Alzheimer's-related brain changes occur 2 decades before symptom onset

Inflammatory brain changes related to Alzheimer's disease may occur as many as 20 years before onset of symptoms, according to new research - a finding that could pave the way for early interventions that could halt disease development.


Alzheimer's disease is the most common form of dementia, accounting for around 60-80% of all cases. Around 5.3 million people in the US have Alzheimer's, of whom 5.1 million are aged 65 and older.

Researchers know Alzheimer's development is related to death of brain cells, or neurons, which leads to the memory loss and behavioral changes that are associated with the disease.

Furthermore, it is believed that brain cell death in Alzheimer's is related to a combination of inflammatory brain changes, tangles that develop inside neurons (caused by a build-up of tau protein), and the development of plaques between brain cells (caused by an accumulation of protein fragments called beta-amyloid).

Researchers believe that these plaques and tangles impair communication between nerve cells, interfering with the processes that aid brain cell survival.

However, precisely when plaques, tangles and inflammatory brain changes begin has been a mystery - one that principal investigator Prof. Agneta Nordberg, of the Karolinska Institutet in Sweden, and colleagues believe they may have unraveled with their latest study.

Using radioactive tracer molecules to monitor brain changes
To reach their findings, which are published in the journal Brain, the team scanned the brains of more than 50 participants using positron emission tomography (PET).

Some of the study participants were at higher risk for Alzheimer's due to having relatives with gene mutations related to the disease, while some patients had non-inherited, "sporadic" Alzheimer's.

All subjects were injected with three radioactive tracer molecules prior to PET scans - PIB, Deprenyl and FDG - which allowed the researchers to track plaque levels and inflammation related to activation of astrocytes, the most common support cell in the brain.

Additionally, the researchers measured the glucose metabolism in participants' brains, providing insight into brain cell function.

PET scans were repeated for half of the participants 3 years later, allowing the team to assess brain changes over time, and all subjects were required to complete memory tests.

Astrocyte activation peaks when plaque accumulation begins
Among participants with Alzheimer's-related gene mutations, the researchers identified plaques and inflammatory changes nearly 20 years prior to the estimated onset of memory problems.

Specifically, the researchers found that when plaques begin to accumulate in the brain, astrocyte activation reaches its peak.

"Astrocyte activation peaks roughly 20 years before the expected symptoms and then goes into decline, in contrast to the accumulation of amyloid plaques, which increases constantly over time until clinical symptoms show," explains Prof. Nordberg. "The accumulation of amyloid plaque and the increase in number of astrocytes therefore display opposing patterns along the timeline."

It is approximately 7 years prior to the onset of Alzheimer's symptoms that brain cell function starts to decline, according to the researchers.

The team identified no such brain pathology among individuals who did not possess Alzheimer's-related gene mutations.

According to the authors, these findings suggest that inflammatory brain changes related to Alzheimer's may occur long before disease onset. What is more, they note that astrocytes could be a possible drug target for the condition; reducing astrocyte activation early on could stop the disease from developing or change its course of progression.

Medical News Today recently reported on a study suggesting that anxiety may increase the risk of dementia.

(Source: medicalnewstoday.com)

Follow a fracture with physical therapy

Over the past couple of weeks, I have noticed a growing trend of patients that have sought out physical therapy treatment on their own, without their physician’s recommendation and sometimes in spite of it. The alarming part is that these patients were relatively young, all had recent fractures that were cast, and were all high-level athletes.

To be fair, there could be a number of reasons these patients were never specifically referred to physical therapy, but to ensure that the reason is not from a lack of information or public awareness, today’s article will review the evidenced based reasoning why physical therapy should be the standard course of care after a cast comes off.

First, let’s talk about fractures in general and what is happening during the healing process. A bone can be fractured — or broken — a number of different ways and as a result of a variety of stresses. Breaks can take on a spiral pattern, they can be displaced, or even splintered; but when it comes to healing them — they all need to be immobilized. This is where the ubiquitous “cast” enters the equation. We’ve all had them, had our friends sign them, and struggled to find the right cooking utensil to stick down them to reach those hard to reach itches.

The primary purpose of the cast is to simply hold the bone still so that as our body builds at first a soft, then hard, bony callus, the healing process is not disrupted, prolonged, or prevented from happening all together.

So a cast is a great, low tech, tool to help ensure successful healing from a fracture, but a cast does some other things as well, however, which are not so beneficial. The simple act of immobilizing any body part can contribute to joint stiffness, atrophy or muscle wasting, and can result in a loss of motor control/coordination.

These side effects of being casted are almost entirely unavoidable, nor are they too serious, but they do need to be addressed before considering yourself fully healed. When the cast comes off after about six weeks, it is not recommended that you simply run back out on the field and do the things that you were doing before — no matter how young and healthy you are. In fact doing so predisposes you to secondary injuries that would be completely avoidable.


Physical therapy is the best way to address each one of these aforementioned impairments and ensure that when you do return to sport, you will do successfully and injury free. PT — while controlling for pain and swelling — will first restore full range of motion addressing both the bony components of joints and soft tissue, begin an appropriate strengthening progression and provide specific activities to regain coordination and balance to allow for a successful return to any sport.

