RECOGNIZING A STROKE
SAVE A LIFE - KNOW HOW TO IDENTIFY THE FIRST SIGNS OF STROKE
Sometimes symptoms of a stroke are difficult to identify. Unfortunately, the lack of awareness spells disaster. The stroke victim may suffer severe brain damage when people nearby fail to recognize the symptoms of a stroke.
Now doctors say a bystander can recognize a stroke by asking three simple questions :
S * Ask the individual to SMILE ..
T * = TALK. Ask the person to SPEAK A SIMPLE SENTENCE (Coherently) (eg 'It is sunny out today').
R * Ask him or her to RAISE BOTH ARMS . If he or she has trouble with ANY ONE of these tasks, call the ambulance and describe the symptoms to the dispatcher.
A neurologist says that if he can get to a stroke victim within 3 hours he can totally reverse the effects of a stroke...totally. He said the trick was getting a stroke recognized, diagnosed, and then getting the patient medically cared for within 3 hours, which is tough.
Let's all keep this vital knowledge handy. We don't know if we happen to be near a possible stroke victim.
'Psychological First Aid'
Conversation - 'Psychological First Aid' Courtesy: The United Nations
Education Is Essential in Post-conflict Situations
www.un.org/Pubs/chronicle/2003/issue4/0403p53.asp
Speaking to the 2,000 participants of the 56th Annual DPI/NGO Conference in New York, Nila Kapor-Stanulovic addressed the psychological aspects of human security and dignity. She experienced first-hand the effects of multiple armed conflicts in the Balkans and treated patients affected by the crises in Bosnia and Herzegovina and in Macedonia. She pointed out that she had been a recipient, as well as a provider, of psychological aid, at times filling both roles simultaneously. Although it had not been easy, Ms. Kapor-Stanulovic explained that the most difficult times were those when she was only receiving such support due, she believes, to the sense of helplessness that results from having encountered traumatic experiences. She strongly endorses the idea of helping victims restore a feeling of being somebody. An expert in "emergency psychology", which includes crisis intervention techniques, post-trauma interventions and psychosocial rehabilitation, she is continuing her work to ameliorate the consequences of the armed conflicts in the former Yugoslavia.
Biko Nagara of the Chronicle spoke with Ms. Kapor-Stanulovic on 10 September
On the psychology of dignity and securityDignity and security within the context of psychology have been addressed but never fully explored. The psychological aspects of life are frequently disregarded by humanitarian agencies and non-governmental organizations (NGOs) because psychology is often associated with illness and psychopathological problems. When I say that I am a psychologist, it is these kinds of problems people tend to associate me with. Psychology, however, is intended for people who have suffered and endured crises, causing a loss of dignity. It is very important to break the misconception that psychology and psychosocial rehabilitation are aimed only at a small number of sick individuals.
On upgrading the role of psychological welfareThe United Nations is primarily concerned with physical survival, which is indeed a priority. Nevertheless, psychosocial welfare has assumed too much a secondary position. Having worked for the United Nations Children's Fund (UNICEF), I understand that the problems are many, while staff and resources are limited. More attention should be paid to questions relating to non-physical survival. We need to disseminate basic knowledge of psychosocial assistance and rehabilitation. It should be understood that we are not here to treat sick people; we are here to promote the well-being of the general population and the recovery of those affected by man-made and natural disasters, such as armed conflicts, poverty, hunger and diseases.
On psychological first aidPsychological first aid is a relatively new concept, which is as important as medical first aid. When someone is bleeding, you don't immediately take that person to a specialist; you do something to stop the bleeding and then take him/her to a specialist. Likewise, you do not take a person who is in need of immediate psychological assistance for psychoanalysis or psychotherapy. Everybody should know the basic principles of psychological first aid to help others recover faster and better from a crisis. What I did in my country and in other places was to make a list. Psychological first aid is a very simple concept that can be broadcast over the radio or printed on brochures and leaflets for anyone to learn and apply. During the NATO bombing of Yugoslavia, I asked local radio stations to explain one principle of psychological first aid every evening for one minute before the news.
It took just one minute over twenty consecutive evenings to describe twenty valuable aid techniques. It is thus simple and inexpensive to publicize such first aid to everyone who is listening to the radio or watching television. People who are empathetic, motivated and willing can apply it without training, while others may need very basic training.
