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martes, 12 de mayo de 2015

Singing to speaking

Hi everybody! 
vvv
I have choosen this article because I love music, when I feel stress or need some motivation, I just listen to music to change my mood. So, when, I heard about this new therapy, I just get exited because our brain is amazing and using such a simple tools, we can help patients recover from their disabilities such as the capacity of communication. 

But, first of all, you can listen this song and have a litte bit of motivation :)

https://www.youtube.com/watch?v=nEjLFpU2pJ4 

I hope you enjoy this article.

SINGING TO SPEAKING

It's amazing to see stroke survivors who've lost the ability to speak suddenly produce accurate words when singing familiar songs. This phenomenon was first reported by Swedish physician Olaf Dalin in 1736. Dr. Dalin described a young man who had lost his ability to talk as a result of brain damage, but who surprised townsfolk by singing hymns in church.

The acquired language disorder now called “aphasia” became a subject of clinical study and a target for rehabilitation beginning in the mid-1880s. Since that time, every clinician working with aphasia has seen individuals who can produce words only when singing. Indeed, this observation prompted American neurologist Charles Mills to suggest (in 1904!) that it might help to play the piano and encourage patients with aphasia to sing well-known songs.  
There appear to be psychological benefits, but singing familiar songs alone doesn’t seem to improve the speech of people with aphasia. This is probably because words that come automatically when singing are intricately linked to the melodies and are not easily separated. 

The spoken word is a different matter. We know the brain has difficulty starting in the middle of highly memorized spoken passages (such as the “Pledge of Allegiance”). We need a “running start” to prime the pump of recall. 
Songs themselves might be used to communicate. I had a patient who struggled to tell his son he wanted to go to a Boston Red Sox game. He finally got his point across by bursting forth with “Take Me Out to the Ball Game.” Unfortunately, there aren’t appropriate songs for every communication need, so it would be better if singing could be used to unblock residual speech abilities. This was the motivation for the aphasia treatment approach known as “Melodic Intonation Therapy,” which we began to develop in 1972.

Why Does It Work For Some People?
We know that aphasia typically results from a stroke or other damage that affects the left hemisphere of the brain, where language ability usually is located. We thought it might be because a stroke increased the use of the brain’s right hemisphere, where many aspects of music and the melody of speech are located. Using this treatment, the dominance of the damaged left hemisphere language areas might diminish while the right hemisphere became more involved.

A recent study using functional magnetic resonance imaging with individuals treated with melodic intonation therapy showed that the right hemisphere does, indeed, play a role in response to this method. Preliminary results suggest that the amount of speech recovery may be associated with how much and what part of the right hemisphere is activated. This study demonstrates the flexibility of adult brains, even those with stroke-related damage.

It is encouraging to know that with special treatment we can learn to use undamaged portions of our brains to perform “new tricks” – even one as complicated as speaking.

Trial And Error
Robert Sparks, a speech-language pathologist, Martin Albert, a behavioral neurologist, and I were working on the Aphasia Unit of the Boston VA Hospital. We saw a woman whose only purposeful speech was the combination of nonsense syllables: “nee-nee-nah-nah.”

At that time, a hospital volunteer was coming to each inpatient ward with a piano on wheels and conducting sing-along sessions with the patients. One day we observed our patient sitting beside him in her wheelchair and singing many of the words of popular songs. Though we had seen this before, this new example convinced us we had to try to develop a method that capitalized on this preserved ability to produce speech when singing.

We knew that simply singing familiar songs with this woman would not do the trick. Through trial and error, we discovered that if we melodically intoned everyday phrases such as “open the window” while helping her tap out the syllables with her unaffected hand, she could produce phrases in unison with us.  Then she could intone the phrases with just a little help at the beginning. Finally, she could produce them on her own.
From this experience, we created a treatment program using melodically intoned and tapped out phrases of increasing length. Usually within a few sessions, patients’ production of nonsense syllables had disappeared and they began to communicate verbally in everyday situations. Our continued research helped identify the best candidates for this method. 

domingo, 3 de mayo de 2015

Medical Surplus


Hi future doctors!

This week I would like you to introduce you into a discussion of something realated with Medicine but is not about any subject.

Sometimes, because of we are so busy studying, with our clinical clerkship and other stuff that we are not informed about what's happening in the medical world.
As you all know, i'm in touch with this world and I want to explain you the situation that we have nowadays in Spain. I would like you to think about it and at the end I would make you some questions.


There are too many medical schools in Spain, and is still expected to open seven more, which, for the Medical Profession Forum, which brings together the most representative industry organizations (schools, deans, students ...), equivalent to an excess of graduates that the system can not absorb. The mismatch between supply of MIR (the specialized training needed to practice in Spain) and graduates every year out of medical schools is now 1,000 doctors. Meanwhile, unemployment among Doctors increases, and with it, migration for work.

"Spain is the second country of over 20 million people with more medical schools per capita, and if they open the seven that are now planned, will be the number one," said today Ricardo Rigual, president of the National Conference of Deans of Medical Schools. "In just eight years we have gone from 28 to 40 schools and 3,450 students who enter school at 7,000," he added during a press conference. Both medical colleges and students, deans, trade unions and scientific societies agree: the absolute control that has reigned in the opening of new faculties must end.

The seven new powers provided are Campus Mare Nostrum (Murcia) and Catholic University San Antonio (Alicante), both private; Concerted in Vic (Barcelona) and four public, three in Andalusia (Almería, Jaén and Huelva) and one in the Balearic Islands.
Doctors have insisted this morning emerging from 7,000 faculty Doctors, but there are only 6,000 places MIR. "Setting those two numbers is essential", said the president of the Confederación Estatal de Sindicatos Médicos (CESM), Francisco Miralles, who has pointed to another problem: the money invested in training a doctor who ends up working outside Spain . "Being a doctor costs between 200,000 and 250,000 euros, according to some calculations we did a few years ago," he explained. Moreover, Mir places offered have declined in the last two calls by 10 percent, while the number of students entering this degree it has in only 1.35 percent, according to the Forum of the medical profession.


What do you think about this measure of creating more medicine faculties in Spain? 40 faculties are few? 
What do you think about our future as a doctors, when the MIR places are reduced each year?
Is something that we could do to try to solve this? 


Have a nice weekend! :) 



Mercè