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“She had a remarkable ability to look at the meaning of the lyrics”

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Every patient seen by a Chroma is different. Each day is never the same.

That’s certainly the case for Lucy, who suffered a stroke.

She presented to A&E with dense left-sided weakness, aphasia and vomiting. CT scans revealed that she had suffered from a right intracerebral haemorrhage.

Lucy was referred to Chroma for Neurologic Music Therapy to address poor breath support, reduced voice volume and monotonous voice quality.

Chroma often works with patients who suffer from monotonous voice quality due to Stroke. And through singing, they can help the patient increase vocal range and emotion in their voice, motivating patients to become more aware of their voice and themselves.

Unfortunately, Lucy’s condition didn’t stop there. She also presented with various cognitive-communication difficulties, including reduced awareness of her communication impairment, reduced initiation, misunderstanding of abstract language and difficulties understanding non-verbal communication.

Chroma therapists adopted the use of Neurologic Music Therapy and provided Vocal Intonation Therapy (VIT) to gradually improve the range of Lucy’s vocal pitch and to improve vocal modulation to give more emotion to her speech.

Therapeutic Singing (TS) was then implemented to incorporate breath support strategies, voice volume and pitch whilst singing songs that Lucy had chosen and were important to her. The songs need to be personal for them to have the most effect.

Therapists believed, following initial conversations with Lucy, that she seemed very literal and gave the impression of reduced emotional affect. But further interaction with her proved that not to be the case.

A song chosen by Lucy, sung by herself and the therapist, struck a chord with Lucy. The lyrics hit too close to home for her. It was a Chase and Status song called ‘When it all goes wrong’.

Lucy immediately drew a comparison between the song lyrics and her situation. She became visibly upset, which allowed the therapist to develop the conversation, discuss the lyrics in the song and how she felt the lyrics related to her.

During this conversation, Lucy demonstrated a remarkable ability to look at the meaning behind the lyrics and was able to grasp more abstract phrases, a skill she seemed to lack in general conversation.

Also, she was able to discuss was her motivation around her therapy and her incentive to keep going, which was previously thought to not have been possible this early on in therapy based on her apparent reduced emotional affect.

NMT also helped improve her cognitive impairments enabling her to pick up on non-verbal cues to increase the volume and intensity of the singing by responding to the volume at which the therapist played. Lucy’s ability to interpret abstract language and humour also improved.

NMT significantly improved Lucy’s condition

Thanks to Neurologic Music Therapy, Lucy’s condition improved dramatically after just three months.

VIT and TS had had a positive influence upon her vocal pitch, volume, inflection and tone. Her breath support considerably improved, and she began to be more animated in conversation. Family members even stated she sounded like her ‘old self’.

Her therapy sessions continue and she is able to think of songs to sing during sessions that revolve around themes of strength and fighting adversity. Lucy and her therapist can address her functional speech and cognitive goals through singing, whilst also being emotionally supportive.

NMT when used alongside other conventional therapies, has been found to improve the rate of recovery of those who have suffered a stroke. This is due to the complex nature of the brain being able to connect automatically with music.

The damaged part of Lucy’s brain which controlled her speech and motor skills was inaccessible, so through the use of music, therapists were able to create new neural pathways in Lucy’s brain for her to be able to re-learn speech and motor skills.

The effect Neurologic Music Therapy has had upon Lucy is astounding.

The Stroke affected her speech considerably and therapy has enabled her to improve all aspects of speech that were affected.

The therapy for her mental wellbeing, which ensued as a result of her connection with music, has also allowed her to come to terms with her condition and face the outlook of her diagnosis positively.

This has, in turn, allowed her to feel comfortable being more animated in conversation instead of being consumed by feelings of depression and is more engaged with therapy with hope for a great recovery outcome.

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Dietitian Diaries podcast series launched

Wiltshire Farm Foods is holding podcasts with dietician Emily Stuart as the host

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Wiltshire Farm Foods is putting its dietetics expertise to greater use by launching a podcast with registered dietitian Emily Stuart as the host. 

Aimed specifically at dietitians and healthcare professionals, The Dietitian Diaries will feature three guests discussing all things nutrition related over the course of the next three months.

Emily said she is delighted to be hosting this new podcast from Wiltshire Farm Foods.

