ఇంటర్నేషనల్ జర్నల్ ఆఫ్ న్యూరో రిహాబిలిటేషన్

Introduction: While journal clubs are a time-honored method of reviewing and discussing the scientific literature in medicine, hitherto there is no universally accepted definition of that. Purpose of the present study involved a comparison between instructive values of meetings that are directed by an authentic faculty member in comparison with conferences that are usually coached by chief residents. Methods: Forty-two psychiatric residents (from two psychiatric training centers) have been quizzed about the intentions, principles or importance of journal club. Both of said colleges had comparable settings, conferences and alike standard psychiatric journals. In one of them the papers were chosen usually by chief resident, who was as well coordinator of the conferences, while in the other one, articles were chosen habitually by a faculty member, as director and coordinator of sessions. After at least one year of attending in associated sessions, all the participants were asked to answer incognito to a Survey Questionnaire, including 23 questions, involved multiple answers, with different Coding Categories. Analysis of data was performed by way of ‘Comparison of Proportions’. Quantities in each group, as well, were analyzed in line with percentage of responds to different Coding Categories. Significance was defined as P ≤ 0.05. Results: While all participants replied questionnaires, significant difference was evident between two groups regarding their response to at least twelve questions. Judgment of residents were generally and remarkably different with regard to ‘goals’, ‘format’, ’necessity of attendance’, ‘quality of participation of faculty’, ‘educational value of core curriculum of journal club’, ‘its critical role with regard to research and appraisal of topics ‘, and in conclusion ‘as a resource for continuous education’. Conclusion: While journal club formats are educationally diverse and appear to be more effective if they have a leader, disciplined organization of journal club by a skilled faculty member may enhance scientific insight and instructive gratifications of apprentices.

The present work aims to investigate in a schematic and organized way all the main human mechanisms of psychological defense identified in the psychodynamic studies of world history, from Sigmund and Anna Freud to Perry, passing through Klein. The claim is therefore to offer the reader a reasoned analysis of the individual psychological mechanisms that underlie the defense of the ego, as a contact structure with reality. Each mechanism is then investigated in all its components: from levels to areas, from sources to analytical descriptions, complemented by practical examples. Finally, the work ends with a quick examination of the psychodiagnostic tools mainly used to investigate these defenses and with practical applications about the subjective interpretations of reality.

Background: Severe neurological diseases are characterized by upper limb limitations especially related with motor weakness and spasticity. The aim of neurorehabilitation is increasing upper limb ability to help patients improving activities of daily living.

Methods: We explore the effects of a hand Glove FES Device (ReGrasp) in patients affected by different types of neurological disorders. We measured the Functional Independence Measure (FIM) and the Ashworth scale to assess mobility and spasticity at admission and after 4 weeks of treatment.

Results: Eight patients were consecutively admitted in our rehabilitation unit (Mean age: 45; M/F 5/3) suffering of Stroke (2 patients), Spinal Cord Injury (5 patients), and 1 patient affected by Multiple Sclerosis, have been treated using a FES hand glove for a mean time of 30 minutes three times per week for 4 weeks in our Occupational Therapy Program. After training we observed a reduction of spasticity using the Ashworth scale. We found improvement of wrist movement in patients affected by Stroke or Spinal Cord Injury with a reduction of 21% from admission to discharge. The FIM did not have a significant improvement considering the total score. Focusing on single items we found improvement of feeding process of about 14%, and transfers improved about 15%.

Conclusion: The use of FES hand glove is feasible and easy to use in different neurological patients. Considering the general improvement, the reduction of spasticity can be reflected by an improvement of single aspects of daily living like feeding and transfers, ameliorating the life of our patients.