On the long-term effects of collective traumatizationCollective traumatization is a more complex issue. In some countries, like Afghanistan and Iraq or my native Serbia, virtually everybody is traumatized because they have all been affected by a crisis. One can only try to support their recovery by re-establishing dignity, self-worth and appreciation for life and individuals; some will recover on their own, while others will not. Unfortunately, people tend to return to violence soon after being exposed to chronic, continuous trauma. Thus, the future is very bleak for countries where the population has been heavily traumatized as a whole. In many post-conflict countries, crime increases, especially among the youth; one cannot expect young people to understand and embrace tolerance once they have been exposed to the violent acts of others. People, especially the young, come to believe that war, anger and hatred are acceptable ways of dealing with others. I don't know exactly what should be done, and so far I don't see any serious willingness to invest in the necessary rehabilitation programmes. Priority has been given to housing, food and medicine, and people therefore will remain traumatized.
On cycles of violence in post-conflict countriesA generation who endures years of brutality will simply take violence as a model of behaviour in relating to other people, so this is a long-term problem-it doesn't stop when the first episode of violence ends. I know from my own country that one cannot just introduce peace in a post-war environment. Although the international community removed our President, who was a dictator, young people continue to be aggressive towards others and we are having great difficulty in introducing programmes to change their beliefs about how conflicts should be resolved. Several programmes on peaceful conflict resolution and tolerance have been implemented, but they cannot reach everyone. Bombs, however, did reach the whole population five years ago, and now huge efforts are required to remedy the damage done in a short time.
On the relevance of educationEducation is essential, but all young people cannot be reached through formal education, because many do not attend school. Some have just graduated, others are simply not attending classes, and these young adults will be leading the country for the next thirty years. You will never reach everybody, and this is a problem. I would like the world leaders to attend at least one course on peaceful conflict resolution offered by psychologists. World, community and religious leaders, as well as any figure of authority, should communicate to others that conflict is normal, but violence is abnormal. Conflict is a part of our lives-both professional and personal-but this does not mean that one should be violent to solve problems. It would be useful to keep in mind that every violent act leads millions of people to believe that violence is the only solution to a conflict; that would help solve much more than anything else. Although the United Nations is doing a lot, it does not have enough resources to reach entire populations.
Education Is Essential in Post-conflict Situations
www.un.org/Pubs/chronicle/2003/issue4/0403p53.asp
Speaking to the 2,000 participants of the 56th Annual DPI/NGO Conference in New York, Nila Kapor-Stanulovic addressed the psychological aspects of human security and dignity. She experienced first-hand the effects of multiple armed conflicts in the Balkans and treated patients affected by the crises in Bosnia and Herzegovina and in Macedonia. She pointed out that she had been a recipient, as well as a provider, of psychological aid, at times filling both roles simultaneously. Although it had not been easy, Ms. Kapor-Stanulovic explained that the most difficult times were those when she was only receiving such support due, she believes, to the sense of helplessness that results from having encountered traumatic experiences. She strongly endorses the idea of helping victims restore a feeling of being somebody. An expert in "emergency psychology", which includes crisis intervention techniques, post-trauma interventions and psychosocial rehabilitation, she is continuing her work to ameliorate the consequences of the armed conflicts in the former Yugoslavia.
Biko Nagara of the Chronicle spoke with Ms. Kapor-Stanulovic on 10 September
On the psychology of dignity and securityDignity and security within the context of psychology have been addressed but never fully explored. The psychological aspects of life are frequently disregarded by humanitarian agencies and non-governmental organizations (NGOs) because psychology is often associated with illness and psychopathological problems. When I say that I am a psychologist, it is these kinds of problems people tend to associate me with. Psychology, however, is intended for people who have suffered and endured crises, causing a loss of dignity. It is very important to break the misconception that psychology and psychosocial rehabilitation are aimed only at a small number of sick individuals.