In other words, without it, you are missing out on one of these most critical components of your overall recovery and you shouldn’t let that happen.

(Source: handfordsentinel.com)

New Special Education Jobs

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from Jobs http://ift.tt/1NB0Ub8

New Special Education Jobs

Profession: Special Educator
Population: Pediatrics
Position:
Location: Manhattan, NY
Description: Toddler in Manhattan zip code 10016 on East 27th St is in need of Special Instruction1x30 per week. May contact parent for scheduling.
from Jobs http://ift.tt/23tzhN8

Physical therapy patients may improve faster without opioids

EDMONTON, Alberta, Jan. 22 (UPI) -- Patients who have not been prescribed opioid painkillers benefit more from physical therapy, according to researchers in Canada.

A study at the University of Alberta found patients not taking the powerful drugs for pain while rebuilding physical ability regain function faster.

The researchers suggest adjusting therapy programs for individual patients' pain tolerance, using a graded approach to recovery by slowly building back to full function.

"Even though opioid medications can be a powerful pain killer, it does not necessarily mean improved function will follow -- pain is not the only factor in determining function," Geoff Bostick, an associate professor of physical therapy at the University of Alberta, said in a press release. "It can be difficult helping people move when they have pain, but as a physiotherapist I know the importance of physical function and we have to help find a way to promote movement, even if it is painful."

In the study, published in the journal Pain Medicine, researchers followed 789 patients in Canada being treated for neuropathic pain from nerve injuries being treated with either less than 200 milligrams of an opioid, more than 200 milligrams, or none.

Patients who were not prescribed any type of opioid had statistically lower disabilities and higher physical function scores over the course of 12 months than those who received the drugs, after adjusting for the severity of individual conditions.

Bostick said opioids can be useful for managing pain, though they do not allow some people to recover function, so the drugs interfere with their lives. He suggests patients use careful measurement of their pain tolerance, walking until they reach the halfway point of what they can handle and stop before it gets too bad, in order to build tolerance over time.

"Pain is very complex, and people experience pain at very different levels," Bostick said. "Opioids can help people with severe pain be more comfortable, but if they are not also facilitating improved function, the impact of these medications on quality of life should be questioned."

(Source: upi.com)

Occupational Therapy "MacGyver" Creates Tools For People With Disabilities.

(University of New Hampshire) University of New Hampshire faculty member Therese Willkomm calls herself “MacGyvette.” But Willkomm doesn’t fight crime like the resourceful 1980s television sleuth; rather, she fashions tools from everyday objects that make life easier for people with disabilities. 

Willkomm, clinical assistant professor of occupational therapy and director of Assistive Technology in New Hampshire Institute on Disability, is a specialist in assistive technology, which she describes as “solutions for easier living, learning, working, and playing.” 

And while the users of her solutions have some form of disability – from an aching back to extensive paralysis – Willkomm’s work rarely deals with expensive wheelchairs, specialized computers or complex communication systems. “Eighty percent of assistive technology costs $100 or less,” she says.
This article also ran in Connecting, which is Raising Special Kids‘ Quarterly Newsletter – Winter 2015.

Willkomm’s assistive technology solutions employ custom items she “MacGyvers” from inexpensive, ordinary items such as Plexiglas, PVC, and assorted tapes as well as off-the-shelf products like wheeled carts, easy-grip tools or two-way radios. And like MacGyver, Willkomm is speedy and resourceful – her trademark is creating solutions in five minutes or less with inexpensive, readily available materials.
“One of the things I’ve struggled with is how long people have to wait for a solution,” says Willkomm. “Often times, people are literally dying while they wait. What I’m trying to do is a whole paradigm shift. What can we do today that can make a difference?

Willkomm shares her creativity in a book, “Assistive Technology Solutions in Minutes: Make a Difference Today!” that helps her students and others find and make quick, easy solutions. Another recent publication, “Solutions for Easier Living Located in Your Neighborhood,” highlights solutions found in most hardware, office supply, or discount department stores.

Among her favorite assistive technology solutions:
Using a plastic flagpole holder, epoxy putty, and Pam cooking spray, Willkomm mounted a camera onto a wheelchair, giving the user – a school-aged boy – a new way to connect with his classmates. “Cameras are great for kids who have a hard time communicating,” she says. “I’m always blown away by what they take pictures of.”

To help an 18-year-old with a brain injury that affected his ability to remember daily hygiene sequences, Willkomm created a rap CD (played in a shower-mounted CD player) that cued each showering activity, from “turn on the water” to “put the soap on the puff” to “rinse off the soap.”

For a dairy farmer with a high-level spinal cord injury, she rigged a two-way radio with a large spring-loaded Plexiglas button so he could call his wife if she was in the field. She mounted it next to his wheelchair; a rubber bumper inside the plastic holder let him activate the call button on the radio with very little head or hand movements.

Willkomm has a special affinity for the dairy farmer; she credits her “make it in minutes” approach to growing up on a dairy farm in Wisconsin. “You’re taught how to fix things fast – if the cows get out, you’ve got to fix that gate now,” she says. She honed her craft at the University of Pittsburgh, where she received a Ph.D. in rehabilitation science and technology and wrote her doctoral dissertation on ergonomic risk factors and tractor modifications for farmers with spinal cord injuries. After working in the field for 25 years and serving as an adjunct professor at UNH for eight of them, she joined the UNH faculty in the fall of 2005. 

