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Each person has the same rights before the law, but in order to protect them it is sometimes necessary to be aware of the precise legal context in which the rights are to be exercised. Cases of injury or disease caused by direct or indirect failure to ensure safety of innocent parties are one situation that no person would ever desire to be in, but it is a situation in which each individual still has rights to be protected whatsoever. Medical compensation is a measure the law prescribes to cover the damages of the victim of unfair practice and to deter responsible parties from neglecting their legal obligations.
Whenever a person suffers negative health effects of any kind brought about by the human factor, the question could be raised whether there are sufficient grounds for medical compensation. An important element of each case of course is the extent of the injuries resulting from the alleged violation – you can’t compare people with permanent mobility problems with light injuries that can be treated on an outpatient basis. The idea behind medical compensation is to make life a little easier to people whose health was damaged and with today’s costs of treatment only a financial package can really alleviate the core problem. Other factors may play in the decision, such as severity of health code violations or history of negligent behaviour on the part of the defendant, so predicting the outcome of a medical compensation claim is never easy.
Some cases are settled amicably out of court, but most claimants are faced with the challenge of providing enough evidence for their claim. This is why medical compensation specialists advise methodical preparation and careful examination of all facts before medical compensation rights are pursued through the legal system.
Screening for diabetes in pregnancy is crucial since gestational diabetes can result in a serious pregnancy complication, if undetected. Equally it is important for those women who had tested positive for gestational diabetes, to be screened for diabetes after they have given birth. However, according to a recent study, there is a lacuna in the required testing here.
A study that examined as many as one million patient records found that 5% of women had gestational diabetes, but that only one in five women were screened for diabetes six months after giving birth.
It was found by the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) trial that even small defects in the mother’s metabolism of glucose could result in health problems for the mother and child.
Further, women have had gestational diabetes are at heightened risk of developing type 2 diabetes later in life which makes this screening even more crucial.
It is currently recommended by the American College of Obstetricians and Gynecologists and the American Diabetes Association that women have to be tested for diabetes 6 to 12 weeks after giving birth, if they had had pregnancy related diabetes. The test usually administered, is a simple 100 gram oral glucose tolerance test; however it is now recommended that the 75-gram oral glucose tolerance test be administered.
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Perimenopause or Premenopause, as it is also known, is the period of a woman’s life that precedes actual menopause and the end of the fertile period of life. At this time, several premenopausal symptoms will manifest themselves, owing the huge hormonal and physical changes that the woman’s body undergoes.
Premenopausal symptoms could be physical and psychological and need to be addressed properly to avoid exacerbation of the symptoms.
Premenopausal symptoms are marked by unpredictability and instability due to the many changes and upheavals going on within the body.
For the most part premenopausal symptoms are not so severe as to need treatment, and in most cases can be managed and the following methods could be used to manage them-
Dietary Changes
Making the shift to healthier eating options that include more fresh produce and fewer refined and processed things can help deliver a number of vital nutrients to the body making it more able to counter these symptoms. Eating soy and soy protein is also thought to help relieve these symptoms.
Also premenopausal women should include plenty of low fat dairy products in their diet – items such as yoghurt, cheese and milk can help. Increasing intake of calcium rich foods is known to not only reduce bone loss, it cal also protect from other premenopausal symptoms such as mood swings and heart disease. Cutting out sodas, and other sugary and beverages and replacing them with either water or fruit, can also help manage symptoms.
Nutritional Supplements
If the premenopausal symptoms include joint aches, hot flashes, and depression or heightened anxiety, certain supplements could be used to counter them. Vitamin E, bioflvonoids, Vitamin C, Vitamin B12 and Folic acid, are seen to alleviate these symptoms.
Glucosamine, borage oil and chondroitin could also be useful. Calcium supplements and calcium fortified food or low fat dairy can help protect women from bone loss that could lead to osteoporosis and brittle bones.