On upgrading the role of psychological welfareThe United Nations is primarily concerned with physical survival, which is indeed a priority. Nevertheless, psychosocial welfare has assumed too much a secondary position. Having worked for the United Nations Children's Fund (UNICEF), I understand that the problems are many, while staff and resources are limited. More attention should be paid to questions relating to non-physical survival. We need to disseminate basic knowledge of psychosocial assistance and rehabilitation. It should be understood that we are not here to treat sick people; we are here to promote the well-being of the general population and the recovery of those affected by man-made and natural disasters, such as armed conflicts, poverty, hunger and diseases.
On psychological first aidPsychological first aid is a relatively new concept, which is as important as medical first aid. When someone is bleeding, you don't immediately take that person to a specialist; you do something to stop the bleeding and then take him/her to a specialist. Likewise, you do not take a person who is in need of immediate psychological assistance for psychoanalysis or psychotherapy. Everybody should know the basic principles of psychological first aid to help others recover faster and better from a crisis. What I did in my country and in other places was to make a list. Psychological first aid is a very simple concept that can be broadcast over the radio or printed on brochures and leaflets for anyone to learn and apply. During the NATO bombing of Yugoslavia, I asked local radio stations to explain one principle of psychological first aid every evening for one minute before the news.
It took just one minute over twenty consecutive evenings to describe twenty valuable aid techniques. It is thus simple and inexpensive to publicize such first aid to everyone who is listening to the radio or watching television. People who are empathetic, motivated and willing can apply it without training, while others may need very basic training.
On the long-term effects of collective traumatizationCollective traumatization is a more complex issue. In some countries, like Afghanistan and Iraq or my native Serbia, virtually everybody is traumatized because they have all been affected by a crisis. One can only try to support their recovery by re-establishing dignity, self-worth and appreciation for life and individuals; some will recover on their own, while others will not. Unfortunately, people tend to return to violence soon after being exposed to chronic, continuous trauma. Thus, the future is very bleak for countries where the population has been heavily traumatized as a whole. In many post-conflict countries, crime increases, especially among the youth; one cannot expect young people to understand and embrace tolerance once they have been exposed to the violent acts of others. People, especially the young, come to believe that war, anger and hatred are acceptable ways of dealing with others. I don't know exactly what should be done, and so far I don't see any serious willingness to invest in the necessary rehabilitation programmes. Priority has been given to housing, food and medicine, and people therefore will remain traumatized.
On cycles of violence in post-conflict countriesA generation who endures years of brutality will simply take violence as a model of behaviour in relating to other people, so this is a long-term problem-it doesn't stop when the first episode of violence ends. I know from my own country that one cannot just introduce peace in a post-war environment. Although the international community removed our President, who was a dictator, young people continue to be aggressive towards others and we are having great difficulty in introducing programmes to change their beliefs about how conflicts should be resolved. Several programmes on peaceful conflict resolution and tolerance have been implemented, but they cannot reach everyone. Bombs, however, did reach the whole population five years ago, and now huge efforts are required to remedy the damage done in a short time.
On the relevance of educationEducation is essential, but all young people cannot be reached through formal education, because many do not attend school. Some have just graduated, others are simply not attending classes, and these young adults will be leading the country for the next thirty years. You will never reach everybody, and this is a problem. I would like the world leaders to attend at least one course on peaceful conflict resolution offered by psychologists. World, community and religious leaders, as well as any figure of authority, should communicate to others that conflict is normal, but violence is abnormal. Conflict is a part of our lives-both professional and personal-but this does not mean that one should be violent to solve problems. It would be useful to keep in mind that every violent act leads millions of people to believe that violence is the only solution to a conflict; that would help solve much more than anything else. Although the United Nations is doing a lot, it does not have enough resources to reach entire populations.
Earth Science sites (Courtesy: http://www.lib.flinders.edu.au/resources/sub/sciengin/earthsciences.html)
Useful links for Earth Science
Library Databases for Earth Science
Electronic Journals for Earth Science
Australian Severe Weather
Climatology and Paleoclimatology Resources
Resource list compiled by the Dept. of Oceanography at Texas A&M University.
Earthguide
An interactive and easy-to-use educational resource about Earth, oceans and the environment.
Earth Science Australia
Flinders University School of Chemistry, Physics and Earth Sciences (SOCPES)
Geophysical Fluid Dynamics Laboratory Gallery
Contains several visualizations which have been prepared in the course of GFDL's research, and subsequently presented at meetings and in the media. These are offered here not so much as scientific research results, nor do they necessarily represent the entire spectrum of research being conducted at GFDL, but rather as examples of various visualization techniques and how they might be used to convey complex results as understandable images. A number of visualizations are also available in the form of annotated handouts.