She holds a joint appointment to the occupational therapy department and the Institute on Disability as the director of New Hampshire’s statewide assistive technology program. An aging population and changing health care make Willkomm’s assistive technology solutions more relevant than ever. She cites a World Health Organization statistic that says the number of people with disabilities will continue to rise, but the money to support them remains level. 

“That means we’ve got to be creative,” she says. “We need to empower the people most influential in the lives of people with disabilities: the family members, the teacher aides, and job coaches.” 

At UNH, Willkomm empowers the next generation of occupational therapists. In the course Introduction to Assistive Technology, she challenges her students to make an on-off switch with nothing more than a business card, some foil tape, and speaker wire. Every student receives a copy of her book and a tool kit that MacGyver would envy, complete with a miniature blow torch and other fabrication tools, epoxy putty, several pieces of acrylic, speaker wire, and specialty tape. 

“Am I trying to turn all my students into MacGyvers? No,” she says. “But I’m teaching them creative problem solving.”


(Source: azednews.com)

To Better Cope With Stress, Listen to Your Body

To handle stress and adversity more effectively, we should probably pay closer attention to what is happening inside our bodies, according to a fascinating new brain study of resilience and why some people seem to have more of it than others.

We live in difficult times, as readers of this newspaper know well. Worries about the state of our world, our safety, our finances, health and more can lead to a variety of physiological and psychological responses.

“When faced with stress, whether it’s giving a talk in front of a hundred people or feeling pressured to get a second gold medal at the Olympics, we experience changes in our body,” said Lori Haase, a clinical professor of psychiatry at the University of California in San Diego and lead author of the new study. Our heart rates rise, breathing grows shallow, and blood levels of adrenaline and other stress chemicals soar.

While this stress response can have desirable results — “I need anxiety to motivate myself to write a grant,” Dr. Haase said — it can easily can get out of hand. Remaining in a state of heightened arousal undermines physical and mental performance, she explained. So while our bodies should respond to dangers and worries, our stress reactions also should dissipate as soon as possible afterward.

This is where resilience comes in. In scientific terms, resilience is the ability to rapidly return to normal, both physically and emotionally, after a stressful event.

Scientists and therapists long have known that some people are more resilient than others but had not known precisely why.

In recent years, Dr. Haase and colleagues have begun to speculate that part of the answer might involve whether and how people listen to their bodies.

To reach that conclusion, the researchers had been examining how adventure racers and elite special-operations soldiers develop resilience in the face of the frequent and often extreme physical and emotional demands of their jobs. The researchers had asked those men and women to lie in brain scanning machines while wearing face masks that, when the researchers touched a button, made it difficult to breathe, conditions that the brain and body find quite stressful.

The scientists soon noticed a common pattern of brain activity among these volunteers. Portions of their brains that receive and process signals from the body, such as changes in heart rate or breathing, were very active when the volunteers thought that their masks were about to close. But despite this heightened awareness, the flow of messages from those parts of the brain to areas that intensify bodily arousal were fairly slight.

In other words, the brains of these highly trained men and women closely monitored the beginnings of bodily panic but dampened the response. They experienced stress but didn’t overreact. They were resilient physically and mentally.

They also, of course, were outliers; most of us are not elite athletes or soldiers.

So for the new study, which was published this month in Biological Psychology, the same researchers recruited 48 healthy adults and asked them to complete a standard questionnaire about their self-perceived emotional and physical resilience. Based on their scores, the scientists assessed them as having high, average or low resilience.

Then they scanned the men’s and women’s brains while the volunteers wore the same type of face masks the athletes and soldiers had and, like them, underwent periodic moments of breathlessness.

The people whose scores had showed that they were highly resilient displayed brain activity very similar to that of the elite athletes and soldiers, as did, to a lesser degree, people with average resilience.

But the brains of those people with low resilience scores behaved in almost the opposite way. As their face masks threatened to close, they displayed surprisingly little activity in those portions of the brain that monitor signals from the body. And then, when breathing did grow difficult, they showed high activation in parts of the brain that increase physiological arousal. In effect, they paid little attention to what was happening inside their bodies as they waited for breathing to become difficult — and then overreacted when the threat occurred.

Such brain responses would undermine resilience, the scientists concluded, by making it more difficult for the body to return to a calm state.

Of course, this study was based on people’s own assessments of their resilience and on a one-time snapshot of brain activity. It can’t tell us why the brains of the different groups of volunteers worked differently or whether we can change our brains’ responses to stress.

But the researchers found the results compelling. “To me, this study says that resilience is largely about body awareness and not rational thinking,” said Dr. Martin Paulus, the scientific director of the Laureate Institute for Brain Research in Tulsa, Okla., and the senior author of the study. “Even smart people, if they don’t listen to their body, might not bounce back” as quickly from adversity, he said, as someone who is more attuned to his or her physiology.