Herbal Supplements
Black Cohosh is one of the most widely used supplements to manage premenopausal symptoms such as hot flashes. Ginseng is also known to help by elevating energy levels and helping manage tiredness and fatigue and help women cope better with stress, both physical and mental.
Studies have demonstrated that soy isoflavones can help to reduce and manage menopause symptoms. Red clover isoflavones are also seen to offer benefits in the management of the symptoms.
In addition, herbal remedies involving Wild Yam, Dong Quai, Licorice, Chaste Tree, Kava Kava, Sage, and Hops are also seen to benefit, when taken in different combinations and proportions, as per individual requirement and symptoms.
Exercise
For a number of reasons exercise is a vitally important component of managing premenopausal symptoms. This helps reduce anxiety and depression, makes joints and bones stronger, and less susceptible to breakage and other problems.
It helps keep weight gain in check, which is another one of the common premenopausal symptoms. Exercise also helps restore the hormonal balance in the body, by helping to reduce stress hormones such as cortisol and increasing levels of the happy hormones or endorphins.
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Numerous studies show benefits of cognitive training in older adults, but a recent study questions their validity. The debate on the effects of specific cognitive interventions is not settled.
A finding that researchers do seem to agree on is that aging is accompanied by brain and cognitive decline. These reductions seem to be modifiable through cognitive and physical exercise. In this vein, our lab recently demonstrated that older adults involved in an 8-week memory training program show less brain atrophy. This gives some hope for older adults wondering whether their training efforts are really worth while.
A major research interest in our lab is how brain structure and memory change across the human life-span. We have recently been able to measure regional changes in the brain within the same older adults over time. In a recent study, my supervisor, Anders Fjell and colleagues found that normal aging Americans (about 60 years old) show regional brain atrophy (shrinkage) of about — 0.5 – 1.0 % after only one year.
The reason why the brain atrophies (shrinks in size) with age is not completely understood. An old myth about aging is that we lose neurons as we age. This does not seem to hold true for healthy older adults. Instead, researchers currently believe that the atrophy is more likely to be driven by 1) nerve cells shrinking and 2) loss of connections between nerve cells
Not only brain size, but also cognitive performance declines as we age. Abilities like processing speed and long-term memory declines steadily. However, the pace of aging varies greatly among older individuals. Thus, a central pursuit in contemporary neuroscience is to undercover modifiers of the aging process.
Various factors are found to be associated with age-related differences in brain structure and cognition. Your genetic makeup seems to be important. Also what socioeconomic background and educational level you have plays a role.
Lately and thoroughly reviewed in the Sharpbrains blog earlier, lifestyle and behavior seem to have a significant impact. One example is nutrition. In fact, David Smith and colleagues in Oxford showed earlier this fall that older adults with mild cognitive impairment have less brain atrophy if they take a vitamin-B supplement regularly.
Other lifestyle factors contributing to individual age-differences in both brain and cognitive function are physical and mental exercise or brain training. The basis for how these influence the aging process is based on the concept of brain plasticity. Brain plasticity is a multifaceted concept, but can be described as your brain’s ability to change structurally and functionally at any age.
In our lab we were fascinated by this ability and asked the following question: Could memory training impact the brain atrophy that takes place in the aging brain? With this in mind, my research group set out to investigate the effects of a memory training program for healthy middle-aged and older adults (mean age = 60 years).
Through a newspaper add, we recruited more than 40 participants and divided them randomly into a memory training and control group. The memory trainers participated in an 8-week program where they learned a visual mnemonic technique known as the Method of loci. Using this technique the participants had to learn and recall new verbal information almost everyday, like the names of American presidents, Roman emperors, members of parliament, and the order of countries in South-America.
After 8-weeks of training, we found that:
a) the memory trainers improved significantly in their ability to remember verbal information in a particular sequence (for instance the name of the 1st or 10th American president). However, they did not improve more on other domains of memory function than the control group, which is in-line with other studies.
b) the thickness of the cerebral cortex increased in several regions of the brain among those who had trained their memory function. Also, participants who had improved the most on the specific memory test where the ones with the most increase in cortical (brain) thickness.