Geoscience Internet Links
This site contains extensive links for the geosciences. It is maintained by the Institute for Geosciences, University of Mainz, Germany.
Indigenous Weather Knowledge
The project recognises the knowledge of weather and climate developed over countless generations by Australia’s Indigenous communities, nicely complementing science and statistically based approaches.
NASA Earth Sciences Directorate Portal
National Groundwater Association (US)
National Oceanic and Atmospheric Administration (US) Paleoclimatology Program
SA Museum-Journal SearchIn 2004, the South Australian Museum and the Royal Society of South Australia became partners in Southern Scientific Press. This led to the amalgamation of their two professional journals. The Transactions of the Royal Society of South Australia now incorporates the Records of the South Australian Museum.
This database covers papers from the old journals and the new combined journal, after five years from publication
Library Databases for Earth Science
Electronic Journals for Earth Science
Australian Severe Weather
Climatology and Paleoclimatology Resources
Resource list compiled by the Dept. of Oceanography at Texas A&M University.
Earthguide
An interactive and easy-to-use educational resource about Earth, oceans and the environment.
Earth Science Australia
Flinders University School of Chemistry, Physics and Earth Sciences (SOCPES)
Geophysical Fluid Dynamics Laboratory Gallery
Contains several visualizations which have been prepared in the course of GFDL's research, and subsequently presented at meetings and in the media. These are offered here not so much as scientific research results, nor do they necessarily represent the entire spectrum of research being conducted at GFDL, but rather as examples of various visualization techniques and how they might be used to convey complex results as understandable images. A number of visualizations are also available in the form of annotated handouts.
Geoscience Internet Links
This site contains extensive links for the geosciences. It is maintained by the Institute for Geosciences, University of Mainz, Germany.
Indigenous Weather Knowledge
The project recognises the knowledge of weather and climate developed over countless generations by Australia’s Indigenous communities, nicely complementing science and statistically based approaches.
NASA Earth Sciences Directorate Portal
National Groundwater Association (US)
National Oceanic and Atmospheric Administration (US) Paleoclimatology Program
SA Museum-Journal SearchIn 2004, the South Australian Museum and the Royal Society of South Australia became partners in Southern Scientific Press. This led to the amalgamation of their two professional journals. The Transactions of the Royal Society of South Australia now incorporates the Records of the South Australian Museum.
This database covers papers from the old journals and the new combined journal, after five years from publication
Medical Knowledge Management
MeduKnowledge Corporate Website - http://meduknowledge.com/
Updated medical information and knowledge is by the far the most important component in the healthcare system. To ensure delivery of optimum treatment and patient care, it is imperative that every stakeholder in the healthcare system receives updated medical information relevant to his/her needs.
MeduKnowledge offers innovative medical knowledge management solutions that encompass all the stakeholders in the disease awareness, diagnosis, treatment, management and prevention through state-of-the-art technology and integrated Information Technology systems.
MeduKnowledge offers innovative medical knowledge management solutions that encompass all the stakeholders in the disease awareness, diagnosis, treatment, management and prevention through state-of-the-art technology and integrated Information Technology systems.
Healthcare Knowledge Management
Healthcare practitioners and managers increasingly find themselves in clinical situations where they have to think fast and process myriad diagnostic test results, medications and past treatment responses in order to make decisions. Effective problem solving in the clinical environment or classroom simulated lab depends on a healthcare professional's immediate access to fresh information. Unable to consult a library for information, the healthcare practitioner must learn to effectively manage knowledge while thinking on their toes.
Knowledge Management (KM) holds the key to this dilemma in the healthcare environment. KM places value on the tacit knowledge that individuals hold within an institution and often makes use of IT to free up the collective wisdom of individuals within an organization. Healthcare Knowledge Management: Issues, Advances and Successes will explore the nature of KM within contemporary healthcare institutions and associated organizations. It will provide readers with an understanding of approaches to the critical nature and use of knowledge by investigating healthcare-based KM systems. Designed to demystify the KM process and demonstrate its applicability in healthcare, this text offers contemporary and clinically-relevant lessons for future organizational implementations.