“I think it’s really important to get conversations started about key issues patients might face when it comes to nutrition by discussing practical issues which dietitians and healthcare professionals encounter daily,” she said.

“My hope is that we can create highly engaging conversations within the HCP community following each episode and provide key learnings for them to put into practice.”

Episode One featured RD Simone Roberts, a senior community dietitian who works with older adults and those with learning difficulties. She is also a member of the BDA’s Older Peoples Group. 

In the first episode in October, Emily shines a spotlight on Malnutrition Awareness Week, founded by BAPEN and Malnutrition Task Force, now in its fourth year.  

Episode Two will focus on the IDDSI framework, how it links to crucial issues surrounding nutrition and how it helps dietitians and healthcare professionals in general to provide the best care to their patients.

Featuring adult neuro Speech and Language therapist, Tess Essop, Emily will discuss the importance of a MDT approach with Tess, her role in meeting nutritional requirements of dysphagia patients and considerations around IDDSI levels when working with her patients. 

Listen to episode one and look out for upcoming episode two of Dietitian Diaries on Spotify here and Apple here. 

You can also share your thoughts on the episode on Twitter with @SNwff using #DietitianDiaries

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Brain injury

Brain clinic created to support former elite rugby players

The Advanced BRAIN Health Clinic provides a specialist pathway for retired male and female rugby players aged between 30 and 55

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A dedicated clinic for retired elite rugby players who have concerns over their brain health, which will also help advance world-leading research into brain injury in sport, has opened in the UK. 

The Advanced BRAIN Health Clinic provides a specialist pathway for both male and female rugby players aged between 30 and 55, who are former England internationals or those have played elite club rugby in England. 

The opening of the clinic, based at the Institute of Sport, Exercise and Health (ISEH) in central London, will offer long-term, ongoing medical assessments to former players, while also carrying out research to help advance knowledge around head injury in sport and ways to improve brain health. 

This new service complements existing specialist clinics at the ISEH in London and Birmingham (RECOS) that provide concussion assessments and management plans for players who are currently competing at both elite and recreational levels.

The Advanced BRAIN Health Clinic is operated by independent experts Professor David Sharp and Dr Richard Sylvester, in partnership with the Rugby Football Union (RFU) and Premiership Rugby.

Professor Sharp, from the Department of Brain Science at Imperial College London and the UK Dementia Research Institute, said: “Players, coaches, clubs and their support teams may have concerns about the long-term impacts of their sport on the brain, and how these risks can be assessed and mitigated. 

“Our new clinic and the aligned research programme will use the latest clinical investigations to identify the cause long-term symptoms retired players may have and will help us to develop new ways to improving the brain health of retired rugby players.”

All players attending the clinic will first undergo a comprehensive set of half day assessments at ISEH, including tests of their cognitive function, 3T MRI scanning to identify subtle structural and functional changes to the brain, and blood tests and a blood biomarker assessment to determine any signs of neurodegeneration or inflammation within the brain. 

Once baseline test results are acquired and consolidated, retired players will return to ISEH between four and eight weeks later to have a face-to-face neurological consultation from an expert in the assessment and management of post-traumatic and neurodegenerative disorders.

Any treatment needs or brain health actions will be shared with the player and their GP.

This process will be repeated two and four years later to assess any time-related changes in brain health. 

The clinic is supported by an integrated research programme to examine the risk, causes, assessment and management of neurological, psychiatric and cognitive symptoms occurring following participation in elite rugby.

Phil Winstanley, rugby director at Premiership Rugby, said: “We continue to invest in world-leading care for our current players but this new clinic is a commitment that we will invest in their health at the end of their career.

“This clinic will allow players the opportunity to gain access to leading independent experts and reassure themselves about their brain health whilst providing the game with the opportunity to better understand the impact of playing rugby. 

“There has been a significant investment of time and resource to get this operational and this is another example of the collaboration and investment in player welfare by the English game.”

Simon Kemp, RFU medical services director, said: “We’re delighted that the doors to this clinic are now open for clients. 

“Since the initial announcement earlier this year we have worked hard with ISEH, PRL and Imperial College London to get things up and running. 

“We hope this clinic will help many recently retired rugby players who might have concerns about their brain health, while allowing us to further develop our understanding in this area.” 

