English Language Learners (ELLs) are the fastest growing segment of school population, especially in urban schools. The teaching workforce has relatively unchanged to match this fast growth. Data ...found no measurable difference in the percentages of teachers’ ethnic backgrounds between 1999-2000 and 2007-2008. This mismatch creates the demand for preparing the K-12 teachers who can work effectively with ELLs. The study examines an innovative program that prepares K-12 teachers through research and service combined with traditional professional development. Findings reveal significant improvement in the teachers’ second language (L2) knowledge and strategies working with ELLs.
In patients with drug-resistant epilepsy, electrical stimulation of the brain in response to epileptiform activity can make seizures less frequent and debilitating. This therapy, known as closed-loop ...responsive neurostimulation (RNS), aims to directly halt seizure activity via targeted stimulation of a burgeoning seizure. Rather than immediately stopping seizures as they start, many RNS implants produce slower, long-lasting changes in brain dynamics that better predict clinical outcomes. Here we hypothesize that stimulation during brain states with less epileptiform activity drives long-term changes that restore healthy brain networks. To test this, we quantified stimulation episodes during low- and high-risk brain states-that is, stimulation during periods with a lower or higher risk of generating epileptiform activity-in a cohort of 40 patients treated with RNS. More frequent stimulation in tonic low-risk states and out of rhythmic high-risk states predicted seizure reduction. Additionally, stimulation events were more likely to be phase-locked to prolonged episodes of abnormal activity for intermediate and poor responders when compared to super-responders, consistent with the hypothesis that improved outcomes are driven by stimulation during low-risk states. These results support the hypothesis that stimulation during low-risk periods might underlie the mechanisms of RNS, suggesting a relationship between temporal patterns of neuromodulation and plasticity that facilitates long-term seizure reduction.
Objective
Responsive neurostimulation is an effective therapy for patients with refractory mesial temporal lobe epilepsy. However, clinical outcomes are variable, few patients become seizure‐free, ...and the optimal stimulation location is currently undefined. The aim of this study was to quantify responsive neurostimulation in the mesial temporal lobe, identify stimulation‐dependent networks associated with seizure reduction, and determine if stimulation location or stimulation‐dependent networks inform outcomes.
Methods
We modeled patient‐specific volumes of tissue activated and created probabilistic stimulation maps of local regions of stimulation across a retrospective cohort of 22 patients with mesial temporal lobe epilepsy. We then mapped the network stimulation effects by seeding tractography from the volume of tissue activated with both patient‐specific and normative diffusion‐weighted imaging. We identified networks associated with seizure reduction across patients using the patient‐specific tractography maps and then predicted seizure reduction across the cohort.
Results
Patient‐specific stimulation‐dependent connectivity was correlated with responsive neurostimulation effectiveness after cross‐validation (p = .03); however, normative connectivity derived from healthy subjects was not (p = .44). Increased connectivity from the volume of tissue activated to the medial prefrontal cortex, cingulate cortex, and precuneus was associated with greater seizure reduction.
Significance
Overall, our results suggest that the therapeutic effect of responsive neurostimulation may be mediated by specific networks connected to the volume of tissue activated. In addition, patient‐specific tractography was required to identify structural networks correlated with outcomes. It is therefore likely that altered connectivity in patients with epilepsy may be associated with the therapeutic effect and that utilizing patient‐specific imaging could be important for future studies. The structural networks identified here may be utilized to target stimulation in the mesial temporal lobe and to improve seizure reduction for patients treated with responsive neurostimulation.
Objectives
Responsive neurostimulation (RNS) is an established therapy for drug‐resistant epilepsy that delivers direct electrical brain stimulation in response to detected epileptiform activity. ...However, despite an overall reduction in seizure frequency, clinical outcomes are variable, and few patients become seizure‐free. The aim of this retrospective study was to evaluate aperiodic electrophysiological activity, associated with excitation/inhibition balance, as a novel electrographic biomarker of seizure reduction to aid early prognostication of the clinical response to RNS.
Methods
We identified patients with intractable mesial temporal lobe epilepsy who were implanted with the RNS System between 2015 and 2021 at the University of Utah. We parameterized the neural power spectra from intracranial RNS System recordings during the first 3 months following implantation into aperiodic and periodic components. We then correlated circadian changes in aperiodic and periodic parameters of baseline neural recordings with seizure reduction at the most recent follow‐up.
