Balance Disability After Stroke

Balance Disability After Stroke Balance disability is common after stroke. The aims of this study were to investigate the frequency of balance disability; to characterize different levels of disability; and to identify demographics, stroke pathology factors, and impairments associated with balance disability. The subjects studied were 75 people with a first-time anterior circulation stroke; 37 subjects were men, the mean age was 71.5 years and 46 subjects had left hemiplegia. Prospective hospital-based cross-sectional surveys were carried. The subjects’ stroke pathology, demographics, balance disability, function, and neurologic impairments were recorded in a single testing session 2 to 4 weeks after stroke. A total of 83% of the subjects had a balance disability; of these, 27% could sit but not stand, 40% could stand but not step, and 33% could step and walk but still had limited balance. The most severe balance disability had more severe strokes, impairments, and disabilities. Weakness and sensation were a ssociated with balance disability. Demographics, stroke pathology, and visuospatial neglect were not associated with balance disability. The most severe balance disability had the most severe strokes, impairments, and disabilities. Demographics, stroke pathology, and visuospatial neglect were not associated with balance disability. They were excluded if they had another mobility limiting neurological condition or bilateral weakness. Data were collected in a single measurement session at the hospital bedside or physical therapy treatment gym by 1 of 4 assessors (2 senior neurologic physical therapists and 2 geriatricians). The demographics, neurologic impairments, functional and pathologic data were obtained. The average of the scores for the upper and lower limbs is taken to provide a total score for the hemiplegic side; the total score was used in this study. Thirteen subjects scored the maximum of 12 on the BBA (step-ups without hand support) and could complete all of the balance tasks. Of the remaining 62 with balance disabilities, 17 could sit but not stand , 25 could stand but not step and walk (, and 20 could step but still had limited balance. There was marked heterogeneity among subjects with different levels of balance ability . There were no differences in the demographic characteristics or the side of stroke for subjects with different levels of balance disability (sitting, standing, or stepping balance). Subjects in the sitting balance group had more severe neurologic impairments, disabilities, and strokes than subjects with limited standing or stepping balance. Conversely, subjects in the stepping balance group were less severely impaired and disabled and had milder strokes than subjects with limited sitting or standing balance. There were significant differences among the 3 groups for weakness, independence, and severity of s troke. More subjects in the sitting balance group had neglect and sustained a hemorrhage (rather than infarct) than subjects in the standing balance group or the stepping balance group. Subjects in the sitting balance and standing balance groups had worse sensation than subjects in the stepping balance group. Individual linear regression modeling revealed that none of the demographic or stroke pathology factors (age, sex, premorbid disability, side of stroke, or stroke type) was associated with balance disability. All of the impairments (weakness, sensation, and neglect) were significantly associated with balance disability. Although rehabilitation of balance and mobility often has been identified as an important goal of stroke rehabilitation, this is the first detailed descriptive study of balance disability after stroke. We found that more than 80% of subjects who had first-time strokes, who were admitted to the hospital, and who met the inclusion criteria had balance disability in the acute phase, with similar numbers of subjects having limited sitting balance, standing balance, and stepping balance. There were marked differences in the severity of stroke, impairments, and disability among subjects with different levels of balance ability. Subjects in the sitting balance group had more severe strokes and impairments and were more dependent than subjects in the standing balance and stepping balance groups, and subjects in the stepping different balance abilities, a measure of balance disability may be a useful predictive tool in the clinical setting and for use as a stratification tool for further rese arch. Moreover, level of balance ability (sitting, standing, or stepping balance) is meaningful to clinicians, patients, and their relatives, and a robust measurement tool (BBA) that is quick and easy to use has been developed. Brunel Balance Assessment (BBA) is a reliable, valid measure of balance disability after stroke. It was good that. Informed consent was obtained from all participants. Reliability and validity for use with people with stroke have been demonstrated. The study failed to find a relationship between age, sex, or side of stroke and balance disability. It is important to know which factors influence a patient’s balance abilities most strongly so that they can be targeted during rehabilitation. A total of 21 subjects had visuospatial neglect. A total of 55 subjects had no previous disability. Spasticity was not included in the present study because of the lack of a robust measurement tool, but many physical therapists believe this to be an important contributor to loss of balance and function after stroke. Tests of eyesight and cognitive factors, such as speed of information processing, also could be considered. The relationship between balance impairments and balance disability also needs to be clarified by including measures of balance impairments in future, more detailed studies. Although the above details, it must be emphasized that all people who were admitted to over the course of 1 year, who met the inclusion criteria, and who were willing to participate. I therefore believe that the findings have general relevance to the population of people with balance disability after first-time stroke. The present study has indicated that weakness and sensation have the most impact on balance. A surprising finding was that neglect was not associated with balance disability. This finding indicates that neglect may be related to the severity of balance disability because it is associated with other impairments (weakness and sensory loss); therefore, people with neglect probably have poor balance. There was no blindness in the study and no external validity was measured. Previously 55 participant’s were no any disability Further studies with a power calculation to ensure that sufficient numbers are recruited to detect balance group had milder strokes, less impairment, and greater independence than subjects in the other groups. Given the heterogeneity among subjects with a difference, should one exist, are needed to investigate this issue. Future studies need to consider which other factors may affect balance disability. Large sample are needed to further test the hypothesis that balance level in the acute stages could be a useful, meaningful prognostic indicator of recovery.

