Monday, 29 March 2010

Research can raise a smile...

But you never know...

Less than a week ago an item on Conductive World reported how I the miserable, depressing English March weather, the spirits can often be raised by a little chortle at how research folks are putting on the style.

Really dismal weather again today but on cue along comes the weekly tragi-comic research round-up from Australia. What jokers some of those researchers are.

Have you heard the one about the multidisciplinary approach?

Hayes, C. (2010) Cerebral palsy: classification, diagnosis and challenges of care, British Journal of Nursing, vol. 19, no 6, pp. 368-73

Abstract. This article aims to build capacity between nursing and allied healthcare practitioner staff in highlighting the unique challenges that caring for people with cerebral palsy (CP) brings. It gives an insight into how CP is classified and diagnosed, and briefly outlines issues of political correctness in labelling people with this condition. It covers the complexities of brain development in people with CP, with consideration of the key aetiological contributors to the incidence of the condition. A straightforward approach to unravelling the classification of movement disorders in CP is adopted. It concludes that a multidisciplinary approach to the management of CP, with the nurse at the centre of this holistic approach to patient care, is pivotal to future healthcare provision.

The joke here is, like last week, the extraordinary feat of non sequitur between what may have been found and the deus ex machina conclusion deriving from this.

Same caveat as last week. Amusement may be a totally unfair response to Catherine Hayes' hard work, on the basis of my having read a mere abstract (though a proper abstract is meant to convey a study's absolute essence). It will cost me a tenner (£10.00) to read this article on line. It will cost less to buy the whole issue in the local newsagent. It was cost less still to read the article standing there! I shall try to remember to call into W. H. Smiths and see what action this matter merits.

More seriously, what are the unstated hegemonic assumptions that set up such a review in the first place?. Indeed,what assumptions  in the first placeshaped the evidence-gathering in that form?

A positive stroke?

Still quite amusing, if you are a connoisseur of Pseuds' Corner, is the strangulated English prose in the Results and the Conclusions sections of the following Abstract (it hails from France and Switzerland).

In this case, however, you can access the whole article, free of charge on line. Thank you Wiley Inter-Science. Respect..

Walusinski, O., Neau, J. P., Bogousslavsky, J. (2010) Hand up! Yawn and raise your arm, International Journal of Stroke, vol.5, ni1, pp.:21-27

BACKGROUND: In some cases of hemiplegia, the initiation of yawning is associated with involuntary raising of theparalysed arm. Reports are scarce in the literature, probably because the phenomenon has largely been overlooked.

METHODS: We studied six patients from two neurologic units, and compared them with published cases from the last 200 years. Brain imaging typically shows a small vascular lesion most often located in the internal capsule.

RESULTS: After comparison with experimental models in cats, we suggest that damage to the corticoneocerebellar tract of the extrapyramidal system disinhibits the spino-archeocerebellar tract, enabling a motor stimulation of the arm by the lateral reticular nucleus, which harmonises both central respiratory and locomotor rhythms.

CONCLUSIONS: When phylogenetically primitive structures are disinhibited, they regain autonomy in the homeostatic process associating the massive inspiration of yawning--a form of behaviour that stimulates vigilance – with a motor control mechanism that is active during locomotion. For this phenomenon, we coined the term 'parakinesia brachialis oscitans'.

There is something substantively very serious here, midst all the serious verbiage, the sort of neurological phenomenon that András Pető would seize upon as what I would call a potential pedagogic tool. Perhaps he did with this one, there is no convenient way of checking up on this. Perhaps conductors who work with adults all know about this one anyway, and utilise it. Ditto.

Either way, this article demonstrates something that everyone seems to know in real medicine, that well described and pertinent case studies, even only half a dozen of them, can indeed provide the basis for a certain essential stage in the research process.

So many conductors have such a rich experience of the strange phenomena, mental and physical, that the damaged brain can manifest. There is a legitimate contribution to be made to research by sharing these in the public domain, even if they are 'only anecdotes'!

Just take it easy with the verbiage.

1 comment:

  1. Well said Andrew!

    I would dearly love to read "anecdotes" from other conductors.

    Unfortunately I have no time to post one of mine this evening!