive to produce these devices. This means more people who need this device and are on disability income are more likely to afford them on their own. Insurance companies are also more likely to cover the device if it is cost-efficient.

Communication Gap Seen Between Patients, Doctors

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What doctors think they are telling hospital patients, and what those patients actually hear, may be very different, a small study suggests.

The findings, from a study of 89 patients at one U.S. hospital, add to research showing that doctors and patients are often not on the same page when discussing diagnoses and treatment.

In interviews with the patients on the day of their discharge, researchers found that only 18 percent even knew the name of the main physician in charge of their hospital care. Meanwhile, just 57 percent left the hospital knowing what their diagnosis was.

In contrast, two-thirds of the 43 physicians interviewed thought their patients knew their name, and 77 percent believed their patients were aware of their diagnosis.

Drs. Douglas P. Olson and Donna M. Windish of Yale University School of Medicine in New Haven, Connecticut, report the results in the Archives of Internal Medicine.

The finding that many patients were unsure of their diagnosis or their doctor’s name may sound surprising, but it is not new, according to Olson. Past studies have found that the majority of hospital patients cannot name their main physician, and frequently cannot name their medical problem.

However, the current study also shows that many doctors mistakenly believe their patients know more than they do.

“What’s new here is the discrepancy between doctors and patients,” Olson told Reuters Health. “Patients aren’t really getting the take-home message.”

The communication gaps go beyond names and diagnoses, the study found. Of patients in this study who were prescribed a new medication during their hospital stay, one-quarter said their doctor never told them about it. And very few — 10 percent — said their doctor discussed the drug’s potential side effects with them.

In contrast, all physicians in the study said they at least sometimes told patients about any new prescriptions, and 81 percent said they described the possible side effects at least some of the time.

In recent years, the medical community has increasingly focused on improving doctor-patient communication. In residency programs at academic hospitals, for instance, doctors-in-training are taught to include patients in discussions rather than talking amongst themselves in front of patients, Olson pointed out.

“But there’s still a disconnect,” he said, adding that even when patients say they understand, that often turns out not to be the case.

One explanation, according to Olson, may be that many hospitalized patients are elderly and have complex medical problems — not just one diagnosis, but several co-existing health conditions — and the information they receive during their stay “could understandably be overwhelming.”

And compared with 30 or 40 years ago, Olson noted, patients’ hospital stays are now typically much shorter; that leaves them with less time to absorb and fully understand information about their condition and any treatment changes.

One potential way to address the communication gaps would be to give patients and families written information, in addition to spoken explanations, during the hospital stay — and not only at discharge, Olson said.

“It’s important for us to take a step back and see how some system changes might improve communication,” he said.

Steps patients and their family members can take include writing down any questions as they come up so they can raise them with the doctor later, according to Olson.

Family involvement is important, he noted, particularly for older patients with more complex medical problems and multiple medications.

“How is my life going to be different when I leave the hospital?” is a good general question that patients can ask their doctors, Olson recommends. It can help start a discussion about a range of concerns, including any lifestyle adjustments and medication changes that need to be made, he said.

Olson also advised that patients lacking a primary care doctor get the number of someone at the hospital whom they can call with any questions after they are discharged.

Chimp Study Offers New Clues to Language

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(WASHINGTON D.C.) – Why don’t chimpanzees have language the way humans do? Researchers are confident that it has something to do with differences in their brains that arose sometime in the past 5 million to 7 million years, when the chimp and human lines went their evolutionary ways. But exactly what differences account for human language are not entirely clear. Size might have something to do with it, because the modern human brain is about 3.6 times as big as that of a chimp. And yet chimp brains appear to share many features with their human counterparts, including a frontal lobe region called Broca’s area (purple in image) that in humans is closely associated with speech and language.