Results
Seizure reduction was correlated significantly with a patient's average change in the day/night aperiodic exponent (r = .50, p = .016, n = 23 patients) and oscillatory alpha power (r = .45, p = .042, n = 23 patients) across patients for baseline neural recordings. The aperiodic exponent reached its maximum during nighttime hours (12 a.m. to 6 a.m.) for most responders (i.e., patients with at least a 50% reduction in seizures).
Significance
These findings suggest that circadian modulation of baseline broadband activity is a biomarker of response to RNS early during therapy. This marker has the potential to identify patients who are likely to respond to mesial temporal RNS. Furthermore, we propose that less day/night modulation of the aperiodic exponent may be related to dysfunction in excitation/inhibition balance and its interconnected role in epilepsy, sleep, and memory.
The study of chronic pain and its treatments requires a robust animal model with objective and quantifiable metrics. Porcine neuropathic pain models have been assessed with peripheral pain recordings ...and behavioral responses, but thus far central nervous system electrophysiology has not been investigated. This work aimed to record non-invasive, somatosensory-evoked potentials (SEPs) via electroencephalography in order to quantitatively assess chronic neuropathic pain induced in a porcine model.
New method: Peripheral neuritis trauma (PNT) was induced unilaterally in the common peroneal nerve of domestic farm pigs, with the contralateral leg serving as the control for each animal. SEPs were generated by stimulation of the peripheral nerves distal to the PNT and were recorded non-invasively using transcranial electroencephalography (EEG). The P30 wave of the SEP was analyzed for latency changes.
P30 SEPs were successfully recorded with non-invasive EEG. PNT resulted in significantly longer P30 SEP latencies (p < 0.01 n = 8) with a median latency increase of 14.3 IQR 5.0 – 17.5 ms. Histological results confirmed perineural inflammatory response and nerve damage around the PNT nerves.
Comparison with existing method(s): Control P30 SEPs were similar in latency and amplitude to those previously recorded invasively in healthy pigs. Non-invasive recordings have numerous advantages over invasive measures.
P30 SEP latency can serve as a quantifiable neurological measure that reflects central nervous system processing in a porcine model of chronic pain. Advancing the development of a porcine chronic pain model will facilitate the translation of experimental therapies into human clinical trials.
•Somatosensory-evoked potentials can be recorded non-invasively in pigs•Neuritis increases latency of somatosensory-evoked potentials•Latency can serve as a quantifiable pain metric in the central nervous system
The Brazilian first republic sought to organize society and amplify its potential for political and economic development, an objective hindered by the precarious health conditions of a population ...devastated by epidemics. An alliance between Brazil and the United States, mediated by the Rockefeller Foundation, gave birth to the arrival of Ethel Parsons in Brazil and the Parsons Mission, which developed strategies to implant a model for raising the standards of nursing in Brazil. This article offers background information about the Parsons Mission, and discusses its impact in public health and nursing education. History shows that the creation and organization of a public nursing health service, in addition to a nursing school based on Anglo-American models, were successful strategies in the construction of a new professional identity for nurses and for the recognition of nursing as a female profession.
Brain activity is constrained by and evolves over a network of structural and functional connections. Corticocortical evoked potentials (CCEPs) have been used to measure this connectivity and to ...discern brain areas involved in both brain function and disease. However, how varying stimulation parameters influences the measured CCEP across brain areas has not been well characterized.
To better understand the factors that influence the amplitude of the CCEPs as well as evoked gamma-band power (70–150 Hz) resulting from single-pulse stimulation via cortical surface and depth electrodes.
CCEPs from 4370 stimulation-response channel pairs were recorded across a range of stimulation parameters and brain regions in 11 patients undergoing long-term monitoring for epilepsy. A generalized mixed-effects model was used to model cortical response amplitudes from 5 to 100 ms post-stimulation.
Stimulation levels <5.5 mA generated variable CCEPs with low amplitude and reduced spatial spread. Stimulation at ≥5.5 mA yielded a reliable and maximal CCEP across stimulation-response pairs over all regions. These findings were similar when examining the evoked gamma-band power. The amplitude of both measures was inversely correlated with distance. CCEPs and evoked gamma power were largest when measured in the hippocampus compared with other areas. Larger CCEP size and evoked gamma power were measured within the seizure onset zone compared with outside this zone.
These results will help guide future stimulation protocols directed at quantifying network connectivity across cognitive and disease states.