Improving internal communications with our bodies may be as simple as spending a few minutes each day in focused breathing, Dr. Haase said. Quietly pay attention to inhaling and exhaling without otherwise reacting, she said. Over time, this exercise should “teach you to have a change in breathing when anxious but be less attached to that reaction,” Dr. Haase said, “which may help to improve your reaction in a stressful situation.”

(Source: well.blogs.nytimes.com)

From not talking to thriving: First-grader overcomes speech delay

For most parents, hearing their 3-year-old say the word "ball" is a common occurrence.

For Jennica Wahl of Ferndale, it was nothing less than an "awesome" experience.

That's because until he was 3, her son, Aubin, hadn't uttered a sound.

But within a few weeks of beginning preschool special education services provided through the Build Up Michigan program, Aubin started using his voice ­– including speaking his first word, "ball."

Today, after three years of classroom activities and speech therapy, Aubin is a thriving first-grader in the Royal Oak school district who no longer requires special education assistance.

"He's gone from being delayed to being above average," said Jennica Wahl, proudly noting that her son is a particularly strong reader.

The power of early intervention

Aubin's case and many others like it statewide highlight the importance of identifying and addressing developmental delays in children as early as possible, said Christine Callahan, director of innovative projects for the Clinton County Regional Education Service Agency, which administers Build Up Michigan.

The program's mission is to provide free, preschool-based assistance to Michigan 3- to 5-year-olds who need it to become ready for kindergarten.

"The evidence is clear that early intervention improves and enhances the development of a child because learning is at its highest rate in the preschool years," Callahan said.

As her concerns about Aubin's lack of speech grew, Wahl contacted Build Up at the urging of her mother, a preschool education specialist.

Aubin would point to numbers and letters, indicating that he understood those concepts, but he simply would not vocalize his thoughts.

"We were wondering what his voice even sounded like," Wahl said. "We were definitely concerned about it."

A special education evaluator screened Aubin at his home and arranged for him to receive preschool services at Gudith Elementary in the Woodhaven-Brownstown school district, as well as speech therapy through Henry Ford Health System.

"It was awesome to hear him speak."

Initially, Wahl and Aubin were taught rudimentary sign language so they could communicate about basic concepts such as food and drink. But within a month of beginning his preschool and speech therapy regimen – which included learning how to manipulate different muscles in his mouth – Aubin used his voice for the first time.

"It was awesome to hear him speak," Wahl said. "He had a little struggle at first, but he's been quickly improving ever since."

Aubin continued to receive speech training as a kindergartner at Erving Elementary in Woodhaven-Brownstown and as a first-grader this past fall at Keller Elementary in the Royal Oak district.

When Aubin returned to school this month, Wahl was informed that he was speaking at an age-appropriate level and no longer required additional services.

(Source: detroitnews.com)

Kindred Healthcare to Pay $125 million to Settle U.S. Allegations Over Therapy Services

Justice Department suit says company overbilled Medicare between January 2009 and September 2013

Kindred Healthcare Inc. agreed to pay $125 million to settle federal allegations it provided unnecessary therapy services to nursing-home patients as part of a scheme to overbill the federal Medicare program, according to the agreement finalized on Tuesday.

Several nursing homes that hired Kindred’s therapy unit, RehabCare, to provide services to their residents separately agreed to pay the federal government about $8 million for their role in the alleged scheme.

Kindred said it agreed to the settlement to avoid costly and distracting litigation, but denied wrongdoing.

A Kindred spokesman didn’t respond to a request for comment Tuesday.

The Wall Street Journal in August reported on how Kindred and other nursing-home operators and contractors increased the share of days they billed for giving patients’ the highest therapy level Medicare will cover—so-called ultrahigh therapy. In 2013, Kindred’s own nursing homes billed for ultrahigh therapy 58% of the time, compared with 7.6% of the time in 2002.

Nursing-home therapists had told the Journal at the time that Kindred and other nursing-home operators pressured them to provide intensive services, even when patients couldn’t participate in the treatment and were unresponsive.

The suit Kindred settled on Tuesday was focused on services provided under contract to nursing homes by RehabCare, which Kindred acquired in 2011. The suit alleged the company overbilled Medicare between Jan. 1, 2009 and Sept. 30, 2013.

The Justice Department alleged Kindred presumptively placed patients in the ultrahigh category, which requires 720 minutes of therapy a week. They said Kindred reported therapy minutes had been provided when patients were sleeping or unable to benefit from the treatment, among other allegations.

(Source: wsj.com)

Occupational therapy is mere child's play

(Maryland) Maylia-Ray Graves, 3, smiled and quickly removed her shoes for Sensory Silly time at Dancing Bear Toys and Gifts, where she might not have expected to work.

“Play is child’s work,” said Kelly Beins, a pediatric occupational therapist, who leads a weekly children’s program at the shop.

In Sensory Silly, Beins guides children in activities that promote physical and cognitive development.

“Sensory systems build motor skills,” Beins said.

Maylia showed her mother, Marci Weddle, how to take off shoes and set them aside before starting.

“She’s a seasoned veteran,” said Brian Graves, Maylia’s father.

Weddle said Sensory Silly also gives Maylia, an only child, a chance to develop her social skills along with physical ones.

In a recent session, Maylia was the only attendee, so she and Beins interacted as playmates might. Beins had an agenda, though.