Most studies of Broca’s area in human brains have concluded that it is larger on the left side than the right, which seems to correlate with the finding that 94% of right-handers do most of their speech and language processing on the left sides of their brains. Scientists had long assumed that this asymmetrical enlargement of Broca’s area in humans was key to language abilities. But in 2001, researchers led by William Hopkins, a primate neuroanatomist at Emory University in Atlanta, began reporting that the brains of many apes also had asymmetrical Broca’s areas. The first such report, in the 29 November 2001 issue of Nature, found enlarged left-side Broca’s areas in the brains of chimpanzees, bonobos, and gorillas. And in a 2008 paper in Current Biology, Hopkins and his colleagues reported that Broca’s area is activated in chimp brains when they communicate with gestures or vocalizations. Hopkins and his co-workers concluded that the enlargement of Broca’s area, and its role in communication, began before the chimp-human split and was not unique to humans.

Yet a new paper, published online last week in Cerebral Cortex, challenges some of these findings and argues once again that the language centers of human brains are special.

The new study, led by evolutionary neuroanatomist Chet Sherwood of George Washington University in Washington, D.C., finds that Broca’s area in the chimpanzee brain does not show a clear asymmetry. And here’s a surprise: One of the co-authors is none other than William Hopkins. How can researchers come up with such conflicting results on such a fundamental issue, one important to understanding the evolution of language?

The answer lies largely with the difficulties in studying Broca’s area. For starters, researchers do not always agree about exactly what part of the frontal lobe should be included under that name. Thus, many brain experts define Broca’s area as two adjacent regions, called Brodmann’s areas 44 and 45, which have been associated respectively with the verbal production of speech and giving meaning to speech. But others have included a somewhat larger area in their studies, called the inferior frontal gyrus (IFG), which includes areas 44 and 45 but a few other structures as well, such as Brodmann’s area 47. Hopkins’s 2008 study, for example focused on the IFG, whereas his 2001 study targetted only area 44.

Another obstacle is that there is great variation among both humans and chimps in the sizes of their Broca’s areas, how asymmetric they are, and even their exact location in the brain. Thus, one key study in 10 humans (five male and five female), led by neuroanatomist Katrin Amunts of the Institute of Medicine in Jülich, Germany, found that area 44 was larger on the left side of the brain in all subjects, but the difference was only statistically significant for the men—whereas area 45 was only significantly larger on the left side for the women! (Nevertheless, this study did confirm the overall enlargement of Broca’s area on the left side.)

For the new study, Sherwood and his colleagues focused primarily on areas 44 and 45. The team studied the brains of 12 chimpanzees that had lived at the Yerkes National Primate Research Center in Atlanta. Within 14 hours of each chimp’s death, its brain was removed and preserved to avoid shrinkage and other artifacts; it was then scanned with MRI and eventually sectioned into tissue blocks. The boundaries of Brodmann’s areas 44 and 45 were defined using special software, and parameters including the volume of Broca’s area and the number of neurons it contained were measured.

The team found that although some of the chimps had what they called “notable asymmetry” in their Broca’s areas—defined as more than a 10% difference in volume or number of neurons between the two sides of their brains—there was no consistent pattern in the direction of the asymmetry. In other words, there was no evidence that chimps have enlarged Broca’s areas on the left side of their brains as humans do.

As for why the new study differs with Hopkins’s previous work, the researchers suggested, among several possibilities, that the earlier studies—which relied upon MRI but not additional tissue sectioning to more exactly define areas 44 and 45—might have picked up differences in underlying white matter, which forms connections with other parts of the brain rather than restricting itself to the gray matter of Broca’s area, where speech processing takes place. If so, the team concludes, the common ancestor of chimps and humans may have evolved symmetries in white matter connectivity before the chimp-human split, possibly associated with gestural or vocal communication, and only afterward did the speech- and language-processing areas themselves become asymmetric.

Although Hopkins, as a co-author of the paper, signed off on this suggestion, he told me in an e-mail that he thinks the jury is still out on whether the Broca’s area of chimps is really asymmetric. For example, he thinks that the team’s data could still be interpreted to indicate that area 44 in chimps is larger on the left side, although probably not area 45. “I think there is much more to the Broca’s story,” Hopkins says. Dean Falk, an anthropologist at Florida State University in Tallahassee, told me that although the paper has “important implications,” she is not convinced by the authors’ suggestions about why the new results differ from Hopkins’s earlier work. Falk thinks the researchers should have included Brodmann’s area 47 in their study because, she says, this area “is now known to be important in semantic processing and might even be more important for evolutionary studies” than areas 44 and 45.