The editors of this book have assembled a group of international contributors that reflects the diversity of KM applications in the healthcare sector. While many KM texts suffer from pitching theoretical issues at too technical a level, Healthcare Knowledge Management approaches the topic from the more versatile "twin" perspectives of both academia and commerce. This unique text is integrative in nature – a practical guide to managing and developing KM that is underpinned by theory and research
Issues, Advances and Successes
Series: Health Informatics
Issues, Advances and Successes
Series: Health Informatics
Bali, Rajeev K.; Dwivedi, Ashish N. (Eds.)
2007, XXVI, 282 p. 33 illus., HardcoverISBN: 978-0-387-33540-7
Signs and Symptoms of Sleep Apnea and Acute Stroke Severity: Is Sleep Apnea Neuroprotective? .
Journal of Stroke and Cerebrovascular Diseases , Volume 16 , Issue 3 , Pages 114 - 118
S . Koch , S . Zuniga , A . Rabinstein , J . Romano , B . Nolan , J . Chirinos , A . Forteza
Abstract
Background: In animal models, brief periods of hypoxemia render the brain tolerant to subsequent ischemic insults. Sleep apnea leads to frequent episodes of nocturnal hypoxemia and may induce ischemic tolerance. Snoring and daytime sleepiness are cardinal symptoms of sleep apnea. We undertook this study to determine differences in stroke severity and early neurologic course in patients at risk for sleep apnea as determined by a sleep questionnaire. Methods: Patients admitted with acute ischemic stroke completed the Berlin questionnaire. The Berlin questionnaire examines habitual snoring, daytime sleepiness, presence of hypertension, and body mass index (BMI) and classifies patients into a high or low risk for sleep apnea group. National Institutes of Health Stroke Scale (NIHSS) score was determined on admission and day 5 of hospitalization. Age, sex, cardiovascular risk factors, BMI, and stroke mechanism were determined prospectively. Results: We enrolled 190 patients with a mean age of 60 years and 53% were men. The Berlin questionnaire classified 103 patients (54%) at high risk for sleep apnea. The median NIHSS score on admission and day 5 of hospitalization did not differ between the two groups after multivariate analysis. Examined separately, we found no effect of snoring, daytime sleepiness, or BMI on acute stroke severity and outcome. Conclusion: We found that a large number of patients admitted with acute ischemic stroke were at high risk for having sleep apnea. We were not able to show that a constellation of symptoms and features highly suggestive of sleep apnea influenced stroke severity or early neurologic course after acute ischemic stroke.
S . Koch , S . Zuniga , A . Rabinstein , J . Romano , B . Nolan , J . Chirinos , A . Forteza
Abstract
Background: In animal models, brief periods of hypoxemia render the brain tolerant to subsequent ischemic insults. Sleep apnea leads to frequent episodes of nocturnal hypoxemia and may induce ischemic tolerance. Snoring and daytime sleepiness are cardinal symptoms of sleep apnea. We undertook this study to determine differences in stroke severity and early neurologic course in patients at risk for sleep apnea as determined by a sleep questionnaire. Methods: Patients admitted with acute ischemic stroke completed the Berlin questionnaire. The Berlin questionnaire examines habitual snoring, daytime sleepiness, presence of hypertension, and body mass index (BMI) and classifies patients into a high or low risk for sleep apnea group. National Institutes of Health Stroke Scale (NIHSS) score was determined on admission and day 5 of hospitalization. Age, sex, cardiovascular risk factors, BMI, and stroke mechanism were determined prospectively. Results: We enrolled 190 patients with a mean age of 60 years and 53% were men. The Berlin questionnaire classified 103 patients (54%) at high risk for sleep apnea. The median NIHSS score on admission and day 5 of hospitalization did not differ between the two groups after multivariate analysis. Examined separately, we found no effect of snoring, daytime sleepiness, or BMI on acute stroke severity and outcome. Conclusion: We found that a large number of patients admitted with acute ischemic stroke were at high risk for having sleep apnea. We were not able to show that a constellation of symptoms and features highly suggestive of sleep apnea influenced stroke severity or early neurologic course after acute ischemic stroke.
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