Banana Peels as Alternative Toothpaste

Hydrogen peroxide is a bleaching agent with antimicrobial effects [Gaffar, 1997] that has been used historically, at high concentrations, for the treatment of severe gingivitis. It is an effective bleaching agent that can penetrate enamel to bleach intrinsic stains. Papain is a naturally occurring enzyme that dissolves protein. There is some evidence to show that the combination of papain and citrate can remove superficial tooth staining.Sodium tripolyphosphate (STP) slows the growth of crystals and so inhibits the formation and growth of hard deposits of mineralized plaque (calculus). [Kohut et al., 1997] At higher concentrations, STP breaks down the stain matrix. It does this by removing calcium bridges between the stain molecules and surface proteins on the teeth, making the stain easier to remove.ABRASIVESAbrasives in toothpaste help remove stains and plaque as well as polish teeth. Common abrasives include silica and calcium carbonate. Toothpaste should be abrasive enough to rem ove plaque and stains, but not so abrasive as to damage tooth enamel.TOOTH DESENSITISING INGREDIENTSPotassium nitrate is used in products to reduce hypersensitivity from exposed dentinal surfaces. Strontium – agents based on strontium reduce the pain from sensitive teeth by blocking the tubules in the exposed dentine.FLAVOURS AND GUMSFlavours – the natural oils and flavours used in oral healthcare products include wintergreen, eucalyptus oil, menthol and thymol. It has been suggested that natural oils may work by reducing the levels of bacterial toxins in the plaque. [Mandel 1988] Gums – various gums are used to thicken toothpaste, but also to retain moisture, so the toothpaste does not dry out if the top is not replaced.CARIES PREVENTIVE INGREDIENTSFluoride may be included in oral health products in many forms, including sodium fluoride (NaF), sodium monofluorophosphate, amine fluoride and stannous fluoride. Fluoride strengthens the teeth against caries by maki ng the enamel less soluble and by promoting remineralization. [Manson & Eley, 1995]At the same time, it interferes with the metabolism of plaque bacteria and so may help inhibit plaque acid production. [Slots & Taubman, 1992] Calcium glycerophosphate (CaGP) has been reported to increase the amount of fluoride that is taken up into tooth enamel. [Forward et al., 1979] CaGP present in the toothpaste has also been reported to increase the amount of calcium and phosphate available for the remineralization of enamel. [Duke et al., 1979]ANTIBACTERIAL AND pH-MODIFYING INGREDIENTSChlorhexidine salts are antimicrobial agents that are effective against a wide variety of bacteria. [Collins & Walsh, 1992] They have been reported to inhibit plaque acid production. [Manson & Eley, 1995; Marsh, 1992]Triclosan is a broad-spectrum antibacterial agent in toothpaste and mouthwash. At low concentrations it interferes with the uptake of nutrients into bacterial cells and inhibits their growth. At higher concentrations, triclosan is bactericidal. [Zuckerbraum et al., 1998] Zinc salts exert an antimicrobial effect by inhibiting a variety of bacterial enzyme reactions, [Mandel, 1988] including the breakdown of sugar into plaque acid. Zinc, used in combination with other substances, has been shown to reduce calculus.It is also reported to be effective against halitosis as zinc ions have an affinity for sulfur compounds, reported to be primary components of bad breath, and convert offensive sulfur compounds to non-volatile substances. [Waler, 1997] Baking soda (bicarbonate of soda) has the potential to modify the pH of plaque, and possibly the activity of the bacteria that cause tooth decay. It may also interfere with plaque metabolism and so reduce acid production. [Legier-Vargas et al., 1995] Sodium lauryl sulfate is a foaming, cleaning and dispersing agent with antibacterial properties.

Examine Some of the Reasons Why Females Commit Less Crimes Than Males.