Nevertheless, the authors say that their results argue anew for human uniqueness. Although the human brain is 3.6 times larger than the chimp brain, they say, the new work shows that on average the left-brain Brodmann’s area 44 is 6.6 times larger in humans and left-brain Brodmann’s area 45 is 6.0 times larger than in chimpanzees. “Because areas 44 and 45 are among the most greatly expanded cortical areas yet identified in humans,” the team writes, “this evidence supports the conclusion that enlargement of Broca’s area on the left side is an evolutionary specialization.”

Communicating With Your Teenager

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Improving the channel of communication between yourself and your teenager is essential to a respectable and loving parent-child relationship. Just as a radio channel signal must to be clear in order for listeners to hear and understand the voices communication between a parent and their teenager must be clear. There are some essential communication tools that can improve the quality of Communication With Teenagers;

1. Listen

2. Set boundaries that reflect your values and provide appropriate punishment

3. Ask and value their opinions

4. Give them privacy

5. Develop an interest in their life

6. Let them know you believe in their potential as a human being and that they are of precious value to you and to the world

Listen

Listening is different to hearing. Often people are having a conversation that consists of them sharing their opinion and then while the other person speaks they are thinking about what they are going to respond without listening. Listening is not a natural quality a lot of people posses rather it is cultivated and developed through constant effort. Listening means that when someone else is talking you are listening to their words, focused on their countenance and sensitive to their emotions. When a person truly listens to another they pick up signals the other person is sending out such as body language. Body language is a huge tool to help one understand the feelings of another. By focusing on another person that person will feel important and therefore are more likely to respect your opinion.

With your teenager they might use phrases such as, “you just don’t understand” or “fine, whatever.” These phrases are closed and basically say “you don’t care about my opinion so I’m not going to listen to you.” If you teenager is constantly repeating “you just don’t understand” then ask her to explain what is so important to her and listen. Now just because you listen and focus all you attentions on your teenager doesn’t mean that you need to agree with then. But it will provide them with an opportunity to evaluate their own feelings and values. Teenagers don’t think that their parents were ever teenagers. Sometimes sharing appropriate stories of being a teenager and making decisions can make you more tangible and real to you teenager.

Boundaries

Purely being your teenager’s best friend will do them no favors. Teenagers Need Structure. Without rules and consequences they will never be prepared for the wide world which awaits them. With this said there must be a balance. Too many rules and not enough freedom will only cause your teenager to rebel. Decide what is must important to you, what do you value must about life. Avoid giving them set rules and provide them with principles. A principle is an accepted code of conduct that may apply in many facets of life. Here are some examples:

Don’t yell – Be respectful

Don’t make a mess – Take care of your possessions

You must clean your room – cleanliness of next to Godliness

Use your manners – Acknowledge your blessings through an attitude of gratitude

The only way that your teenagers will integrate these principles into their life is if they see them exemplified through your actions.

When deciding an appropriate consequence to bad behavior involves your teenager. Have family discussions and ask them what they think would be an appropriate consequence. This way when they are disobedient they can not moan about the consequence because they helped create it. Also involving your teenager in the discipline process is a manifestation that you care about what they think and that elevates them with a sense of maturity.

Ask

Teenagers are developing their ideas and opinions about the world in which they live and although those with evolve throughout their life they thrive on sharing their present thoughts. Ask you teenager what they think about smoking, teenage pregnancy, sex, underage drinking, higher education, work ethics etc… By asking then the questions they will be thinking about those topics and will be more likely to make logical and smart choices.

Privacy

Everyone enjoys some privacy especially teenagers who’s body is changing with soaring hormones. The emotional rollercoaster that accompanies the teen years often calls for some well need privacy.

Be interested

If your teenager knows you are interested in their life and their hobbies they will feel more comfortable in sharing things with you.

Importance

If you can try to always discipline with love your teenagers will soon learn that you do all you do because you love them. Tell them that they have great potential because of who they are rather than because they were captain of the football team or received an “A” in an exam. This doesn’t that these things are not accomplishments but make sure you are praising your teenagers for the choices they make and person they are becoming.

By: R. Kapoor

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