Institutional Culture of Belonging and Attrition Risk Among Women Health Care Professionals.

Attrition of women health care professionals is high, threatening patient care and advances in health care sciences. Women health care professionals have often reported experiencing challenges in the workplace that lower their sense of belonging and may precipitate their attrition. The current study sought to identify dimensions of workplace belonging in women health care professionals and to determine the relative strength of association of these belonging dimensions with intent to leave (ITL) their institution.

Workplace Belonging of Women Healthcare Professionals Relates to Likelihood of Leaving.

Purpose: There is a high rate of attrition of professionals from healthcare institutions, which threatens the economic viability of these institutions and the quality of care they provide to patients. Women professionals face particular challenges that may lower their sense of belonging in the healthcare workplace. We sought to test the hypothesis that workplace belonging of women healthcare professionals relates to the likelihood that they expect to leave their institution.

Disruptions in Structural and Functional Connectivity Relate to Poststroke Fatigue.

Poststroke fatigue (PSF) is a disabling condition with unclear etiology. The brain lesion is thought to be an important causal factor in PSF, although focal lesion characteristics such as size and location have not proven to be predictive. Given that the stroke lesion results not only in focal tissue death but also in widespread changes in brain networks that are structurally and functionally connected to damaged tissue, we hypothesized that PSF relates to disruptions in structural and functional connectivity.

A pilot [C]PBR28 PET/MRI study of neuroinflammation and neurodegeneration in chronic stroke patients.

Neuroinflammation occurs in response to acute ischemic stroke, and has been speculated to underlie secondary poststroke pathologies, such as depression, that often develop over time poststroke. However, no study has examined whether neuroinflammation is present in chronic stroke patients (e.g.

Corticospinal tract diffusion abnormalities early after stroke predict motor outcome.

Background: Prognosis of long-term motor outcome of acute stroke patients with severe motor impairment is difficult to determine.

Objective: Our primary goal was to evaluate the prognostic value of corticospinal tract (CST) injury on motor outcome of the upper limb compared with motor impairment level and lesion volume.

Methods: In all, 10 acute stroke patients with moderately severe to severe motor impairment of the upper limb underwent diffusion tensor imaging (DTI) and testing of upper limb strength and dexterity at acute, subacute, and chronic poststroke time points.

Predicting efficacy of robot-aided rehabilitation in chronic stroke patients using an MRI-compatible robotic device.

We are investigating the neural correlates of motor recovery promoted by robot-mediated therapy in chronic stroke. This pilot study asked whether efficacy of robot-aided motor rehabilitation in chronic stroke could be predicted by a change in functional connectivity within the sensorimotor network in response to a bout of motor rehabilitation. To address this question, two stroke patients participated in a functional connectivity MRI study pre and post a 12-week robot-aided motor rehabilitation program.

Increase in sensorimotor cortex response to somatosensory stimulation over subacute poststroke period correlates with motor recovery in hemiparetic patients.

Background: . Somatosensory input to the motor cortex may play a critical role in motor relearning after hemiparetic stroke.

Objective: .

The neural basis of constraint-induced movement therapy.

Purpose Of Review: This review describes our current understanding of the changes in brain function and structure that occur in response to an intensive form of motor rehabilitation, constraint-induced movement therapy (CIMT), that has been shown to be efficacious in promoting motor function of the paretic upper limb of stroke patients.

Recent Findings: Studies using transcranial magnetic stimulation have demonstrated consistently an increase in the size of the representation of paretic hand muscles in the ipsilesional motor cortex after CIMT. This motor map expansion occurs in response to CIMT delivered at all time periods after stroke, from within days to after several years.

Microstructural status of ipsilesional and contralesional corticospinal tract correlates with motor skill in chronic stroke patients.

Greater loss in structural integrity of the ipsilesional corticospinal tract (CST) is associated with poorer motor outcome in patients with hemiparetic stroke. Animal models of stroke have demonstrated that structural remodeling of white matter in the ipsilesional and contralesional hemispheres is associated with improved motor recovery. Accordingly, motor recovery in patients with stroke may relate to the relative strength of CST degeneration and remodeling.

Structural damage to the corticospinal tract correlates with bilateral sensorimotor cortex reorganization in stroke patients.