First it was a dance.

“Shake, shake, shake, shake your body,” Beins said in time with music and Maylia’s giggling.

They shook and stretched and twirled a bit before settling in to more interactive engagement.

Beins pulled out a plastic bag with some ice cubes after getting Maylia to think about different types of weather and precipitation, thinking of snow.

They explored how ice melted in their hands, and they blew on it.

“When you press it, it melts,” Maylia said. “It’s cracking,” she added, letting Beins know that she heard it.

“That’s using our hands and our ears,” Beins said with encouragement.

Before the half hour was up, they had used large muscles and small to move arms, legs, fingers, to lift heavy things and place them in a basket. They considered the weights of stuffed toys and textures of materials.

“Using heavy things helps them use their bodies … build muscles,” Beins explained to Maylia’s parents.

Beins and Maylia discussed the kinds of animals that live in snowy climates, and mimicked their behavior.

“Do you know how penguins walk?” Beins asked Maylia.

She helped Maylia position her feet, toes turned out and up, heels down, to walk more like a penguin.

“You’re doing it,” she said. “Good job.”

Dancing Bear’s programs address sensory skills and emphasize the importance of more play time and less screen time for toddlers and preschoolers, said Theresa Fer, the shop’s Children’s Program coordinator.

Dancing Bear, which excludes electronic and battery-operated toys and games from its merchandise, focuses on activities that engage imagination, intellectual curiosity and ingenuity. That aspect appealed to Beins.

“I choose activities that promote developmental opportunities and model how to play with the children, and parents and kids get an opportunity to play successfully together,” Beins wrote in email. “It’s not about the toys, but what experience the toys offer and what we do with the toys.”

Sensory Silly is for 3- to 5-year-olds, and another program that Beins’ office runs is for 1- to 2-year-olds: Big Moves for Little Feet.

Big Moves requires registration and costs $5 per session. Sensory Silly is a free, drop-in activity.

Fer said the shop started partnering with Beins to become a resource in the early childhood development, and a place where parents may come to socialize, while learning about the developmental stages. Beins and her associates explain to parents what skills are being developed with the activities.

Occupational therapy is about making purposeful activities, Beins said.

Parents get a chance to learn how to present activities in a way that supports development if they do not already know, Beins said. They also get to experience playful time with their child “which is huge in supporting development of all skills,” she wrote in email.

Childhood development starts with the parent-child relationship, she said.

“I see kids get an opportunity to interact socially with same-aged peers, and sometimes kids will do things with other children that they will never do with their parents. … It’s like pint-sized positive peer pressure,” Beins wrote.

Graves watched Beins pull Maylia on a rolling sled. The activity required Maylia to firmly hold one end of a rope that Beins pulled. Maylia had to keep her balance on the sled so she would not be pulled off it.

Graves said Maylia’s two years attending the sessions have had a positive impact.

“I think this program has really helped her progress,” he said.

Weddle said Maylia looks forward to attending.

“She really loves this,” Weddle said.


(Source: therapeuticresource.com)

Honoring Dr. Martin Luther King Jr.

He dared to dream and changed many lives.   On this day we honor the legacy of Dr. Martin Luther King Jr.

Having Friends Is Good for You, Starting in Your Teens

Having friends is good for your physical health, and the benefits appear to start early in life, according to a new study.

Researchers used data from more than 14,000 Americans in four large, nationally representative surveys of health from adolescence to old age. They measured social integration with an index that quantifies the number and nature of social connections — in romantic relationships, with family and friends, and by participation in religious and social organizations. The study appeared in Proceedings of the National Academy of Sciences

After controlling for education, smoking, depression, alcohol consumption, diabetes and other characteristics, they found a lower score on the social integration index was associated with higher levels of C-reactive protein,a measure of general inflammation, and with higher blood pressure, higher body mass index and larger waist circumference.

The associations were stronger at some ages than others. For example, social isolation in adolescence raised the risk of inflammation to about the same degree as physical inactivity. Being isolated in old age raised the risk of hypertension as much as having diabetes did.

The relationship between social isolation and poor health is “well known among aging people,” said the senior author, Kathleen Mullan Harris, a professor of sociology at the University of North Carolina. “But this is the first to study it starting in the very beginning of the life course, when people foster these relationships — early adolescence.”

(Source: well.blogs.nytimes.com)

Lack Of Deep Sleep May Set The Stage For Alzheimer's

There's growing evidence that a lack of sleep can leave the brain vulnerable to Alzheimer's disease.

"Changes in sleep habits may actually be setting the stage" for dementia, says Jeffrey Iliff, a brain scientist at Oregon Health & Science University in Portland.

The brain appears to clear out toxins linked to Alzheimer's during sleep, Iliff explains. And, at least among research animals that don't get enough solid shut-eye, those toxins can build up and damage the brain.

Iliff and other scientists at OHSU are about to launch a study of people that should clarify the link between sleep problems and Alzheimer's disease in humans.

It has been clear for decades that there is some sort of link. Sleep disorders are very common among people with Alzheimer's disease.

For a long time, researchers thought this was simply because the disease was "taking out the centers of the brain that are responsible for regulating sleep," Iliff says. But two recent discoveries have suggested the relationship may be more complicated.