Dr Richard Sylvester, consultant neurologist at ISEH, the National Hospital of Neurology and Neurosurgery, and Homerton University Hospital, added: “The clinic will provide first-class medical care to retired rugby players with neurological symptoms and concerns about their brain health. 

“The allied research programme provides an incredible opportunity to understand the underlying basis of these issues and will provide important insights into the effects of playing professional rugby on subsequent brain function. We look forward to seeing our first patients.”

More information for any retired elite rugby player aged between 30 and 55 who may want to attend the clinic is here 

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World-leading neuroscience centre opens in US

The UCSF Joan and Sanford I. Weill Neurosciences Building will pioneer research and unite researchers globally

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The opening of one of the world’s largest and most comprehensive neuroscience centres has been hailed as helping to pave the way towards a “new era” of research. 

The UCSF Joan and Sanford I. Weill Neurosciences Building is part of a campus already home to Nobel-Prize winning research on the nervous system and brain and is hailed as a global destination for researchers to develop innovative treatments for intractable brain diseases.

The six-story building will be the new hub for the UCSF Weill Institute for Neurosciences and the UCSF headquarters for the Weill Neurohub, a research collaboration with UC Berkeley and the University of Washington that was launched in 2019 to support groundbreaking, cross-campus research.

Together with the nearby Sandler Neurosciences Center, Arthur and Toni Rembe Rock Hall, Genentech Hall, and soon-to-be-opened Nancy Friend Pritzker Psychiatry Building, the facility will bring together some of the most innovative researchers in the field.

The building will serve as a cornerstone of neurological care for UCSF Medical Center – recognised as the United States’ best hospital for neurology and neurosurgery by U.S. News & World Report for 2021-22 – with specially designed clinical areas to serve up to 450 patients per day.

“This is a remarkable time for neuroscience,” said S. Andrew Josephson, professor and chair of the UCSF Department of Neurology and a member of the steering committee for the UCSF Weill Institute for Neurosciences. 

“The UCSF Weill Neurosciences Building will stand as a beacon of hope, striving to push the frontier of what we know about the brain and expand the possibilities for effective treatments.”

“The UCSF Weill Neurosciences Building is a place for patients with the most complex and challenging cases to receive expert care, and a place for researchers to find answers to the most perplexing neurological and psychiatric conditions,” said UCSF Chancellor Sam Hawgood. 

“The building’s design will enable us to bring researchers and clinicians together with our patients, to continue to advance that care into the future.”

“Traditionally, neuroscience has been partitioned into sub-disciplines, working in relatively small labs with limited access to engineering and computational resources,” said Stephen Hauser, director of the UCSF Weill Institute for Neurosciences, and professor of neurology.

 

“But big goals require close collaboration of large multidisciplinary teams. The UCSF Weill Neurosciences Building will enable widespread sharing of expertise, data and tools to tackle the big problems.”

The building provides space for multiple clinics and research centres, with dedicated laboratory areas integrated with engineering and computational research, to further our understanding of the brain’s complex biology and circuitry. It also has shared facilities for studying brain conditions caused by genetic diseases, as well as by autoimmune and infectious diseases.

The building was made possible by a $185 million gift in 2016 from Joan and Sanford “Sandy” I. Weill and the Weill Family Foundation. 

The gift – one of the largest in the United States for neuroscience – brought the Weills’ more than five decades of philanthropy to a total of more than $1 billion in support of medical, educational, cultural and art institutions.

That support included an additional $106 million to launch the Weill Neurohub, whose emphasis on collaboration across three top universities in neuroscience research enables the most innovative projects to tap into an unprecedented strength in the field.

“Joan and I are ecstatic about the completion and opening of the building, as it has been a labor of love for us and so many over the years. Our goal is to bring together the resources and talent to tackle the most debilitating neurologic disorders and mental diseases,” said Sandy Weill. 

“This is a challenge that can’t be solved by one person or even one institution, given the vast resources needed. 

“By partnering and bringing together the best and brightest in their respective fields and giving them the support and facilities they need, we believe they will have an enormous impact on improving the quality of people’s lives and curing the diseases that will present the biggest challenges to our country in the decades to come.”

That support has the potential to transform the lives of millions of people, Joan Weill added, noting the impact the Weills have already seen through the UCSF Weill Awards for high-risk, high-return research, which were funded through the Weills’ gift.

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