•SPES was delivered via intracranial electrodes in patients undergoing long-term monitoring.•Stimulation intensities of ≥5.5mA produced consistent CCEP and evoked gamma-band power response up to 100ms poststimulation.•Hippocampus showed the largest response across areas and patients.•CCEP amplitude and evoked gamma-band response were 9.9 and 120.0% larger in the clinical SOZ than outside it
•This case report highlights the intricacies and challenges of conducting a comprehensive neuropsychological evaluation and Wada test with a deaf adult.•In the absence of ASL proficiency on the part ...of the neuropsychologist, consultation, extensive review of the literature, and close collaboration with qualified interpreters are instrumental.•ASL interpreters must be involved prior to the evaluation to ensure test instructions and content are understandable and relevant. It is also helpful to score tests and discuss behavioral observations with the interpreter subsequent to testing.•Tests that are heavily verbal and depend on knowledge in English may not be appropriate.
In high-stake cases (e.g., evaluating surgical candidacy for epilepsy) where neuropsychological evaluation is essential to care, it is important to have culturally and linguistically appropriate and accessible neuropsychological instruments and procedures for use with deaf individuals who use American Sign Language (ASL). Faced with these ethical and professional issues, clinicians may be unable to provide equitable services without consulting with other psychologists and collaborating with the patient and interpreter. This is a case report describing a 43-year-old male with bilateral sensorineural deafness and a lifelong history of drug-resistant temporal lobe epilepsy who presented as a candidate for a comprehensive neurological workup to determine surgical candidacy. He was bilingual (ASL and written English). We describe all aspects of the evaluation, including functional magnetic resonance imaging (fMRI) and Wada testing, using an ASL interpreter. Results from the neuropsychological evaluation were not clearly lateralizing, but suggested greater compromise to the non-dominant right hemisphere. fMRI and Wada test results revealed language and verbal memory functions were lateralized to the left hemisphere. The patient was deemed to be an adequate candidate for surgical resection of portions of the right hemisphere. Comprehensive assessment of neuropsychological functioning in deaf persons who use ASL is feasible. This case report illustrates the important considerations relevant to neuropsychologists providing culturally and linguistically informed assessments to deaf ASL users with epilepsy. Additional research in this area will support future efforts to develop effective and efficient models that could be implemented across different settings. Moreover, clinical guidance is warranted to guide professionals interested in promoting access to high quality neuropsychological services.
Objetivo: analisar as repercussões no atendimento em saúde mental pela implantação de Protocolos de Conduta Assistencial em Unidade Básica de Saúde, em Juiz de Fora - MG - BR.
Método: estudo ...histórico-social, realizado no ano de 2018, tendo por fontes diretas, documentos escritos e depoimentos orais, analisadas pelos pressupostos da Reforma Psiquiátrica.
Resultados: apresentam-se as categorias: a) Reorganização da assistência em saúde mental por implantação de Protocolos de Conduta; b) Processo de referência e contrarreferência entre Unidade Básica de Saúde e serviços de atenção especializada em saúde mental; c) Transformação da assistência em saúde mental.
Conclusão: protocolos organizaram a rede de atenção em saúde mental, sustentando a capacitação multiprofissional, introduzindo atenção primária à saúde como porta de entrada para acolhimento, tratamento e acompanhamento em saúde mental territorial.
Purpose In recent years, issues related to body image, fat shaming, and societal perceptions of weight have gained more attention in educational discourse (Carmona-Márquez, et al. , 2023; Dark and ...Aphramor, 2023; Nutter, Ireland, Alberga, et al ., 2019; Schorb, 2022). The purpose of this paper is to explore the importance of engaging students and educators to critically examine fat ideology in teacher education and P-12 classrooms through the lens of multicultural education. Design/methodology/approach Using a multicultural lens to examine fat phobia in education. Findings This paper explores the importance of engaging students and educators to critically examine fat ideology in teacher education and P-12 classrooms through the lens of multicultural education. Practical implications By acknowledging the intersection of body image bias with cultural diversity, educators can foster inclusive environments that challenge harmful stereotypes and promote body positivity. This paper also provides strategies for integrating discussions on fat ideology within the multicultural education framework, aiming to empower both teachers and students from a multicultural education perspective to think critically and advocate for social justice. Social implications This paper also provides strategies for integrating discussions on fat ideology within the multicultural education framework, aiming to empower both teachers and students from a multicultural education perspective to think critically and advocate for social justice. Originality/value The issue of fat phobia is rarely discussed in education.
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