The first finding emerged in 2009, when researchers at Washington University in St. Louis showed that the sticky amyloid plaques associated with Alzheimer's develop more quickly in the brains of sleep-deprived mice.

Then, in 2013, Iliff was a member of a team that discovered how a lack of sleep could be speeding the development of those Alzheimer's plaques: A remarkable cleansing process takes place in the brain during deep sleep, at least in animals.

What happens, Iliff says, is "the fluid that's normally on the outside of the brain, cerebrospinal fluid — it's a clean, clear fluid — it actually begins to recirculate back into and through the brain along the outsides of blood vessels."

This process, via what's known as the glymphatic system, allows the brain to clear out toxins, including the toxins that form Alzheimer's plaques, Iliff says.

"That suggests at least one possible way that disruption in sleep may predispose toward Alzheimer's disease," he says.

To know for sure, though, researchers will have to study this cleansing process in people, which won't be easy.

Iliff studied the glymphatic system in living mice by looking through a window created in the skull. The system also involved a powerful laser and state-of-the-art microscope.

With people, "we have to find a way to see the same sort of function, but in a way that is going to be reasonably noninvasive and safe," he says.

The solution may involve one of the world's most powerful magnetic resonance imaging machines, which sits in a basement at OHSU. The MRI unit is so sensitive, it should be able to detect changes that indicate precisely when the glymphatic system gets switched on in a person's brain, says Bill Rooney, who directs the university's Advanced Imaging Research Center.

When humans enter deep sleep, and toxin removal begins, there should be a particular change in the signal coming from certain salt molecules. That would indicate that fluid has begun moving freely through the brain.

In young, healthy brains, the signal should be "robust," Rooney says, indicating that the toxin removal system is working well. In the brains of older people, and those who are likely to develop Alzheimer's, the signal should be weaker.

Rooney and Iliff have received funding from the Paul G. Allen Foundation to test their approach. They hope to begin scanning the brains of participants within a year.

One challenge, though, will be finding people able to fall asleep in the cramped and noisy tunnel of the magnetic resonance machine.

"It's a tricky thing because it's a small space," Rooney says. "But we'll make people as comfortable as possible, and we'll just follow them as they go through these natural stages of sleep."

If Rooney and Iliff are right, the experiment will greatly strengthen the argument that a lack of sleep can lead to Alzheimer's disease. It might also provide a way to identify people whose health is at risk because they aren't getting enough deep sleep, and it could pave the way to new treatments.

"It could be anything from having people exercise more regularly, or new drugs," Rooney says. "A lot of the sleep aids don't particularly focus on driving people to deep sleep stages."

(Source: npr.org)

New Special Education Jobs

Profession: Special Educator
Population: Pediatrics
Position:
Location: Manhattan, NY
Description: Toddler in Manhattan zip code 10069 on Riverside Boulevard is in need of Special Instruction Therapy 1x60 per week. May contact parent for scheduling.
from Jobs http://ift.tt/1Q652WY

Here's What You Shouldn't Do When Trying To Revive A Newborn

"You have a minute to help that baby breathe," says Dr. Mark Hathaway. He works as a senior adviser for family planning at USAID's Maternal and Child Survival Program, and he is showing me how to get a newborn to take its first breath.

And it has to happen now — during the "golden minute" after a baby is born. That's what the medical world calls the tiny window of time an infant must bring oxygen into its lungs.

But I'm not a doctor or a nurse. I'm a reporter. So I am pretty clueless.

I lift up the "baby," a mannequin called NeoNatalie. Filled with water and covered with soft plastic, it's heavier than I expected — about 5 or 6 pounds, just like a real newborn.

A wave of panic washes over me. I do what I remember seeing on TV shows. I lift the baby by its feet and slap its backside.

"Yeah, don't do that," says Hathaway.

I have a lot of company in the club of clueless birth attendants. In the developing world, there's a dire shortage of health care workers and nearly half of all births take place without a skilled birth attendant.

A nonprofit called Seed Global Health is determined to change things. In 2012, Seed teamed up with the Peace Corps to create the Global Health Service Partnership, a volunteer program that sends U.S. doctors and nurses to Africa to train medical professionals in a variety of techniques, including how to resuscitate a newborn who's not breathing.

Seed Global Health has so far introduced the program in Malawi, Tanzania, Uganda and, most recently, Swaziland.

In the past two years, 73 American volunteers have trained more than 7,200 African faculty, residents and students.

After my failed attempts to help my mannequin breathe, Hathaway shows me the proper procedures. He turns the doll to one side and begins vigorously drying its back and head with a towel to help the baby warm up.

"Sometimes that's all that's needed," says Hathaway.

If that doesn't do the trick, he has all the tools ready for Plans B and C: a suction tool and a bag mask.

The suction tool, which looks like a turkey baster, clears out a baby's nasal passages by removing mucus and gunk from its nose. Using it once is usually enough to help a baby breathe.

If 20 seconds go by and the baby still isn't breathing, Hathaway would turn to the bag mask, which pumps oxygen from the air into the baby's lung passages.