The four regions of the brains in which memory training increased cortical thickness are illustrated below. Two effects were located in the frontal lobes (lateral orbitofrontal cortex), and one in the fusiform region of the right temporal lobe.

Figure 1. The figure show the strength of the effects mapped on a template brain. Top row is the right hemisphere in lateral (from outside), ventral (from under) and medial (from inside) views.
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The changes in cortical thickness in the control and training groups are shown in the second figure below. You can see that the control group decreased slightly, whereas the memory trainers increased. Also note that the changes are small (less than 0.05 mm in most areas).

Figure 2. Bar plots of the group-changes in cortical thickness. The green bars are the control group, the blue colors are the training group. Lighter colors are the average thickness at follow-up.
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What do these findings tell us? It seems as middle-aged and older adults who train their memory vigorously in a 2-month period have different, more positive changes in brain structure, compared with those who do not. The ones who had better memory improvements also had more positive changes in the brain. The effects on memory performance were positive, but the transfer effect was seen on brain structure only. We did not look at the effects beyond the 2-months, and we are waiting to see whether cognitive exercise indeed alters the way our brains age in the long-term. Since our study was published, other very recent studies have shown that cognitive exercise in the elderly can also modify the blood flow to, and the underlying nerve fibers (white matter) of the frontal lobes.
Memory training improves specific memory functions, but also seems to make positive changes in the aging brain such as less atrophy and even increased cortical thickness. These results strengthen the conclusions about the value of mental exercise for older adults.
— Andreas Engvig was an intern at Sharpbrains a couple of years ago. He is now a MD-PhD candidate in the Center for the Study of Human Cognition at the University of Oslo, Norway. He is currently pursuing his PhD investigating the effects of memory training on aging brain structures. His first publication recently achieved 8th place in Neuroimage’s “Top 25 Hottest Articles” list.
References
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Engvig, A., Fjell, A.M., Westlye, L.T., Moberget, T., Sundseth, O., Larsen, V.A., Walhovd, K.B., 2010. Effects of memory training on cortical thickness in the elderly. NeuroImage 52, 1667–1676.
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Engvig, A., Fjell, A.M., Westlye, L.T., Moberget, T., Sundseth, O., Larsen, V.A., Walhovd, K.B., submitted manuscript. Memory training impacts short-term changes in aging white matter.
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Esiri, M.M., 2007. Ageing and the brain. J Pathol 211, 181–187.
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Fjell, A.M., Walhovd, K.B., Fennema-Notestine, C., McEvoy, L.K., Hagler, D.J., Holland, D., Brewer, J.B., Dale, A.M., 2009. One-year brain atrophy evident in healthy aging. J Neurosci 29, 15223–15231.
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Kramer, A.F., Erickson, K.I., 2007. Effects of physical activity on cognition, well-being, and brain: human interventions. Alzheimers Dement 3, S45-51.
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Mozolic, J.L., Hayasaka, S., Laurienti, P.J., 2010. A cognitive training intervention increases resting cerebral blood flow in healthy older adults. Front Hum Neurosci 4, 16.
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Smith, A.D., Smith, S.M., de Jager, C.A., Whitbread, P., Johnston, C., Agacinski, G., Oulhaj, A., Bradley, K.M., Jacoby, R., Refsum, H., 2010. Homocysteine-lowering by B vitamins slows the rate of accelerated brain atrophy in mild cognitive impairment: a randomized controlled trial. PLoS ONE 5, e12244.
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Valenzuela, M., Sachdev, P., 2009. Can cognitive exercise prevent the onset of dementia? Systematic review of randomized clinical trials with longitudinal follow-up. Am J Geriatr Psychiatry 17, 179–187.
Source: Andreas Engvig
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