Examine some of the reasons why females may be less likely than males to commit crimes. Women in general seem to have a lower rate of offending than men. Some sociologists take the view that it is social factors rather than biological factors that cause the gender differences in offending. Sociologists have put forward three main explanations of gender differences in crime, which are the sex role theory, the control theory and the liberation thesis.The sex role theory and the control theory both give us explanations for why females are less likely than males to commit crimes, however the Liberation thesis argues this, and suggests there are no gender differences between male and female crime rates. Gender differences in crime began by focussing on differences in the socialisation of males and females. Boys are encouraged to be tough, aggressive and risk taking. This means they are more disposed to commit acts of violence and take advantage of criminal opportunities when they present themselves to them.Parson’s traced down differences in crime and deviance to the gender roles in nuclear families. Whilst men take the instrumental role of a breadwinner, women perform the expressive role in the home where they take the main responsibility to socialise the children. As girls have access to an adult role model and boys to not it means that, boys are likely to reject feminine models of behaviour that express tenderness, gentleness and emotion and distance themselves by engaging in ‘compensatory compulsory masculinity’ through aggression and anti-social behaviour that lead to acts of delinquency more than women.Furthermore, new right theorists argue that the absence of male role models in matrifocal lone parent families leads to boys turning criminal. Also, men have much less of a socialising role than women in the conventional nuclear family; therefore socialisation for boys is much more difficult compared to girls. Cohen argued that this relative lack of an adult male role model meant boys are more likely to turn to all male street gangs as a source of masculine identity. In these subcultural groups, status is earned by acts of toughness, risk taking and delinquency.However, this sex role theory is criticized by Sandra Walklate for its biological assumptions. Walklate argues that Parson’s assumption is that because women have the biological capacity to bear children, they are best suited to the expressive role. Furthermore, it is argued mainly by control theorists that women always conform to men and their role as a housewife. Heidensohn expanded on this control theorist view and suggested, due to women being a part of a patriarchal society it reduces their opportunity to offend as the nuclear family lifestyle at home acts as a prison to them.He further notes that men are able to impose this control upon women through domestic violence and by controlling their finances it limits their activities. Daughters are also su bject to patriarchal control. Girls are less likely to be allowed to come and go as they please or to stay out late. As a result they develop a ‘bedroom culture’ socialising at home with friends rather than in public places, they are also required to do more housework than boys. As a result they have less opportunity to take part in deviant activities.Conversely, what Heidensohn doesn’t take on board is that modern relationships nowadays are much more equal and as the liberation theory argues, women have many opportunities outside the home and there has been a large increase in independence for women. On the other hand, the liberation thesis debates that if society becomes less patriarchal and more equal then women’s crime rates will become similar to men’s. Put forward by Adler, she suggests that as women become liberated from patriarchy their crimes will become as frequent and as serious as men’s.Women’s liberation has led to a new t ype of female criminal and a rise in the female crime rate. The changes in the structure of society according to Adler have led to changes in women’s offending behaviour. As patriarchal controls and discrimination have lessened, and opportunities in work and work have become more equal, women have begun to adopt traditionally ‘male’ roles in both legitimate activity(work) and illegitimate activity (crime). As a result, women no longer commit traditional ‘female’ crimes such as shoplifting and prostitution.They now also commit typically ‘male’ offences such as crimes of violence and white collar crimes. This is because of women’s greater self -confidence and assertiveness, and the fact they now have greater opportunities in the legitimate structure. For example, there are more women in senior positions at work and this gives them the opportunity to commit serious white collar crimes such as fraud. To support her view, Adler argued that the pattern of female crime has shifted.She cited studies showing rising levels of female participation in crimes previously regarded as ‘male’ such as embezzlement and armed robbery. Nevertheless, many critics reject Adler’s liberation thesis by arguing, the female crime rate began rising in the 1950’s long before the women’s liberation movement, which emerged in the late 1960’s. Also that most female criminals are working class; they are least likely to be influenced by women’s liberation, which has benefited middle class women much more.According to Chesney- Lind in the USA poor and marginalised women are more likely to be criminals compared to liberated women. On the whole, it is arguable that females do commit fewer crimes than males simply due to their roles as housewives and the patriarchal society we live in today. Despite this, it is still considered through the liberation thesis that there are no gender differences with the rates of crimes between males and females.

The Leadership Styles And Behaviours Of The Ceo Of Virgin...

Assessment 2: Case Study Introduction Looking at the case study on leading in the 21st century, which is comprised of two short scenarios that describe situations in two very different companies, where the leadership styles and behaviours of the CEO of one company and the owner of the second company are evident on a day- to-day basis. Comparing Richard Branson’s (CEO of Virgin Group) leadership style, behaviour, and his impact on employee motivation with Terry Gou’s (Owner of Foxconn Factories) leadership style, behaviour and impact on employee motivation as well as suggesting improvements Gou could make to Foxconn to make it a more harmonious and less toxic workplace. Question 1 a) A democratic leadership style is exhibited by Richard Branson. Democratic leadership can be defined as the performance of three functions: distributing responsibility among the membership, empowering group members, and aiding the group s decision-making process (Gastil, 1994). ‘Branson values removing barriers in the corporate hierarchy and sharing ideas and social events with his workers. Listening to others is important to Branson, particularly his employees, as is allowing them to keep motivated through applying their skills in areas and new projects he is not as good at’. By Branson doing this he is strongly aiding the group’s decision making process, and distributing responsibility between his employees whilst keeping them motivated, which are qualities evident in a democratic leader.Show MoreRelatedLeadership Styles : Transformational Leadership1426 Words   |  6 Pagestransformational leadership styles have a major influence on the employee motivation and organisational culture, hence influence the long term success of the business. 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