Aliasgar Khaki, a 24-year-old fifth-year medical student from Dar Es Salaam, Tanzania, is one of the trainees. He was taught by Dr. Esther Johnston, a former Seed Global Health volunteer who is now the director of family medicine for the nonprofit.

In Khaki's country, roughly a quarter of newborn deaths are caused by birth asphyxia — a lack of oxygen to the lungs. But the university he attends didn't have the resources to teach its students the proper techniques.

"They had a program, but the problem was that the equipment wasn't there," says Johnston. "It's hard to teach neonatal resuscitation without a mannequin. You can teach the principles, but if you don't practice it, it doesn't get into your muscle memory."

Inspired, Khaki started organizing trainings for other students, nurses and interns in the area, demonstrating with donated NeoNatalie dolls from global health groups like Jhpiego. The NeoNatalie set costs about $70 for nonprofits.

Dr. Vanessa Kerry, co-founder of Seed Global Health, hopes the trainees will now show others what they've learned.

"If we focused on teaching new doctors and nurses how to be great educators with the idea that one doctor could go on and teach 10, who could go on to teach 10 more, and so on, we could have this great force multiplying effect," she says.

For Hathaway, the future of Seed Global Health's training program will ultimately rely on the power of the individual.

"What moves things forward is a champion," he says. "If you have someone in a health facility who really wants the infant mortality reduction to happen, that person will work hard to keep following through on things."

Since Khaki's training with Seed Global Health, he's had a chance to practice his neonatal resuscitation skills in real life.

A week after his first training with Johnston, he visited a hospital with a relative. In the nursery ward, he saw a "code blue" situation: a baby struggling to breathe.

The nurse on duty didn't know what to do. Khaki quickly stepped in and saved the baby's life, using the step-by-step techniques he learned from his training (which is what Hathaway showed me in my mini-lesson).

How did it make him feel?

"Every cartoon character has their own superhero outfit," he says. "Mine was my white lab coat."

(Source: npr.org)

Hillary Clinton Outlines Plan To Address Autism

This week in Iowa, Hillary Clinton announced a detailed plan to address autism, including additional resources and research. NPR's Kelly McEvers speaks with Ron Fournier, a columnist for National Journal and father of a child with Asperger's syndrome, about the plan and the significance of a presidential campaign taking on the issue.

KELLY MCEVERS, HOST:

There are a lot of issues on the presidential campaign right now - ISIS, gun control, health care. And Hillary Clinton just added one more - autism. At an event in Iowa this week, Clinton announced a plan to fund research and support people with autism and their families.

(SOUNDBITE OF ARCHIVED RECORDING)

HILLARY CLINTON: A lot of those families are just at their wits' end trying to figure how to get the services, to figure out what to do for schooling and then, as a child becomes a young adult, what to do for housing and employment. I want to be the president who helps families in our country deal with some of those issues.

MCEVERS: Ron Fournier wrote about Clinton's plan for National Journal, and he also has a personal connection to this story. His a son Tyler has Asperger's. Ron, thanks for being on the show today.

RON FOURNIER: Thank you so much for having me on, Kelly.

MCEVERS: This is not really an issue that's gotten a lot of attention from presidential campaigns. I mean, how big of a deal is this announcement for autism advocates and for parents like you?

FOURNIER: Huge, huge.

MCEVERS: Really.

FOURNIER: Let me just talk about it just as a parent. When you first find out that - especially a son or daughter is - has autism, you know, first comes the tears, and then comes the fear. And then comes, really quickly, a feeling that you're alone, that nobody you know has dealt with this, that you don't really know what it is. It's a scary word, and it's a broad spectrum. And what she has done for people, the community - is saying, you know, you're not alone; at least I'm going to talk about this.

MCEVERS: What do you think about the substance of the plan?

FOURNIER: Well, again, if you take it without any skepticism or cynicism, which I can only do if I talk about it as a parent, it's impressive in the sense that it addresses - there's - oversimplifying, there's two general camps that parents tend to fall into. You can be the kind that want a lot of research to go into finding a cure or prevention of autism. There's a lot of people that that's their main and sometimes only focus.

And then there are folks who are more interested in finding ways that you can support people with autism, that - somebody like my son - he doesn't want to fight his autism. He wants help in dealing with his autism. If you could offer me - and I'm just one parent. If you could offer me a cure for my son's autism, I wouldn't take it because the way he's wired is what makes him so uniquely different. But I understand that not every parent is in the same boat. And apparently, so does secretary Clinton because her plan really does address the concerns of parents at both of those camps.

MCEVERS: So let's get to the skepticism now, though. I mean, you've covered Hillary Clinton for some time. You've been pretty critical of her in the past. I mean, what do you think about this as a campaign move?

FOURNIER: Yeah. And just, again - and more recently, I've been very critical of her on the email issue. I think that showed a lack of accountability and honesty. On this one, I think, in fairness, you've got to recognize that she has always been an advocate for children and families even before she moved up higher in the political spectrum. When she was back as a first lady in Arkansas - even before she was first lady of Arkansas, she was involved in these issues, working for the Children's Defense Fund. So there's a consistency here that I think gives her some credibility politically.