Damage to the corticospinal tract (CST) in stroke patients has been associated with functional reorganization in the ipsilesional and contralesional sensorimotor cortices. However, it is unknown whether a quantitative relationship exists between the extent of structural damage to the CST and functional reorganization in stroke patients. The purpose of the current study was to examine the relationship between structural CST damage and motor task-related cortical activity in chronic hemiparetic stroke patients.

Correlated change in upper limb function and motor cortex activation after verum and sham acupuncture in patients with chronic stroke.

Background: Acupuncture may improve motor function in patients with chronic hemiparetic stroke, yet the neural mechanisms underlying such an effect are unknown. As part of a sham-controlled, randomized clinical trial testing the efficacy of a 10-week acupuncture protocol in patients with chronic hemiparetic stroke, we examined the relationship between changes in function of the affected upper limb and brain activation using functional magnetic resonance imaging (fMRI).

Methods: Seven (7) chronic hemiparetic stroke patients underwent fMRI and testing of function of the affected upper limb (spasticity and range-of-motion) before and after a 10-week period of verum (N=4) or sham (N=3) acupuncture.

Enhanced cortical activation in the contralesional hemisphere of chronic stroke patients in response to motor skill challenge.

The brain processes involved in the restoration of motor skill after hemiparetic stroke are not fully understood. The current study compared cortical activity in chronic stroke patients who successfully recovered hand motor skill and normal control subjects during performance of kinematically matched unskilled and skilled hand movements using functional magnetic resonance imaging. We found that cortical activation during performance of the unskilled movement was increased in the patients relative to controls in the contralesional primary sensorimotor cortex.

Structural and functional plasticity in the somatosensory cortex of chronic stroke patients.

Animal studies have demonstrated that motor recovery after hemiparetic stroke is associated with functional and structural brain plasticity. While studies in stroke patients have revealed functional plasticity in sensorimotor cortical areas in association with motor recovery, corresponding structural plasticity has not been shown. We sought to test the hypothesis that chronic hemiparetic stroke patients exhibit structural plasticity in the same sensorimotor cortical areas that exhibit functional plasticity.

Finger motion sensors for fMRI motor studies.

The kinematics of motor task performance affect brain activity. However, few functional magnetic resonance imaging (fMRI) motor studies have accounted for on-line kinematics because there are currently few MRI-compatible devices to record motor performance. We built a device based on Micro-Electro-Mechanical System (MEMS) gyroscopes that measures the angular velocity of one segment of each of the 10 fingers while a subject performs a finger motor task during fMRI.

Acupuncture for upper-extremity rehabilitation in chronic stroke: a randomized sham-controlled study.

Objective: To compare the effects of traditional Chinese acupuncture with sham acupuncture on upper-extremity (UE) function and quality of life (QOL) in patients with chronic hemiparesis from stroke.

Design: A prospective, sham-controlled, randomized controlled trial (RCT).

Setting: Patients recruited through a hospital stroke rehabilitation program.

Motor rehabilitation and brain plasticity after hemiparetic stroke.

This review intends to begin to build a bridge between our understanding of the effect of motor rehabilitation and brain plasticity on recovery after hemiparetic stroke. It discusses the impact of intensive post-stroke motor rehabilitation on motor recovery. This is followed by an overview of our current understanding, based on human brain mapping technologies, of brain plasticity underlying spontaneous recovery after hemiparetic stroke.

Motor recovery and cortical reorganization after constraint-induced movement therapy in stroke patients: a preliminary study.

Constraint-induced movement therapy (CIMT) is a physical rehabilitation regime that has been previously shown to improve motor function in chronic hemiparetic stroke patients. However, the neural mechanisms supporting rehabilitation-induced motor recovery are poorly understood. The goal of this study was to assess motor cortical reorganization after CIMT using functional magnetic resonance imaging (fMRI).

Motor cortex activation is related to force of squeezing.

Primate studies have demonstrated that motor cortex neurons show increased activity with increased force of movement. In humans, this relationship has received little study during a power grip such as squeezing, and has previously only been evaluated across a narrow range of forces. Functional MRI was performed in eight healthy subjects who alternated between rest and right hand squeezing at one of three force levels.