On the other hand, the Clintons, and Hillary in particular, can be awfully political and, you know, manipulative. And it can't escape their attention that because of the way we look at autism, and scientific community is changing, that more people now know somebody who has autism. So this is just - purely cynically, this is a great way to connect with voters.

MCEVERS: So her plan calls, among other things, for, you know, more access to insurance compliance with Medicaid, more outreach on autism, a national campaign, help for people with autism to transition from school into adult life. I mean, how likely do you think it is that this could actually happen?

FOURNIER: Probably not very likely because one, all of that is very expensive. Two, you would have to get a polarized Washington, D.C., working together to get it done. And three, you know, it's fair to have doubts about her ability to be able to bring a fractured Washington together. So my guess is it's not very likely, but even then, just the fact that she's put it on the national agenda is a big first step. And I hope I'm wrong. I hope she can get it done.

MCEVERS: That's Ron Fournier. He has an upcoming book about raising his son. It's called "Love That Boy." Thanks so much.

FOURNIER: Thank you very much.

(Source: npr.org)

Pediatric occupational therapist empowers kids with disabilities

(PLAINFIELD, IL) – Not all dragons attack with breaths of fire. In fact, most don’t.

They attack with shyness, anaphylaxis, impaired motor skills, disrupted sensory processing, speech impediments and even big ears.

Just ask Joseph Bauer of Frankfort, the DJ who tours with Stacey Glorioso, a Plainfield-based pediatric occupational therapist, as part of her “dragon crew.” Glorioso also is the author of “Joshua’s Dragon,” the story of an autistic boy who beats his fear of loud noises by pretending the fear is a dragon he’s slayed.

Bauer, who recently finished his tour with Atlantic Records for his album “Illuminate,” according to a news release, said other kids used to make fun of his oversized ears.

But Bauer, the person who creates the sound effects for interactive readings of “Joshua’s Dragon” at school assemblies and then talks to kids about conquering his own dragon, has stood that fear on its head.

“My dad always told me, ‘Tell them you can hear better than they can,’ ” Bauer said. “And now I actually work in audio.”

It’s that kind of attitude that inspired Glorioso to write “Joshua’s Dragon.”

Inspired by young heroes

During her 16 years of practice, Glorioso said her young clients have constantly inspired her with their motivation and courage in the face of disabilities: the deaf child who learns to talk; the wheelchair-bound twins who learn to play basketball despite cerebral palsy.

Even Glorioso’s own son, Grant, 11, has a severe peanut allergy, which made him fearful of stepping away from Glorioso. But armed with knowledge of his condition, keen observation skills, common sense and an EpiPen, Grant has learned to face his dragon and live like other kids do.

But Glorioso didn’t write “Joshua’s Dragon” just for them, she said. She wrote it for everyone else, too.

“I always thought that with this push for inclusion, we just never got enough education on autism and cerebral palsy and Down syndrome,” Glorioso said. “And kids have to accept [kids with disabilities], not realizing the dragons these kids face each day.”

But the book is for more than showing elementary school children the difficulties kids with disabilities battle, such as navigating social situations and learning to walk, talk and eat. It’s to acknowledge them as heroes so even kids without disabilities can overcome their own Achilles heel.

“It’s really about recognizing that we are more similar than different,” Glorioso said.

Dragon tours
Glorioso released “Joshua’s Dragon” in August and began touring in October. A tour stop is a 45-minute upbeat school assembly, she said. Glorioso estimates that her tours – so far – have reached 10,000 children in preschool through sixth grade.

Sean Smith, principal at Grande Park Elementary School in Plainfield, said Glorioso’s presentation is the most inspiring he’s seen in the four years he’s been with the school. The kids were thoroughly engaged, he said, and they bought books.

“She really inspired the kids to do some self-reflection and to think about their own selves,” Smith said. “She gave them that extra boost and motivation to continue to work hard, and the message that hard work does pay off.”

Glorioso’s dragon presentation is part recorded reading, part music and part video of other dragon slayers. One video presenter is Alyssa Gialamas of Naperville, who was born with arthrogryposis, a disorder that affects the use of joints and muscles, according to the Team USA website.

Gialamas was selected to represent Team USA in swimming at the London 2012 Paralympic Games, where she came in fifth place, the website stated. Gialamas was happy to make the video.

“I really liked the story, and I really liked the underlying theme,” said Gialamas, now 20 and a communications major at the University of Maryland. “Everyone has dragons, but in order to conquer them, you have to go through stuff.”

Despite her upbeat and uplifting exhortations, and despite the life lessons Glorioso brings home to her own children – who include Genna, 9, and Griffin, 4 – Glorioso admits providing occupation therapy to youth with disabilities is not easy.

There are losses. Children pass away. Others don’t progress. Glorioso said she has one 8-year-old client she is simply maintaining. That’s not bad, of course, but Glorioso wishes she could do more.

“It’s an emotionally difficult field, I think,” Glorioso said of pediatric occupational therapy. “But I stay in because the kids are amazing. And no matter how hard the issues are they’re going through, they are always happy. It’s a hard thing to explain. They are happy and they don’t know anything different. And they do what they’re supposed to do, no complaining; they just do it. They’ve always been my inspiration. They’re just amazing kids.”


(Source: theherald-news.com)